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Science in the shrubbery

Briony Fleming28 May 2019

This post has been written by Dr.Hayley Pye who is a Research Associate in the Centre for Molecular Innovation.


Last august; thinking ourselves well organised and ready to ‘communicate some science’, a group of friends and colleagues took ourselves off to Einstein’s Garden. Einstein’s garden is full of scientists and science stalls – all hidden between bushes and beneath trees. It is part of a four day music festival called Green Man, set beneath a misty mountain in the beautiful Brecon Beacons.  This blog will hopefully be of help to anyone who wants to do something like this themselves – something I would strongly encourage you all to do.

Lesson one – you are not as well organised as you think!

…and you will forget things! Just one of the many, many things we forgot or only realised we needed once we were there…  was kitchen roll.  We needed something for cleaning up one of our activities, luckily a few of us – having had previous music festival experience– knew to bring copious amounts of baby wipes. These were a brilliant replacement and we still had enough spare to have ‘baby wipe showers’ when needed. In contrast however, one of the team had never been to a music festival before and this leads to my first piece of advice… make sure everyone has had ’preparations in their expectations’. The portaloos were perhaps something I should have mentioned, but all credit to her, she quickly threw herself into the spirit of things and never complained. Also credit to Green Man (or perhaps the festival goers) as it is the best festival I have been to for a high quality portaloo experience! Going a little off track… so back to lesson one; throughout the first day be prepared to adapt all of your activities for the reality of the environment (and the crowd). Three of us had done Einstein’s garden before (more than once) so felt like we had a good idea about what would work, but we had never run this particular activity before and, despite a practice and loads of prep, the realities of how it worked best only became apparent when we were there doing it for real. The first day the public are allowed on site is quite slow – people trickle in – and this is perfect – allowing you to adapt and come up with better ways to run the stall and activities. To allow this to go smoothly make sure you have a toolbox of spare bits and bobs to help, for example a small tool kit, big bits of paper, colourful pens, string, a cargo net, cable ties – always bring cable ties! Cable ties are almost as important as babywipes.

Lesson two – people like to touch things.

The activity we had to adapt the most on this first day was our microscope activity. In Einstein’s garden you have no mains electricity – you can generate it yourself or you can go without. We made some fabulous portable mobile phone to microscope convertors using this tutorial; https://www.instructables.com/id/10-Smartphone-to-digital-microscope-conversion/, we then adapted some for 100X magnification using 3.0mm diameter, sapphire ball lens (#43-644) from Edmonton optics based on work by https://availabletechnologies.pnnl.gov/technology.asp?id=393.

A DIY Mobile Phone to Microscope converter with instructions lying in the grass

A DIY Mobile Phone to Microscope converter

A family uses their mobile phone as a magnifying glass using the DIY converter

A family uses their mobile phone as a magnifying glass using the DIY converter

We wanted members of the public to understand what things look like under the microscope and so various bit of stained tissue were put under these microscopes for the public to take pictures of with their own phones. To help with understanding scale, some had parts of insects – much more immediately recognisable than say…a piece of oesophagus! The original plan was to have one of these microscopes on hand to show people how it worked before sending the public off to find the other 5 microscopes with matched laminated information sheets that we had hidden in the grass all around the stall area. The microscopes are very robust but have one key weakness… if you turn them upside down or drop them from a height the tiny 3mm lens can bounce out – and in a Welsh field it will disappear forever into the long grass – which they subsequently did. We had predicted this to some extent and marked up the microscopes with… ‘PLEASE DO NOT TURN ME UPSIDE DOWN’… we also had two spare lenses as back up. Despite this – our expectations were exceeded and less than one hour into the first day we went out to inspect the microscopes and had lost 3 out of 5 lenses. I had had been watching people using them from afar and no one was being excessively rough, but both adults and kids couldn’t help picking them up and handling them, passing them around, especially when they were excited about what they were doing. Shortly after this first inspection – we fixed them up and moved them onto a table inside the stall for people to use in a ‘more controlled environment’. This also worked well for the engagement as we could cover the science in more detail but it was more labour intensive for us and perhaps less exciting than a treasure hunt. Since back at UCL our microscopes have now been adapted with a cover glass  to keep the lens safe – perhaps they could now survive out in the Welsh wilderness.

Lesson three; experiment with your activity in your living room first.

