Focus group discussions in the study area
Following the second round of expert interviews, the song was translated into Tshivenda. The song was then workshopped by the musicians and they adjusted the tempo as well as simplifying the lyrics and making changes to disease determinants. They quickly established that a certain style of drumming would need to be selected, as traditional Vhavenda music had a specific rhythmic component and the speed needed to be adjusted so small children could dance or move to the beat. It was also agreed that repetition should be central to the song structure. Every verse, would start with ‘nne ndi vhunyunyu’ (I am a mosquito), and end with ‘ndi na malaria!’ (I have malaria!).
The full-length song (for children older than 5 years of age) as well as a simplified version that included fewer verses (for children younger than 5 years of age) were recorded. The songs were then played to the two focus groups in the study area. The overall feedback from both focus groups was unanimously positive. Many of the members of the first group (mothers, teachers and grandmothers) started joining in singing and chanting to the beat of the song. One mother had a young child about 3 years old with her and her little boy started dancing to the song, with the encouragement of the mothers and grandmothers!
One mother said, “We can’t wait to hear this on the radio.”
Another said, “I think it’s so import to start teaching kids early about these things through music; maybe more things could be done like this in the future.”
Neither group, however, was positive about indoor residual spraying (IRS) being included in the song. Group one (caregivers) said that if they were not home they did not want children letting strangers into the house. Group two, some of whom were officials responsible for IRS in the study area, were also worried about young children coming into contact with the poisons being sprayed, they said that generally they sent children far away during spraying.
Both of the focus groups believed that adding the symptoms of malaria was important to early diagnosis. This would help children to tell their parents or caretakers they may have malaria if they knew what it felt like. All respondents in both focus groups felt the song and music were both culture and age appropriate. One preschool teacher in the first group said: “Well Yes! The repetition is important I think. This is going to make children learn faster, and I like how it connects mosquitoes to malaria.”
One of the musicians involved in developing the song, helped facilitate the focus group meetings, as he came from the study area and spoke fluent Tshivenda. Few members of the first focus group spoke English fluently, so he was able to explain the questions and sing parts of the song in the vernacular, as well as modifying the lyrics in accordance with the suggestions of focus group members. Respondents talked to him freely in Tshivenda about the changes they wanted and modified words and phrases so they would be easily understood by village children. The members of the first focus group felt strongly that sleeping under mosquito nets should be added to the song. This came as a surprise, as the experts had said otherwise.
Caregiver 4 (a grandmother) said, “I think adding nets to the song is very important”
Researcher replied, “Oh! Do you have nets in your house currently?”
Caregiver 4, answered, “EH! I have!
All respondents were then asked who used nets at home. Four of the seven women currently used nets currently in their houses. One noted that she understood that she needed a net, she just had not purchased one yet. After the first focus group discussion, caregiver 4 led the way to her house where she showed everyone her mosquito nets. They were not obtained free from the government, the village women purchased them from a small village shop nearby, called “The China Shop”.
During informal discussions with the first focus group members, all seven agreed strongly that malaria symptoms should be added to the song so that sick children could be taken quickly to the clinic for treatment.
Caregiver 1 said, “I think symptoms are important for children to understand, so they can tell their parents when they are feeling sickness.”
Following this, it was decided to add verses about bed nets and symptoms to the song lyrics. The musician asked the advice of the village women in the first focus group, on how best to include these ideas in the lyrics. The women suggested Tshivenda words that small children would understand easily and that made sense. They also sang them, to show the musician how to incorporate them in the rhythm and beat of the traditional music. This was truly a participatory research approach, as women in the study area are adept at improvising songs about village life and the young musician grew up in the same area.
The first focus group agreed unanimously with the words of the song, after he had changed them. All participants agreed that the words were no longer ‘complex’ or ‘deep’ Tshivenda terms; and they liked the repetition of the first and last lyric. It was felt that even if the children might not learn all of the lyrics initially, they would understand and sing along with those being repeated throughout the song. When asked if the song was age and culture appropriate, two members of the first focus group commented:
Caregiver 1 (a mother) said, “Yes! It is! And I think that all children will be able to learn it fast.”
Pre-school teacher 1 said, “Well Yes. The repetition is important I think.” “This is going to make children learn faster like she said, and I like how it connects mosquitoes to malaria.”
During the song improvisation, those from the first focus group also suggested adding motions and actions to the lyrics. They thought children would learn better, if actions were attached to some of the words. Caregiver 4, who was a pre-school teacher, even suggested:
“Umm…what if this were paired with a game?”
The possibility of a game about malaria, attached to the song, had also been brought up by one of the experts from the early childhood education sector consulted during the opinion surveys.
The second focus group, which included only adult male respondents from the MCP, did not contribute as much as the first group. However, the questions and answers, that were relevant to the song process, are narrated below.
The researcher asked, “Are the determinants used in the song the most important, or would you use different determinants to prevent malaria for children under the age of 5?
Second group, member 2, answered “The only thing I see missing would be the symptoms. I think that it would be ok to add them so that people can understand, even if it’s just fever or headache so they can understand. Sometimes flu can be misunderstood.
Second group, member 3, contributed, “I think that IRS is too much for children. You know some people have stigma against the sprayers and they don’t let them spray. So I think maybe the song should just talk about accepting the sprayers but not discuss spray because maybe the children will get the doom spray thinking its IRS and then that child could harm himself, just because he wants to help out.”
The use of bed nets for young children was also suggested by the second focus group. All members of the second focus group agreed the song was culturally appropriate and they said they liked it. As the first focus group had also felt negative about IRS, suggested the use of bed nets and wanted the children to recognize the signs of malaria, these three suggestions, were subsequently incorporated in the lyrics.
On returning from Thohoyandou, the group of musicians and the Venda cultural expert, convened in a recording studio in downtown Pretoria and reworked the changes to the lyrical content. The
Zwidade rhythm was programmed into a computer, using recording software, and an appropriate tempo was set accordingly. The repetitive structure at the start and end of each verse was kept, but it was decided that for maximum impact and potential participation for children who might not remember all the lyrics, the final line of each verse (
ndi na malaria!—I have malaria!) should include a multitude of voices, giving the aural impression of a sing-along, with loud hand-clapping. The final song is included as a sound byte (Additional file
1). In the Tshivenda language, a singular mosquito is
lunyunyu. In the plural, this becomes
vhunyunyu
The final lyrics of the malaria song were:
(The English version was translated verbatim from Tshivenda)
Verse 7 (×4)
Ri vhana vha Afrika
We are the children of Africa
Ro pandela vhunyunyu
we chased away the mosquitos
All the above were then repeated.