Case Study 4: Cambodia - Lotus on Muddy Lake

Lotus on Muddy Lake is part of a youth program on Cambodian radio called Especially for You, Young People. It was initiated by the British NGO Health Unlimited (HU), which first sponsored media campaigns in HIV /AIDS and reproductive health issues in 1994. After an evaluation of these campaigns in 1995, HU set up an integrated IEC project managed by HU and the Cambodian Health Education and Media Service (CHEMS). The project sustains a second radio program in the eastern area of BattamBang, which is not covered by the FM95 and National Radio transmitters.

Especially for You, Young People is broadcast three times a week and aimed at the 12-to-24 age group. The interactive magazine program is hosted by a young man, Brother Sothea, and an older woman, Aunt Virya, who advise, inform and sympathize with callers and letter-writers on all aspects of growing up, reproductive health and sexual behavior. The format varies and includes letters, a live phone-in slot, drama, panel discussions, testimonials, short stories, and health news.

The 20-minute soap opera, Lotus on Muddy Lake, is designed to tackle difficult and sensitive issues about sexual and reproductive health through drama. Commercial sex is widely available in Cambodia and culturally acceptable. The illiteracy rate is high, and denial and shyness about sexual matters are major problems in the fight against the high HIV prevalence rate. HU's studies have shown that many Cambodians still believe that traditional doctors can cure AIDS.

Lotus on Muddy Lake has eight main and a dozen supporting characters. Normally, three to four storylines run at any one time. The main character is Kosal, a shy but attractive 19-year-old boy from Bong village. Traditional rural life, featuring Kosal's relatives, neighbors and friends, is the backdrop of the story. The storylines are designed to bring out issues related to changes in adolescence, contraception, condom-use and STDs, HIV/AIDS, young love and domestic violence, abortion, arranged marriage and sexual identity. The HIV/AIDS storyline centers around Vuth, Kosal's rebellious but charming stepbrother who contracts an STD after having sex with a prostitute. He tries to cure himself with herbal remedies but Kosal advises him to take a blood test for HIV. Vuth, who took over a taxi driver's job who died of AIDS, is afraid to get tested, and he continues with his promiscuous ways.

Recently, CARE supported a third series of Lotus on A Muddy Lake, which follows a young female character as she moves to the city to work in a garment factory - thus highlighting the plight of many young people in Cambodia who move to the urban areas looking for work. The title - Lotus on Muddy Lake - is a metaphor for how good can bloom in the poorest conditions, the lotus being similar to the beauty within the people of Cambodia who have come through one of the most violent periods in recent history.

Management: The radio project is produced by CHEMS in Cambodia, but managed from HU's office in London, UK. On a day-to-day basis the project is run by the Khmer Acting Project Manager in Phnom Penh. However, HU personnel fly out regularly to train staff, conduct planning sessions and organise evaluations. London realizes the need to devolve power to a greater degree and is encouraging CHEMS to become independent and self-financing, but it acknowledges they are not yet ready for this. HU's head office has experienced problems with accounting for the project from a raft of different donors, each with its own timescale and reporting format. Other management problems include the cultural problems of criticism being taken personally and weak information flow among staff members. Too much daily problem solving has been done from London, with all the attendant communication and cost implications.

Staffing: There are twelve core staff in Cambodia and two/three supporting staff in London who work on the radio project part-time. Most of the CHEMS staff members have been trained from scratch, as only three of the original staff had basic radio experience. International personnel, including a senior producer from the BBC's Archers, provide training in radio and video production, scriptwriting, and editing. There have also been staff exchanges with other HU projects in Africa. The staff is now able to produce and run the radio project themselves, as well as produce health-related TV and video spots and training sessions for other organizations.

Writing and Production Process: The HU training consisted of five modules: building characters; identifying setting and location; dialogue; mental picture of a scenario; and linking and cutting scenes. One of the challenges was to steer Cambodian scriptwriters towards more realism and away from the overly melodramatic style to which they were accustomed. Storylines are planned 40 to 60 episodes in advance, corresponding to 6 to 8 months. An average of 15 key messages are chosen through extensive audience research.

Messages and storylines are based on the advice of medical experts and the initial KAP survey, as well as ongoing listener-based research coordinated by a researcher who sits with the writing team. The writers also incorporate feedback received from listeners through letters and phone calls. All technical production is done on-site in the studio HU built, which is equipped with up-to-date SADIE editing technology.

Formative Research: A KAP study on HIV/AIDS with 700 informants was done by HU before start-up. It also carried out a nationwide media survey - the first of its kind in Cambodia. HU had been working in rural areas of the country on reproductive health matters for several years, and was therefore well acquainted with the issues. The organization had carried out several month-long media-based campaigns on HIV/AIDS and birth spacing, which were well received and thoroughly evaluated.

Monitoring and Audience Feedback: The project has several permanent focus groups at village-level. Researchers, writers and producers meet with them about every six weeks to gather feedback. All letters and calls are also logged. Interestingly, significant numbers of listeners have objected to the program's use of "obscene" or "pornographic" words. In one instance, a caller to the magazine show objected to using the word "penis," for which the presenter immediately apologized. The Project Manager later admonished the presenter for apologizing, since the show's task was to be more up front. The producers have had to strike a delicate balance between the need to use medical and biological terms, and the problem of offending people. Several evaluators have commented that one of the project's biggest challenges is conservatism. But clearly an attitude shift is necessary, not only among the audience, but in the production team as well (Woods and McKenzie, personal communication).

Supporting Activities: CHEMS writes a supporting column in a local magazine aimed at youth, which appears twice per month. It undertakes a regular series of trainings for government and NGO personnel in IEC/health education media activities. It designs and produces video and radio spots on health (HIV/AIDS and birth spacing) on a consultancy basis for other agencies, both local and international. CHEMS also does occasional short health education media campaigns, such as to coincide with World AIDS Day and the like.

Sustainability: The original project plan predicted that CHEMS would be independent of HU by the year 2000, but this has not yet happened. At mid-term, the CHEMS/HU staff members were "only 60 percent confident that they can run the media education project on their own" (Catalla, 2000). The idea still is to expand CHEMS' training services and make it into a local NGO. One problem is that CHEMS staff members feel that HU, as an international organization, protects them from the general corruption in Cambodian public life. Another problem is the low skills base in the country, especially English language, report writing, technical, planning and marketing skills, despite CHEMS staff's high degree of motivation and pride in their work (Catalla, 2000). The question of how an initiating organization lets go of an institution it has created becomes even more acute when the institution in question is being asked to battle against the conservatism and cultural norms of its host society.