Participant dips a paper leaf in ink to creak a marble effect

Participant makes a marbled ‘leaf’ to make up as part of a Green Man’s hair and beard

Our main activity involved paper marbling, the patterns you obtain with this technique can look remarkably similar to the histological staining of cells when viewed down the microscope. We wanted people to create their own images of human tissue or plant cells on pieces of paper while we talk to them about how we use microscope images of tissue to diagnosis disease.  It would have been a disaster for the stall if the marble kits had not worked properly i.e. if they had not created the type of images we were after, not dried quick enough or not washed off the trays (or worse, not washed off the people). Another consideration was the dyes not being environmentally friendly – something which is central to the ethos of Green Man and would prevent us disposing the water waste into the environmental waste streams. So before we left London we set-up pilot experiments buying marbling kits from different companies and trying out different staining techniques and paper types to get the images just right. We discovered that only one of the four kits we tried was suitable:https://www.brianclegg.co.uk/education/toys/ink/marbling-ink/marbling-ink-assorted-standard-colours-6x25ml-bottles.

Examples of marbling next to similar looking the samples of histological cell staining.

Examples of marbling next to similar looking the samples of histological cell staining.

One of the kits we rejected because it needed white spirit to remove it from your hands (and turns out…my carpet), however the images were very bright so we used it on stall decorations prepared before we left (in the garden this time). Another was too weak and didn’t create the effect we needed, and the final kit failed because it required a much more complicated technique where you had to add oil to the mixture, making it too intensive both to teach and to clean. Another thing we ‘discovered’ in our experimenting was that it was possible to squeeze the dye bottles in such a way that the lids exploded off and the dye went everywhere – resulting in yet more carpet cleaning, but also an idea to use empty vape bottles as small decanters to avoid spills and allow us to stretch valuable resources by restricting the amount of dye used.

Lesson four; ‘kids’ activities are not just for kids.

Initially we had thought the marbling activity would just be for younger visitors to the stall but it was surprisingly effective for everyone who visited. Stall visitors of all ages created some beautiful and effective marbling artworks with ease. We even heard a whisper that some of our ‘artwork’ made it backstage of the main stage. Although Einstein’s garden attracts a lot of young children, the audience at Green man spans people of all ages, which can make it hard to plan activities suitable for all. The marbling activity was surprisingly effective in this way.

Adultsenjoying joining in with the marbling activity

Adult participants enjoying the marbling activity

The elements to this activity that we think made it particularly adaptable to all ages were; It was a simple and quick and did not require much instruction. This was key for children and adults alike, as they could quickly grasp, complete and repeat independently leaving plenty of room for the discussion of the science while groups of people work. The discussion could then be adapted for the particular interest and level of understanding of the people around the table. Once trained, the independent aspect of the activity also meant it suited people who prefer to interact at their own pace as well as people who wanted more attention and discussions. The creativity and ease of the activity was also key – impressive patterns could be made easily with little more than random water movement, but those with the disposition could spend longer designing a more created art work picking colours and patterns more consciously. Adults of all ages could be initially resistant to engage in a ‘kids’ activity but having a lot of the artwork on display really helped as it made them curious, and connecting it more to the scientific images on display kept them interested when at the table. It also has to be noted that during quiet periods even the stall staff could be found creating all sorts of marbled masterpieces. That or catching a quick nap…

Workshop facilitator takes a quick nap during a quiet period.

Workshop facilitator takes a quick nap during a quiet period.

Lesson five; pick an activity you will enjoy – even with lack of sleep.

Plan an activity that does not always need 1:1 staff to visitor interaction, or that can be scaled up or down. This helps when the stall gets busy and toward the ends of the day when you can slowly scale things down to help with packing up. Green man is really hard work so it is important your team enjoy communicating the activity and that you have the ability to be flexible to allow people to go off and have breaks when they naturally want or need them. There is a lot of unpredictability with the crowd, and it can be time of day, weather and line up dependent. You will get waves of interest and it can go from 1-2 people to 20 within minutes. Try and plan your activity so that it is not too monotonous for the staff  – if they are happy at the stall they will want to spend their time there and be part of its success, and you wont be negotiating breaks all day. The stalls are not open during the evening so you never miss headliners but there is also plenty to experience in the day. There is one thing I do advise you do ‘schedule’ more officially however, and this is picking just one or two people to be responsible for opening up every morning, rotating the responsibility, even if this means scaling down the stall for the first hour each day. This allows people to stay out late / sleep in at least one morning if they need to. Despite this scheduling – we found within the first few hours almost everyone had normally found their way to the stall anyway – often with some delicious but strong welsh coffees balanced on a little cardboard tray.  One particular morning I think a well timed appearance of someone with a ‘spare’ cheese toastie may just have saved my life. So yes – be prepared – the work is hard and sleep is lacking (festivals are loud).

