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Changing behaviours to end NTDs in Nepal, one radio listener at a time /

The Koshi bridge that connects Manebhanjyan rural municipality to other neighbouring districts

In the hilly and mountainous area of Manebhanjyang, Nepal, a local youth group has been dedicating their spare time to spreading awareness of Neglected Tropical Diseases (NTDs) that are affecting their communities.

With the closure of many of their normal activities due to the Covid-19 outbreak, Sabin, Tara, Bishwa, Prakash and Manoj have channelled the extra time they have had into a series of awareness activities to educate residents on NTDs, such as Visceral Leishmaniasis (VL) and Lymphatic Filariasis (LF), which are common in this part of the world.

Sitting with a crowd outside Atithi Bhojanalaya, a local hotel, Bishwa shares a story of a Nepalese lady who was bitten by a mosquito carrying Lymphatic Filariasis. He tells of how the disease made her leg swell to the point where she could no longer walk. Unable to work and stigmatised for having a disability, the woman’s life spiralled into a state of poverty. And yet, Bishwa explains to those listening, there are preventative measures that can help control and even eliminate NTDs in the area.

This is a fictionalised scenario that unfolds as part of a Nepalese radio drama that has recently been broadcast to over 753 municipalities, however the context behind the story is unfortunately very close to reality.

One quarter of Nepal’s 27 million population lives below the poverty line. Often residing in hard to reach areas with limited access to nearby health facilities, this segment of the population is most at risk of contracting endemic tropical diseases, known as NTDs.

Nepal is committed to preventing these diseases and has already made major strides towards achieving this goal. In 2018, it became the first South-East Asian country to eliminate Trachoma as a public health problem. As Nepal continues its progress, the UKAid-funded ‘Accelerating the Sustainable Control and Elimination of NTDs’ (Ascend) Lot 1 programme is working alongside the government to strengthen capacity of the health systems, as well as its drug supply chains. The programme has a strong focus on strengthening existing systems to ensure solutions that are durable and sustainable. After all, some of these diseases have been around since the Egyptian pharaohs – so it’s about time they were eliminated for good.

Radio drama team gathering information for the show on NTDs affecting Manebhanjyang’s community from the local health post convenor

Throughout the Covid-19 outbreak, Ascend Lot 1 has been quick to adapt NTD programming, providing risk assessments and guidance on how NTD activity can restart safely during the pandemic. New tactics have been deployed, such as screening for NTDs at the same time as testing for the Covid-19 virus in quarantine centres.

But It is the new radio drama series that has been the most unique NTD activity. Titled ‘Sancho Bisancho’ meaning ‘good health and not good health,’ it was initially planned as a series of street dramas, but the performances have been converted into a radio show, following the pandemic, to communicate awareness of NTDs through the stories of Sabin, Tara, Bishwa, Prakash and Manoj. With a total of 36 episodes playing on a weekly basis across 20 national radio stations the messaging is reaching approximately 10 million people.

To date, the radio show has proved effective as an education tool and in changing behaviours, particularly in its far-reaching accessibility to hard-to-reach areas, that otherwise might get left behind. Each episode is translated into 10 local languages to ensure the widest reach possible.

By using storytelling as a mechanism to convey public health concerns, the messages both entertain and inform, resonating with a wider range of listeners than conventional methods. The show also spreads awareness amongst the 32% of the population that are illiterate and would otherwise be omitted from written forms of communication.

At the end of each episode, listeners to the show are provided with dial-in numbers if they require further information on NTDs, Covid-19 or health advice. An automated Interactive Voice Response (IVR) shares this information in a choice of different local languages. The aim is to encourage further action to prevent and treat the diseases, including follow-up visits to health centres. Demographic data is also collected from callers to help the Ascend team more accurately map those suffering from NTDs across the country.

With 36 episodes planned to run into 2021, Ascend will continue to share stories of the youth group through its mass radio campaign as part of wider work with the Nepalese government to eliminate NTDs. By ensuring the Nepalese population are well-informed about the diseases, more can be done to prevent them ever being contracted – taking the ‘neglected’ out of Neglected Tropical Diseases in Nepal.

Listen to the show:

1. English translation of a public service announcement using narrative to inform listeners about Covid-19.

 

2. English translation of a public service announcement using drama to engage people on visceral leishmanisis, also known as Kala Azar.

 

 

The UKAid funded Ascend programme in Nepal (Lot 1) is managed by a consortium of Crown Agents, Oriole Global Health, ABT Associates and KIT Tropical Institute