- develop qualitative data (photographs and narratives) on township resources and problems for Management Sciences for Health (MSH), Department of Health, donor agencies, and township residents to use in making programme and funding decisions;
- increase awareness of the township's resources and problems as seen from the perspective of participating youth;
- motivate greater participation by community residents in community issues; and
- promote constructive dialogue on problems, resources, and solutions among community residents of all ages.
The youth who participated were either associated with Youth Academy (a youth-run, nonprofit organisation that implements projects and advocacy activities in health and the environment in Mdantsane) or were members of the National Association of People Living with AIDS. Eight of the women and one of the men were HIV positive. Six participants and leaders had completed 10th grade, 8 had graduated from high school, and 2 had continued their studies (one had a BA). All participants and leaders were unemployed. Most participants had never done any community work before and had never worked in teams or groups. These youth developed 80 photographs and narratives of problems and resources in their community from their point of view.
This programme was organised around a communication strategy called "photovoice", which is described here. In brief, main activities included:
- Each participant drew a picture of one Mdantsane problem and one resource and discussed them before organisers handed out cameras. "This kept us focused on project content, and not on the technology of the cameras."
- Group team-building sessions were held in which participants learned about how to use photography as a research and activism tool. Session leaders presented the concept of point of view, taught visual literacy skills, and helped develop guidelines for the group work. Each session incorporated ice breakers and participatory exercises (e.g., to spark brainstorming on how to deal with challenges); two of the more experienced youth leaders led most of these exercises. "The exercises kept the level of interest high, made the project more culturally relevant, and taught important concepts, such as persistence and listening."
- Participants then went on photo missions in the neighbourhood.
- They gathered to discuss photographs with each other and with policymaker guests ("We mounted 'mini,' or 'trial' exhibits on the days that policymakers visited. This promoted fruitful dialogue and helped the participants develop the final exhibit in stages.") These discussions were structured around the SHOWeD methodology, which involves the following questions:
- What do we see here?
- What is really happening here?
- How does this relate to our Lives?
- Why does this situation exist?
- What can we do about it?
- Participants then identified themes or categories for the exhibit, selecting photographs and writing accompanying narratives. They sought consent from every person appearing in an exhibit photo.
- Having identified policymaker audiences and how to reach them, the youth created and sent out exhibit invitations and created and posted exhibit flyers.
- Participants formatted the photos and created project booklets, mounted the exhibit, and had an opening ceremony.
- After celebrating and evaluating their efforts, participants self-selected into committees to discuss possible future actions.
Policymakers in the Mdantsane context include the participants, their families, teachers and school administrators, public health staff, elected officials, and local non-governmental organisations (NGOs). The project reached policymakers through dissemination activities that included a newspaper article about the project, four exhibits, and an invitation distributed to about 300 people including the Deputy Mayor, the Mayor, City Councilors, hospital staff and board members, Department of Health officials, and others. The project also reached policymakers on a personal level by inviting them to participate in "mini-exhibits" and discussions of the photographs and narratives during project implementation. Policymaker attendees included health care workers, hospital administrators, a school principal, community volunteers, a lawyer, a social worker, EQUITY Project staff, the Youth Academy Managing Director, and unemployed youth. In addition, the participants shared their project binders (including handouts and their photographs) with families, friends, and neighbours.
Youth, Health, HIV/AIDS.
Photovoice (not to be conflated with the Europe-based international organisation PhotoVoice) is a methodology mostly used in the field of education which combines photography with grassroots social action. It was developed in the early 1990s by Caroline C. Wang of the University of Michigan, and Mary Ann Burris, research associate of the School of Oriental and African Studies (SOAS) at the University of London. The concept owes a debt to Paulo Freire's paedagogy related to critical consciousness, feminist theory, and empowerment.
The above-summarised project was found to be effective at developing leadership skills, civic commitment, and improved health behaviours among youth, while increasing awareness at all levels of local conditions from the perspective of youth. Photovoice aims to increase community dialogue around project themes and to help break down barriers between people who are HIV-positive and those who are not. Instead of seeking outside assistance or waiting for outside assistance to come, the participants are enabled to become proactive in developing their own ideas of possible solutions and taking action to realise them.
To learn more about the project, please contact Laura S. Lorenz at the email address below, including "Re: Mdantsane Township, South Africa Project" in the subject line.
EQUITY Project, a project of the Department of Health, U.S. Agency for International Development (USAID), the South African Department of Health, and MSH; Youth Academy; and the Department of Health's Cecilia Makiwane Hospital.
Email from Laura Lorenz to The Communication Initiative on February 25 2002; "Photovoice: Giving Youth a Voice in Their Community", by Laura S. Lorenz, July 3 2002; Laura S. Lorenz website; and Wikipedia, accessed on November 20 2008.