Lesson six; mix it up for your staff.

Another thing worth sharing that worked well was the different ‘jobs’ on our stall which ranged in their intensity and level of interaction / difficulty. E.g. From doing the ‘washing up’ of the marbling materials behind the tent; cutting out paper materials; sitting down explaining science; being up front explaining the stall; or encouraging people in who were lingering around the tent. Day one, everyone was taught all the roles and throughout the festival people would naturally move around these jobs depending on what needed doing, their natural preferences and how they felt at that point in the day. But the most important job of all was also the final job of the day.  After we had finished moving everything onto a table and covering it so it would not be affected by the morning dew – the person who was ‘washer up ‘ had to empty the wash up bucket and re-fill it with cold water so we could fish out cold beers from the bucket and all have a well deserved sit down behind the tent!

several beers lines up in green man festival branded glasses

Green Man Beers

Lesson seven; like any good science project – keep your aims in mind and measure something.

Write some aims before you start and keep these in mind as you plan everything. There was definitely a lot of benefit in our flexible and adaptable activity (see above) but it meant a lot of the linking to science was done verbally. It was very easy to lose this when the stall was really busy. Next time, I will make sure some our key aims are more clear, having them more visibly on display or perhaps available to take away. Another problem was that when it was busy it was very hard to get people to fill out additional questionnaires or quizzes in order to get some measurable outcome data from the activity. For us, the only thing that worked really well was when we embedded outcome data directly into the activity itself, i.e. asking people to complete an activity which leaves something behind at the stall, something where people can see the visible effect of their interaction and/or something that will visibly change over time. We combined these ideas into our marbling activity; people got to marble both a microscope slide and a leaf shape, they could add their name to the slide and take it away but they were asked to add their leaf to a giant green man’s face we hung in a tree. His bead grew throughout the festival as more and more leaves were added, we could count these leaves at the end of the festival as an indication as to how many people engaged in this activity. This, alongside some qualitive photographs taken throughout the weekend of stall activity, meant we could estimate how many people in total likely visited the stall over the whole weekend (about 500). The artwork created also looked very impressive on display and was a great way to entice people into the stall.

Thank you to my wonderful stall team, Einstein’s garden and Green Man festival. Also to the Biochemical society for funding us because since Green Man Festival both parts of our stall have been used internally and externally 6 times by the Division or myself. It has been so successful our Communications, Marketing and Events Manager at UCL has secured funding to make 10 more microscopes. Please get in touch if you want more tips or information on how to make and/or use any of the activities we developed (h.pye@ucl.ac.uk). If I have inspired anyone to get involved applications to Einstein’s Garden at Green Man open around March / April every year https://www.greenman.net/information/get-involved/. Good luck to anyone who applied and don’t forget the cable ties!

Make an Impression: From Conception to Realisation

e.edem-jordjie21 May 2019

This blog has been written by Edinam Edem-Jordjie, a STEP Intern with the UCL East Community Engagement Team. 

(STEP) ping into place

In the North Cloisters, from the 12th April until the 24th May, UCL Culture presents ‘Make an Impression: Prints from East London schools’. A new exhibition featuring 90 small scale black and white dry point etchings by young people from six colleges and schools across East London, with support from UCL staff and Slade School of Fine Art students. This exhibition was co curated by Emma Bryant, the Schools Engagement Manager and I, Edinam Edem-Jordjie, the STEP Intern for UCL Culture and UCL East. We co curated this exhibition with the intent to showcase  the student’s prints and to highlight the work that UCL Culture is doing in east London, as we move towards the opening of our UCL East Campus. How the opportunity for me to curate this exhibition came to be for a multitude of reasons but none more important than the reason I’m here in the first place. STEP and UCL Culture.

