A great deal of time and effort these days goes into making TV medical dramas both authentic and technically accurate. But it would appear that an unlooked for bonus of such detail is that these dramas – whilst being mainly entertainment vehicles- unintentionally improve health awareness in the watching public. They do so by providing accurate health information and can cause individuals to take action in regard to their own health or that of their family. In other words, take action to achieve “wellness”. These dramas can thus aid the current shift of focus of governments and public health practitioners to deliver Health & Wellness, aka Health & Wellbeing, (a National Wellness service rather than a National Health service?)
This shift to Wellness i.e. staying healthy, is in response to the rise of chronic diseases and inequity. The aim is to empower the individual to make healthy choices and to address the social, environmental and economic factors which limit that choice. Health awareness is therefore a prerequisite for wellness.
Call the Midwife, the hit medical TV drama, works hard to depict accuracy and authenticity
An essay in April's Journal of the Royal Society of Medicine describes the steps taken by the writers, production team and actors of the hit BBC TV series, Call the Midwife, to ensure the series has sufficient medical accuracy and authenticity [the series is set in the poor Poplar district of East London during the early years of the National Health Service (1950s)]. The series is viewed by more than 10 million people each week, and sold to almost 200 territories worldwide.
The author of the essay is the actor Stephen McGann who plays the local community docter [GP], Dr Patrick Turner.
As one would expect, a clinical advisor [a practising midwife and lecturer] oversees childbirth and nursing procedures but this series has gone further. Open-access journals and the Wellcome Trust archive are used as resources by the writer, and relevant health charities are called upon to provide an insight into the health impact of social conditions of the time. McGann himself deliberately chose to make his character a smoker “after reading a BMJ study* [by Richard Doll: Mortality in relation to smoking’: 50 years' observation on male British doctors BMJ 328 (7455): 1519] which observed the effects of smoking on men over a 50-year period, starting in 1951. A total of 34,439 smokers took part in the research – all of them doctors.” [*The first publication based on this cohort was in 1954 and is in the Global Health Archive database: ‘The mortality of doctors in relation to their smoking habits ’. BMJ 328 (7455): 1529.]
But McGann then goes on to explain that the medical accuracy and authenticity pioneered by ‘Call the Midwife’ has communicated valuable insights to ordinary people into important public health issues …giving them the information to improve their own health.
He gives us two examples:
- Advancing health for women and children
In 2014, the Call the Midwife production team was asked by the charity, BBC Media Action (see Pushing boundaries: A TV birth in Bangladesh), to provide technical assistance to a Bangladeshi TV company. The company wanted to depict authentic birth scenes in a new TV health drama [Ujan Ganger Naiya (Sailing Against the Tide)], something which had not been done before on Bangladeshi TV. The collaboration succeeded in communicating safe maternal health practices in a conservative culture where discussion of pregnancy and childbirth is still considered taboo.
- Improving uptake of vaccination in the UK
When an episode of ‘Call the Midwife’ featured a mother with diphtheria [15 February 2015], the “NHS Choices website reported that user enquiries for information on diphtheria increased by a massive 3720% – with 30,000 visits occurring during transmission”.
Advancing health for women and children forms part of the current discussion of the sustainable development goals (SDGs), which will succeed the millennium development goals (MDGs). Richard Horton in The Lancet Offline: Where are the women and children? comments on the SDGs and how vital it is to communicate “the new knowledge produced in recent years—on tackling epidemics of pneumonia and diarrhoea, reducing newborn and stillbirth deaths, boosting midwifery services, and improving nutrition – directly to those on the frontline who have the power to act” [i.e. all caregivers including mothers].
You may wonder why Stephen McGann felt able to write this article…it turns out researching his role led him to be inspired to take an MSc Science Communication at Imperial College, London!
USA medical drama…what do they do?
Impressed by the public health impact of Call the Midwife, I turned to USA medical drama and found that there is an organisation called Hollywood, Health & Society (HH&S)which provides specially tailored health & climate change information FREE to help writers, directors and producers make their shows and films accurate. It was set up by 2 public health organisations in 2001, one of which includes the Centers for Disease Control and Prevention (!), and is now supported by several other globally known health organisations. All it takes is a phonecall to HH&S to bring a group of experts to the writer’s room or to set up a field trip. Their advice is usually called upon for clinical issues but it has been used for “public health issues” like skin cancer, obesity, teenage sex, and even the problems of finding an organ donor when you are of mixed race or Afro-American (we have this problem too in the UK). HH&S believe that this way of working, using a narrative, is more effective ultimately than standard public health messages because the viewer engages with the characters and is not being lectured.
The use of narrative (e.g. travelling plays and radio soap opera) to deliver health messages is not new: its common practice in those working to improve health in poor communities in Africa, Latin America and Asia. But in high income high literacy countries, public health messages (in the adverts) and health awareness days are more commonplace.
What is new, and McGann and the HH&S have recognised, is that helping writers provide accurate, authentic, health information whatever the outlandish medical storyline they wish to use, ultimately delivers effective health awareness to the population.
As McGann says: “In an age when complacency or misinformation regarding the safety and purpose of vaccine [vaccination] threatens the return of previously eradicated contagions, the power of dramas like Call the Midwife to raise medical awareness should not be underestimated.”
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