Radio to the rescue: saving lives via the airwaves
Could the humble radio save a million lives in the developing world?
Researchers have shown that a radio campaign broadcasting key health messages in Burkina Faso really does change people's behaviour.
In Radio Djiawoampo's studio, the actors are hamming up the benefits of using a proper toilet instead of relieving yourself out in the woods.
The entertaining drama is part of a radio campaign promoting child health across Burkina Faso.
Three quarters of the country's population listen to the radio every day, so it can have real impact, according to Matthew Lavoie of Development Media International (DMI), the organisation behind the campaign.
"One of the most troubling, devilling, stubborn public health problems in the developing world is child mortality [...] Our goal is to reduce mortality, and we think that the most effective tool is mass communication."
Millions are spent each year on health campaigns in developing countries, but is there any real proof they work?
And in the current Ebola outbreak, public health messages are being put out by a number of radio stations.
In the first trial of its kind, researchers have shown that radio - often written off as an old-fashioned medium - really does affect people's behaviour.
And this translates into saved lives: DMI has developed a mathematical model that predicts their campaign could save a million lives over several years, if it was rolled out across ten developing countries.
Not only that, pound-for-pound it could be as cost-effective as essential health interventions like vaccinations.
They are putting their model to the test in Burkina Faso, and early results are encouraging.
Dinyeri Pognoagou stirs baobab leaves into a pot, while her nine children are busy ploughing the field.
Six years ago one of her sons fell ill and died.
At the time, they thought his illness was "maize sickness," says Dinyeri.
"When the maize grows, the children pick it from the trees, then they get the disease and need treatment."
But it was malaria - the leading cause of child death in the country - that killed six-year-old Difiri.
One in 10 children in Burkina Faso dies before they reach the age of five; many of these deaths could be avoided by recognising the signs of malaria, or by adopting healthy habits like hand washing.
Radio Djiawoampo is Dinyeri's local station, and is one of seven community stations involved in the child health campaign.
As well as dramas, local radio personalities broadcast adverts and live phone-ins about things like the importance of breastfeeding, or how to spot medical emergencies like pneumonia.
Radio is more cost-effective, argues DMI's Innovation Manager Cathryn Wood, than other health initiatives like touring theatre and video screenings - which may only reach a few hundred people at a time, or poster campaigns - where illiteracy can be an obstacle.
And frequency is key in driving health messages home, she says: their minute-long health adverts are broadcast 10 times a day, while two 15-minute dramas air each weekday evening.
Both funny and sad dramas have the desired effect on listeners, according to scriptwriter Patricia Ouaba.
"They say they prefer the funny ones because the ones that are so sad make them miserable [...] But then we ask them - do the sad ones still help to change your behaviour? And they say yes!"
The radio team clearly believe in their ambition of improving child health.
But is it just a nice idea, or is it really having an effect on people's habits?
"The problem with mass communication is that it can be very soft - its effects aren't accurately measured," says Roy Head, CEO of Development Media International.
Child mortality rates have improved in Burkina Faso in recent years, but there was no proof that it was radio making the difference, rather than other factors like better trained health workers.
So researchers from the London School of Hygiene and Tropical Medicine and Centre Muraz in Burkina Faso are running a randomised control trial to determine which changes are genuinely down to the radio campaign.
Because each of the seven radio stations only transmit to a limited area, they were able to compare people within range of the broadcasts - the experimental group - with those outside the broadcast range - the control group.
They surveyed both groups before the trial started, and again after 20 months to see what difference, if any, the broadcasts had made.
There was solid evidence that they were effective - though not in every case.
"Not all behaviours are equally easy to change," says Professor Simon Cousens, who led the research.
"One-off behaviours, like seeking care for a sick child, appear to have increased as a result of the campaign; for daily behaviours like hand washing and child feeding practices, the campaign seems to have had little or no impact so far."
Roy Head was surprised by the results.
"We thought what people could do in their own homes would be easier to change, rather than when they needed to actually travel to a health clinic. But in fact the campaign has been much more effective at getting people to go to a clinic."
'Opened my eyes'
The trial's final results are due out next year, and they will assess the reduction in child mortality during the campaign as well as behaviour changes reported by those surveyed.
If the results are what DMI hope, it would be the first time anyone has proved, definitively, that a media campaign can save children's lives.
But Dinyeri Pognoagou already has no doubt that the radio has changed her family's health for the better.
They have stopped drinking water from the dam and take the long walk to the safer water of the village pump instead.
Her husband even built a toilet, after constant nagging from their children - who also listen to the radio.
And now if one of them falls sick, they go to hospital straight away.
"The radio has opened my eyes," says Dinyeri.
"It's like a school for me. The radio is my teacher."