Stigma-Free Spaces for Healing, Empowerment, and Self-Determination

Abstract

This chapter presents further findings from our study on the five health education works led by Kamarra Bell-Wykes and produced by Ilbijerri Theatre Company from 2006 to 2019. These findings draw on interviews conducted with eight practitioners who were involved over the years as performers, production staff, and advisors, a research yarn conducted between co-authors Sarah and Kamarra, and Kamarra’s own critical reflections while putting together this volume. We also analysed documents and data from Ilbijerri’s corporate archive and published works such as those by Clare Keating (‘Chopped Liver’ Evaluation Report. Effective Change Pty Ltd. Melbourne: Ilbijerri Theatre Company. Supplied, 2009) and Blayne Welsh (The Hepatitis C Trilogy: A Case for Indigenous Theatre as a Contemporary Manifestation of Traditional Healing Business. Australasian Drama Studies 73: 20–41. https://search.informit.org/doi/abs/10.3316/ielapa.146479491877297, 2018). This chapter explores the third of three prominent themes within the data: how the works engaged audiences in the health messaging and information and created culturally safe spaces for challenging stigma and promoting community empowerment and self-determination. As such, we continue to argue that the works progress the dramaturgies of wellbeing, strength, and resistance that characterise contemporary First Nations theatre in Australia.

The previous chapter discusses the aesthetic and performative elements of the health education works in terms of their function as ‘gripping dramatic yarns.’ We now discuss how this enabled the works to artfully walk a line between entertainment and education, effectively promoting audience engagement and connection and supporting the health education and messaging. Perhaps more importantly, the culturally centred storytelling also created safe spaces that challenged stigma and supported movement towards collective empowerment and healing. We discuss how the performances invited audiences to take control of their own lives and wellbeing and to be inspired and filled with a sense of pride at seeing their own stories and lives represented on stage. The findings also point towards the importance of these works in building the skills and capacities of audience members, community members, health workers, performers, and creatives, both in learning about and addressing the health issues but also in terms of transforming their own lives, ‘giving back’, and adopting community leadership roles. This reflects the need for the work to address change at the structural level, as opposed to only focusing on individual behaviours (Low 2017). As such, we continue to argue that the works progress the dramaturgies of wellbeing, strength, and resistance that characterise contemporary First Nations theatre in Australia, as discussed in Chap. 3.

Audience Engagement and Connection

The previous chapter demonstrates how audiences were strongly engaged by the performance aesthetics in the health education plays, which speaks to their power, not only as standalone theatre works but also in terms of their capacity to deliver health messaging and education goals. A critical element in the success of the performances in engaging audiences—as is the case with most applied theatre—was that they were toured into communities as opposed to mainstream theatres, largely meeting audience members where they were. Isaac Drandic attributed Chopped Liver’s success to this: “Going to the communities is a big one, going to them rather than anybody coming to us. In the city, it’s hard to get people through the doors” (interview, 2021). Jesse Butler described how impactful it was to tour Viral into communities in terms of them being the “right audiences” for the work:

You’re going to make ten times the impact if people understand the story and they can relate to it, and they understand what’s going on and they’re going through it maybe themselves. … This is why we get sick of performing in front of those audiences that we know it’s not for because you’re just like, I feel like I’m wasting an hour here. I should be performing in front of people who are going to get something from this. (Interview, 2020)

As health worker and reference group member Peter Waples-Crowe observed, this presents some challenges in terms of the cost of mounting tours, which can result in performances having limited reach and therefore limited impact (interview, 2021). Nevertheless, over the past fifteen years, Ilbijerri’s health education performances have reached over 26,000 audience members in a wide variety of community settings, and findings from the data suggest that these performances have been highly engaging.

While it is impossible to gauge the long-term effects of the performances on individual and community health, as will be discussed further below, evidence suggests that the immediacy and liveness of a theatre performance create a unique affective response that supports the continued use of theatre in this context. As discussed widely in the literature, live theatre possesses specific qualities that highlight its potential as a unique vehicle for health education and messaging. In the context of a community event, theatre’s liveness, energy, and emotional intensity (when done well) lends itself to critical, dialogic, collective meaning making and experiential learning in ways that often transcend what is possible through other artforms such as visual art or recorded video (Brodzinski 2010; Cahill 2017; Campbell and Gindt 2018; Low 2017; Prendergast and Saxton 2016). These qualities certainly are not found in more traditional approaches to health education and messaging, such as pamphlets and seminars. As Melodie Reynolds-Diarra observed:

That’s the magic of live storytelling … you’re sharing the same air space as these people that you’re telling the story to. … I think it vibrates and stays with people longer and in more layers of them when there is someone live in front of you [and] the one-to-one contact of looking in someone’s eyes and going through something onstage, [as] opposed to looking into a television’s eyes, or a movie’s eyes. … There’s that humanisation of, ‘Hey, it’s okay, we’re all going through it too, but here’s us helping each other.’ (Interview, 2021)

Melodie describes here the relationality that is at the heart of these works’ power as ‘gripping yarns’, where audiences could identify and connect with the characters and stories on stage in a visceral sense, becoming part of a community of people on a journey together towards healing.

