Cathy Watson is helping adolescents and young adults to make important life choices by encouraging frank discussion and education about sexuality, HIV and Aids and other sexually transmitted diseases. She is revolutionizing behavior change communication and HIV and Aids education in Uganda through her numerous newspaper publications, radio shows and media outreach efforts.
The New Idea
In the early 1990s when the Ugandan HIV and Aids pandemic reached its peak, there was very little public knowledge about youth sexuality and HIV/Aids. In 1993 Cathy pioneered the idea of talking openly about sensitive topics regarding adolescence and HIV and Aids. Her new idea is based on the notion that silence on sensitive topics only frustrates interventions against HIV and Aids.
Cathy believes that only when the public openly talks about adolescence, sexuality and STDs meaningful interventions will achieve lasting results. Cathy started the Straight Talk newspaper to provide adolescents in Uganda with frank information about sexuality and HIV/Aids. A typical Ugandan newspaper—usually communicating in favor of or against the interests of a specific group—will give citizens a biased view of an issue. Ugandan society has often been split along partisan lines, and newspapers have often not acted as a tool to unite an ethnically diverse population.
In many ways Straight Talk is a model for public communication. Cathy designed the newspaper to encourage open dialogue among adolescents and young adults. The content is largely based on the opinions of the readers and is communicated in a non-judgmental and non-argumentative manner. To capture the interest of the young readers, the newspaper is highly illustrated, simple, and enjoyable. To encourage further dialogue and to cater for young people who may not easily access the newspaper, she started radio programs, now in 12 languages, that reach a much wider audience. With its participatory methods and dedication to open dialogue, Straight Talk has become the national reference for how to educate young people by eliciting their own ideas and experiences.
Uganda is a landlocked country in East Africa with a population about 28 million. Uganda was among the first and hardest hit countries with HIV and Aids. The first cases were reported in 1982: Superstition and talk of witchcraft characterized the initial response from communities amidst lack of clear government response. Consequently, the pandemic spread rapidly to much of the country. By the end of 1992, the national prevalence rate among adults was estimated at 18.3 percent, with some centers registering rates above 30 percent. This was followed by a period of steady decline in prevalence rates from the mid 1990s to 2000 to around 6 percent.
This decline was attributed to favorable prevention policies. However, this was not before the pandemic had a devastating impact on the country’s population and society. The extreme mortality of Aids has had an effect on life expectancy in Uganda, which is now less than 50 years. Adolescents are profoundly vulnerable to the pandemic because the vast majority has little or no access to education: only 16 percent of secondary school aged children (13 to 18 years) are in secondary school, and only 4 percent of Ugandans have completed secondary school. In Uganda parental presence is often absent: less than 50 percent of children and adolescents aged 10 to 14 years live with both parents. While HIV infection is low in early adolescent years (especially among boys), it increases by 3 or 4 times in the age range of 20 to 24. By age 18 to19, girls are 18 times more likely to have HIV than boys the same age. By age 20 to 24, over 6 percent of females have HIV.
By hitting the most economically and socially active portion of the population (20 to 45 years), HIV took on a new dimension: from a health hazard to a social and economic challenge. The pandemic affected Ugandan society in all dimensions. Today, every family in Uganda has been negatively affected by the pandemic. To address this disaster, a number of citizen sector organizations started in the 1990s and aimed to change behavior among the adolescents to reduce the HIV and Aids rates among young adults. These early interventions were faced with a barrage of other social and economic issues that make the fight against the pandemic tougher. Among them is the risky sexual behavior of adolescents.
In Uganda, 60 percent of women bear a child by age 20. As a result, Uganda has the third highest population growth rate at 3.4 percent per annum. Child bearing in adolescent years is also the major contributor to Uganda’s rate of maternal mortality, one of the highest in the world.Culturally, many practices are risky for adolescents, yet they are the norm. Early marriage and polygamy are two of the most detrimental. Poverty also drives many risky practices. For instance, girls are married off early for their bride price, and the cost of education prevents 50 percent of children who complete primary school from going on to secondary school. Before the emergence of Straight Talk in the media, talking about sexuality in public was a taboo. Many parents communicated little to their children on the subject of sexual behavior and sexually transmitted diseases. Radios, televisions, and newspapers provided little space for discussion on issues regarding sexuality. With little discussion and exposure to education, adolescents did have the basic understanding of how HIV and Aids affects their bodies, their sexuality, and how to respond to the pandemic.
When Cathy Watson started the Straight Talk newspaper in 1993 no one dared to talk openly about sex and sexually transmitted diseases in Uganda. Then hired by UNICEF to write a bulletin on citizen organizations working on HIV and Aids in adolescents, she quickly realized the need to encourage frank talk among adolescents on the taboo topics of sexuality and HIV and Aids. She turned the bulletin into a newspaper that engaged young people to talk openly about the link between their sexuality and STDs, including HIV and Aids.
While at the time The New Vision, The Daily Monitor and other major newspapers were running, little space was dedicated to such significant health-related topics and they did not encourage reader participation in content development. Cathy’s success can be attributed to her astute understanding of Ugandan geography, society, and political setup. Working from home, Cathy released her first publication answering basic questions on sexuality and HIV and Aids. While the response to the first publications was massive, most of it was in the form of requests to redefine certain terms. Instead of providing direct answers to requests in the next issue, Cathy understood that a better way of packaging the information was needed. She restructured her newspaper, reducing text by introducing graphic illustrations. The illustrations helped teenagers to quickly relate to a familiar picture rather than a clinical term.Throughout the design and implementation of Straight Talk, Cathy emphasizes participation of her audience. While the design and illustrations are centralized at the Straight Talk offices, the content of the newspaper is largely a result of feedback from adolescent readers. This flexible method of compiling issues ensures that only relevant information and messages are communicated, and her readership is provided with practical guides that can be applied in their daily life to manage their sexuality. Cathy believes that unilateral approaches to behavior change communication do not achieve lasting impact. What is required is a comprehensive understanding of issues surrounding a social problem and simultaneous addressing of all related issues.
