EP52 PCI Media with Meesha Brown

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I AM GPH EP52 PCI Media with Meesha Brown

EP52 PCI Media with Meesha Brown

Vaibhav Srinivasan: My name is Vaibhav Srinivasan. Our guest for today will be Meesha Brown, the Executive Director for PCI Media. In our episode, we talk about the work PCI Media does in the field, the various agencies they work with producing an Emmy nominated video series on the Ebola crisis, working with popular Western African artists to create a music video. Now let's listen to our conversation with Meesha.

Meesha Brown: My name is Meesha Brown and I'm the executive director at PCI Media. And what we do at PCI is very special. So we use storytelling to inspire people to change their knowledge base, their attitudes towards certain issues and their behaviors towards sudden certain issues in three areas. Health is one of the areas that we work in, but we also have programming that addresses issues in the environment sphere and in the area of social justice.

Vaibhav Srinivasan: Okay. So how long has PCI Media been doing this?

Meesha Brown: So PCI Media is 34 years old. I've been working with the organization in different capacities for about the last nine years. So yes, a long history of doing this work. And in fact PCI Media started its work in health communications around access to sexual health information and reproductive health planning for women and girls around the world.

Vaibhav Srinivasan: Wow, that's amazing. So how did PCI Media make the jump from working with the women of sexual violence, to health and then eventually environmental and social justice? How did it expand?

Meesha Brown: So I think in a few ways. So one, you realize our methodology is participatory in nature. So we're always in dialogue with the communities in which we're working. And you very quickly begin to realize that an issue that seems like it's isolated to one health issue actually is situated in the lives that people live. And so as the programming takes on this sort of dialogic and participatory nature, people start to talk back to you or to us, they did, and say "it's really great that we're talking about this one issue. But if we could expand the scope of the programming to look at some of these other issues that might be useful as well." And so as we began to have those experiences, especially in our Latin American programming, it really opened our eyes, with our global team, to start thinking "what are other spheres of influence where our methodology would be useful." So it really opened us up to a broader scope of work.

Vaibhav Srinivasan: So which country did you start working with? Or, which community? Was it based in the US or was it global like Latin America, like you mentioned?

Meesha Brown: Well. So our first radio drama, long before my time at PCI Media, of course was in Tanzania and it was really about helping couples understand their sexual activity and planning their families. And every organization has its mythologies and it's stories that run through. And one of the great stories about that early work in Tanzania is that at that time, much of the population thought that you could not get pregnant if you had sex standing up.

Vaibhav Srinivasan: Okay. That's interesting.

Meesha Brown: It is interesting. And we all have our own, to this day, very interesting mythologies about what can and cannot happen when we have sex in certain ways. So at that time, in that community, that was a pretty common belief. And so of course the characters in the radio drama have sex standing up and low and behold the wife becomes pregnant. And so this entire series of discussions with the grandmother, and the guy at the market, and the best friends ensue about how in the world could she be pregnant because we had sex standing up. And so of course it created this dialogue in the community about, "Oh my goodness, this thing that we thought was true is not true. And if we are not interested in having children at this time, maybe we need to find another way to address our birth control needs."

Vaibhav Srinivasan: Wow. That is really interesting. I did not know that.

Meesha Brown: Well, I mean, it's such an interesting thing about health communications, is that of course there's the science of health, and the technicalities of health, which are very important. Things are true or not. And the vaccination movement, and the anti-vaccination movement, really is a great example of this because a lot of people's unhealthy behaviors are not really tied to the science of the thing. They're tied to beliefs, attitudes, fears, motivation. So it's really about understanding what motivates people to act in the ways that they do. And what are those deep seated beliefs or customs that individuals and communities are adhering to and inspiring or inciting people to think about those things more critically, talk about them, challenge them as a way to create space for change.

Vaibhav Srinivasan: Wow. So it's more about breaking a person's notion rather than the science itself and their basic understanding.

Meesha Brown: Definitely. And there's definitely a compliment between the two. But I'm sure in your studies, and just in your experience, you can think of many cases where the science is very clear on something. The classic example is doctors that smoke.

Vaibhav Srinivasan: Exactly, yes.