Nevertheless, our research shows that some audiences were more engaged than others, echoing Jesse’s earlier assertion that the works needed to find the “right audience.” As discussed in Chap. 5, when Viral was toured to schools, there were sometimes lower levels of engagement from audiences. Performer Shannon Hood put this down to a potential lack of experience with the themes and issues being presented, and Jesse Butler suggested that a factor in this may have been the sheer size of the audiences and the fact that school students were less likely to let down their guard. However, there is overwhelming evidence that prison audiences were among the most highly engaged, particularly for tours of Chopped Liver and Viral. Blayne Welsh (2018, 31) observed,

Throughout the comedic moments, but also in the emotionally intense and sad moments, there was constant laughter from inmates at each of the correctional centres. The inmates made for a very engaged audience. During the yarning circles held afterwards, they were also highly expressive and very respectful.

Both Isaac Drandic and Melodie Reynolds-Diarra described how prison audience members’ body language would change as they let their guard down throughout the performance of Chopped Liver. Melodie recalled:

They’d start like this with their arms folded. It’s like they completely blocked off, they didn’t want to be there. … Within the first couple of minutes their arms, their body language completely changed, and they were engaged in the work.

Melodie vividly described how this also extended to the prison guards, highlighting the power of the performance to break down the hostile division between “prisoners” and “screws”:

There was, I think, 160 inmates and that’s the first time that they’d had all those all inmates in one area ever, so there was about 60 guards … all standing in a semicircle around the back. … All of them were just scanning the group, not even paying attention to us setting up or starting or anything like that. I remember the … feeling the tension in the room. It was just like, ‘Whoa!’ … So you had this tension on both sides and then you had us—like, me, Isaac, and PJ [tour manager] all tense like that too because of all this but, no, just go ahead with the story. I remember about ten minutes, 15 minutes into it and then I looked up … I saw the screws’ faces; well, their arms had dropped, like so they weren’t crossed, and they were looking at us. … They were focussed on the story that was happening … and they weren’t looking at the inmates because they noticed as well that the inmates weren’t focussed on each other … they were just focussed on the story. I was like, ‘Wow!’ … that’s some pretty honest and raw writing and [the] way that the performance was put together as well that made that happen, that could even capture that attention from such hard-core military almost, kind of energy into, ‘No, I’m going to listen to this yarn here.’

By taking performances into prisons and other community sites, these works also engaged many first-time theatregoers. Nazaree Dickerson described how this was one of the things she enjoyed: “I always love it when you hear somebody from the audience say that’s the first theatre show I’ve ever seen. That is just something that blows me away” (interview, 2021). Peter Waples-Crowe echoed this sentiment: “The people I brought along to Chopped Liver more recently, it just made their day to see Aboriginal people up there, acting. They probably never get exposed to theatre that way, it’s really important.” To counteract some of the traditionally held expectations of silence and composure in viewing theatre, performances included a preamble or set of protocols for the audience to follow so that they felt they had permission to call out or respond. This cut through some of the awkwardness of performing in small spaces and invited audience members to engage more freely. As outlined in the tour notes from Viral:

We found that it changed the atmosphere for the better when we got Mary [stage/tour manager] to announce that it was okay to laugh, cry and respond to the work, as for a lot of the audiences, it was their first time seeing a performance. The start was always a little tense as they weren’t sure how to act within the performance context. We found that once we’d announce this, the audience would get straight into the performance as it released the mental stress of how to receive the work. Mary forgot to do this at one of the performances and they were really tense for the first ten minutes because they didn’t know to react to the stimuli. (Tour Notes – Improvements for next time! n.d.)

Another key audience for the works was professionals working in the health and social sectors, where performances were delivered at conferences. These performances have invariably received high praise (often standing ovations), with delegates finding them a highly innovative and entertaining way to impart health information and education. Shannon Hood reflected on how fulfilling it had been for him to perform in this context: “A lot of people came up and thanked us for the performance and that sort of thing. Yeah, I thought that was the highlight” (interview, 2021). This finding has implications for building professional capacity within the health and social care sectors, as will be discussed later, drawing workers into the emotional truths and complexities of the health concerns being explored.

Everyone who contributed to this study acknowledged that not all the health education performances were equally engaging for audiences, sometimes with different factors at play in influencing the levels of engagement. Kamarra reflected that the differences between Chopped Liver, North West of Nowhere, and Body Armour had to do with the energy of the plays.