To tackle issues that contributed to the devastation of HIV and Aids, under the Straight Talk Foundation, which she registered in 1994, she printed spin-off newspapers: Young Talk, for primary school students, Farm Talk for the rural sector, Parent Talk on parenting, Tree Talk on environmental issues, and Teacher Talk for teachers. Together the publications have an annual circulation of 11 million copies, 90 percent of which are distributed outside Kampala (in a country of 28 million people).While the demand for the newspaper soared, Cathy was bothered about getting her newspaper outside Kampala—the capital city to all corners of the country. With alarming HIV and Aids infection rates among teenagers information on sexuality and STDs was much more needed in rural areas than in the city. Cathy embarked on building a nation-wide distribution network for the newspaper.
She built a network of distribution points where schools, organizations working with adolescents, and youth clubs could pick-up their monthly copy. Short of resources, her first target was citizen sector organizations working with adolescents and HIV and Aids. Such organizations were desperate for information, and Cathy could provide prevention, awareness, and treatment information consistently every month. Over the years, she has pieced together the most comprehensive information distribution network in the country, reaching 16,000 schools, 2,000 faith-based organizations, and 1,000 community-based organizations in all parts of the country. Straight Talk is also one of the biggest clients of the Uganda Post Office, sending newspapers to 25,000 addresses. The network also includes mosques, dioceses, and shops. Internationally, Straight Talk newspapers are sent to 400 addresses. For the numerous questions that Cathy could not answer in her publications, she believed there were more people that had the answers. In 1993, Cathy started the first radio talk show on health in Uganda. “Capital Doctor” allowed callers and writers to ask intimate questions about sexuality, HIV and other STDs, and brought in young brilliant doctors to answer these questions on public radio. By getting the doctors to say the sensitive things first, it became more acceptable for people to talk about private issues in the open.
The weekly radio show was simple but very revolutionary, setting the tone for other talk shows all over the country. Today, there are over 100 radio stations in Uganda and on average each station runs one weekly radio talk show on HIV and Aids and STDs. Her Straight Talk Foundation runs 19 radio programs—11 on youth and 7 adult programs— reaching all corners of the country. Around the radio shows, adolescents have formed listeners’ clubs to discuss the issues and monitor each other’s behavior. There are 800 Straight Talk clubs all over the country.Central to Straight Talk’s extensive coverage is the constant concern for clear, simple, and enjoyable communication tools. The newspapers have been published and radio programs aired in 11 languages. This means that Straight Talk information can now be accessed and applied in almost any part of the country. However, Cathy still faces the challenge of translating reproductive language into local languages. Where the local languages fail in print, Cathy switches to radio where it is easier to communicate.
Over the past 13 years Cathy has set the standards for behavior-change communication in Uganda. The Straight Talk Foundation is widely credited with helping Ugandan youth make the transition from childhood to adulthood armed with unbiased, secular information on sex, reproduction, abstinence, and contraception, all in the context of Uganda’s fight against the HIV and Aids pandemic. Uganda is considered to be a success story in HIV and Aids containment. Hardly any youth goes through their adolescent years without seeing a copy of Straight Talk. Straight Talk ‘language’ has been adopted by government and other citizen sector organizations as the language for behavior change communication.
The Straight Talk Foundation was chosen to write the secondary school sex education book for the Ministry of Education and Sports under the Presidential Initiative on Aids Strategy for Communicating to Young People. In addition, Straight Talk has also empowered young people become active in their own communities. The Straight Talk concept has been replicated in Kenya, Tanzania, Zambia, Zimbabwe, Malawi and Botswana. With Straight Talk Foundation well grounded and used by government and citizen sector organizations as the reference point, Cathy is looking at working on her vision of a prosperous countryside. Her latest initiative, the Muvule Trust, is focused on encouraging talented children and young people to remain in rural areas by keeping them in school and promoting understanding of environment and development needs. Cathy is also interested in developing public radio service for the entire region of East Africa.
Cathy Watson was raised in an intellectual household. Her father and grandfather were professors and she was raised to believe that she should do work that made the world a better place. After graduating from university, by which time she could speak five languages, she worked with The World Bank on environmental issues. However, she grew increasingly frustrated with her work, trained as a nurse to get a hands-on, workingrelationship with people. As a student nurse, she started a newspaper column and broadcasting on the BBC. At the time the HIV/Aids pandemic broke out in Africa, Cathy was working as nurse in the UK while writing for nursing magazines and newspaper like The Guardian. A few years later, she found herself working as a journalist for the BBC in Uganda, and she was approached by UNICEF to write a newsletter on HIV and Aids activities for youth.
Instead, Cathy started a newspaper for youth, and even though her abrupt style of journalism faced some resistance from more conservative elements in society, the number of letters piling on her desk after her first publications confirmed the immense need for simple, clear and positive communication tools on HIV and Aids.From 1986 to 1993—when she started Straight Talk—Cathy worked as a freelance journalist for the BBC in East Africa. However, it was after her experience in genocides in Rwanda and Burundi that she decided to focus full time on writing about critical issues in social development. In 2003, her environmental publication, Tree Talk, won the Uganda Wildlife Clubs award and she was awarded the joint second place St. Andrew’s Environment Prize in Scotland for 2005.