One year ago, 9,000 people in Mumbai started to gather in Dharavi, one of the largest informal settlements in the world, for an artistic festival unlike any other.
Visitors to the Dharavi (or Alley Galli) Biennale, which launched in February 2015 and ran for three weeks, were confronted with puppet shows about tuberculosis, Bollywood-style portraits of healthcare providers, a quilted map depicting violence hotspots and many more provocative exhibits that encapsulated health education in art.
As befits Mumbai’s status as one of the largest cities in the Global South, Dharavi alone has one million inhabitants crammed into less than one square mile.
“Dharavi and its people are really rather famous,” says Professor David Osrin of the UCL Institute of Global Health, who is a Wellcome Trust Fellow and a driving force behind the biennale. “As a hallmark informal settlement with all sorts of health problems, it’s almost trotted out as a kind of buzzword at conferences. But we’re very much aware that the people who live here are not aware of the debates on indoor air pollution, active transport, infectious diseases, emerging and old infectious diseases and so on. We thought we’d reflect back all of those subjects to the people those subjects actually affect.”
The biennale was the product of a partnership between UCL, the Wellcome Trust and local non-government organisation SNEHA (Society for Nutrition, Education and Health Action), which sought to intertwine art and science to improve public health.
“The aims of the project were quite high-flown,” Osrin reflected in a public lecture in May 2015. “We wanted to publicly acknowledge the huge contribution of urban slumdwellers to economic and cultural life; democratise sharing of information on urban health science; encourage artistic creation in a forum in which professionals and amateurs develop ideas together; and communicate with urban health experts and the public.”
Health is not a single issue
Originally a paediatrician, Osrin started working with SNEHA more than a decade ago, using participatory approaches to improve newborn survival in Mumbai’s informal settlements. Through his work with SNEHA’s Dr Nayreen Daruwalla, an expert on gender-based violence in India, it became quickly apparent that the health of women and children has multiple interconnections with other issues in informal settlements, from fertility and reproductive health to nutrition and gender-based violence.
Thanks to a small international engagement award from the Wellcome Trust to foster dialogue in the communities affected by these related issues, the team organised ‘Dekha Undekha’ (‘Seen Unseen’) a year-long initiative culminating in 2012 that saw people living in Mumbai informal settlements introduced to professional artists. Discussions on sanitation, domestic violence and maternal health played out through textiles, ceramics and photography led to a well-attended exhibition of original artworks in a local school.
“We wanted to publicly acknowledge the huge contribution of urban slumdwellers to economic and cultural life.”
Having captured the imagination of locals and more funding from the Wellcome Trust, Osrin and his colleagues determined to go larger with a ‘biennale’, remaining faithful to the aim of fostering dialogue provoked by Dharavi residents’ perspectives and ways of life.
Osrin expands: “There was quite a strong mandate that artworks would use recycled materials, consider recycling behaviour, examine health issues, involve research, make people think – and not be about ‘messages’,” (a lesson that had emerged from earlier experiences working with women’s groups on health issues).
Healthy creativity: thinking inside the box
The Dharavi Biennale organising team, led by Dr Daruwalla, decided to support professional artists – from India and beyond – to work with groups of Dharavi residents on urban health issues to produce artworks for the festival.
For two years the artisans and locals collaborated, ultimately producing 17 ‘art-boxes’. The results were strikingly original and vibrant. The Provoke/Protect art box questioned the idea of women’s clothing as provocation for rape. Ten Dharavi women were mentored by textile artist Susie Vickery and fashion designer Nika Feldman, and went on to make saris filled with protective symbols from popular culture and socio-religious beliefs, such as horseshoes and traffic lights.
One group of Dharavi children mentored by artist Nitant Hirlekar took 300 photos documenting the occupational hazards of industries in their area, such as plastics recycling. They learned how to compose the photographs while learning about the need to wear gloves while cleaning glass bottles.
Air pollution was the theme of the Growing Fresh Air art-box, led by urban gardener Adrienne Thadani and designer Nicola Antaki, which used learnings from NASA about the ability of houseplants to produce fresh air. An area of Dharavi inhabited by potter families is smoky and polluted from their kilns, yet their livelihoods depend on producing pottery. The families learned about local plants such as the areca palm and the snake plant that can filter toxins from the smoke, and space-saving gardens of these plants were installed by residents as a result.
The Safety Deposit Box sessions involved Dharavi women and girls creating miniature rooms depicting places where they felt safe, sparking discussions about safety and gender-based violence in Dharavi, and helping women identify safe spaces where they could go in their community.
A local recipe for success
“There were many and varied constituencies,” says Osrin. “Women, men, young people, children, artists, designers, artisans, healthcare providers and the media; the media really got behind it.”
Indeed international press ranging from the Wall Street Journal and the Guardian to Buzz Feed hailed Dharavi Biennale as a massive success, and even the art world embraced the concept, with a number of commentators noting that the Dharavi Biennale took more account of the sense of place and involvement of local people than other more established biennales.
The scale and commitment of local people was impressive: 450 inhabitants of Dharavi took part in creating the artboxes over a period of two years. Charity professionals confirmed the difficulty of securing a groundswell of local support for development projects during a discussion following the screening of a film made for the biennale by local residents with UCL’s Development Planning Unit. So why did the biennale succeed?
SNEHA’s Dr Nayreen Daruwalla is certain that Dharavi residents took part so enthusiastically because SNEHA knew the community through years of working with them closely. “You cannot do a project of this magnitude and scale unless you have the community buy-in,” she says. “You cannot just go to a place where you have never worked and start undertaking this process.”
