Saving Lives with Picture Books

Saving Lives with Picture Books

Who doesn't love a good picture book? We say goodnight to the cow jumping over the moon in the great green room. We hop off a shelf and join a small teddy bear in green overalls (with a missing button) in search of a home and a friend. We sail in and out of weeks and almost over a year. Ah, the memories.

But as I've learned over the past seven years while teaching PWR 2 (Once Upon a Cause: Creating Picture Books for Local Children), picture books can do more than take us down memory lane—more than create memory lane for new generations of kids. They can also console and enlighten and teach. They can teach literacy, empathy, friendship, courage, perseverance, and the importance of eating one extra fistful of rice with all three meals, beginning with the 2nd trimester, to gain adequate weight so that your child is born with normal weight. Huh?

Yes, picture books can even teach nutritional and behavioral recommendations to pregnant women and new mothers, including mothers in rural Bangladesh. At least that was the premise of the PWR 91 course I taught in Fall 2018 titled, "Saving Lives with Picture Books."

The idea for the course came last year when Laura Kwong, who was finishing her PhD in Mechanical and Environmental Engineering at Stanford, asked if we could discuss a research project she was a part of in Bangladesh. The project aimed to improve maternal nutrition; early childhood stimulation; responsive feeding; water, sanitation, and hygiene (WASH); infant and young child nutrition; and lead and arsenic exposure prevention. Laura thought that a more visual, storytelling approach might complement the team's project to educate rural mothers during visits by community health workers. In other words, maybe picture books could help.

I pitched the idea for PWR 91. And before I knew it, 12 students were meeting in Wallenberg 326 to learn about picture books and the health challenges facing people in rural Bangladesh. Soon students were brainstorming and pitching ideas for picture books that could convey hefty lists of behavioral recommendations in engaging, culturally sensitive ways. Instead of producing their books in 18 months, as in the publishing industry, students had 10 weeks.

Creating five picture books, in groups, involved many cycles of deliberation, countless rhetorical choices, and a lot of creative problem solving.

In one of the books, which aims to teach various nutritional recommendations for young children, a boy named Azam aspires to play cricket for the Bangladeshi national team, but his dreams evaporate when he learns that malnutrition has irreparably stunted his growth. After learning about proper nutrition, Azam vows to do everything he can to ensure that his younger brother, Malik, avoids the same fate. It works. Malik grows up to become a professional cricket player, while Azam "becomes a community health volunteer to help other children get the nutrition they need."

Another book promotes healthy thinking through the story of a young mother named Dalia who struggles to manage her anxiety in the face of her many responsibilities. She needs to care for her baby, cook for her family, prepare for the upcoming Pahela Baishakh festival, and deal with a judgmental mother-in-law. The narration notes that Dalia "was born with a beautiful halo of light radiating from her heart." Flashback illustrations show this light in vibrant colors, and as Dalia feels increasingly overwhelmed and exhausted because of her work, she gradually loses her light. Her husband helps her recognize this and supports her, along with other family and friends, so that she gets more rest and relaxation. In the end, she regains her light.

These aren't exactly traditional picture book plots, but they fit the unique rhetorical situation.

Befitting the course's designation as a Cardinal Course, as well as its contribution to PWR's Notation in Cultural Rhetorics, cultural issues arose constantly while creating the books. To help navigate the cultural complexities and nuances, students received generous feedback from the research team in Bangladesh, including a Zoom videoconference at 10 p.m.—the late time necessitated by the 13-hour time difference. In addition, students received feedback on black-and-white book dummies from Bangladeshi mothers, who shared what worked well and what caused confusion.

Students were also lucky to have Dr. Kwong available. She joined the class almost every day of the quarter and suggested ways to make the students' drafts more culturally accurate and authentic. For example, she let students know that their initial sketches of characters cooking while standing up in Western-style kitchens did not match the reality of mothers cooking while crouching before small stoves on dirt floors. She shared relevant photos from her research trips to Bangladeshi villages. Students could see what a street vendor's table looks like, what a lead-contaminated mustard oil tin used to store food looks like, or how women dress.

Sometimes cultural authenticity conflicted with the students' progressive visions. For example, in the book about Dalia, students initially showed her husband offering to help with the housework so she could get some rest. Dr. Kwong and the team in Bangladesh pointed out that this was extremely unrealistic in such a patriarchal society. A more likely scenario would be for Dalia's mother-in-law to help out. Students then revised to show Dalia's husband saying that he would ask his mother to cook. Similarly, in the book about Azam, students initially had him grow up to be a doctor. But the researchers felt that a more realistic ambition for a village boy was to become a community health worker, so that's what he becomes.

Such revisions were at odds with the kinds of stereotype-crushing choices students routinely make while creating picture books in my PWR 2 course. But such constraints did reinforce the idea that rhetoric is cultural, and cultural expectations are rhetorical. Still, students did include some forward-thinking cultural moments. For example, one book features a girl named Asma who accompanies her father to the market to trade mangoes for a variety of healthy foods to give her pregnant mother. When she brings her colorful bounty home, her grandmother reaches out and says, "I will make something special for Father!" Asma replies firmly, "But Grandmother, you also have to make special foods for Mother and Baby. They must try all of these foods!" The group made the grandmother more sympathetic by having her suggest that her daughter-in-law eat one of the lemons Dalia has gathered to relieve her nausea (it works).

A Cardinal Course grant not only covered the cost of art supplies for students' picture books but also the expense of printing the books in Bangladesh to distribute to the rural mothers and their families during the research team's community visits to promote health.

Ultimately, although the picture books that students created in PWR 91 may not become bedtime classics, they have great potential to improve real lives in impoverished communities in profound ways.