We have found that because of such factors as the low literacy rate, a general aversion to formal meetings, time constraints and perceived community priority, the most effective health intervention strategies in Cambodia are those which are entertaining and use participatory methods of conveying health message. The materials which are developed and tested in rural communities are easy for community based leaders to use without being forced to “teach”. It has therefore been easier for designers and client NGOs and government agencies to involve non- traditional health educators (school teachers, monks, clinic assistants, rural development officers, and traditional healers) than would otherwise be possible.

The participatory design of materials also allows for educators to more easily evaluate the degree of understanding by the target group of the health messages promoted. If the participants are, for example: putting together hygiene bingo, and explaining the concepts which the game depicts then it is more easily recognizable that the message being delivered was understood. This approach has received widespread appreciation from international organizations and government ministries. The interest has increased with the realization of how thoroughly designers pretests the materials. Examples of the materials which have been developed, tested and marketed to ministries, international organizations and other local NGOs include:

The Fly: To promote good hygiene designers made giant fly costumes and props and wrote a script to depict how flies transmit disease. The materials developed have been sold to numerous NGOs and UN agencies in Cambodia.

Puzzles: Puzzles covering a wide range of health education message from proper latrine use to the benefits of immunizations have been developed by designers. The correct use of puzzles has been taught to numerous NGOs many of which, UNDP/CARERE, Action International Con le Faim, Concern, Action Nord Sud, European Union, Partners for Development, Battambang women AIDS Project, Handicap International, Adventist Development Relief Agency, Department of Rural Health Care of Ministry of Health, ZOA Refugee Care Netherlands, Youth with a Mission, SAWA – Cambodia, Partage avec les Enfants du Monde, World Vision International, Servants to Asia’s Urban Poor, Mine Advisory Group, UNICEF-Cambodia, Marie Stopes International, Medecins Sans Frontieres, Catholic Relief Services, Consortium – Cambodia, Reproductive and child Health Alliance, International AIDS Alliance, Health Net International, Norwegian People’s sid, and other more…have purchase the puzzles for use in their own programs. Some of their programs have been focused on homeless families, orphans, IDPS and primary school students.

Hygiene Bingo: Hygiene bingo seems to have been blessed by the traditional fondness which Cambodians have for gambling. The bingo games interactively edify the participants concerning proper water use, latrine use, and sanitary home environments. Numerous NGOs have purchase sets for training their local staff and community activists in identifying health hazards and determine solutions.

Cards: Another game which parallels gambling, the Latrine Use and Maintenance Playing Cards, have been a fun way to reinforce health messages. Six good and Bad health messages are depicted in a deck of cards. Participants play to get only good health messages in their hand by picking and throwing out the bad messages. NGOs have purchase the problems.

Campaign and Contest Materials: Numerous NGOs and various government agencies have requested assistance on developing health education intervention strategies for various health problems. Where possible the strategies were developed to complement existing sectors or invested resources. Messages were kept simple and entertaining while methodologies encouraged participation and repetition. In one intervention a contest was held in Battambang primary schools for students to design posters for world water Use Day. UNDP had billboard and T-Shirts made by Design team and distributed and throughout the province. T-Shirts to promote land mine awareness, World Women’s Day, and many other government and NGOs activities have also been designed and produced.