Keywords

The performance works examined in this volume represent a contemporary continuation of cultural storytelling, performance, education, and healing ceremony that have been practised by Australian First Nations communities for millennia (Welsh 2018). It is beyond our scope to undertake a full review of scholarly research on such performance practices, but this remains a critical underpinning for the works under examination, and we return to these ideas throughout the study. Viewed through the lens of Western theatre studies, the works can be seen as stand-alone examples of contemporary First Nations theatre practice but also as sitting within areas that have been variously described as theatre in education (TIE), theatre in health education (THE), and theatre for development (TfD)—all forms that are often collected under the broader banner of applied theatre (Prendergast and Saxton 2016). This branch of theatre studies recognises the inherent qualities of theatre—its capacity to aesthetically engage people through a live, communal, immediate event—as a powerful portal to transformative social change (whether educational, political, cultural, or therapeutic). The integration of contemporary Australian First Nations performance practice with contemporary applied theatre is unique, which we suggest makes a study of these works significant for a global audience. This chapter therefore consists of a broad contextual review encompassing contemporary First Nations dramaturgies in Australia and their relationship to community wellbeing, followed by a review of theatre for health education in First Nations and global majority contexts. By bringing together these strands, the chapter aims to situate Ilbijerri’s health education performances within a theoretical framework that extends beyond the notion of social impact to offer a foundation for subsequent discussions in the book.

First Nations Theatre in Australia: Dramaturgies of Wellbeing, Strength, and Resistance

Since their inception, Kamarra has been employed as a lead creative in most of the health education works produced by Ilbijerri (aside from the most recent production, Goodbye Aunty Flo, which was written and directed by Nazaree Dickerson). Outside of these projects, Kamarra has also worked in strong artistic collaborations, creating independent productions such as Chase (2022), Whose Gonna Love ‘Em? I am that I AM (2022), and A Nightime Travesty (2023). Her performance collective A Night Daylight ConnectionFootnote 1 brings a unique vision to the contemporary theatre landscape, producing challenging, visceral, darkly funny works that disrupt the limiting narratives and expectations often associated with First Nations Australian theatre on the mainstage (Nair et al. 2023). Kamarra brings this sensibility to the health education works, arguing that they must be well crafted, energetic, and engaging to deliver their educational goals successfully. Ilbijerri Theatre Company itself boasts a three-decade history of producing highly successful First Nations Australian stories for the stage, with many of their plays achieving international success and critical acclaim, and becoming established in the canon of Australian theatre (Casey 2013).

This body of work sits within a broader context of contemporary First Nations theatre making in Australia that first gained prominence in the 1960s and 1970s, which was led in part by the production of Kevin Gilbert’s 1968 play The Cherry Pickers (Gilbert 1988) and the establishment of the National Black Theatre in 1972. The works produced combined traditional Aboriginal or Torres Strait Islander performance traditions with Anglo-European theatre conventions and were seen to bring unique “innovations of form” to the Australian stage (Casey and Craigie 2011), building on a continuous legacy of contributions to Western theatre since the first European settlements (Casey 2000, 86). It is beyond our scope to examine this history in detail, but these works are seen as processes of continuous storytelling, adaptation, and survival over millennia—in the contemporary settler context, contributing to assertions of sovereignty and representation, achieving reconciliation and truth telling, and providing spaces to heal from the traumas of colonisation (Bracknell et al. 2021; Casey 2000; Enoch 2002; Perkins 2000; Syron 2021).

