TVO Video

There’s now a short video on the Theatrescience website (Youtube link) covering the school shows, company research, TVO performance and post show discussions. I’ve just watched it (well, OK, I edited it). It’s not meant to document the project just give a brief idea of it. What jumped out to me was:

‘Antibiotics cure everything!’

‘You need a prescription!’

The two school show songs.

’50 cases already’.

‘Antibiotics for the people!’

‘This is India…’.

Mobile phones – toilets?

The last image of the show.

‘It’s not too late!’

Performances

A few thoughts on the shows:

Great cast!

‘Design’ worked well, especially the screen images.

Couldn’t have been better received by the audiences (e.g. ‘wonderfully scripted play… I have very seldom seen such a telling performance which is so contemporary, relevant, well-produced and well-acted’ – Director, Bangalore International Centre).

However, audience were not huge (though respectable) and many members were already well-informed on AMR so how much ‘new’ public engagement actually took place I’m not sure…

We’ll have  to wait for the Evaluation!

Further performances are planned – We’ll let you know.

Rehearsals

A few observations before doing the get-in, starting technical rehearsals:

It hasn’t been ideal rehearsing without the writer being present, especially with the 13 hour time difference between LA (where Gautam is) and Bangalore.

Visits to NCBS to talk to scientists and to a local Primary Health Centre were useful.

The ‘open rehearsal’ we did for some of the students who performed their own AMR plays at Jagriti was interesting – we even got some laughs!

Discovering more about the AMR debate in India, and meetings  some of those involved, has definitely fed-into rehearsals, at the very least to confirm our main points of concern.

As director I’ve very much enjoyed working with a very talented bunch of actors (not forgetting the stage-manager). This must be about the twentieth Theatrescience project and they don’t get any easier. I suppose balancing the ‘science’ with the ‘art’ will never be exactly easy, but that, I suppose, is the point…

 

An observation

We have had children from five schools on the Jagriti stage performing plays – not more than 10 minutes each – that they have written on the subject of AMR – Antimicrobial Resistance – a global problem that is rendering useless the antibiotics that we use.

An irritating cough was, invariably, the precursor to further complications and the message of unnecessary use of antibiotics was clearly and convincingly conveyed. Characters central to the plot were doctors and pharmacists both prone to corruption. One play had a pharma company palming off untested drugs to the doctors for liberal use – and to the profit of both – so that “he can do our trials” with fatal results. Another featured a “whistle blower” junior doctor who was then acknowledged and applauded for the courage of his convictions. Distraught parents, siblings and friends lamented the unexpected turn of events.

What was most impressive was that the scripts were written by each group with no involvement from the organisers or the faculty in each school. The presentations flowed briskly and easily. Use of the stage and the sets and the props was confident and self assured. Characters were well etched and played with competence. A total of twelve plays from 5 schools with a total of 100 odd players were staged with gusto to an enthusiastic audience of peers, teachers and parents.

Jagdish Raja

Director, Development

Jagriti

Interim view from back in the UK

After eighteen school workshops (three per group, six in five schools) and a cast read-through of the third draft of the script for The Vaidya’s Oath it seems like a good time, looking at things from back in ‘Blightie’, for a few thoughts. After all, the whole process is meant to be evaluated in a formative as well as summative fashion…

The education project is, let it be said, not easy. We’re asking 13/14 year- olds to consider AMR in an Indian context and devise/write their own scripts about it. At an evaluation meeting before I returned to the UK (22/11/15) we discussed this at length. The main difference for me between this project in India and similar ones in the UK over the last twelve years or so was the general lack of teacher involvement. In the UK we have generally insisted that an English/Drama teacher and a Science teacher were directly involved in the sessions. This has not been the case in India (or Uganda), usually because such specialist teachers might not exist or just because it was assumed that we were the specialists. On the plus side this has meant that the students did ‘own’ their work, it was not dictated by a teacher, but on the other hand the students have been, at least apparently, rather left to their own devices. Given this I think we should probably have scheduled more sessions with the students. (We have in fact planned a few extra ones already). Having said this, the revised scripts have begun to trickle in and we await further developments.

The script for The Vaidya’s Oath has now  been read by the intended cast and a further draft is in progress. As always with Theatrescience scripts (this is about the twelfth) there is a tension between the science and the drama, but then that’s why Theatrescience was set up in the first place. Theatre tends to be about humans and their emotions not bacteria and antibiotics. Gautam’s impressive attempt to link the two still has some issues (discussed after the reading) on this front. I had mentioned to Gautam Simon Turley’s very successful play about Chronic Fatigue Syndrome (CFS), ‘Something Somatic’, that never mentioned the condition but CFS is a sydrome with no proven scientific cause, AMR is not, so we do have to talk about it. It has been interesting to look at the numerous articles that are currently appearing in both Indian and UK newspapers on the subject (also a few tv programmes). Are we (once again) slightly in front of the curve on this issue or do we just notice what other people are talking about because we are too?