Meesha Brown: Right? So then you have to ask yourself, if someone's very clear on the knowledge, then what are those other underlying motivations that create the situation where the person still chooses something that is unhealthy for them. And diabetes is another great example. My mother has diabetes and so a lot of the work that we do with my mother is all about stress management and the foods that make her emotionally feel good but physically not so much. And so what you're not really addressing is we're not really talking about the technicalities of the disease so much. We're really talking about the emotional relationship to the disease and all of the other things that are going on in her life.

Vaibhav Srinivasan: So healthcare communications helps deal with an emotional aspect rather than, just like I mentioned before, the science.

Meesha Brown: Yes.

Vaibhav Srinivasan: Or just the physicality of it. Like actually dealing with human emotions and connecting with them.

Meesha Brown: Yes, definitely. Definitely.

Vaibhav Srinivasan: So here we like to talk about the intellectual trajectory and the experiences which brought you from one field to the next one. So could you tell us how you got into the healthcare field? Specifically with how did you start working with PCI Media?

Meesha Brown: Yeah, sure. Sure. So I am an educator by training. I'm in pedagogue and so I actually do not see myself. We do have a health team at PCI Media, but I'm not a healthcare professional. I'm an educator even rather than educator, I would say a facilitator of learning. Creating the space for people to learn. And so what I think is so beautiful about the work that we do is that we are not... Although as I said, we do have technical teams in our organization that bring technical expertise, even in the field of medicine the fields are so vast that you cannot be an expert on everything. But what we bring is an understanding of great communication and learning methodologies. And we always do our work in partnership with other organizations such as the CDC, or UNICEF, or WHO. Organizations where their teams bring to bear expertise on the situation that's happening at that time. So for example, when we produced the, I Survived Ebola campaign during the previous Ebola outbreak in West Africa, we worked with Doctors Without Borders, and UNICEF, and WHO officials and health officials from the three affected countries to really make sure that the technical messaging was correct. But then we bring in this expertise of understanding how to help people learn, and frame, and communicate messages in a way that are inviting. So my trajectory has really been coming at this from a learning perspective and seeing that media and communications and, especially if you're able to, as we do in our methodology, programs so that the communication is two-way so that there's an opportunity for people to, for example, call into a radio show or participate in a community dialogue or participate in some sort of community activation event where they can show up and act themselves into a new way of thinking. Then you create these spaces where you have the technical information, but also these opportunities that respond to the way that humans learn to do things new.

Vaibhav Srinivasan: Could you talk more about the-

Meesha Brown: Sure. I Survived Ebola.

Vaibhav Srinivasan: I Survived Ebola. Sorry, apologies.

Meesha Brown: Yes, no worries. No worries. It's, first of all, one of the campaigns that I'm most proud about in my time at PCI Media. During the Ebola outbreak, again, the first one, or the first very severe one in West Africa, that began in 2014. As you may remember, Ebola splashed on the scene. It was completely unknown to most people, very frightening. And all you knew were about 80% of people were dying. I mean that was it. Like, don't get it, you're going to die. And so we had actually been working in West Africa on some environment programming. And of course when the Ebola outbreak happened, all programming ceased because there were restrictions, as there should have been, on mobility and the number of people who could gather together, and so as I said before, we do a lot of work that requires that sort of thing. And so a lot of our programming was halted. But we had teams in situ and we, as I said before, we always work with local communities. And that includes contracting with local people that live in all of the different places we work around the world. And so our team members live in these places. These are their friends and countrymen, and women, that are being affected by this outbreak and their families. And so we all collectively really felt like we wanted to do something. So then we started to ask ourselves, and we're huge proponents of the positive deviance framework and methodology, and so we're always looking for the answer to this question, "what's working and how can we amplify what's working in a variety of ways as a solution set for some of these problems." And so the question we started to ask ourselves is, "well, if about 80% of people are dying, then what's happening with the 20% that are living, that are surviving? So what's happening there?" And we started shopping this idea around and found some very willing and beautiful partners at the Paul G. Allen Family Foundation and Vulcan Productions. And together with them, and all of the partners that I mentioned before, we were able to produce this really beautiful series that included 30 first-person narratives from individuals who had survived Ebola, including, at that time, the youngest Ebola survivor, Patrick from Liberia and his father. Also the first pregnant woman that survived Ebola, Josephine Karwah, beautiful human being. And in addition, we also produced a series of radio dramas that would air in each of the three affected countries, and then also facilitated, as we could, different ways for different stakeholders to come together and have discussions about the issues.

