Research Review W 17.1 (2001)91-95 MUSIC AND HEALTH MESSAGES Misonu Ainu The mention of music in health related issues readily brings to mind the use of music for curing diseases, which is best referred to as Music Therapy, Music Therapy is approached differently depending on the kind of disease involved. In traditional situations for instance, a priest or a priestess is responsible for curing diseases and music is provided as a means of possession to direct the medium (priest/priestess) to effect cure. Mokwunyei (1.992) makes a comparative study of music and healing in Nigeria and Ghana. In this case, music making thus features dominantly because it is believed that the deity involved is possessed by the medium, through music. In our contemporary world the use of music for healing takes a different form. The therapeutic value of music for alleviating mental disorders, physical distress and other such conditions is widely recognized, In such cases the patient listens and may take part in the music making. It has been proved, as indicated by Twerefoo (1979/80), that a systematic application of music in mental homes has actually produced very effective therapeutic results. However, the concern here is not that of using music to heal a sick person, but to use music as a means of delivering or carrying health messages. The issue of survival and care in our changing cultures has become a global concern. The youth and adults alike, in the quest to survive or earn a living or amuse themselves have been exposed to all sorts of health hazards through their own behaviour, often behaviour which would not have been permitted by customary mores and traditional practices, A rapid increase in social vices has resulted in the spread of various diseases. For the sustenance of a healthy society, there is the need for a careful planning of childbearing and the prevention of such Sexually Transmitted Diseases (STD's) as HIV/AIDS as well as other health interventions. Thus a conscious effort is being made globally, to promote family planning and also to combat, the spread of this deadly disease HIV/AIDS. To achieve effective and successful results, various means of getting the appropriate health promotion message across are being sought. The Center for Communication Programs in Johns Hopkins University has conducted extensive research on health issues. In this study, the Entertainment-Education approach described as the use of entertainment for ecM.icati.onal purposes was developed. The quarterly journal, International Family Planning Perspective (2000), stated thai entertainment-education is a communication strategy, consisting of the insertion of educational or motivational information into entertainment media. The entertainment-education (enter-educate) concept (which aims at change of behaviour) has thus been used by John Hopkins University for over a decade to communicate health messages in many countries including India, Mexico, Turkey, Egypt, Philippines, Zimbabwe, Nigeria and Ghana to mention just a few, to promote family planning and to stem the spread of HIV/AIDS. Some of their findings were that health messages could be effectively communicated through mass media, entertainment and media, advocacy. Indeed, much has been achieved by means of the media and entertainment. So in effect, by way of entertainment, health messages are communicated through drama, concert-parties or soap operas, songs or any form of such. My intention here is to focus on the use of songs in the enter-educate approach as a means of reaching society on health, issues. The use of music as a means of communicating messages and developing issues and as a source of entertainment emphasizes its rttuliifaceted role in many societies. In fact in Africa, music forms a significant part of the culture of most societies and its prevalence in the life of the African right from birth to death is evident, it is therefore, not 91 surprising thai contemporary songs on social vices have been part of She Ghanaian culture. Musicians are usually sensitive to whatever is going on in their societies, and latterly, their sensitivity is geared towards HIV/AIDS and other health interventions. Therefore, as their contribution in waging war against this deadly disease, musicians are proclaiming their message through songs. To what extent is the impact felt? Lessons from Some Societies First of alt I would like to discuss some of the successful studies undertaken through the enter-educate approach. Then I will attempt to find out to what extent the enter-educate approach has been effectively used in Ghana. In the studies carried out by John Hopkins the first step was to caution the youth through songs about immoral practices and encourage them to desist from rushing into sexual relationships. Songs were thus composed to promote family planning. In the Philippines, Lea Salonga performed songs written by Manny Aquino urging people to resist unwanted or mistimed pregnancy and warning them not to make wrong decisions. The following is an excerpt: There's so much in life That we would like to do. We can wait for love Until we know it's true, ft's up to us Not to jump into that situation... (Health Communication 