An Art-In-Hospitals Project
A MAKE ART/STOP AIDS Initiative
A program of the UCLA Art & Global Health Center
In 2004, a health communication organization called Nalamdana, meaning “Are you well?” in Tamil, began collaborating with the Government Hospital of Thoracic Medicine in Tambaram, India, just outside Chennai. Six years later, Are You Well has evolved into a leader in its field, using theater, music, and radio as tools for HIV education, stigma reduction, and to promote an atmosphere of healing. The key to success has been a close working relationship between medical staff and artists. In conversation with the hospital’s director, doctors, nurses, and counselors, Are You Well devises brief interactive role-plays and longer evening plays on issues relevant to people living with HIV and AIDS. The plays entertain and generate goodwill among a particularly appreciative and eager audience of hospital patients, and the project fills a communication vacuum for up to 1,000 new patients who arrive at the hospital each day.
After witnessing the program’s profound ability to enhance communication, education, and health throughout the hospital campus, Are You Well came up with another novel idea: a cable radio program. Since 2007, they have operated a state-of-the-art public address system known on campus as Thendral, which means “breeze” in Tamil. The name was suggested by patients themselves, recognizing the cooling solace provided by basic human interaction on radio. It is education in an entertaining format. Thendral broadcasts for seven and half hours daily, six days a week, in the hospital’s 17 Tuberculosis and HIV wards as well as the out-patient area. It features hospital staff as on-air personalities.
Are You Well programming includes a 14-day curriculum, covering such topics as: What is HIV? What do my medications do in my body? Why is drug adherence so important? And how can I best handle the stigma of HIV/AIDS when I return to my home village? One special component of the curriculum deals with the psychosocial needs of HIV-positive women, who were not initially as responsive to the program as men. These new inputs come via the Mothers’ Voices curriculum devised by YRG Care, Chennai and AIDS Project Los Angeles (APLA). Thanks to funding from WHO/SEARO and APLA/YRG Care, weekly support group meetings for women have also been introduced.
In 2009, an independent research agency conducted a mixed methods evaluation of the model including series cross sectional surveys with over 250 patients as well as interviews and focus group discussion with patients, staff, nurses, counselors, doctors and administrators and programmers-artists, revealing in multivariate analysis that:
- Exposure to Are you Well programming was associated with significantly higher HIV-related knowledge (15%, p<0.05), and lower levels of stigma (2-7% lower, p<0.10);
- Exposed participants had 15-20% higher levels of adherence knowledge (p<0.001) and 20% higher mean WHO HIV-Related Quality of Life scores (p<0.03) as compared to unexposed participants;
- Each additional message recalled was associated with a 28% lower level of felt stigma (p<0.10), greater adjusted odds of consistent condom use (AOR): 1.12, p=0.01), doctor-patient communication (AOR: 1.20, p=0.003), peer advice-giving (AOR: 1.18, p=0.03) and HIV-related advocacy (AOR: 2.35, p=0.07);
- Importantly, all stakeholders expressed support for Are you Well? programming, attributing to it greater optimism, drug adherence, and health-seeking by patients. In particular, the flexibility of Nalamdana, its evolution based on local needs and perceptions as well as its role as a bridge between patients and the hospital was noted.
We estimate that these programs reach over 278,000 HIV and TB patients and over 250,000 caregivers annually. In the coming year we propose to demonstrate the effectiveness of the Are You Well? Model at another Centre of Excellence and additional government hospitals/ healthcare settings in Tamil Nadu and neighboring states by evaluating health outcomes.
We thank you very much for your interest in the Are You Well,аn Art-in-Hospitals Project. If you have any questions, please contact the Art & Global Health Center’s Executive Director, David Gere (E: email@example.com; T: 310.206.1334) or the Center’s Director of Development, Elisabeth Nails (E: firstname.lastname@example.org; T: 310.825.6938).