Contemporary Australian First Nations dramaturgies are invariably situated at the “interface” (Nakata 2007) with non-Indigenous (or Western) performance traditions—one that is often troubled by questions of ownership, representation, and the oppressive legacies of colonisation (Lo and Gilbert 2002; Syron 2021). Acclaimed Aboriginal playwright and arts leader Wesley Enoch (2002, 14) highlighted the interdisciplinarity of First Nations performance as being “commonplace,” with the integration of art forms such as painting, dance, and song: “The ‘theatre’ or ritual and play is made of … relationships between artforms.” Susan Thurow (2018, 132–133) observes that the “particular cultural horizon” of contemporary First Nations theatre remains grounded through these interdisciplinary practices. Syron (2021, 108–109) suggests that trying to define “Indigenous theatre” as a discrete genre is therefore unhelpful, instead examining “what makes a work Indigenous?” She goes on to explore how Indigenous sovereignty and ownership are asserted through performance development and rehearsal practices. This accords strongly with Kamarra and other contemporary performance makers who seek to decolonise rehearsal and performance spaces by centring First Nations cultures and practices (Bracknell et al. 2021; Hyland et al. 2018; Neumeier 2014) and challenging the dominance of non-Indigenous producers and arts leaders who stage works in ways that perpetuate colonial power relations (Boehme 2018). This is relevant to the health education works under examination here, with added complexities such as how Anglo-centric frameworks for health and wellbeing interact with the creation of these works. We now introduce some further elements within contemporary Australian First Nations dramaturgy that are of critical importance in examining the health education works.

Establishing deep and ethical community collaborations and reciprocal relations, both within and beyond the rehearsal space, is a critical feature of most First Nations-led theatre practices. This reflects the strong sense of obligation to family, community, and Country among Aboriginal and Torres Strait Islander artists (Thorner et al. 2018) and a recognition that knowledge that is generated and transmitted through performance is a shared project that requires adherence to cultural protocols (Harvey 2018). This can include consulting with Elders and knowledge holders to ensure that cultural processes and representations within works are respectfully and appropriately conducted (Bracknell et al. 2021). Citing Ilbijerri Artistic Director Rachael Maza (2015), Liza-Mare Syron (2021, 3–4) suggests that “ownership” in Indigenous theatre encompasses both the individual ownership of creatives and the collective ownership of communities. We have previously drawn on Opaskwayak Cree scholar Shawn Wilson’s (2008) theorising of relationality as integral to Indigenous ontologies and epistemologies, which encompasses relations with people, with the environment/land, with the cosmos, and with ideas. For Wilson (2008), ethics in Indigenous research involves “relational accountability,” which forms a key aspect of Kamarra’s approach to performance making and our thinking around the health education works (Woodland et al. 2023). Relational accountability can be seen to inform how First Nations stories are represented on the stage, as discussed further below, as well as how cultural safetyFootnote 2 is maintained in the process of making and presenting works (see also Bracknell et al. 2021). In a contemporary settler context, this approach contributes to the decolonising project, removing the hierarchical (colonial) structures of Anglo-European rehearsal and performance spaces.

Kathryn Kelly and Emily Coleman (2019, 53) discuss how “community engagement” has become prevalent in the Australian performing arts landscape, with artists and companies promising (sometimes uncritically) that works will provide “connection, collective endeavour and reciprocity without expectation.” However, in the context of Aboriginal and Torres Strait Islander performance practice, this carries a much deeper resonance that infuses all aspects of the work. Ilbijerri has always naturally integrated community engagement with their mainstage theatre work, an approach that Kelly and Coleman (2019, 56) argue shifts the binaries between “community” and “professional” arts practice, which in their view contributes to “showing the important contribution of Aboriginal knowledge frameworks to the Australian performance sector.” Nevertheless, to speak to mainstream narratives of arts policy and practice in Australia, Ilbijerri has categorised the health education works discussed here as part of their “Social Impact Program” (Ilbijerri Theatre Company n.d.), separating them from their mainstage works. However, First Nations efforts towards health, education, and activism are most frequently intertwined with artistic and cultural practices; they are dealt with holistically, with little use for silos or binaries between social impact and cultural practice.