1991), The songs, it stated, were promoted on T-shirts and posters, through contests and in radio and TV spots, and were also linked with a telephone hotline. Prisma, a Mexican musician wrote similar songs for use in Mexico. See excerpt below: Hear how our heart beats, Hear how fast it beats. Waif. Feel how this great love grows. Feel how everything is shaken up. Understand. I no longer can, I no longer can. I wan! you in my arms, I want to love you... (Health Communication 1997/ The Nigerian songs, '"Choices" and "Wait for me" written by Onyeka Onwenu and King Sunny Ade respectively were performed jointly by the two. Excerpts follow: Choices, Choices, Choices, We can make the choice. This is the time When we have to make a choice. Take a stand On the kind of world we want. Is it love with peace of mind, Or children we are not prepared for? We can make the choice .., (Health Communication 1 997j, All these songs basically carry messages of family planning encouraging young people to avoid pre-marital sex and make love without making children. When a person engages in a sexual relationship at the right lime, only then are the chances of unwanted pregnancies and being infected with STDs very minimal. In Nigeria, the Planned Parenthood Federation has 92 Rcsrarch Review US 17.1 (2001)91-95 established a high-powered advisory panel composed of religious leaders and other respected individuals to review such compositions before their release on the market. Such a body here in Ghana could regulate or monitor the ethical standards of our musicians, to prevent the flooding the market with compositions with derogatory and dehumanizing lyrics and encourage and challenge them to focus on writing meaningful health related songs. Ghanaians need to be fed more with songs that caution society against social vices. Writing under the heading "Effects of an Entertainment-Education Radio Soap Opera on Family Planning and HIV Prevention, Vaughan et al. (2000), produced "Apwe Plezi", a radio soap opera for broadcast. The actual purpose of the study was to assess the achievements of its educational goals. The programme was broadcast over a period of 2 years from February 1996 to September 1998 in two phases. Phase 1. (Feb. 1996 - May 1997). With each episode lasting 15 minutes and broadcast 4 days in a week on Radio St. Lucia, a total of 260 episodes were covered within the period. Phase 2. (July 3997 -• September 1998) 105 episodes were broadcast. This time two new 15 minutes episode were each aired three times in a week. To augment the effects of this programme, the RARE Center in collaboration with the St. Lucia Planned Parenthood Association organized other activities (Family Planning Perspectives 2000). These included, a street theatre performance featuring the "Apwe Plezi" characters, story updates of "Apwe Plezi." that appeared regularly in the local press and advertising the programme on bumper stickers and billboards. Results of the broadcast, showed that. "Apwe Plezi" was the second most popular programme on Radio St. Lucia. It was also the fourth most popular programme on any radio station in the country. This then is a clear indication that a lot of people listened to this programme and got to know about HIV/A IDS, teenage pregnancy and family planning, A survey conducted after the production showed that about 60% look cognizance of its educational value. From these studies., then, it is evident that serial dramas, soap operas and songs have successfully relayed enter-educate messages about reproductive health on radio or television. John Hopkins developed a formula for the Enter-Educate approach, to help explain why entertainment is effective in the dissemination of information on health practices (Piotrow et al. 1997). It is clear that this approach can be very effective at all levels. Towards Adopting the Enter-Educate Programme for Ghana. One very important factor to note from the John Hopkins experience is that programmes based on enter-educate must be carefully planned following a series of planned stages. It also stressed the importance of studying audience preferences for a successful enter-educate approach. And again, good materials that have been approved can be exported for use in other countries. For instance, a feature film about AIDS, "It's not easy", produced in Uganda was distributed to more than 60 TV stations throughout -Africa in English and French. The effectiveness of this production in other countries has been confirmed in Kenya and Zimbabwe, Discussions were held among friends, people reverted to practicing monogamy or using a condom. In fact, URTNA (Union of National Radio and TV Organizations of Africa) has fully supported the exchange of radio and TV programmes to the extent of even dubbing fiims and videos into different languages when the need arises. Such, dubbings include programmes on family planning, prevention of HIV/AIDS and other STD's, child survival and other health issues (Piotrow etal. 1997), The study also revealed that a great number of people are readied through illegal pirating. For instance., the tapes, "Choices" and "Wait for me" were found on Ghanaian markets within a 93 month of their release in