It was something to do with the pace of the story telling, and I think that first of all, Body Armor had all these scenes in the doctor’s office, which were awful. It was death on stage, and it became a ‘performed pamphlet,’ which we’ll never do again. However, then North West of Nowhere, even though people enjoyed it, it was a much softer yarn and it was a much slower kind of yarn. I think that … wasn’t received as well as Chopped Liver … and Viral, because of that. Therefore, … you’ve got to have some fast—you’ve got to grab people. You’ve got to get in there at a truly high energy to captivate harder to engage audiences like teenagers and prisoners, although this would be different when creating work for say Elders. (Interview, 2021)

Kamarra discussed with Jesse Butler how North West of Nowhere was perhaps less engaging than Viral, particularly in terms of the target audience of young people. Echoing comments cited earlier, Jesse suggested that the audience may have felt awkward with the material, “But you kind of hope that you kind of are just planting seeds, and just reiterating to people what is important and also with blackfullas, you know, like we’re not forgetting you.” Kamarra suggested that this may have also been due to the development of the piece, which, with an outside director, unlike Viral, had not been built from the ground up through community workshops. As discussed elsewhere, over the course of the five productions, Kamarra became aware that with higher levels of community engagement from the outset, there would be higher levels of audience engagement at the end, informing how she now approaches the health education work, as discussed in our conclusion.

‘Walking the Line’ Between Entertainment and Education

Integrating the gripping dramatic yarn with appropriate health messaging takes a specific set of creative skills at the writing and development stage so as not to make performances didactic or clunky. The health content in these works was delivered via compelling characters and scenarios, where relationships between people, cultural norms, and wider political contexts were explored, rather than just the pointy end of messages and behaviour. Cahill (2017, 94) suggests that this needs to be approached carefully, as “good theatre can potentially be bad health promotion.” She warns against using worst-case scenarios as central subject matter, as this is akin to fear tactics. Furthermore, using stock characters and good/bad binaries can exacerbate stigma and connect illness to moral character. Kamarra’s approach has always instinctively followed this advice, with the conviction that the plays are never only about the health issues but also about the emotional, social, and political contexts surrounding them. By asking, “What is the play really about?” (see Chap. 2), Kamarra pushed the performances beyond being “performed pamphlets” and into meaningful narratives of transformation. Not only does this deepen the nuance of the interrogation from an educational perspective, but it also enables stronger aesthetic engagement from a wider audience that may include friends, family, health workers, and others. As discussed elsewhere, this impacted Kamarra herself and other creatives involved in the works in terms of deepening knowledge of health and wellbeing for themselves and their communities. In this way, Blayne Welsh (2018, 34) argues that educational theatre works such as Viral represent “a contemporary form of healing ritual” by extending traditional cultural frameworks and practices to provide a space for all involved—creative teams, performers, and audiences—to engage in a relational exchange of transformative storytelling.

The plays have managed to ‘walk the line’ between art and education through several deliberate strategies and approaches, sometimes in tension with requests from funding bodies, who sometimes want facts and information to be delivered in dry, obvious ways. Kamarra recalls how the first draft of Chopped Liver read like a spoken pamphlet and, as such, died on the creative development floor. She realised that her task was not to inform audiences about the virus but to make them feel something, to make them care enough to seek out their own information and support. She therefore abandoned the alarming but boring statistics and returned to the basic principles of good theatre, truth, emotion, and a good story. Chopped Liver needed to deliver a compelling and endearing human story that would open the hearts of the audience, break through stereotypes, and allow practical information to be received. During Viral’s development, the community workshops unearthed numerous misconceptions about hep C and its treatment that felt essential to include. To incorporate these different perspectives without overloading the main characters, the team used vox pops, as part of the documentary narrative, as a scene transition device. The actors transformed the “Viragon” set as a chorus of fictional community members, creating a tapestry of voices expressing issue misinformation and stigma.

Actor 1::

Think I was immunised against it in school

Actor 2::

Hep C? That’s like AIDS isn’t it?

Actor 3::

Can’t you catch it from kissing?

Actor 1::

Sex?

Actor 2::

Mozzies?

Actor 3::

Holding hands?

Actor 1::

That’s why I don’t drink out of chipped cups.

Actor 2::

It’s a junkie’s disease isn’t it? Dirty junkies.

Actor 3::

Waste of space.

Actor 1::

Why should our tax dollars pay for their treatment?

All::

Scum! (Viral - Are You the Cure?2018)

For Kamarra, one of the reasons Body Armour was less successful, both artistically and educationally, was the inclusion of a doctor’s office where most of the play was set and where the piece didactically delivered facts and statistics.

Doc::

And your ‘old man’ is hepatitis C positive?

Harley::

He’s dead positive.

Doc::

Oh, I’m assuming he had chronic hepatitis C for some time then?