Vaibhav Srinivasan: Well, that sounds amazing. So all this was happening right during the Ebola crisis in 2014?

Meesha Brown: Yes. And then into 2015.

Vaibhav Srinivasan: And PCI media was right there in the field when it happened?

Meesha Brown: Yes. I, myself, went to West Africa twice during this period with a team from New York to also work with our teams there on the ground. And actually, because of the way that travel was situated, travel by ground, because air travel was impossible at that point, to all three countries. So crossing borders from Liberia, into Guinea, to Sierra Leone, and yes temperature checks and hand washing stations and the whole bit.

Vaibhav Srinivasan: So within narratives only through radio programs, or did you do anything else apart from that?

Meesha Brown: So the narratives are videos, so they're video narratives. You can actually see them online. I completely encourage everyone to look them up. They're beautiful stories and as you will be able to see, the people are amazing as people are. So we filmed 30 first-person narratives. They're actually award winning, Emmy nominated. We didn't win. But they're very special pieces.

Vaibhav Srinivasan: Emmy nominated, that's big.

Meesha Brown: We cut the audio from those videos into audio tracks that could also play on radio and podcasting. We had television broadcast, radio broadcast. We also sourced out the material through other organizations. Like, World Food Program would do a food drop. We would make the videos available to play at the food drops. And this is one of the things that is so fascinating to me about this particular program. So, in health emergencies the technical work has to catch up to the outbreak, just by nature of what's happening, and of course everyone's working very hard and trying to get the messaging out. But we began production with a sense of what the official messaging would be, but WHO's list of, I think at that time, it was 15 health behaviors, preventative behaviors was not yet released. So we began production, and just talking to these people that have survived. And Foday says, "I'm an ambulance driver, I went to this house, there was this little boy there, his family was dying. I picked him up and I consoled him. My PPE had a tear in it. Days later I was sick myself. I isolated myself. I went to the clinic, I took my treatment even when I didn't want to take it, I took it." Of course, these are the things he's saying. We produced the videos, the set comes out, WHO's messaging comes out.

Vaibhav Srinivasan: At the same time?

Meesha Brown: Around the same time.

Vaibhav Srinivasan: Okay.

Meesha Brown: So we've finished, we've wrapped production, there's no going back to fix anything.

Vaibhav Srinivasan: And WHO just comes out with their own preventive measures.

Meesha Brown: Yes. So I'm quite the data freak, I am. And so I ask my team to cross reference the messages that WHO is recommending, or the behaviors, and the messaging that has organically come up in the videos. And in every one of the videos there are at least eight of the recommended behaviors that WHO puts out. Up to 12 of the 15 in some of the videos.

Vaibhav Srinivasan: Are in the PCI videos?

Meesha Brown: Yes.

Vaibhav Srinivasan: Okay.

Meesha Brown: Because, this idea that people in the very same circumstances who have managed to survive this outbreak, they've contracted the virus and they survived understanding what they did. Of course, it's going to align to the technical messaging. But if you have a chance to see the videos, you see very clearly that they're not technical in nature at all. So, if I'm a regular person in Liberia and I watch Esther's story, it's just one mother talking to another mother. And saying, this is what I did. No technical language, no frightening presentation-

Vaibhav Srinivasan: Yeah. Something to scare them.

Meesha Brown: Exactly, it's very personable and engages you in your soul. In the place where you live as a human. And so then you think, well, Esther's no different than I am. So if Esther can go, I can go. If Esther can survive, I can survive. And you hear even many of the survivors in their stories saying this, but they realize that one of the things that they can do as survivors is demonstrate and encourage other people. That if they can do it, if they have done it, others can do it too.

Vaibhav Srinivasan: Well, that sounds really amazing, especially in a time where no one knew what it Ebola was trying to break the notion of fear and saying that you can still go about your life.

Meesha Brown: Yes. And so the campaign had three main objectives. Of course, one was to spread lifesaving messaging, go to the clinic. We know it's scary, but you need to go. Two, really to reduce stigma.