With obligations to family, community, and Country, First Nations theatre makers sustain a deep consideration of the politics and ethics of representing stories on the Australian stage. Since first contact and colonisation, representations of First Peoples in Australian discourse and media have been controlled, manipulated, and placed in the service of agendas to advance (White) settler domination and ‘progress’. For the most part, these representations have vacillated between romanticised portrayals of primitivism and exotic ‘otherness’ and deficit-laden depictions of disadvantage that paint Aboriginal and Torres Strait Islander peoples as a ‘problem’ to be solved by White interventions and policies (Langton 1993). Writing a decade ago, Maryrose Casey (2013, 160–161) drew on Wesley Enoch’s reflections to highlight how “there is a need to be aware of the image of Aboriginality that will be taken away by audience members who may well never either deal directly with Aboriginal people or see another Aboriginal performance.” She went on to observe that artists such as Enoch must negotiate a “bind” between works that will invariably come to represent a “generalised notion of Indigenous people” to White audiences, but which are, in fact, expressions of “individual sensibility” (Casey 2013, 161). As Casey (2012, 2) writes elsewhere, on the mainstage, White audiences and producers have long played a role in determining “what is culturally real and unreal” in First Nations performance, based on notions of “authentic” representations of culture as being traditional, fixed, or archaic, rather than contemporary, fluid, and evolving (see also Thorner et al. 2018; Casey 2013). This attitude has shifted to some degree but persists today—with our observation that non-transformational trauma narratives have recently gained currency among mainstream (White) audiences as an expected benchmark for ‘authentic’ black theatre.

Nevertheless, contemporary theatre makers continually strive to challenge reductive representations of Aboriginal and Torres Strait Islander identity and culture and to bring their experiences and perspectives to audiences in all their complexity and nuance. A crucial facet of presenting such stories is finding empowering aesthetic frames through which to acknowledge and challenge the traumas, injustices, and oppressions that continue to impact Aboriginal and Torres Strait Islanders’ lives in colonised Australia. Contemporary theatre makers have approached this in a variety of ways over the years, tackling difficult themes such as the Stolen Generations, intergenerational poverty, incarceration, and family violence through the prism of strength and survival (Casey and Craigie 2011). In discussing the integration of traditional dance and movement practices into contemporary performances, for example, Syron (2021, 102) suggests that a radical space of performative dialogue emerges—one that conveys the complexity of contemporary Indigenous lives:

Through dance and movement the theatre makers were involved in connecting with wounds, losses, traumas, and memories carried by Indigenous bodies, whilst at the same time actively moving towards the restoration and celebration of the Indigenous body as a knowing subject.

This “restoration and celebration” of bodies enacts sovereignty over the stage and over the contemporary cultural landscape, challenging the preconceptions and prejudices of mainstream audiences. Also critical to this assertion of power and sovereignty in First Nations theatre is the use of humour in undercutting the traumas and indignities of life under colonisation. In her survey of Aboriginal and Torres Strait Islander monodramas, Casey (2013, 163) observed that humour and self-mockery were a common feature, “Enab[ling] people to survive and continue with some sense of self and dignity.” We discuss later how humour is crucial to the health education works, which builds on millennia of yarning and storytelling practices that feature it as vital to entertainment, communication, and pedagogy.