Harley::

He was sick. How do I know if it was the virus, the drugs, or the grog?

Doc::

Most likely a combination of all three.

Harley::

Towards the end his skin had this yellow tinge; like smoker’s fingers, a walking nicotine stain. And his eyes, you know when you take a leak, and your piss hits the water, spreads like smoke—muddy yellow mist. That’s what his eyes looked like, like toilet water tainted with piss. (Bell-Wykes 2018a)

Despite all attempts to maintain the artistic integrity of the work, this device came as a direct request from a reference group member at considerable cost to the artistic integrity of the work. The play crossed the line into pamphlet territory to the detriment of the art, the audience, and ultimately the health message. Peter Waples-Crowe observed that in his role in the Aboriginal Community Controlled Health Organisation (ACCHO) space, “You are often at loggerheads with the Department of Health anyway. They have a set of performance indicators they want to meet, and they’re very bureaucratic.” For Peter, handing the reins to Kamarra as the lead creative made perfect sense: “She’s the expert in this field.”

Walking the line for Kamarra has meant sometimes digging more deeply into the issue than simply delivering information about how to be safe or healthy. In North West of Nowhere, the Department of Health wanted to promote the new contraceptive implant Implanon as a way of promoting safe sex. Kamarra was conscious, however, that this did not negate the possibility of contracting STIs, and she had been made aware that in some communities, boys were rubbing girls’ arms to see if they had a rod in a kind of courting gesture. She therefore included this in the script, providing the audience with more nuance on the topic than an uncritical promotional message would. The works have also maintained their artistic integrity through finding creative solutions to explore the various health topics in interesting but appropriate ways. A sexual interaction between Nella and Cuz in North West of Nowhere was demonstrated via a text-driven, stylised dance demonstrating consent and the negotiation of safe sex, offering the characters’ internal perspectives and poetically elevating the performance (Fig. 6.1).

Nella::

A smile, a smell, a wink, a wave, eyes meet, hold for a moment, shyly look away.

Cuz::

A whisper, a wiggle in her hips, guards are down, sexy lick of the lips.

Nella::

Flirting, dancing, hands touch for a beat, instant connection, a certain type of heat. (Bell-Wykes 2018b)

Such artistic decisions also extended to exploring the wider systemic, political, and community contexts in which health issues exist. For example, ‘White Spirit’ branded kerosene cans were incorporated into the scene transformations of Viral, symbolising the infiltration of the colonial virus infecting the worlds of the characters (and the audience). This theme was again expressed by the community workshop participants, and Kamarra was determined to acknowledge and represent it through the piece. Audience feedback in the guest book for Viral (2018) directly reflected how successfully these works were able to walk the line between aesthetics and health messaging:Verse

Verse Great performance – dance sequence profound. Will distribute health materials to our Mob. Such an amazingly powerful show, I learnt heaps!! So powerfully done. So illustrated the barriers and complexities to taking up treatment. Thank you so much, very deep, heart-warming, and informative. Very touching performance but with lots of education. Absolutely amazing performance. Very touching and informative. Thank you. Great show, it was a great way to put the message across in an accessible way.

Fig. 6.1

(L-R) James Henry, Shaynee Brayshaw, and Ian Michael, North West of Nowhere. Image by Stephen Rhall (2014)

Stigma-Free Space for Yarning

The quality of the works as dramatic yarns was integral to their function in breaking stigma and opening a safe space for open talk or yarning about personal experiences and connections to the content. Even in cases prior to Viral, where performers may have felt rushed on tours, delivering multiple shows per day in a variety of settings, in most cases, there remained high levels of audience engagement and community connection, leading audience members to share their own personal experiences, sometimes for the first time in yarning circles afterwards. Isaac Drandic suggested that the quality of Chopped Liver as a piece of theatre enabled the actors to earn the trust of the audience so that they would be more receptive to the pamphlets that were ultimately handed out at the end (Fig. 6.2). This sentiment was echoed by Kamarra and Laila Thaker in their conversation about Viral:

Laila::

You could see them loosening up through the show so probably by the time we did get to the yarning circle … from what I observed it seemed like … they’d been given themselves permission to just…

Kamarra::

To let their guard down.

Laila::

Yeah. (Interview, 2021)

Dramaturgies of strength, wellbeing, and resistance in contemporary First Nations theatre often work to challenge the shames and stigmas imposed by colonisation. The ‘colonial load’ of negative connotations around poor health as signifying poverty, neglect, or ‘dirtiness’ has been projected through the mainstream media and culture in Australia since colonisation. Intergenerational trauma impacts such as family violence and drug and alcohol dependence are also shrouded in a sense of shame for many Aboriginal and Torres Strait Islander communities, where the blame for such wellbeing issues is wrongly laid at their feet. Nazaree Dickerson highlighted the important role of theatre in counteracting this sense of blame, shame, and stigma:

Theatre’s such a wonderful way of bringing people together to discuss things that sometimes don’t get discussed in … community forums, without it being about a blame game. It is actually about … just safely discussing something.

