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ss triple helix - winter 2006,  Pictures making a difference

Pictures making a difference

John Martin recounts an amazing partnership

Here is a story of two people:[1] a visionary innovator and a courageous implementer. David Morley’s heart began to be stirred with a concern to address poverty and health in the 1950s. The chance arose for a rare opportunity to undertake research on children growing up in the Nigerian village of Imesi Ile. Quickly, the practical priorities of developing world medicine became very clear for David.

On leaving West Africa he took up a post as lecturer in the London school of Hygiene and Tropical Medicine where his collection of colour slides quickly proved to be a powerful learning tool. So the head of department suggested they should be made available as teaching sets with a detailed interactive script for students to take home.This is how TALC (Teaching-aids At Low Cost) was born.

Now meet Edwin Mapara, a young doctor with strong Christian convictions.We pick up his story many years after David’s return to London. Edwin was working at Athlone, a 175-bed district hospital in the Lobatse region of Southern Botswana where his experiences confirmed TALC’s belief in the power of colour pictures in teaching. In his spare time, with a group of other health workers, Edwin started to run discussion groups on the threat of HIV/AIDS. This was early on in the epidemic and many asked to see cases like those he spoke of. Edwin obtained colour pictures of the effects of the disease from TALC.

For his audience to discuss and understand the fundamentals of transmission he found it necessary to show explicit pictures including an ulcer on a penis and in a female perineum. These pictures were highly effective in creating discussion and a real understanding of the disease.[2] However, they also produced a strong reaction.

Older people walked out of the discussions. Edwin was reported and fined by the local chiefs. There was an outcry from the churches and a strong reprimand from the health ministry. However he persisted and over 10 years ran over a hundred workshops at all levels. Even departments of Government came to accept the approach and support it.

Edwin received requests to run discussion groups from the police, local communities, schools and churches. He even received a request from a church to show his pictures from their pulpit. But perhaps the most striking response came from the same community members who had resisted the teaching in the early days.Words spoken publicly by a community leader who once firmly resisted Edwin’s message show both an amazing change of heart and a stark challenge:

‘You doctors are to blame for what has happened to us and particularly our children in Africa.You should have done this ten years ago before a third of our population became infected? The blood of our children who have died rests on your heads.’

It’s a comment that witnesses to the impact of TALC on lives in many parts of Africa and beyond. Thanks to TALC’s approach in Botswana, a diagnosis of AIDS has less stigma associated with it compared with many other South African countries.

Wider recognition of the work followed. In 2000, the United Nations Development Programme declared Athlone Hospital’s initiative as one of the ‘best practices’in Botswana,[3] and it is being replicated nationwide. TALC remains a small NGO but has now been providing information for health workers in the Southern hemisphere for forty years. For the first 20 years TALC’s approach remained the same: simple but effective slides, with detailed interactive scripts.TALC sent out over seven million of these mostly to Africa.

Recent technological advances heralded change. In 2000 the UK government provided a three year grant to create free CD-ROMs on Health Development. The first went out in 2001 and since then 4,000 go out about twice a year with 100 new addresses received each month.

TALC is heightening emphasis on overcoming poverty and improving health care. The majority of health care workers in less privileged countries are starved of up to date reliable information to continue their education and provide health care. Where a health worker has access to computers a free CD-ROM proves to be a great benefit.

TALC Resources

The regular production and growing demand for the TALC free CDROMs is both encouraging and problematic. Producing the CD-ROMs is expensive and demands time over and above normal duty. From the start it was recognised the CD-ROM had to be available free. Additionally, selecting the right material to meet the wide requirements of district hospital and community levels is demanding. The BMJ, Lancet, RCP Journal of Clinical Medicine, Cochrane Abstracts and Tear Fund are just some of the organisations generously providing material.

TALC is looking for people with recent experience of health care in the developing world to select suitable material. There are plenty of opportunities to support the work of TALC by volunteering and through regular prayer.

Donations are very welcome
Contact: Teaching-aids at Low Cost (TALC)
PO Box 49, St Albans, Herts AL1 5TX.
Tel: +44(0) 1727853869

  1. David Morley is the founder and president of Teaching-aids At Low Cost (TALC), based in St Albans, UK. Edwin Mapara is a postgraduate student studying for an MSc in infectious diseases at the London School of Hygiene and Tropical Medicine, UK
  2. Mapara E, Morley D. Picturing AIDS: Using mages to raise community Awareness. PLOS Medicine 2004; 1 issue 3 e43
  3. Athlone resource centre is number one. Botswana Press Agency, Daily News Online 2000; 6 December.
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