Dr. Joseph O. Prewitt Diaz Head of Programs – India American Red Cross New Delhi, India Dr. Seema Pawar Director – Capacity Building and Material Development American Red Cross New Delhi, India Abstract The American Red Cross is currently supporting the India Red Cross Society in developing a community based program. The thrust of the program is to enhance knowledge, attitude and practice of health and psychosocial practices in target communities. This article describes the strategy utilized to develop materials that are linguistically, culturally, and contextually appropriate for the communities’ language and cultural groups. Lessons learned are shared and discussed. Introduction The American Red Cross has been providing technical assistance to the Indian Red Cross Society and other Participating National Societies in developing programs for the last six years. These interventions include large numbers of visual and written materials that directly impact large numbers of disaster affected population. The American Red Cross (AmCross) began to work in India after the Gujarat earthquake in January 2001. Since then, it has been involved in the Global AIDS Project, Disaster Mental Health and Water & Sanitation. Presently, AmCross is working mainly in two major projects, (1) Gujarat Earthquake Recovery Program in Anjar, Kutch, Gujarat and (2) Tsunami Recovery Program in Chennai, and Kanyakumari in Tamil Nadu. These projects are integrated programs and incorporate activities in two sectors: community health and psychosocial support. The purpose of this paper is to describe the challenges and opportunities in the development of culturally and technically appropriate material, and the role of the Behavior Change Communication strategy in bringing about a sustained behavioral change. This paper explains: how BCC strategies can be utilized in target communities using a variety of communication channels to (1) develop new behaviors, (2) promote and sustain individual, community and societal behavioral changes, and (3) to maintain correct behaviors. The Need for timely and adequate simple information The Sphere Standards (2004) propose that access to information is not only a human right, but that, it also reduces unnecessary public anxiety and distress. Information should be disseminated according to the principles of risk communication, i.e., it should be uncomplicated (understandable to the local 12-year-olds) as well as empathetic (showing an understanding of the situations faced by the disaster survivors). In a meeting sponsored by the Government of India, USAID, and a four nation consultative group known as the Program for Enhancement of Emergency Response (PEER) in 2007, it was reported that amongst the challenges faced by the member organizations in India, the most prominent ones were: 1) language barriers - materials have been produced predominantly in English and Hindi while ignoring the 19 other national languages, 2) lack of contextualization - adaptation of material were mostly limited to linguistic translation without contextualization in line with the local realities leading to materials that can be confusing, misleading, or even outright erroneous when considered in light of local customs and standards. Drawing inspiration from the derived conclusions from this meeting, the delegates committed themselves to find ways to produce contextualized materials including public awareness materials, documentaries, and campaigns; and to hold broad-based and extensive consultations with the targeted communities to develop the best and most powerful messages for audiences among these communities. The MHPSS guidelines (2007) suggest that information and communication systems should be designed to help community members play a part in the recovery processes immediately after a disaster, thus enabling them to become active survivors rather than passive victims. Information and communication technology along with traditional methods of communication and entertainment such as sketches, songs and plays, can play a crucial role in disseminating information on survivors’ rights and entitlements. Furthermore, appropriate information about relief and the whereabouts of displaced people can help reunite families. Development of a Material Development Centre The American Red Cross in New Delhi developed a centre for the development of materials for information dissemination in the communities and staff development. There are two objectives of the Staff Development Centre: (1) Enhance the capacity of the IRCS to work collaboratively with local government, villages and schools in order to develop and support an integrated program in which all the core areas will have capacity building component as the major focus area of their activities. (2) Develop culturally, linguistically and technically appropriate materials which are contextualized. AmCross programs aim at reaching the target communities through a wide range of communication channels and approaches which facilitate a targeted change in the behavior of participants. The Staff Development Centre produces materials in three basic forms - print, electronic and traditional media. The process of material development is promoted in a manner which relies on and takes advantage of the participatory methodologies, including encouraging community input to assure appropriate context and content. The materials developed include manuals, children books, posters, tri-folds, documentaries, animation films, community radio productions and the traditional media. Lessons learned India has a complex social system with different castes, classes, creeds and tribes. The rate of illiteracy also varies from state to state which accounts for the inadequacy of mass media to reach the large Indian population which reside in villages. In a country like India with its multilingual and diverse character, the knowledge of the habits, customs, traditions and culture of the target populations in different states serve as significant tools in the development of culturally and linguistically appropriate material. Prewitt Diaz, Lakshminarayana and Bordoloi in 2004 discussed the challenges faced by IRCS in material development. One of the challenges faced by the IRCS staff was to identify the best methodology to develop materials for communities. Attempts were made to find out the kind of materials that would most appropriately represent the community-accepted behaviors in the pre-impact, impact, and immediate post impact situations after disasters. Initially the development of trifolds and posters was guided by the assumption that the behavioral responses to an event of mass destruction were universal (for example, confusion, anger, negotiation and resolution). Although the technical component of the materials was appropriate, the visuals however did not represent the realities of all the target communities. This resulted in community members focusing more on ‘that visual is not like us’, rather than the information provided by the trifolds. The other challenge was that the materials generated in English had to be translated into four languages namely Hindi, Gujarati, Telugu, and Tamil. There have been concrete efforts to translate questionnaires [Saxena, Chandiramani, Bhargava 1998; Sharan, Kulhara, Verma, Mohanty 2002] and manuals [Sen Dave, Sekar, Bhadra, Rajashekhar, Kishore Kumar, Srinivasa Murthy 2002; Sekar, Sen Dave, Bhadra, Rajashekhar, Kishore Kumar, Srinivasa Murthy 2002] related to mental health into local languages. The lessons learned from these efforts became the starting point for the AmCross effort in developing contextualized materials. The materials developed by AmCross were field tested in the target communities. The following are some of the lessons learnt by AmCross: 1. Not all messages in Hindi reach all people. 2. Translation of materials may not have been adopted the culturally appropriate nuances of the target population. Cultural nuances may prevent people from accepting change. 