In her report on Chopped Liver, Keating (2009, 17) cited an audience member in observing how the play broke down stigma “through accessible, real, funny characters and a story that you believe” and “humanising hepatitis C so that it is no longer this scary, dirty thing, but a fact of life.” She went on to highlight that “from the perspective of [partner organisation] Hepatitis C Victoria, having anywhere from 20 to 300 people laughing and chatting about hepatitis C is a major achievement” (19). For Kamarra, the significance was much greater, breaking down years of historical stigma and providing a sense of relief among audience members at finally being given “permission” to talk about hep C.

At the time that Chopped Liver was commissioned, it was one of the dirtiest words and there was so much shame. There was, nobody was talking about it. People didn’t know what it was, the rates of it were so high. So suddenly when you got that, started getting named on stage and jokes were being made and emotional truths were being identified about that experience. The permission that was kind of given to these audience members that had been holding this shame inside them for so long, it was almost like a floodgate was being opened.

Health worker Peter Waples-Crowe described how these levels of shame and stigma contributed to misinformation and “urban myths,” which could only be challenged through honest, unflinching examination of the issue and surrounding behaviours. In relation to the depiction of injecting drugs, he was adamant:

Let’s not shy away from it. It is one of the biggest methods for transmitting blood borne viruses, like hep C and HIV. For our communities, sometimes we don’t want to bring more shame on our community, and I can see why people feel that. But I feel we have to name and make it realistic, and I think that’s what the plays do, they don’t steer away from it.

Shannon Hood observed how important the freedom to discuss the virus safely enabled audience members at Viral to learn about the new safe and simple oral treatment for hep C and take this information back to their communities: “They were like, ‘Oh yeah, well my niece has got it,’ or, ‘My daughter has got it,’ or, ‘My son’s got it and we didn’t even know that there was a treatment for it’” (interview, 2021).

This is reflected in the literature, where we see that there is often a palpable sense of relief in audiences when a stigmatising topic is presented with compassion rather than judgement. In discussing the performance Sexwise in Aotearoa, New Zealand, Trish Wells (2013) tracks significant positive responses from both students and teachers around the affective impact on students, including the pleasure (and relief) of dialogue around these topics. Jacob Boehme also reflected on how his performance Blood on the Dancefloor prompted audience members to approach him privately to discuss the impact of HIV in their families and communities (Campbell and Graffam 2018, 363). Campbell and Gindt (2018, 28) describe how the communality created by an ephemeral performance can then lead to a “viral” spreading of conversation and engagement beyond the life of the performance, inviting the wider community to engage with the complexity of lived experience and the associated stigma.

When Chopped Liver was first toured, there was no formal yarning or debrief with the audience built into performances with this happening organically over food and drink as described by Isaac above. During this conversation with Isaac, Kamarra recalled being shocked by how this occurred in the prison setting, describing it as a “confessional” where people were sharing deeply personal experiences of the virus. After this first tour of Chopped Liver, the need became evident for a more formal, facilitated yarning circle after performances, where people would be invited to reflect on the performances. Jesse Butler articulated the importance of this process from a cultural perspective:

The yarning circles weren’t there to talk about how great we are or how good this message is. It was about breaking down … all the stigma and breaking down everything that we put up and just getting rid of it, and sitting in a circle which is what blackfullas do. We sit in a circle, and we yarn and we’re honest. Then, we perform in front of each other, and we talk about stuff. … Therefore, it’s not just sitting in a circle on chairs talking about the kind of health stuff.

In describing how people in the circle “perform in front of each other,” Jesse alludes to the times when the yarning circle extended beyond the health issues at hand and created a space where audience members felt they wanted to share their own creative offerings:

There were a couple of fellas that got up and were like, ‘I’ve prepared this song,’ or, ‘I’ve made this thing.’ So, all of a sudden, we opened up this little creative space. People just felt so open. Some people said they can’t speak anywhere else, and they spoke to us. … I think that’s not just about what they said, but the fact that they could speak in that space to us.

This points towards the holistic function of these works as promoting a sense of positive identity, empowerment, and wellbeing that we discuss further below.

It requires a specific set of skills and capacities to create a safe space for yarning about normally stigmatising issues such as these. Nazaree Dickerson pointed out that this included speaking in “plain language” without using theatre or health jargon and allowing the yarning to be genuine:

It could easily become a contrived situation where you’re trying to control this thing that’s meant to be organic, but it is just about actually creating the opportunity for that organic conversation to happen and using plain terms, so that everyone understands.