The Shared Employment and Training Programme (STEP) is a 12-month London Living Wage paid Internship programme for the creative and cultural sector. Established by the London Legacy Development Corporation (LLDC), this programme gives young people the opportunity to work across two different organisations or two different departments within the same organisation. Interns work across 7 organisations (Worldwide FM, London College of Fashion, Bow Arts, Sadler’s Wells, The Film Office, Artichoke, V&A, and UCL) who are of the East Bank development on Queen Elizabeth Olympic Park. I am currently completing a 12 month internship at UCL, with 6 months in the Exhibition department for the Museum & Cultural Programmes Team and the rest of the internship in the UCL Community Engagement Team (East).

It’s because of STEP that I’m I started in UCL Culture in the first place and what led to the circumstances that enabled me to co – curate this exhibition and gave me the skills and knowledge needed to curate one. This exhibition marks the end of my time in exhibitions and I think it’s fitting that my last project got to incorporate a little bit of everything that I’ve experienced and learned throughout my internship, from learning how to use software such as InDesign and Illustrator to being involved in projects that have taken me to the UCL Art Museum, The Grant Museum and across East London.

To mark this occasion, I thought I would document my experience of co-curating this exhibition, from conception to realisation. So without further ado, this is my experience of curating ‘Make an Impression: Prints from East London Schools’.

Image of interpretation panels from Make an Impression Exhibition

Introductory interpretation Panels for Make An Impression exhibition in the North Cloisters.

How it began

On the 27th day of November, last year, I was invited to help facilitate a printmaking workshop with students from Sir George Monoux College. The workshop introduces students to the art of dry point etching and gives them practical printmaking skills, alongside an insight into what it’s like to study Fine Art at a world class university. The workshop is run by UCL Culture in partnership with the UCL Art Museum and the Slade school of Art. For those of you who don’t know what UCL Culture is, UCL Culture is the creative force behind the university’s museums, collections and theatres and who facilitate engagement and curate UCL content.

The printmaking workshop is one of many run by the department’s Schools Engagement Team, which are designed to activate the museum’s collections and run with the intent to engage young people with the university. The workshop was run over 2 days with one day spent on campus at the UCL Art Museum and the Slade School of Art; with the other day spent at the school/college of the participating students.

On the first day at UCL Art Museum, students look at original prints by celebrated artists such as Rembrandt van Rijn and James Abbott McNeill Whistler to learn about technique, symbolism and composition. The students have the UCL Art Museum to themselves, with the original prints mounted into frames and put on display across the museum. In addition to studying the prints, students also get the opportunity to try and draw the original prints, so that they can try and emulate the technique and composition as well as learning the difference between using a stylus to scratch an image on to plate versus using a pencil to draw an image on to a piece of paper. Each class is then given a guided tour of UCL by students from the university, where they can see inside the artist studios and the work being produced by students here today, as well as learning about what it’s like to study Art at UCL. At the end of the day in the printmaking studio, students make a joint etching and see the whole printmaking process from conception to realisation.

Image of a book with feedback about the exhibition and the workshop.

Feedback about the exhibition and the workshop.

On the second day at their school or college, students work with two artists who have studied at the Slade to produce a piece of work suitable for their artist portfolios. UCL provides all the technical equipment needed in a mini-printmaking studio, which fits into a large suitcase. Students are taught how to use the printing plates and tools in the dry point technique, before having a go with the etching press themselves and inking up a plate to create their prints. These prints go through several metamorphoses before reaching the final versions of the images.

The opportunity to take part this workshop was really exciting to me, as my only experience with printmaking t was dipping shaped sponges into paint in primary school. So it was interesting to learn about and see all the different forms of printmaking and to try what was practically a new art form to me. I also got the chance to see more of the campus and the Slade School of Art, which t I hadn’t got to know yet as I was only 2 weeks into my internship at the time. After the workshop, I commented on how interesting and informative I found the workshop and that it would be nice if the prints that the students created could go on display. Emma had been planning to show the prints, but hadn’t firmed up how yet. When she asked me to co-curate an exhibition I felt a bit unsure as I didn’t think that I could do it. However Emma was adamant that we should at least try and before I knew it the exhibition was born. I’d never really considered just how much work actually went into co curating an exhibition. We roughly knew what we wanted the exhibition to be about but everything else was still up in the air.  I was given the tasks of designing the layout and the interpretation panels. It was a big task, from collecting the materials to deciding what message/statement I wanted to get across with the exhibition. So before anything else, the first thing that I did was research. If I was going to create an exhibition about printmaking, I wanted to be sure that I knew what I was talking about so that the art of printmaking could be accurately represented in the layout and in the interpretation panels.