Anyway, the whole project is certainly now up and running. at least one more session will be held with the school groups (run by Vandana and Rebecca) before they perform at Jagriti on the 27th and 28th of January (I’ll be returning to Bangalore for that) and then rehearsals start on the 1st of Feb for the show proper which starts on  March the 10th. See you there..?

 

 

 

Those days of immersion

Gautam Raja, TVO playwright, makes notes during an immersion visit to NCBS. Picture by Jeff Teare

More than the actual beheading of the rat, I was startled by how matter-of-fact the whole process was. “How many rats have you killed?” I had asked the scientist who was preparing to dispatch another rodent to the great cheese warehouse in the sky.

She shrugged. “I’ve lost count,” she said, barely even looking up from prepping the microtome that would cut fine slices off the rat’s brain. “For this cycle alone… maybe 200?”

With an economy of movement that spoke of all the furry dead, she introduced the anaesthetised rat to the guillotine, which performed its job with a swift press of a lever. Using a scalpel on the severed head, the scientist exposed the skull, and then cut it open with a tool I shall call a skull snipper. She popped out the brain which she deftly plunged into an icy bath of artificial cerebrospinal fluid. I don’t think even a minute had passed.

Before October 26, all my research for this project has been reading; my only “field” visits being to the public library. But once the engagement cycle of The Vaidya’s Oath began, it got interesting very quickly, with visits to the Indian Institute of Science, to PHC’s or government Primary Health Centres, the microbiology department of St. John’s Hospital, and of course to our project partners, the National Centre for Biological Sciences.

I’ve written about the characters in TVO here, and you’ll see the play features two government doctors, a microbiologist and a seismologist—there are a lot of strange worlds here I must learn about in some detail.

In upcoming posts, I’ll talk about these immersion visits and what I’ve learned from them. Most exciting for me is that I have realistic dialogue for the play, some quirky details, and ideas for important connections between the characters and the play’s superobjective, which is of course, antimicrobial resistance.

The four acts of infection

When I started work on The Vaidya’s Oath, I planned the structure of the play a lot longer than I normally would before starting on writing dialogue. The result was a first draft that ran (or perhaps more accurately, hobbled) from start to finish. The human story has been sketched out, with several holes large and small awaiting research and immersion on the medical and scientific side of the story.

During my background reading, I was intrigued to find that infection follows four stage process:

1) Incubation: the interval between the entrance of the pathogen and the appearance of the first symptoms

2) Prodromal: the appearance of generalised symptoms of illness such as malaise, fatigue and low-grade fever.

3) Acute: when specific symptoms of the infection present themselves, such as rashes or a sore throat.

4) Convalescence: Or, if things have not gone well, death.

It’s easy to see that classical storytelling follows much the same process, and I didn’t need much persuasion to adopt this structure for TVO, which now is loosely in a four-act structure, the acts named after each stage of infection.

It feels right, because at its core, TVO is the story of the “infection” and decline of a marriage. Who will convalesce and come away stronger, and who will succumb, as it were, to the disease?

Let’s meet the characters in TVO, without revealing too much of course.

Dr. Ajay
We first met this guy in The Invisible River (TIR), a previous Theatrescience play on bacteriophage therapy and the Ganga. A driven, inflexible man, Dr. Ajay was seen stalking up and down the banks of the Ganga shouting at people dipping their babies in the water. In TIR he confronts a politician and since then he’s been given a punishment transfer from Allahabad to a rural area somewhere in Uttar Pradesh.

Uma
Another character from TIR, Uma is a microbiologist from Bangalore. She met Ajay during a research trip to Allahabad where she was studying bacteriophage action in the Ganga. Though she didn’t like him at first, TIR hinted at a developing relationship between Ajay and Uma. Since then, they’ve fallen in love, got married and spent about nine months out here in this rural posting.

Rahul
A young seismologist from Bangalore and a friend of Uma’s. For much of the play, we’re not sure what their relationship is—they are comfortable with each other and seem to be very close friends.

Anwar
Played by the same actor who plays Rahul, he is a young doctor in the government hospital Ajay supervises.

Kamala
A young mother who lives in poverty and has a recently born baby under Ajay’s care in the hospital, severely ill with infant sepsis.

School workshops

Having now completed 12 school workshops (five schools but two groups in one school) it’s probably time for a few thoughts on them, after all we believe in being ‘reflective practitioners’ here at Jagriti/Theatrescience…

1. Having the input from NCBS scientists at the first workshops has been great. They’ve all taken a different approach, from plasmids to ‘zombie snails’, but they all gave us a jump-off point for the anti-microbial resistance drama exercises.

2. We’ve had to invent a horizontal gene transfer/plasmid drama game to show how bacteria ‘outwit’ antibiotics. It’s still not perfect but I doubt there’s ever been one before.

3. The students in the lower income school immediately went for local stories that affected them directly. Students at the higher income school also attempted a story about low-income issues but didn’t really know what they were dealing with. However, they knew it.