Contemporary First Nations dramaturgies therefore have a strong legacy of deploying a complex array of traditional and contemporary approaches to tackle difficult themes. As Kabir Matharu (2009) observes from a medical humanities perspective, many Australian First Nations plays can be seen as instructive for healthcare professionals, exposing existing structural health inequities and depicting the erosion of social determinants of health and wellbeing. Jacob Boehme’s Blood on the Dancefloor (2016) represents a significant recent work that addresses shame, stigma, and sexual health from a First Nations perspective. Produced by Ilbijerri, Boehme’s ground-breaking performance integrated contemporary dance, digital media, and personal narrative to depict the experience of being Aboriginal, gay, and HIV positive. Made for public audiences, the work did not have an educational focus but instead was an intense celebration of hope, life, and love that surfaced a largely hidden issue facing many First Nations peoples today. Boehme described his approach as “such a different take on the HIV conversation to date—being very irreverent and very dark, black humour” (Campbell and Graffam 2018, 352). Through the work, Boehme explores themes of community, kinship, vulnerability, and acceptance through a story that might otherwise be mired in sorrow: “Here’s another story that’s about living and thriving, … rather than the usual AIDS plague where everyone dies. We live with it now. Our communities have been part of the fight dealing with HIV/AIDS since the 80s” (Boehme, interviewed by Bergman 2019). The work therefore has strong emotional, political, social, and cultural underpinnings, framed through a sense of resistance, survival, and celebration. Although intentionally educational, Kamarra’s approach to the health works for Ilbijerri aligns strongly with this sensibility. As such, Boehme’s work forms a kind of conceptual bridge we might cross between contemporary First Nations performance and theatre for health education. While First Nations contemporary theatre in Australia has always been concerned with promoting the strength, survival, and wellbeing of Aboriginal and Torres Strait Islander communities, we now turn towards a brief survey of theatre and performing arts used explicitly in health promotion and education in First Nations and global majority communities.

Theatre and Health Education: First Nations and Global Majority Approaches

The health education works discussed in this volume have been developed and toured in the context of intergenerational social and health inequities in Australia brought about by colonisation and sustained systemic racism across the intergovernmental domains of education, justice, social welfare, and health. This has resulted in Aboriginal and Torres Strait Islander peoples being disproportionately affected by poverty, disadvantage, illness, and low life expectancy, with efforts towards “closing the gap” between Aboriginal and Torres Strait Islander and non-Indigenous health outcomes failing to achieve results in many areas (see Commonwealth of Australia 2022). Aboriginal and Torres Strait Islander peoples have been identified as experiencing disproportionally higher rates of blood-borne viruses (BBV) and sexually transmissible infections (STIs) when compared with the non-Indigenous population (D’Costa et al. 2019). Despite Ilbijerri’s longstanding efforts in this space through the productions Chopped Liver (2006–2009, 2017), Body Armour (2010–2013), North West of Nowhere (2014–2016), and Viral—Are You the Cure? (2018/2019), the Australian Federal Government (2018) recently identified a lack of culturally respectful health education and prevention services and the presence of shame and stigma as among many contributing factors to the disproportionate risks and burden of blood-borne viruses (BBV) and sexually transmissible infections (STI). This disparity, along with an alarming resurgence of syphilis in Aboriginal and Torres Strait Islander communities (Hui et al. 2022), led to the Victorian Department of Health’s funding for Ilbijerri to develop The Score, which addresses sexual health and healthy relationships for young people. Strobel and Ward (2012) observe that Aboriginal and Torres Strait Islander peoples have experienced centuries of violence in relation to sexual health, including medical incarceration in “lock hospitals”Footnote 3 and medical experimentation. This is critical to understanding the fear, shame, and stigma that are associated with sexual health and BBV in this context. The issue of family violence (as addressed through the production Scar Trees) similarly disproportionately affects First Nations communities in Australia, with a lack of resources and high levels of shame and stigma also contributing to the challenge of providing support services (Fiolet et al. 2021). This speaks to Kamarra’s intentional approach to challenging fear, shame, and stigma through health education theatre works.

First Nations-led approaches to health and wellbeing have continued to place their communities, cultures, and knowledges at the centre of efforts to address health and wellbeing inequities, with an identified need to adopt holistic, culturally led, strengths based approaches and to examine how cultural as well as social determinants of health might be considered in health promotion and prevention strategies (Dudgeon et al. 2020; Gee et al. 2014; Sunderland et al. 2023; Verbunt et al. 2021). An emerging body of evidence supports community-led, arts-based programs for health promotion and education in response to health inequities among Aboriginal and Torres Strait Islander communities in Australia (Hickey et al. 2021; McEwan et al. 2013; Sunderland et al. 2023). These approaches have been found to reduce stigma and increase capacity for open discussion around sensitive topics such as sexual health, create enjoyment and community connection in rural/remote regions, and can act as a catalyst for further work in prevention and harm minimisation (see Cairnduff et al. 2015; Rogers 2013). The imperative to adopt First Nations- and culturally led approaches to health education and promotion has contributed to Victoria’s Department of Health engaging Ilbijerri to deliver this work since 2006 (see Victorian Government 2022).