3. Popular, non- written language, visual or auditory messages may be best understood. Behavior Change Communication Behavior Change Communication (BCC) is the tool used by the AmCross in India to translate information (from policies, higher other messages, monograph and government directives) relating to psychosocial support, community health and disaster management, in such as way so as bring it down (or up) to a level that is understandable by the affected population (the target for the Host National Society and ARC sponsored programs). Behavior change communication plays an essential albeit often neglected part in any emergency. In the past, many emergency responses in South Asia gave little attention to addressing risky practices, poor habits and communication needs of the affected individuals and families. Experiences from the tsunami response in South Asia showed that communication preparedness for emergencies coupled with risk communication and behavior change communication (BCC) initiatives that benefit affected individuals and communities, were not always given adequate importance and funding, and thus, were not coordinated, planned, managed or monitored well (UNICEF, 2006). The role of educational tools has been acknowledged as vital to disaster management for a long time. BCC gives insight into the broader socio-economic impact of the disaster, and hence help mobilize political, social and economic responses needed to build an effective program. BCC tools have relevance during the response and recovery phases. Educational tools can be used to establish a link between the emergency operation centers, ham/community radio stations and community crisis committees. This link can be helpful in the need-assessment, in collecting information on rescue and relief activities, giving information about missing people, and in motivating the community, government and other agencies for responses. There is a need to integrate new technologies with the more conventional communication methodologies like the traditional media. Communication through mass media can ensure that correct information reaches a specific population which can then model positive attitudes. But when an individual or community is motivated to attempt new behaviors, existing or emerging policies and the larger social environment become more important. When audiences become ready to change, the activities, services, or products being promoted must be made available to them. Adults are motivated to learn when they experience needs and interests that learning can help satisfy (Knowles, 1984). Learners need to see practical applications for what they learn. They need to be able to use their new ideas and acquired practices immediately in their work, private lives and in their community. As we design educational experiences, we need to provide opportunities for the learner’s anxieties to be expressed - either privately or in small groups. Effective BCC should make sure that people have the basic facts made available to them in a language, visual medium or other media that they can understand and relate to. BCC should create a demand for information and services, and should urge action at all levels - right from the national level down to the local community level. Process of Behavior Change Figure: 1.1 American Red Cross Model of Behavior Change The American and Indian Red Cross Communication Model The communication strategies at the community level use participatory community and social change techniques to involve communities. This helps ensure that change is facilitated and grown from within, rather than dictated by the outside sources. AmCross also coordinates all the activities with the system-wide changes required to structurally facilitate desired behaviors. For example, the community members are involved in activities of material development and as actors in preparing documentaries. Important techniques for eliminating translation-related problems include reverse translation, consultation and collaboration with other people during the translation process itself, and lastly, pre-testing or piloting (such as in interviews) whenever this is possible. To address the need for translation of materials, the methodology of translation and reverse-translation (Brislin 1980) will be followed. This methodology involves looking for equivalence through (a) translation of text from the source language to the target language, (b) independent translation of these back into the source language, and (c) comparison of the two versions of the text in the source language until ambiguities or discrepancies in meaning are clarified and removed. The model, proposed herein goes through a pattern of production. All the written materials are prepared by the technical assistants in English after meeting and consultation with the target population in the native language. Once reviewed for technical adequacy by content area experts. Then, the material is back translated into the language of the target communities. The translation work is to be done in a workshop mode. There is to be at least two workshops for the translation work. In the first workshop, IRCS staff and the ARC staff sit together to translate the manuals into the target language. Then the translated materials are given another group who will conduct the back translation. The second workshop type of meeting is organized with technicians advisors and paid and volunteer staff of the local Red Cross Branch. In this workshop the translated version is to be distributed among the participants are asked to go through it and check for any discrepancy in the translation and the message that the material want to take to the communities. The technical group checks whether the material is linguistically and contextually appropriate. Before finalizing, the materials are sent for field-testing to study its effectiveness and appropriateness. The material evaluation activities focus on maximizing impact and reach, scaling-up of promising models, and integration of BCC with other project components. The most effective and successful behavior change strategy is to make the people realize the benefits of the new behavior. People need to be provided with the skills, confidence and resources so as to give them the confidence to attempt behavioral change. In all programs that attempt to bring about behavioral changes in communities, it is always helpful to identify probable barriers that prevent or make it difficult for people to change their behavior. At the end, quantitative methods of monitoring and evaluation provide numerical information about the impact and coverage of BCC interventions for the community, while qualitative methods will examine the pathways of change and why specific interventions were successful or not. In addition, participatory methodologies are used to collect information about the process and effectiveness of interventions from the audiences we are trying to reach, and, simultaneously, to reinforce behavior change messages. Summary This paper presented the challenges and opportunitites that American Red Cross is facing in developing culturally, linguistically and technically appropriate material for integrated programs in India. The paper focused on the importance of behavior change communication in any risk communication strategy. The paper concludes that communication should be an interactive process of exchanging information and opinions between individuals or community with an end goal of helping them make the best possible decision during an emergency. References Behavior Change Communication in Emergencies: A Toolkit (2006), p37, UNICEF Brislin, R.W (1980): “Translation and Content Analysis of Oral and Written Material” in H C Triandis and J W Berry (eds), Handbook of Cross Cultural Psychology: Vol 2, Methodology (pp 389-394), Allyn and Bacon, Inc, Boston, MA. Darwish, A (1999): The Translation Process: A View of the Mind. 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