Kamarra believed that having lived experience of hep C deepened her capacity to lead the yarning circles around that issue, although she acknowledged the high levels of skill that cast members who did not have those experiences also brought to the yarning circles. Another key factor in supporting this process was to ensure, where possible, that a health worker was present to provide accurate information and relieve the performers of this burden. A further layer of safety was provided in the yarning circles by performers and creative teams managing input from non-Indigenous audience members. Mary Quinsacara recalled how in one performance of the Viral tour, the decision was made to dispense with the yarning circle, as there were some non-Indigenous folks in the audience who were at risk of dominating the conversation (interview, 2020). Nazaree Dickerson explained that for First Nations audiences, the presence of non-Indigenous members in the yarning circle can lead to self-censorship.

If you’re someone that - from the community that doesn’t necessarily speak or articulate yourself in a polite way, you’re just going to shut your mouth rather than swear in front of these nice white people that you don’t really know to tell your story.

While these works did not exclude non-Indigenous audiences, First Nations voices were given priority so that the space itself did not become colonised. Kamarra was clear, however, that in sector-related shows, non-Indigenous health workers and other professionals could be invited to unpack issues through yarning, as this formed an important part of their professional development, as discussed further below.

Fig. 6.2

Gregory J. Fryer (L) and Nazaree Dickerson (R), Chopped Liver. Image by James Henry (2017)

Delivering the Health Messages

Notwithstanding a commitment to artfulness and theatricality in these performances, Kamarra always maintained a strong focus on the brief of delivering the key overall health messages and information that were being sought by health partners and advisors, albeit in conversation with the wider systemic and political drivers of ill health among Aboriginal and Torres Strait Islander communities. As discussed elsewhere, the messaging was contextualised and deepened in Viral through community consultation, dialogue, and collaboration with the people directly affected by the issues, reflecting best practice in Aboriginal and Torres Strait Islander health (Gee et al. 2014) as well as theatre for health education (Brodzinski 2010; Low 2017, 2020). Furthermore, as discussed in Chap. 5, their aesthetic framing as culturally informed yarns provided an anti-oppressive framework for imparting the health information. Our literature review highlighted the shortcomings in evaluating the success of theatre-based programs such as these, and several authors discuss how difficult it is (perhaps impossible) to credit such interventions directly with positive health outcomes, especially in the longer term (Brodzinski 2010; Prendergast and Saxton 2016). Emma Brodzinski (2010) notes the trend in arts and health to place high value on evidencing results and the tensions of working between traditions of empirical data in the sciences and qualitative data in the arts (a perceived polarity that is often stereotypical and inaccurate on both sides, as she clarifies). Traditional “post program” evaluation tools such as those used by Ilbijerri and other arts organisations, while helpful in making the case for continued funding, can sometimes have shortcomings in capturing meaningful data that might give a fuller picture of the work’s efficacy. We are currently attempting to address this tension through our latest project, The Score, as discussed in the conclusion.

Despite these tensions, Ilbijerri’s archive of evaluation data and reporting at least provides a snapshot of the positive impact of the works on audience members. Audience survey data for Viral (2018 and 2019) and Scar Trees (2019) indicate that the plays raised understanding of the issues, promoted help-seeking behaviours, challenged stigma, and therefore may have contributed to overcoming barriers to treatment or support (see Tables 6.1 and 6.2).

Table 6.1 Data gathered from Viral performances (2018, 2019) using the Culture Counts survey platform

Table 6.2 Data gathered from Scar Trees performances (2019) using the Culture Counts survey platform

The Chopped Liver report highlights how, in some cases, audiences already knew the information being imparted, but the play functioned as a compelling reminder to seek testing and treatment.

In the male prisons, we’ve moved beyond the prevention message because it seems like just about everyone has it, but the play is a wake up and reminder call. I have had prisoners ask detailed questions because they haven’t known about testing. (Kirk Peterson, Victorian Prisons Program Educator, as reported in Keating 2009, 7)

It provides information – we have to see that as a starting point. But more importantly, it provides a moment of clarity. We sometimes see people literally recognise themselves there. The play reminds them of the need for testing. It reminds those who may even have a diagnosis that it can take a long time before someone becomes symptomatic. I hope it means that people will take the right steps. (Jen Johnson, Australian Research Centre in Sex, Health and Society, as reported in Keating 2009, 8)

Keating (17) also observed that the play promoted positive outcomes from the development of treatments that people may not be aware of. Reports from performances of Chopped Liver, North West of Nowhere, and Viral further highlight how those works prompted audience members to seek help.

I have had a number of students make appointments to see me about their sexual health after the performance and I am certain it was the production that prompted them to see me and seek advice about STI check-ups and STI prevention. (Secondary School Nurse, Castlemaine, North West of Nowhere, Ilbijerri 2015)

Keating (2009, 18) cites Sandra Gregson, a sexual health and blood-borne viruses nurse at the Victorian Aboriginal Health Service (VAHS) who reported having “lots of conversations with people because of Chopped Liver. People think about things for a long time. They are happy to ask me questions.” Reporting from Viral also demonstrated some positive outcomes for audience members in terms of providing a catalyst for seeking support and testing.