An Introduction to Printmaking

Image of board that explains the process of printmaking for Make an Impression exhibition in the North Cloisters.

Today, looking at the various ways in which one can see the same image – through social media, posters, billboards, adverts etc., it can be difficult to imagine a world where images are rare. Yet, prior to the invention of printmaking, that was the way the world was. Images were by and large found locked away in places which few, typically the very wealthy, had access to, such as palaces.

Printmaking can be described as the process where an image is made on one surface, and transferred to another, in a way that is repeatable; this enables the same image to be reproduced multiple times. These images are known as prints or impressions.

The idea of making repeatable designs can be traced back to Mesopotamia, one of the earliest known civilisations who created designs on to the end of cylinder seal, which when rolled on to clay tablets left impressions. This was typically used for stamps and signatures. Prior to the invention of the woodblock printing technique which forms the basis of printmaking as a technique as we know it today, this was the only way to duplicate designs.

The woodblock printing technique originated in China as a method of printing on textiles and later paper. Printing with this technique involves creating a relief pattern on a block of wood with a either a knife, chisel or sandpaper. A relief pattern means that the areas which are meant to be ink-free are that bits that are cut away. Once left with the desired design on the block of wood, you then ink it and press it on to either a paper or cloth, to leave a print.

The technology of printmaking forever changed our perception of images. It made it possible for hundreds of practically identical images to be produced from one template within hours whereas before, it could have very well taken a lifetime for the same result to be achieved by hand. When this invention was followed by the printing press which allowed books, newspapers etc. to be produced in the same manner and speed,the possibilities for the spread and knowledge and ideas were limitless. Printmaking was initially used to reproduce different religious texts and manuscripts for distribution. However as it spread through Asia and then on to the rest of the world, the demands and needs for printing changed. In Europe, for example, the initial demand driving the early print market were playing cards and cheap devotional images.

People viewing Rembrandt prints in the UCL Art Museum

Printmaking was an important vehicle for social change as it facilitated the wide circulation of symbols, ideas and information. What was once accessible to a few, typically the very wealthy and educated, suddenly became accessible to all as printmaking provided a means of mass-producing objects that brought them within the reach of even the poorest members of society. It led to; the democratisation of knowledge, the decline of Pan-European Latin in Europe, the first copyright laws and the invention of the news media, commonly called the press, after the printing press.

Printing in general was about ensuring that works, whether they were religious, manuscripts, art or the news, were readily made available and accessible to large groups of people. It has shaped the way we live and think today. It is through printmaking that we have most of our earlier art forms reproduced and preserved for today’s generation and printing in general that we have knowledge of past events.

Seeing as how there are many different types of printmaking, I enquired as to why the art of dry point etching was chosen for the workshop. There are benefits and drawbacks for each printmaking method and dry point was chosen for its benefit of often being regarded as the simplest intaglio (where the image is created directly on the plate) method because the sharp stylus or needle which is used to scratch lines directly into the metal plate, works in a similar way in which one would use a pencil/pen to paper which makes it easier for students to get used to considering the time restraints. It is also the safest in terms of the materials used, as it doesn’t require acid like some methods do. It is also something that isn’t taught in schools a lot, so using this method is a great way to introduce people to the art of printmaking relatively quickly. In all, you could say that drypoint is a simple yet effective way to introduce someone to the art of printmaking.

Making an Impression

After I finished my research about printmaking, I had to find a way to condense all the information I’d learnt along with information about the printmaking workshop and the exhibition onto three panels with no more than 450 words on them. I had to find a way to make sure that the panels came across as informative but clear without being patronising. What I’ve written about the workshop and printmaking process here is essentially the long form version of what is written on the panels.  The whole process of designing panels was new to me as prior to starting this internship, I had never I used design software such as Adobe Illustrator and InDesign.  Throughout March when I was designing the panels, I went to several exhibitions at organisations such as; the V&A, The British Library, The Museum of London and the National Gallery, and past exhibitions by run by UCL Culture. I did this because I wanted to see the different ways in which organisations interpreted works of art and to note how the styles and messages changed depending on who the audience was.