“It’s your development dictionary dream to try to encourage community buy-in to something that originates from outside,” Professor Osrin remarks. “But you also have an ethical duty to respond to the issues that arise as a result of a project like this. Unusually among NGOs, which are often combative, we have always partnered with public sector services. We have a long-term partnership with the municipal corporation’s health services and we work with lots of doctors, nurses and administrators from those services to try to improve them.”
Artist Dilip Thawal, who led an art box for the biennale, confirmed the inherent scepticism his community usually has for people from the outside, saying that “if a foreigner shows up, we make fun of them.” But this process was different: “Biennale and SNEHA did a very good job in collaboration”. Paying the art-box leaders for their time and artwork strengthened the perception of the project as a fair and trust-filled interaction.
Mediators of engagement
Osrin describes engagement as “facilitating an elusive process”. ‘Participation’ means different things to different people, and while the organisers wanted the art-box leaders and Dharavi residents to have as much autonomy as possible, it was fundamental that the original health aims were realised.
Osrin and Daruwalla recognise that such intervention in an artistic process may not form a purist participatory approach, but it was crucial to ensure that the art stimulated health conversations with depth and, even more importantly, accuracy.
They also had to engineer the process in other ways to help ensure success. Putting together artists, scientists and local residents wasn’t always a natural combination for harmonious working. Some artists had no experience working with groups; others had a clear idea of a piece of art that they wanted to produce, but it didn’t necessarily have a health aspect and wasn’t always the result of a democratic discussion with the participants.
As a result, the organisers had to meld different sets of experiences, personal agendas and factual health information carefully to have the best chance of success.
The challenge of measuring impact
Despite the wide praise for the project, Osrin is surprised that more difficult questions haven’t been asked. Can you do art about health issues? And how can you really measure the impact of a project like this?
“We’re not intimidated by these questions,” Osrin explains, “we’re really rather engaged by them. We spend a reasonable amount of time at fora and discussions where people debate this.”
“In terms of public engagement, we did engage people of Dharavi to have conversations around health, and to have their creativity transferred into artworks,” says Daruwalla. The change we saw in most of the participants was the ownership they developed.” As well as learning about health issues through the art-boxes and resulting artistic outputs, the Dharavi residents naturally started to think of possible solutions to the issues facing their community too.
“Whatever I’ve learned here, I pass on to my children… I speak to them with a free mind, keeping aside all shame.”
This is exactly what the organisers hoped to achieve. “You can’t give someone a health message and measure a direct change in behaviour,” Osrin says. “It’s about starting conversations with the people who they actually affect.”
There is poignant anecdotal evidence, however, that some residents have already made fundamental changes as a result of the biennale. “We learned some principles for life,” one participant states, who decided to speak openly to her family about sex education and the risk of attack, having suffered abuse as a child. “Whatever I’ve learned here, I pass on to my children… I speak to them with a free mind, keeping aside all shame.”
Twelve-year-old Asmaan said, “I would get anxious every time I was expected to interact with a large group of people. And then I did the play… The regular practice and the performance changed something within me. Now not only am I free of my anxiety, but I am also one of the first to sign up for performances in my school. Now I love performing on stage!”
Other participants described how the project gave them confidence, opened up new ways of expressing themselves, helped them work through difficult times at home, and how they felt empowered by being charged with educating their community about health.
There was also a ripple effect of impact for the local artisans involved in the biennale. Art-box mentors such as Dilip gained more commercial awareness about the work that they do, such as the cost of materials and how much they could reasonably sell their work for. The global media attention on the biennale created unexpected opportunities too; Dilip was commissioned by curator Nick Tobier to produce an artwork for an exhibition in Detroit. “Sometimes wealth can be made from waste,” he reflects.
Measuring the impact of a project that uses art to increase understanding of health can be an imprecise business. Uncertainty in how to measure impact is often perceived as being unscientific, breaching the comfort zones of many academics – and philanthropists.
Daruwalla acknowledges that the ‘feel-good factor’ of NGO work simply doesn’t cut it any more. “Funders want to know impact. If you’re not in a position to show impact, you don’t reach that world-class league for the work you do.”
“UCL brought academic rigour and experience of evaluation to NGO activism,” says Osrin. To match the artistic nature of the project, the organisers adopted creative ways of measuring and evaluating the project, with “arty” and “comicky” methods of classifying the findings, including infographics and a comic-style treatment of the debate on evaluation, alongside the more conventional qualitative formal evaluations by social science researchers, and quantitative measures of participation, such as numbers of participants, outputs, visitors and website traffic.
Moving on: a digital, globalised biennale
Still basking in the praise that’s been heaped on the Dharavi Biennale, the pressure’s on to continue the fruitful work that SNEHA, UCL and the Wellcome Trust have started.
Daruwalla thinks the next biennale should “bring Dharavi residents out of Dharavi… There is a lot of talent, but that talent is never shown to the outside world.”
“We’re looking at a digital, globalised Dharavi Biennale to bring the outside in and the inside out,” Osrin expands. “Perhaps in real time, perhaps performances simulcast to other places or with other participants in other places doing parts of the same performance.”
It’s a powerful relationship that enables a blend of action with research and evaluation – and great ambition. Ultimately, thoughtfully-conceived projects with a rigorous framework can empower communities to thrive.
“A lot of my work in public health research involves counting stuff and counting people,” says Osrin. “But my work is also about showing that the people we count, count. Everywhere is somewhere and everyone is someone.”