4. All the students seemed to have some idea about anti-microbial resistance in an Indian context but few had any idea of the political/social/economic causes, let alone the actual scientific ones. In each first workshop they were sent away to research on-line, except in the lower income school when we had to rely on newspaper cuttings.

5. Mostly the students were involved and enthusiastic except for one session. The teacher explained that as they had been allowed to turn up late (11.30am) they’d probably stayed up late and got up late as well.

6. Initial short, or not so short, improvisations tended to confuse general pollution with bacterial infection but that’s hardly surprising in Bangalore (India?).

7. After the second workshop all groups hopefully had some basis for the next stage which is to script a 10 minute piece. They have to deliver this before the next workshop so we can work on it with them. We shall see…

8. Thankfully some groups have taken on our suggestion to use music and possibly dance. We don’t need wall-to-wall doctor/patient scenes…

9. Almost every impro had someone coughing. I now have a cough.

Public Engagement Projects

Jagriti, in conjunction with Theatrescience UK and the National Centre for Biological Sciences (NCBS), Bangalore, has been awarded a Wellcome Trust UK International Engagement grant. This is for work that engages and brings about public awareness on bio-medical issues, through the arts. Our application looks at the field of anti-microbial resistance (AMR), a global problem, but one that looms large in India, over foetal and infantile health.

The outcome of the project will be a play called The Vaidya’s Oath written by Gautam Raja. The dramaturge and director is Jeff Teare of Theatrescience UK. The scientific advisor is Dr. Mukund Thattai of NCBS. Two plays from similar, earlier projects are The Invisible River and The Clearing.

Jagriti’s collaboration with Theatrescience UK and the National Centre for Biological Science (NCBS) has been a rich and rewarding one. Two earlier awards to Theatrescience have given us rich returns in the field of drama as a tool to bring about awareness of biomedical issues apart from of course the new plays that it has provided.

This time the award, comes direct to Jagriti, bringing with it a responsibility to the arts, the sciences and to the public involved. While these are responsibilities we deal with all the time as a theatre company with a physical theatre space to run (www.jagrititheatre.com), it does bring with it a new perspective on the public engagement front.

The Education Project: Why are they Superbugs?

This is organised for November when both Gautam and Jeff will be over in Bengaluru (Bangalore). We are in the process of confirming school participation and will have the list up soon. The students will also be joining the blog eventually. The project offers a series of four workshops where the students will interact with researchers from NCBS, the playwright and with Jeff Teare as representative of Theatrescience and representatives from Jagrit’s theatre education and training department. Once the students choose an aspect of the issue to dramatise in their own way (with a little help), they will get the chance to perform at Jagriti.

–Arundhati Raja, producer

“Moral: If you use penicillin, use enough”

The warning label for antibiotics came with the very first one we developed: penicillin. On December 11, 1945, Sir Alexander Fleming delivered a caution we aren’t listening to even 70 years later.

“But I would like to sound one note of warning,” Fleming said at his Nobel lecture on his magical fungal derivative. “Penicillin is to all intents and purposes non-poisonous so there is no need to worry about giving an overdose and poisoning the patient. There may be a danger, though, in underdosage.

“It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body.”

(Watch Sir Alexander deliver a 1954 speech about his discovery during which he presents Prince Philip a culture plate of the original mould that made penicillin.)

I was directed to this speech by an article by Timothy R. Walsh and Mark A. Toleman (published by Expert Reviews, 2011) titled ‘The new medical challenge: why NDM-1? Why Indian?’

There are a number of interesting dramatic points in the article that I’d like to talk about later, but focussing on Fleming for now, Walsh and Toleman say in the article, “Fleming’s warning has fallen on ears deafened by the sound of falling money. It seems inevitable that future generations will not only bemoan the erratic weather patterns we will leave them due to global warming, but they will also lament that, for those who knew better, we created superbugs with little regard to the long-term consequences.”

Fleming anticipated a time when penicillin may be “bought by anyone in the shops”. He said, “Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”

He goes on to give an example for the misuse of antibiotics. Short of poor Mrs. X’s death (and the specific antibiotic used), this scenario may well have been enacted in your very home last week.

“Here is a hypothetical illustration. Mr. X. has a sore throat. He buys some penicillin and gives himself, not enough to kill the streptococci but enough to educate them to resist penicillin. He then infects his wife. Mrs. X gets pneumonia and is treated with penicillin. As the streptococci are now resistant to penicillin the treatment fails. Mrs. X dies. Who is primarily responsible for Mrs. X’s death? Why Mr. X whose negligent use of penicillin changed the nature of the microbe. Moral: If you use penicillin, use enough.”

Note the use of the word ‘educate’. We’ve spent the last 70 years giving our microbes a thorough education, and some of them out there have the equivalent of a quiver of PhDs: they are resistant to all the antibiotics we currently know of.

We are often cautioned to not panic when faced with disease outbreaks (usually viral). It really does seem though, with bacteria, that we’re not nearly scared enough.