Image of two students pointing to their work on display at the Make an Impression Exhibition launch.

Two students viewing their prints on display at the Make an Impression Exhibition launch.

When starting the process, I just knew that I wanted panels that were simple, informative and which had elements of printmaking as an art form represented on them. What I really like about drypoint, is that simplicity allows you to see the beauty of the details, like the burr (a raised edge) and the different shading/texture, so I wanted the design of the interpretation panels to reflect that. All I used to design the panels were the colours; black, white & beige, lines and images of scanned Rembrandt prints from the UCL Art Museum, along with a few images of the workshop. Seeing as how I’m still relatively new to using design software, I thought it’d be best if I made the best use out of what I already knew.

The same thought process was used in designing the layout of the prints. We decided to hang the prints on a string, in a similar fashion to the way the prints are hung to dry after being run through a printing press. Considering that we have 90 prints on display, we wanted to display it in a way that ensured that the prints were the focus of attention and that they weren’t cluttered.

Image of a small selction of prints from Make an Impression exhibition in the North Cloisters.

A few of the prints on display for the Make an Impression exhibition in the North Cloisters.

The last thing to do after the design process was to host a launch event. We wanted to host the event to not only promote the exhibition but to give all the participating students a chance to come in and view their work. We opened the event to the participating students and their families, teachers, governors, head teachers and partners that UCL Culture has across the university and beyond.  We hosted the launch on the 30th of April and had over 40 guests in attendance.  Alongside viewing the exhibition, we also had refreshments, a speech by Kieran Reed – director of the Slade School of Art, a tour of the UCL Art Museum and a private viewing of the Rembrandt prints. It was a really nice night and a good way to end the exhibition project.

Image of students posing in front of their prints on display for the Make an Impression exhibition in the North Cloisters

Students from Stoke Newington School pose with their prints.

Lasting Impressions

The event also marked my last day in the exhibitions department. Seeing as how my second internship involves me working in UCL East, the exhibition project was a nice way to say goodbye to the exhibitions department as I got to use all the skills I had acquired throughout my internship, and a nice way to say hello to the UCL East community engagement department as I got to experience some of the work that UCL is doing in east London, as they move towards the opening of the UCL East campus. I am really glad that I got to do this exhibition project, especially as it wasn’t in my original work plan. I was offered the chance to experience a printmaking workshop and got the incredible opportunity of curating my own exhibition as a result from it.

Doing this project opened my eyes to a lot of things, from seeing whether I was capable of using the skills I had learned throughout my time in exhibitions to the logistics that go in to planning events. I feel like it prepared me for a lot of the event work that I’m going to be doing in my second internship.

Coming into STEP, I wasn’t sure what to expect and I was worried that a lot of the work I was going to be doing was purely admin. Not that admin is bad, but being on an internship should be an experience to learn to do all types of things and I’m glad that STEP and UCL Culture has given me the opportunity to do that so far. If you told me six months ago that I would be curating my own exhibition, I’d never have believed you. But I’ve done it and now I’m here. If this is what I’ve managed to do in the first half of my internship, I’m really excited for what comes next!

 

With thanks to the students and staff at:  Stoke Newington School, BSix Sixth Form College, NewVic Sixth Form College, Hackney New School, Sir George Monoux College and Canary Wharf College.  Special thanks to the: The UCL Art Museum and the Slade School of Fine Art and its students.  Exhibition and workshops made possible by UCL Culture and Access and Widening Participation.

 

Fun and games can prevent diabetes

Briony Fleming14 May 2019

This Blog has been written by Joanna Morrison, Senior Research Associate in the Institute for Global Health, and this project has taken place with funding from The Wellcome Trust, and additional support from a UCL Culture Beacon Bursary award.


On February 22nd and 23rd the dusty public park of Bara Bigha in Janakpur was transformed into a themed fun fair by artists from the Janakpur Women’s Development Centre (JWDC). The theme of the fun fair, or ‘Mela’, was prevention and control of type 2 diabetes.

Crowds enter the Janakpur Mela.

Crowds enter the Janakpur Mela.