Nigeria, This no doubt deprives the rightful owners of legitimate income, but you just cannot help it now, John Hopkins in conjunction with Ghana Ministry of Health used popular highlife music and concert parlies during the family planning campaign in Ghana, to convey the campaign's messages. The campaign theme song "Awo dodo", by S.K. Oppong became a national hit. The end result was that, the campaign was fun! Mass media messages were cast in entertaining formats on audiocasseltes featuring popular highlife music, video and film shows or live drama performances. The campaign entertained, informed and educated. It also worked" {Partners in Family Health, 1992). Indeed, the success of education through entertainment was clear, A few years ago, as part of the campaign for the prevention of HIV/AIDS, Ghanaian popular musicians were invited to compete in a contest for the selection of a suitable song for the purpose, James Ampadu's song "AIDS rtnye" won the contest. The song urges everyone to avoid indiscriminate sex because AIDS is deadly. But the song died out just like that without any notice, perhaps the broadcasters may be in a better position to tell us why. Lately there has been a release of a musical video on AIDS by All Stars of Ghana. This production is by a team of Ghanaian musicians and may be described as a medley. Some of the artists are Stella Dougan, Tic Tak, Diana Akiwumi, Paapa Yankson, The song is in highlife- hiplile-rap vein and in different languages. Excerpts follow: You can maintain one lover If it's not on it's not in You can wait until marriage Love life, stop aids. Fante Dzi nokware ma wo hokafo Se etwa nkontompo a Ebohu de bone nsuma da Aids yareba yi Se ekefa ba fie a Na awerehow aba English Be faithful to your partner ft does not pay to lie to your partner AIDS is deadly If you come home with it You bring sorrow... With this type of production, I believe that both voting and old will well receive the message as each and everyone will get a taste of their music. It seems to me that this song is the only one that is shown on TV these days but sadly enough it does not appear as often as one would expect. It is usually accompanied by the inscriptions "Stop Aids Love Life" and "If it's not on it's not in". I am tempted to say that Ghanaian musicians have done very little in the promotion of health issues. Nevertheless, it will be interesting to find out from the traditional musicians what they are doing or how they are also composing songs to educate the community at large. Or whether in fact, they are concerned about the issue at all, 1 am convinced that there are songs to create awareness to a certain level of consciousness. I also believe that to a very large extent, the songs that are produced, in the areas of study, are making a solid mark or impression on those to whom they are targeted and this obviously is welcome news. 94 Research Review NS 17.1 (2001) 91-95 Conclusion To conclude, I would like to quote Piotrow et al, (1997) writing on changing channels of communication: The world is undergoing a communication revolution, and communication now aims to spread new community norms and encourage new individual behaviour. As more channels of communication become available, audiences will have choices for information gathering and information sharing. Thus health communicators will have to work harder to attract audiences' attention. At the same time the growing number of channel means that messages can be more easily addressed to specific audience segments. Musicians in general are looking ahead and are therefore composing to make a meaningful and positive impact in our lives. What do they say? How does society receive the message? In other words are they really making any meaningful impact in our lives? What kind of audience do they target? How often and in what context are such songs performed? So in effect, are their songs promoting the infection of AIDS or helping to stern its spread'7 All these and other related issues need to be investigated in a research study. The campaign for the prevention of HIV/AI.DS is still on. Since music plays an important part in African culture, this awareness should be revamped musically. It is important therefore, that our musicians put their ideas together and produce more songs to get the HIV/AIDS prevention message across. We need a global reformation of musical health education, in our lives. References Ghana Ministry of Health, 1992. Partners in Family Health, Pp. 12-14. Mokwunyci, Joe Ngozi, 1997, A comparative profile of music and healing in two African locations: Nigeria and Ghana. Unpublished paper presented al the International Conference on Music and Mealing in Africa and the Diaspora, at University of Ghana, l.cgon. Piotrow, P.T, el al. 1997. Health Communication: Lessons from Family Planning and Reproductive Health. Westport, Connecticut: Praegcr. Twcrefoo, Gustav Oware, 1979/80, Therapeutic Value of Music for Mental Disorders. The Fifth Inter- Faculty Lectures, University of Ghana. Vaughan, I\W., 2000, Effects of an liritertainrnent-Education radio soap opera on family planning and HIV prevention in St. Lucia. International Funnily Planning Perspectives 26.4: 148 - 157 95