Vaibhav Srinivasan: Right, that's the biggest.

Meesha Brown: Yes, huge one because it impacts not only people's willingness to seek treatment, but also people's willingness to do what we wanted as a third outcome was the reintegration of survivors. So as people are surviving and they're coming back knowing that once they've had the virus there's immunity, they're not contagious. Of course, post-Ebola sexual activity needs to be controlled and monitored, but by and large it was a big deal for things like Ebola survivors coming onto radio shows and sitting with radio hosts. And then the radio host being fine and everyone knowing that's happening. Or us having public gatherings where people that have survived Ebola are there with us and we're eating together and communing together and communities seeing that and seeing that it's okay. So modeling that reintegration.

Vaibhav Srinivasan: So how did you convince Ebola survivors or someone to sit with an Ebola survivor? 'Cause one thinks the fear would be there on either side. So how did you break that barrier with one, the survivor, and the person on the other side?

Meesha Brown: Well, so for our team, of course we were with our partners on the cutting edge of all of the medical information. So we were all very comfortable with the fact that we were not going to contract the virus from a survivor. We were clear on that. So there was no hesitation. And we were also, unlike many other people, which is what are one of the things our campaign was designed to do, very aware of the preventative measures, the hand-washing, the monitoring for symptoms. So in the case that something did go wrong, we felt confident, one, that with the right care we would be able to survive. But two, that if one follows the preventative measures, that the risk of contraction is actually very low. I mean, yeah, it turns out. So it's a very scary disease, but actually the risk of contraction, if your burial practices are safe, if your hygiene practices are rigorous, you're probably not going to contract the Ebola virus. But in the overall narrative that was permeating at the time, that's not what one would think.

Vaibhav Srinivasan: Yeah, exactly.

Meesha Brown: Right. So on our side, we and our team, we were very comfortable. And then from the perspective of the people that had survived Ebola that were sharing their stories with us, we actually happened to be some of the first people that were so willing to engage in that way because there was lots of fear and misunderstanding and mistrust. I'm still connected with many of the people that we worked with today and we're Facebook friends like everyone else.

Vaibhav Srinivasan: Have you gone back to West Africa after that?

Meesha Brown: So only once more. And in fact there is a contingent who's saying "Meesha, when are you coming back again? It's time."

Vaibhav Srinivasan: Could you tell our listeners what the name of the video is so they can go and look it up?

Meesha Brown: #ISurvivedEbola, and if you type that into your browser or your search engine, so many things will come up. 30 videos, a music video-

Vaibhav Srinivasan: A music video? Okay.

Meesha Brown: Yes, yeah.

Vaibhav Srinivasan: So could you tell us more about the music video, which you guys created as part of the I Survived Ebola?

Meesha Brown: Yes. Yeah, so when we had the third 30 first-person narratives, but we believe in entertainment education, so we are Love not Lost, we're positive it's going to be a party. That's what's going to happen. So we partnered with a few of Liberia's really popular musicians, Takun J, Peaches, a few others to produce a music video called We Survive, a song and music video and it's a great song. I recommended it. I wish I had it with me to play for you. I'll send you a link.

Vaibhav Srinivasan: Right, please do.

Meesha Brown: I will, it's great. So we produced the music video and again, usual suspects, YouTube, television, Facebook distribution. And so, yeah.

Vaibhav Srinivasan: So what was the reaction to the music video? You just spoke about surviving Ebola and celebration of it?

Meesha Brown: Yeah. Celebrating the fact that your family and friends and community members have survived. Feeling, knowing from them that you can survive. Really for entire communities and for countries, your entire world is engulfed in this. And of course I've never lived this, I can only imagine and know from what people are telling me. But when our colleagues, when we would talk to them after the outbreak began, our colleagues in Liberia would say to us, "the streets look like it's the civil war. There are bodies in the street." So entire communities needed to know that there's hope that in the midst of something really scary you can survive, you can regenerate. There's, there's hope and these people that have survived actually contagion. If they can survive, then they're an inspiration to the rest of us. And so it was really inspirational, uplifting, and we would go do school visits and some of the people that made videos would come with us and the music artists would be there. And we'd put on concerts for students and do question and answer with them about Ebola and the after effects, and things like that.