Type 2 diabetes affects an estimated 96 million people in South East Asia (Cousins, 2017), and can be largely prevented or delayed through a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco. But awareness about diabetes is very low, particularly in Nepal’s rural areas. A local doctor in the Janakpur Zonal Hospital told artists: ”People are not aware about what causes diabetes, what are its complications… they think diabetes is a fatal disease and worry that they cannot eat any of the things they enjoy… but you can eat everything, just you have to control your portions, and eat a balanced diet.”

JWDC artists also interviewed their neighbours and friends about diabetes. While sitting on a wooden bed outside her bamboo and mud house, Mrs Anita Sah*, told us that her diabetes was very difficult to manage as she could not afford the medicine: “I go for checkups in Janakpur. The treatment is very expensive. For one visit, it costs me around 3000-4000 rupees. Sometimes it gets difficult to manage money, and I have to take a loan.” Diabetes drugs are on the free government essential drug list, but they can only be supplied by trained health workers, of which there are very few. The WHO package of essential non-communicable disease interventions is being rolled out slowly by the Government of Nepal, but in the meantime many diabetes patients are experiencing great financial hardship.

Artists also found that there was social stigma around diabetes, Mrs Manju Yadav* was afraid to feed her grandson with her hands in case she passed the disease to him, and a group of young non-diabetic women confirmed that this misconception was widespread: “When someone has diabetes, we should not go near them because the disease can be transferred from them to you.” Some of the artists themselves had family members with diabetes and had experienced social stigma and financial hardship and they were keen to change attitudes.

Child has photo taken in a hand-painted face-in-hole board

Child has photo taken in a hand-painted face-in-hole board

Using traditional Mithila art, artists made a drama where artists dressed in costumes as giant Coke, Fanta and Sprite bottles which tempt the protagonist to eat unhealthily, smoke giant cigarettes and drink alcohol. His belly grows and giant needles and tablets come to treat the development of diabetes. Only when he begins to eat vegetables and start being physically active is he able to lift the colourful dumbbells again over his head. The drama travelled to 17 villages around Janakpur and opened the stage show at the Mela. Artists passed the colourful dumbbells through the crowd demonstrating that exercise is for everyone, whatever your gender or age.

Women dressed as fizzy pop bottles, as part of a diabetes awareness fun-fair

Women dressed as fizzy pop bottles, as part of a diabetes awareness fun-fair

The crowd was then blasted into Zumba action by Janakpur’s Beats and Step Dance school, and the artists showed that wearing a sari is no impediment to dancing to good health.

Large crowd of women in colourful Sari dance at the Janakpur Mela

Large crowd of women dance at the Janakpur Mela

Crowd of onlookers as women dance at the mela

Crowd of onlookers as women dance at the mela

In another corner of Bara Bigha, people could listen to the stories of those who are managing their diabetes through a photo-voice exhibit, and film shows. For those with a good aim, winning a mithila printed vegetable bag was the prize for throwing vegetable bean bags into the mouth of an unhealthy man or woman, or knocking down unhealthy sweets and snacks with bean bags. An immersion tunnel overwhelmed participants who were attacked by giant ice-creams, cigarettes and sweets, emerging to be faced with hordes of children wearing vegetable face-paints, dressed-up as mini carrots.

It wasn’t all fun and games though, as we provided over 800 people with free random blood glucose tests, and counselling on diabetes risk factors and a nutritious diet. One of the artists, Mrs Saraswoti Sharma*, found out that she may have diabetes. Understandably upset, she was surrounded by artist friends, who reminded her that it wasn’t the death sentence that they had previously thought. She agreed that she knew how to control her diet, and she would keep up the daily exercise they had been doing at the JWDC, and she felt able to beat diabetes.

a hand outstretched as a healthcare practitioner tests for blood glucose levels

Event staff undertake blood glucose testing on Mela participants

 

*names changed to protect their identity.

Acknowledgements: The mela and associated events were funded by the Wellcome Trust and implemented by the Janakpur Women’s Development Centre in collaboration with the University College London Institute for Global Health, Herd International, Media for Development, and the Nepal Dietician Association. Photos are all credit to Anuj Adhikary.

For further information please contact:

Dr Joanna Morrison (UCL) 9851002502 joanna.morrison@ucl.ac.uk

Mr Satish Sah (JWDC) satish2015@teachfornepal.org

Ms Abriti Arjyal (Herd International) abriti.arjyal@herdint.com

 

“It did mean a lot”: What public engagement with teenage mothers taught us about our research.