One person disclosed they had hep C … but didn’t follow-through with treatment and we have been able to provide support. (Staff member from Braybrook Community Hub, Viral Community Tour Report 2018)

We had more tested and also we have men talk about hep C more. (Staff member Ravenhall Metropolitan Remand Centre, ibid.)

Definitely suggesting doctor for others. (Audience comment, Viral 2019 audience survey)

Peter Waples-Crowe discussed the benefit of the plays in promoting conversation, nevertheless acknowledging how difficult it can be to capture these impacts.

[When] people pull you aside and have a conversation, and I think sometimes the play has probably done that for a lot of people as well and made people think. But we just can’t measure that impact, you know. That’s one of the impacts we don’t know how to measure.

It is often accidental or anecdotal feedback that tells us how effective a program or performance has been. Kamarra vividly recalled a Chopped Liver audience member recognising her at the local shops after seeing one of the shows while serving time and joyfully calling out, “Hey you’re the one that came inside with the hep C show!” A handful of prisoners on long-term sentences testified to seeing all the plays, affectionally expressing a clear investment in the work, discussing their favourite characters, and asking about actors from past tours.

Community Empowerment and Self-Determination

The impacts reported in the evaluations, although somewhat limited in terms of rigorous and artful research design, indicate the possibility that audience members were prompted towards developing positive behaviours and attitudes that might support their own and others’ wellbeing. Nevertheless, as suggested by the range of literature we have explored for this study, health and wellbeing outcomes in projects such as these can be seen as “much richer and more complex than mere behaviour change” (Low 2020, 15). While the findings cited above around health education and challenging stigma for audiences are extremely promising, through the process of developing and touring these works and the spaces for yarning that were created, there was potential for much deeper engagement that could promote empowerment, capacity building, and wellbeing in a broader sense.

An important but underreported outcome from projects such as these is the potential for them to develop the skills and capacities of performers and creative teams (beyond performance skills, as discussed in Chap. 5), empowering them to strengthen their own health and wellbeing and to become advocates and facilitators for change in their communities. Several creative team members we interviewed described how being involved in these works was rewarding, reinforcing their resolve to give back to their communities and strengthening their skills in working responsively, ethically, and flexibly with community participants and audiences. As discussed in Chap. 5, Jesse Butler talked about how being involved in Viral opened his eyes to how performance could be and do so much more than what he had previously experienced in mainstream theatre. Laila Thaker also reflected on how educational theatre enabled her to give back to her community and make “meaningful change.” She cited Viral as one of the most “memorable” productions she had been involved in. “I learnt a lot from that project and definitely it’s just made me a better person.” She went on to describe how this was an important legacy work for her:

You don’t want to give up on the project or the community because it’s bigger than you, you’ve got to put yourself aside and understand that - keep coming back to the bigger picture. Next generation stuff. You’re doing it for the next generation so it’s easier.

In terms of direct health and wellbeing outcomes for creative teams, Kamarra herself highlighted how the process of writing Chopped Liver supported her in her own hep C journey: “I came to really give myself an education about the virus. … I started managing the virus better and undoubtedly improved my own personal health outcomes and emotional trajectory around the virus.” At the start of the creative development for Viral, because none of the other ensemble members had lived experience of hep C, Kamarra asked the team to write down everything they knew about the virus, including any stereotypes and misconceptions. Laila Thaker described how this enabled her to “unpack and rip open” the stigma, providing a collective starting point before engaging with the facts and emotional truths explored in the play. By participating in the creative development and the community workshops that informed the work, the creative team entered their own process of challenging stigma and educating themselves about the virus.

Perhaps the most compelling example of this was in the case of Shannon Hood, who drew on his own parallel lived experiences of addiction and rehabilitation to inform his roles in Viral while also developing his skills in performance and community engagement. Shannon related how he drew on his personal experience of recovery to respond to the unfamiliar demands of performing and touring.

It’s very challenging and it’s a big commitment. Probably the biggest commitment I’ve made in the last couple of years. … What I’d overcome [with addiction] I thought was a lot bigger and a lot harder to do than actually getting through a three-week tour or a six-week tour doing a theatrical play. I kept telling myself, this is a lot easier, there’s no withdrawal. You might be missing this, or you don’t have time to do that and that. Thought about drinking, thought about smoking, rah, rah. Yeah, just hav[e] to keep your mind concentrated on what you’ve committed yourself to and basically at the end of the tour what you would have accomplished in a personal sense and then in a community sense, as well.