Vaibhav Srinivasan: Well listening to all of this now we know that healthcare communications is actually very important and it's much more than what we know. So could you tell us the other projects PCI Media does? So I Survived Ebola was huge, but what are the other projects? You said you worked with the CDC, UNICEF, WHO, what are the current projects, PCI Media's working on?

Meesha Brown: So I'll stick to our health communications work because I know it's something your audience will be most interested in. But if you're interested, please feel free to go to our website to get a broader view of what we do. So in our health communications portfolio, we're working on a range of issues, everything from adolescent nutrition in Bangladesh to anemia, nutrition also, but around anemia and stunting with the World Food Program in Peru. Also, working on a long running serial drama, actually the longest running serial drama in Mozambique called Ouro Negro, which is actually the title alludes to the fact that it's set in a mining town in Mozambique.

Vaibhav Srinivasan: Okay, that's interesting.

Meesha Brown: Right? Because the way that we work is, it's not about messaging per se. So the messages are there, the information is there of course. But really it's about inviting people into a world where they can imagine a different way of living. Because to go back to the example of a smoker, imagine a world where you don't smoke.

Vaibhav Srinivasan: That's interesting.

Meesha Brown: What would that world look like?

Vaibhav Srinivasan: Well, much cleaner first, less death.

Meesha Brown: And so if you cannot imagine the world, you cannot create it. It will never happen. If it does not first exist in our minds and our hearts, it will not happen. So it's like coming to graduate school, there is a period of imagination. Some people call it planning, but there's a period of imagination. What would it be like to move to New York and come to NYU? What would that look like?

Vaibhav Srinivasan: What would that look like. Yeah, exactly. I feel that's what every student must feel like before they came here.

Meesha Brown: Exactly. So what we really try to do is, we're creating this new world called Ouro Negro, this imaginary town where there are people in this town that live very healthy lives. And they are able to provide for their children's nutrition, and make sure they are immunized, and take care of their own health as parents so that they can care for their children and their families. So it's about life and how within the constraints and pressures of life do we still manage to do these things that keep us healthy and happy.

Vaibhav Srinivasan: Through this longest running series, how have you been able to affect change in the community? You spoke about nutrition and immunizing their kids, taking care of the children, so how have you been able to modify behavior to get people to do this through the show?

Meesha Brown: So I have to say to you, I am not a fan of behavioral modification language. And that's me. Not everyone is me. So I have to say I'm speaking from my and my organization's perspective.

Vaibhav Srinivasan: Okay, apologies.

Meesha Brown: No apologies necessary because there are many ways to approach things. There are many ways to approach things and there are many who do approach the work in what we call the larger social and behavior change communications landscape, from the lens of behavior modification. And I'm not saying that that's not appropriate in some cases. However, what behavior modification requires, often, is continued reinforcement. It's built around a series of reinforcement. What allowing people to learn to take on new behaviors does, is allows for this idea of integration, so that it's not the behavior that I want you to do in the way that I want you to do it. It's, for example, feeding your children a nutritious meal. I may have my own ideas about what you should feed your children, but you may say, well actually in my district of Mozambique, these things that you're suggesting on my budget are not available to me. So this is the way that I'm going to integrate that understanding into my lived experience and make it happen. And so making room for the presentation of a different path, dialogue about that path, the dialogue is very important because not only does it allow people, the audience, the opportunity to process and integrate, it's also a great two way communication mechanism for service providers. So our partners, our health provider partners such as UNICEF and their health workers, we're able to hear what people are saying back about what's difficult for them, what are the barriers? And then that information can be used to really think about how can service providers better adapt their services to meet the needs of their clientele. To go back to the Ebola work, a great example of this was the initial guidance that came out about waiting three months to have sexual intercourse or using protection for that period. And the call in shows audiences were very clear. Number one, we're not so clear about that timeline. It sounds suspicious to us, which interestingly enough, the science followed people's suspicion about that being a long enough period. So they did actually change the guidelines later on. And secondly, people have a hard time having protected sex when there's not an Ebola crisis going on. So please understand that this is the context that you're dealing with when you're telling people to have protected sex. And so there needs to be some additional support for this community around the dire importance of them taking on this. So, people talking back, we're able to I think really inform some of the support and messaging that happened subsequently. So, it's more about people deciding to modify their own behavior. So we're really looking for people in our pre and post, in our rapid surveys and our SMS responses, are people looking for more information? Are they in better dialogue with their healthcare providers? Because today it's nutrition and then your child grows up and then you're talking about their HPV immunization, and you're talking about whatever other health care that they need as they're growing into a new stage of their life. So it's more about a lifestyle around certain choices and the role modeling that allows people to see that they can live in a different way rather than only focusing on an isolated set of behaviors.