Briony Fleming7 May 2019

This blog has been written by Dr. Katie Harron, Senior Lecturer and Sir Henry Wellcome Fellow based in the Child Health Informatics Group.


Around 20,000 babies are born to teenage mothers in England each year (about 1 in every 25 births). Teenage mothers face a number of challenges, including lower levels of education, less stable careers and lower income than most other older mothers. Whilst teenage motherhood is a positive experience for many, it is also linked to unhealthy behaviours during pregnancy (e.g. smoking), lower levels of prenatal care, and worse physical and mental health throughout childhood and beyond. For these reasons, an intensive early home visiting service called the Family Nurse Partnership (FNP) was introduced in England in 2007, aiming to improve outcomes of teenage pregnancies.

As the FNP programme evolves and adapts over time, so too have the methods used to evaluate its effectiveness. Administrative data is increasingly being used to help inform policy, and linking FNP data with information routinely collected from hospitals and schools offers an appealing way to evaluate the programme on a larger scale than has previously been possible. To help us develop this study, we held a workshop to engage with FNP participants and family nurses.

The workshop aimed to provide mothers with the most up to date research into FNP, offer an opportunity for mothers to challenge the current research agenda and raise new issues, and explore attitudes about using administrative data for research. We incorporated a range of elements including visual presentations, group exercises and participant discussion. The exercises helped mothers open up about the most important aspects of the FNP programme to them (Figure 1.). Mothers said they would like more information about immunisations, more emotional support, and mother groups with family nurses in rotating locations. The discussion highlighted concerns about the stigmatisation of being a young mother in society, and mothers talked about different experiences and mechanisms for building confidence and interacting with other or older mothers (e.g. having a buddy system).

 Skilled hands exercise: What’s important to you as a participant in the FNP?

Figure 1: Skilled hands exercise: What’s important to you as a participant in the FNP?

We used flip charts labelled ‘+’, ‘-‘ and ‘interesting’ to facilitate collective discussion about what mothers perceived as positive or negative elements of using administrative data for research, and what they would like to know more about. Positive ideas focused around mothers liking to share their data, especially when it helped them, or could help others. Negative ideas included the risk of being put into a wrong category, or prompting worry that would not otherwise have been there (e.g. around safeguarding issues). ‘Interesting’ ideas included questions about why data were not already linked up across services, how to find out what data is being used for, and feedback on how the impact of research using their data. We ranked ideas about how mothers would like to see research disseminated, and how they would like to be involved in shaping research in the future. Ideas generated from this included a need to include dads in research, and innovative ways to feedback results of research (including blogs and social media).

Did we succeed?

At the start of the workshop, we asked participants to stand up and place themselves on an imaginary spectrum line across the room according to how confident they felt in their knowledge and understanding of FNP research. The exercise was repeated at the end of the session, and we compared photos of before versus after, to help us discuss what we had learnt. The ‘after’ photo showed participants bunching up at the confident end of the spectrum. Encouragingly, one of the young mothers has agreed to sit on our Study Steering Committee, and will continue to be actively involved in the research. In an email after the event, she reflected positively: “It did mean a lot to understand why the family nurses were there for us rather than the normal health visitors. We got a lot of talk about data controls but we didn’t actually understand where our data was actually going and how it actually helped progress the programme”.

Personally, I valued the opportunity to hear young mothers’ voices, to understand their experiences, and discuss the perceived impact of their involvement in the programme. Identifying participants’ priorities for the direction of research into FNP has helped me to think about my research in a new way. We’re still trying to put into practice some of the ideas from the event, including more public engagement through social media. The experience has also given me a fresh appreciation of public engagement more generally. It is so much more than a box ticking exercise, and I know that the continuing involvement of the public in my research will enrich my work in many ways.

Teenage pregnancy rates in England have more than halved over the past decade, with the rate of conceptions per 1000 women aged 15-17 falling from 41.6 to 17.9 between 2007-2017. However, negative stereotypes, stigma and discrimination continue to dominate teenage experiences of motherhood. Dialogue with teenage mothers is essential in helping design and evaluate interventions that are effective in supporting young families, and carefully designed public engagement that inform, involve and empower young mothers can offering valuable insights for researchers.