While evidence is growing for the use of various art forms such as music, hip-hop, dance, and visual art in Aboriginal and Torres Strait Islander health promotion and education (see, for example, Anthony et al. 2018; Cairnduff et al. 2015; McEwan et al. 2013), there is very little documentation or evaluation in applied theatre or theatre for health education in Australian First Nations contexts. An examination of productions entered into the AusStage databaseFootnote 4 yielded examples such as The Kangaroo Tale (1995) and its sequel Slow Down Cuz (1997), both Handspan Theatre Company shows incorporating puppetry, presented by the Koori Health Unit, and tackling sexual health and sex education; Lost and Found in the Smoke (2012), a school touring show by Ngarrama Productions about the dangers of smoking; and Gift of Life (2012), a show about kidney disease and organ donation, written by Ben Graetz, supported by the then Australian Government Organ and Tissue Authority, and toured by Artback Northern Territory throughout remote communities (see https://youtu.be/NvAKeMr2l6Y). Details about these examples are somewhat thin but demonstrate that this approach certainly is not new. More recently, JUTE Theatre Company in Far North Queensland, through its Dare to Dream program, includes touring works for children written by Isaac Drandic that address personal safety (I Gut This Feeling 2023) and road safety (Back on Track 2021–2023). Multi-art performances and festivals are often presented to coincide with annual events such as Mental Health Week and NAIDOCFootnote 5 week, where local Aboriginal Community Controlled Health Organisations (ACCHOs) are present to hand out information and provide health checks.

A review of scholarly literature for this study uncovered only a few theatre- or drama-based health education works in Aboriginal and Torres Strait Islander communities beyond the Ilbijerri works described in this volume. Fagan et al. (2015) discuss the Kasa Por Yarn (KPY) radio drama project (in English: “Just for a Chat”), which ran in the Torres Strait from 2010 to 2012. This aimed to raise awareness of HIV and STIs, building on and responding to community learning as a result of previous health initiatives in the area, including the Torres Hip Hop Project (McEwan et al. 2013). With the support of a Torres Strait Islander scriptwriter, the community developed KPY as a relationship drama about family and life in remote areas. The play was written and performed in the language of Yumpla Tok Kriol by local Torres Strait Islander performers. The authors discuss improvements in sexual health knowledge as a result of the project and offer reflections from community members on its value. Additionally, in the Torres Strait Islands and Far North Queensland, Mooney and Sariago (2015) discuss the 2Sprits program, a multi-arts HIV/AIDS whole-of-community education program that incorporated work with young people through the superhero characters “Condoman” and “Lubelicious” and the production of radio scripts that the authors note were a powerful tool to reach remote communities.

Globally, there is increasing evidence to support the effectiveness of theatre in health education, particularly in global majority and First Nations contexts, where it is commonly focused on HIV/AIDS and sexual health and includes projects in India, the USA, Africa, Indigenous and First Nations Canada, and Asia Pacific (Brodzinski 2010; Cahill 2017; Goulet et al. 2011; Haseman et al. 2014; Jaganath et al. 2014; Low 2020; Van Hout et al. 2020; Wells 2013). These projects adopt a range of approaches to theatre and performance, target various groups as participants and audiences, and represent a diversity of models in terms of funding and structure. Research into this work has highlighted the benefits of theatre and drama in promoting positive attitudes and behaviours, empowering people to explore complex emotional and social terrain through the art form, creating space for open dialogue and discussion, and reducing stigma in relation to sexual health (Goulet et al. 2011; Heard et al. 2019; Kauli 2018). Crucially, some projects were seen to provide an opportunity for communities to discuss inequities in healthcare systems and other legacies of colonial power (Flicker et al. 2014; Linds et al. 2013).