Vaibhav Srinivasan: So it's not more about the behavior modification, but then them taking charge of their own behaviors and it's creating a dialogue between the healthcare provider and the people in the community. That is very interesting. So when we talk about behavioral modification, behavioral change, social behavior communication. I think one aspect, which is overlooked, is dialogue. And rather than giving people the power to make their own decisions, rather than us deciding what's best for them, because we wouldn't understand.

Meesha Brown: Yes. I understand the difficulties. As an educator, often it's very frustrating. Why won't people just do this thing that's very clear that they should be doing.

Vaibhav Srinivasan: Exactly.

Meesha Brown: Why do we even have to talk about it? But, again, to go back to the example about the anti vaccination movement. I think it's a great example of, for many, many years there is a compulsory component to vaccination in the US. If you want your child to be able to come to school, you take them, you get them vaccinated. Because if they don't, then you get a nasty note from the school and nobody really knows why. There's no dialogue about it. And so all well-intentioned, but of course what it's created is this vacuum of a common understanding and narrative around why we do these things and why they're important. That now we have, of course, thankfully a great community of activists and educators and medical professionals that are filling that void. But this is what the absence of dialogue leaves room for is misinformation, fear tactics, these types of things. So we want to keep that healthy dialogue going.

Vaibhav Srinivasan: Well at least now people know the other aspect of healthcare communications, creating a dialogue.

Meesha Brown: Yeah, definitely it's important and people love it. I mean what we find, people respond very well to it. And you have to have a tolerance for dissonance, and you have to have a tolerance for divergent thinking. But you can always use that to really help people understand the pros and cons, which in the long run is better for all of us.

Vaibhav Srinivasan: So can you tell us one thing that you look forward to, or ritual you have when you come into work?

Meesha Brown: One thing I look forward to? Well, so our offices are on the corner of 44th and First. So we're right in the thick of Midtown, Turtle Bay, all the UN. And our conference room, we're on the fifth floor and our conference room, overlooks the General Assembly. So it's beautiful to go, and we see all the flags along First Avenue and there's sunlight streaming in into the conference room when the days are sunny.

Vaibhav Srinivasan: Right, like today.

Meesha Brown: Like today. So I do love to make my cup of coffee and go back to the conference room and look at the world, as it were.

Vaibhav Srinivasan: Painted a lovely picture right there. I'm picturing it right now.

Meesha Brown: Well you're more than welcome to come visit us anytime.

Vaibhav Srinivasan: If we can, definitely. I would definitely love to come and check out PCI Media.

Meesha Brown: Yeah, we'd love to have you over. Thank you.

Vaibhav Srinivasan: So what advice would you give MPH students who are about to graduate? How can they set themselves up for success? Especially in this line of work?

Meesha Brown: So, in the line of healthcare communications I would say: explore. As I said, there are many different ways of approaching this work. There are a growing number of organizations that understand the importance of this work. And often we're finding that even the organizations that we partner with, there are positions within those organizations where they don't do the breadth of work that we do, but there are people or a team responsible for coordinating the type of work that we do. And so if it's a field that you're interested in, it sometimes can be a little difficult to find. But, I would say explore, really talk to a ton of people. We're all communicators, we love to talk. And also, I think be open to trying new approaches and learning, and having fun.

Vaibhav Srinivasan: Well, thank you so much for coming today Meesha, and talking about PCI Media, about your Emmy nominated video series, I Survived Ebola, the music video. I think this opens up a lot of scope for what is out there and what people can achieve by working with communities and opening up a dialogue. So thank you so much for coming in.

Meesha Brown: Thank you so much, I appreciate it.