What’s the link between community health programmes and the Universal Declaration of Human Rights? Or, more specifically, the MMR vaccination and Article 29, ‘Everyone has duties to the community’? Once you find a link, how do you write a play for 12 year olds that explores that connection?
This is the task we set ourselves when applying for an Arts Award from The Wellcome Trust which brings together artists and scientists to explore biomedical issues. Working with Dr Tom Churcher from Imperial College I wanted to highlight the dramatic downturn in the uptake of MMR and encourage discussion amongst teenagers regarding the protection it offered not only to the individual but also the community in a new play called Bind.
Many see the decision whether to get vaccinated or not as an individual choice. However, with measles, mumps and rubella, the diseases that MMR protects against, if enough people are vaccinated they cannot persist in the community, protecting everyone. This is known as “herd immunity” and in the past it has protected people who for medical reasons are too weak to have the vaccine or babies who are too young to receive it. 95% of the population need to be vaccinated for this to be successful but with current rates of uptake nowhere near that, fears of a measles epidemic have been expressed and those who are vulnerable are most at risk of contracting a very nasty disease.
The severity of measles was an aspect that really interested me as this seems to be disregarded, brushed off as a slight childhood sniffle that is all part of growing up. Roald Dahl, whose daughter Olivia died of the disease aged 7, wrote a very moving article dismissing that stance and outlining the very real side effects it can have.
This social dimension of the MMR is one little discussed with parents, according to medical professionals I talked to. In fact, according to one senior paediatrician, if people knew their children would be protected through herd immunity, uptake would drop to even lower levels. This sounded like a shocking admission but seemed to play out in consultations that we undertook with students on the issues.
These started with trying to understand what ‘community’ was, summed up by one of the students as: “Community’s a really hard thing to explain or describe. I dunno, it’s important because if you don’t interact with your community you can’t make it better.”
Most students identified their communities as their neighbours, families and fellow students, those people that they had a sustained relationship with, built up over time. They had an expectation that they would be protected and cared for by those people and they in turn had a responsibility to them. But when it went beyond that close knit group there was disagreement:
“I didn’t know it would be protecting anyone else, I hadn’t really thought about it. Doesn’t change my view about taking it. I wouldn’t care if it hurt anyone else, I would if they were close to me.”
“It would make a lot of difference to me because either if it was my family member, close friends I would still get it done because of the pure fact it’s helping me and it’s helping other people around me even if I didn’t know them or not.”
“They haven’t done nothing for you so why should you help them.”
This issue of the reach of a community and to whom you actually have a duty of care has been a catalyst for Bind, which focuses on the relationship between two girls, Lucy and Lilli, and the repercussions the action that one girl’s family has on the other. The play also looks at other ways in which duties to the community can be explored including complicity through inaction and isolation borne out by a population becoming more and more risk adverse.
Currently in its first draft Bind has been written to be performed by two actors in classrooms without scenery, lighting or sound. It is not there yet, and the play will go through at least another couple of drafts before it is ready for its first schools tour later this year. My hope is that it will provoke discussion about a really fascinating and underdiscussed topic but also a really good piece of theatre that encourages students to create their own performance responding to issues that impact on their everyday lives.
By Sara Masters, co-Artistic Director of iceandfire