While this was at times challenging for him and his fellow cast members, Kamarra saw his development as equally important as the show and the audience experience. In her view, Shannon’s involvement as an inexperienced actor but identifiable community member contributed to raising aspirations in community audiences, encouraging them to imagine taking the stage and adopting a similar leadership role, prompting her to develop this approach in the current project The Score in ways that would deepen the wellbeing impacts by building capacity in communities.

After seeing Shannon on stage … dropping lines, making mistakes, having a laugh, just keeping on going. … For the first time people said, ‘I reckon I could do that. I want to do that.’ Our audiences never said that before. They would say, ‘Amazing performers, wow, they’re so amazing. Wow, how do you do that? I could never do that; how do you do that?’ So that was another important revelation to wanting to move this work in that direction.

Shannon described the power of this from his perspective, highlighting his role as a peer mentor within his community:

For me, to be up on stage and committing and doing a performance, I was hoping it would send the message to certain people - and even the lads in the jail and that sort of thing. They know my history too, a few of them. A couple of my cousins came up and said to me, ‘Mate, I’m proud of you. From when I saw you a few years ago, mate, I would never have thought this was possible. I thought you would have been in here, been in the greens [prison uniform], not in a performance mate.’ That was a massive incentive to me to continue and try and just let a few lads out there know that change is very possible.

Speaking more broadly, Jesse Butler discussed how First Nations stories are not told enough in the mainstream and that with more representation, more First Nations peoples might become involved in creative programs and projects. Peter Waples-Crowe also described how the works might impact audiences in this way:

I just know some of the Aboriginal people I work with just found the whole experience really life affirming, and yeah, just seeing themselves reflected and seeing such excellence, and how deadly it all was. … I think sometimes we’re pushed to the margins and seeing us at the forefront and doing innovative stuff is really good. I think it just counteracts a lot of negative narratives. … Maybe it inspires people in the audience to go into acting, you know, maybe they see a potential for themselves. … Or you know, they might want to work in that area.

In her report on Chopped Liver, Keating (2009, 16) described how empowerment for audiences has always been on Kamarra’s agenda as a writer.

Because the play is so powerful and the acting is so strong and the play concludes on such a positive ending, those who have toured with the play say that at the end, the sense of pride of Indigenous audience members is palpable. …This response is exactly what was intended by playwright Kamarra Bell-Wykes, who observed that ‘these (young guys) don’t get that sense of pride very often – it just doesn’t happen when you are so marginalized. But I’ve seen the young guys watch this and puff out with pride at the end – that is really special. That’s exactly what I wanted to do.’”

Despite having such intentions towards empowerment and affirmation for audiences, the experience of touring Scar Trees demonstrated that this was not always a given in these performances. Kamarra observed that while it was well received by the arts community, the tour should have focused on perpetrators or professionals and policy makers rather than victim-survivors:

It felt like there wasn’t really any empowerment for the victims. … It just kind of felt like there was a bit of a retriggering process that was going on and I don’t know whether it was for the right people or not.

Nazaree Dickerson agreed that it was possible that audiences were “left with these wounds that have maybe been reopened and we don’t know.” For a performance focusing on family violence, this was certainly not an ideal outcome. The funding body, reference group, partner organisations, Ilbijerri team, and Kamarra all underestimated the impact of the show and failed to adequately interrogate who it was for and why, leading to this significant oversight. For Kamarra, this highlighted the importance of maintaining strong community consultation and engagement at all stages and establishing clear and appropriate goals for projects, a lesson that she again carried into her more recent work.

The presentation of the works at conferences and other professional development settings such as Aboriginal Community Controlled Health Organisations (ACCHOS) was also an important step in widening the impacts of the work, building capacity for health and social care workers to understand the complexities of the issues beyond behaviour change and for health leaders to discuss strategies for meeting specific challenges (Keating 2009, 18). As Peter Waples-Crowe stated in the Community Tour Report for Viral (2018):

It also left an impression on the Thorne Harbour Health Staff who attended and strengthened our relationships and their knowledge of hep C and Aboriginal theatre. A cultural awareness raising exercise for the mainstream mob in the audience.

Conclusion

This chapter demonstrates that the health education works operated in multiple ways to achieve holistic outcomes in wellbeing beyond simply imparting health information and messaging or promoting behaviour change. The data suggest that witnessing their own stories and experiences portrayed on stage filled audience members with “life-affirming” pride and aspiration. Furthermore, the plays nurtured the skills and capabilities of various stakeholders—audience members, community members, health professionals, performers, and creatives—to not only acquire knowledge about health issues but also undergo personal development and transformations that might ripple out into the wider community. However, as we conclude in the next chapter, Kamarra acknowledges that unlocking this potential requires a deeper and more sustained level of community engagement within the projects. The journey towards meaningful change continues, with the theatre serving as a powerful catalyst for both personal growth and collective transformation.