Despite growing evidence for the success of such programs, some tensions and challenges remain—both for program delivery and for measuring impact. The research has begun to highlight some lessons as to the pitfalls of theatre for health education, alongside what might represent best practice in terms of creating, delivering, and evaluating this work. As Katharine Low (2017) points out, this tension originates in how communities define concepts such as “health” and “wellbeing” and whether these are driven by Western models of an absence of disease or a notion of wellbeing that promotes neoliberal notions of productivity and market values. Cahill (2017) cautions against a focus on behaviour change at the individual level through individual storylines rather than addressing the structural inequities and social and cultural determinants of health. This places the burden on the individual and eliminates the opportunity for engaging participants with agency around the issues they face as a community. While encouraging behaviour change may certainly achieve positive outcomes in the short term, it is unlikely to have lasting effects. This can create tensions around evaluating the efficacy of programs, which can be difficult to achieve in a longitudinal sense and is still often undertaken using more traditional positivist approaches that privilege quantitative, longitudinal data as being the gold standard and therefore able to speak more effectively to the mainstream fields of medicine and social sciences—and by extension to government policymaking. However, as discussed by many in the field—particularly those working in First Nations health—this is not necessarily the most effective approach for evaluating arts-led, community-led practices (Brodzinski 2010; Keating 2009; Low 2017).

According to our review of the literature, the most effective programs are developed from the ground up with communities so that their own definitions of health and wellbeing, determined by cultural and social traditions, become the drivers for program goals and outputs (Low 2017). Katharine Low (2017) proposes that theatre and performance practice can offer ways of situating and articulating experiences of health that are relational to the individual, according to that person’s own understandings of what health means, as shifting, transitional, and affective. Cultural understandings, material conditions, and emotions can contribute to a holistic model of what health “is” at any one time, to any one community and individual. Key strengths in these programs when done well include engaging audiences in active learning as opposed to top-down messaging; audiences see themselves reflected in the performers, storylines, and cultural content; projects typically adopt a whole-of-community approach that draws together target groups, stakeholders, community-controlled health organisations, and community leaders/Elders; the presence of peer mentoring and peer teaching within programs (Brodzinski 2010; Baxter and Low 2017; Cahill 2017). As will be discussed later, these notions of best practice have been implicitly present to varying degrees throughout Ilbijerri’s health education works, driven largely by Kamarra’s educational background, artistic instincts, and cultural positionality (as opposed to formal theoretical knowledge of theatre for health education). Certain elements, such as greater community engagement, were high on Kamarra’s agenda for future iterations of the work. Of particular interest to us are those theatre- or drama-based programs for health education that are developed and delivered by established local theatre/performance companies. The Life Drama project in Papua New Guinea, for example, enabled the prodigious expertise and legacy of an existing company (Raun Raun) to be deployed for HIV/AIDS education in communities, thereby foregrounding localised cultural and aesthetic approaches to the issue and building a sustainable model for subsequent work into the future (Haseman et al. 2014).

Conclusion

In this chapter, we have offered an integrated examination of contemporary First Nations dramaturgies in Australia and theatre and drama as explicitly used for health education in First Nations and global majority contexts. The aim has been to locate our study of Ilbijerri’s health education productions within a theoretical framework that encompasses theatre, performance, cultural practice, and holistic, arts-led approaches to health wellbeing in Aboriginal and Torres Strait Islander communities. This framework also represents an intersection between our disciplines as authors and collaborators, providing a grounding for the chapters that follow. We now move to the findings of our study, which illuminate three prominent themes across the works. The first of these, as discussed in the next chapter, focuses on culturally led, culturally safe practices both in creative development and performance of theatre for health education in a First Nations Australian context.