It’s an unusual collaboration. A laboratory and a performance space, both in Bengaluru, and a theatre group in the United Kingdom have come together to produce a play on a subject as dense as resistance to antibiotics.
Playwright Gautam Raja, who is currently based in Los Angeles but has been part of Bengaluru’s Jagriti theatre, said his biggest realisation while researching The Vaidya’s Oath was that it isn’t given the importance it should. “In spite of the seriousness of this issue, systemically, there’s no acknowledgement of antibiotic resistance as something that needs to be addressed,” said Raja. “[Anti-microbial resistance] is not a sudden event, and not dramatic in the way of, say, a new viral outbreak.”
The play, which will be staged at Jagriti this week, is set against the background of this health threat.
Global threat
Antibiotic resistance, also called antimicrobial resistance or AMR, has emerged as one of India’s biggest public health menaces in recent years. Its causes range from inconsistent hospital standards, patients not completing full courses of medication, and over-the-counter availability of inexpensive antibiotics. Researchers have found that the uncontrolled use of antibiotics in India – which is sometimes used even as growth boosters for livestock – has created a flood of antibiotic resistant organisms that are now being found around the world. The situation is so serious that a recent survey by the National Centre for Disease Control found that 20% of patients in India were resistant to last-resort antibiotics.
A case in point is New Delhi Metallo-beta-lactamase-1, or NDM-1, a drug resistant superbug first seen in the national capital, which then spread to more than 70 countries around the world.
The idea of bringing antimicrobial resistance to the stage first struck the play’s director Jeff Teare five years ago when he heard scientists talk about it at a conference in Bengaluru. By 2012, antimicrobial resistance had become so much more serious that medical experts from across India came together to pass the Chennai Declaration to evolve an implementable policy to “combat the serious menace of antimicrobial resistance in the country”.
Teare is the co-founder of the UK-based theatre group Theatrescience, which has been trying to create good theatre out of biomedical issues since 2002. It has collaborated with the Bengaluru laboratory and Jagriti for the last 10 years resulting in productions like Darwin in India, about evolution, and Hinduism and The Invisible River, about bacteriophages (bacterial viruses) in the Ganga. The Vaidya’s Oath is their fourth production.
“I suppose you could say we are more interested in good theatre than we are in the science,” Teare said. “But the social, economic and political effects of the science makes good theatre”.
But the project goes beyond just theatre. The Theatrescience team, along with Jagriti, has also conducted a series of theatre workshops in schools on antimicrobial resistance.
A scientific and social problem
The scientist from the National Centre for Biological Sciences in Bengaluru who worked with Teare and Raja on the play said antibiotic resistance was a huge problem that had to be tackled in tandem by society and the government “Compare antibiotics with vaccines and hygiene – all good ways to keep you healthy,” said Mukund Thattai. He added that hygiene was no longer a scientific problem but one for society, government and institutions to crack. Vaccines, on the other hand, were a scientific problem to be decoded in laboratories.
“Antibiotics are a combination of both,” Thattai said. “There are huge societal problems with how we use them. There are huge institutional problems with companies not being incentivised to discover new antibiotics because they get very little money out of it. There are scientific problems as well, which is how to respond to antibiotic resistance that scientists are working on as well.”
A metaphor for human weakness
The Vaidya’s Oath is about a doctor and his microbiologist wife in a rural outpost in Uttar Pradesh. The doctor is treating a newborn ill with sepsis caused by antimicrobial resistance. The story, said Raja, tracks the breakdown of the doctor’s marriage through the lens of the health crisis.
While writing the script, Raja was drawn the idea of strength when it comes to microbes. “For resistant super bugs, it merely means that they have developed a very specific set of defences for a very specific set of circumstances,” Raja said. “If those circumstances changed, then their strength meant nothing… I was drawn to the parallels in the defences we evolve as humans – in our adaptations to stress, or our way of dealing with conflict, or the incredible webs of psychological defences we weave to avoid confronting our own weaknesses.”
The playwright was also struck by the classlessness of antibiotic resistance, which can affect someone in a rural health centre as much as it can a patient in a five-star hospital.
While Raja and Teare feel the project is about telling a good story through good theatre, scientist Thattai sees it as one more medium to get the message out about the seriousness of antibiotic resistance. “This is not meant for scale,” he said. “It is meant to engage… Am I satisfied with just one person coming away with something they didn’t know before? I am.”
The Vaidya’s Oath plays at Jagriti theatre in Bengaluru from March 11-13.
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