A project of the Schistosomiasis Control Initiative (SCI) in collaboration with Theatrescience, Acting Against Worms is a theatre project which took place in Busia, Uganda, from October 2009 until April 2010. Funded by the Wellcome Trust, it was designed to share health messages about the prevention and treatment of bilharzia. This educational drama project worked with members of local community-based organisations and primary schools - students, teachers, and community workers - to create and perform drama productions, which were then showcased at a festival.

Communication Strategies: 

According to the organisers, the lakeside district of Busia has one of the lowest uptake rates for annual drug treatment of bilharzia. The goal of the project was to create a drama-based initiative actively involving school children to provide appropriate information, education, and communication to widen the knowledge and ultimately change behaviour of individuals at high risk.


The first stage of the project took place in October 2009 with a visit by Theatrescience to Uganda. On the first day, an in-service training workshop was held, exploring methods of devising drama and performance, as well as the biology of bilharzia, and incorporating messages about the prevention and treatment of the disease. Teachers from all the participating schools and local community-based organisations (CBOs) attended.


Over the next five days, workshops for twenty students from year six were held in each of the nine participating schools: Nanyuma, Lumuli, Busime, Bubo, Bwanikha, Sirere, Lunyo, Busiabala, and Bulekei. The workshops concentrated on storytelling exercises and activities based on making physical images to communicate narrative. They also incorporated the sharing of local songs and dances, the biology of bilharzia, and the latest health advice, as well as discussions about why carrying out that health advice was often difficult or even impossible. During each workshop, two students were selected to lead their group. They were given an airmail envelope and their main job was to collate all of the students' ideas and develop them into one story with drawings for visual reference to send to Theatrescience in the United Kingdom over the Christmas break.


All the participating schools sent stories to Theatrescience, some with artwork attached (which can be viewed on the Theatrescience website). These were adapted into scenario form, which were emailed back for distribution to the CBOs who brought the workshops to the schools. The CBOs then revisited the schools and began the process of turning the scenarios into a performance.


In April 2010, the Theatrescience team returned to Uganda to help the schools finalise their productions. Organisers describe how the performances had been rehearsed outside, generally underneath the largest tree in the playground. Often pupils and teachers had to overcome a list of obstacles: non-expert teachers, regular pupil and teacher absence, illness, blazing sunshine, and rehearsals watched by hundreds of other children.


Five schools were chosen to present their work at the culminating festival. On the third and fourth day, the whole team visited all five schools at least once to work on the pieces. All of the rehearsals/run-throughs in schools were witnessed by other pupils, in one case by the entire rest of the school. Peer learning appeared to take place during these rehearsals.


The Festival took place on April 10, on the playing field of Bwanikha School. School children, parents, and other people from the local community were invited to watch, discuss, and judge the plays. The audience consisted of non-performing school groups, parents, students from the adjoining technical college, members of the general public, and various local politicians and dignitaries, who gave speeches between the performances. Two local adjudicators gave very detailed scores and feedback on all of the pieces at the end, based on various categories, including effectiveness of message, stagecraft, acting, and audibility. Sirere School was declared the overall winner and was presented with a goat as first prize by the Guest of Honour, a local politician.

Development Issues: 


Key Points: 

Bilharzia, or schistosomiasis, is a waterborne disease that causes ill-health and can kill if left untreated. Worm parasites, which cause bilharzia, or schistosomiasis, live part of their life-cycle in snails found in freshwater and part in humans. Lake Victoria, a 68,800 km2 stretch of freshwater, supports a thriving fishing community around its shore and, due to regular contact with the water, the local community has the highest prevalence of bilharzia in Uganda.


A knowledge, attitudes, and practices (KAP) carried out after the project ended revealed that there was little difference between the intervention and control arms at follow-up. However, a significant increase was seen in the proportion of students who heard about schistosomiasis through their teachers, and an impact on knowledge of how one becomes infected with schistosomiasis were both seen in the intervention group at follow-up. Additionally, although there was no difference between the two arms at follow-up, there was a significant increase in the correct answers given at follow-up than at baseline for how schistosomiasis is transmitted from person to person. These differences are interpreted as being a result of the drama intervention. To learn more, please see "Related Summaries", below.

Partner Text: 

The Schistosomiasis Control Initiative (SCI) and Theatrescience. Funding provided by the Wellcome Trust

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