The Speaking Book was created by South Africans for South Africans and has developed to reach low literacy and disadvantaged communities across the globe. The Speaking Book addresses a major inequality - illiteracy - which deprives people access to life-saving information. Over 785 million adults are illiterate and Africa has a literacy rate lower than 60% . Illiteracy critically reduces health care literature efficacy - however good written material is, if people cannot read, the messages are ineffective. Illiteracy is a potentially life-threatening issue and health is lowest where literacy is poor. People with low health literacy are 12 to 18 times more likely to not understand, ignore or confuse medical treatment and preventative measures, and therefore are more highly likely to suffer further affliction, illness and victimisation. For developing countries, illiteracy affects 30 to 80% of the population.
Even in countries with relatively high literacy, serious gaps in health literacy are recorded. The traditional model of patient education through brochures and pamphlets has become selective in its target. Illiteracy is on the increase, and appropriate healthcare communication is critical to the health of all people. The Speaking Book is an interactive education tool for communities with low levels of literacy which is effective over a long period of time. The Speaking Book empowers the user, regardless of who or where they are, and no matter their level of reading ability, to look, listen and learn, so that vital health care messages are clearly understood and retained. Whilst the focus of the Speaking Book is primarily to benefit disadvantaged communities, home based care workers, nurses and social workers benefit enormously from a portable teaching tool that ensures the health care messages they are conveying are correct and stay on track. The Speaking Book has successfully created an effective means to present complex health care issues by adapting to the culture, skills and needs of communities while encouraging them to build self-confidence with a simple action plan.
The Speaking Book is a simple, extremely effective and unique solution to low literacy, particularly in rural communities where the absence of electricity, radio, TV, internet and computers makes these forms of communication impractical and expensive. The Speaking Book is totally self-contained and user-driven, so that the messages can be listened to in any order and as often as necessary.
The Speaking Book combines the latest sound chip technology featuring a sound track read by well-known local celebrities in the local language, with a durable laminated hard backed book, to take the reader on a step-by-step guide to wellness.
Each Speaking Book consists of 16 pages of colourful illustrations supported by straightforward and easy to understand text. For each page there is a corresponding push button that triggers a sound track of the text, so no matter the level of reading comprehension, the information will be seen, read, heard and understood with powerful results.
The Application to Patient Education
Existing patient education projects rely heavily on community volunteers to become peer educators and costs for training and transport are high and there is rapid turnover. Reliance on radio to spread education messages assumes audiences will know when to listen and will comprehend the content immediately.
Speaking Books are user driven. They are not dependent on electricity using easily replaced long life batteries. Messages can be played as often as required in the privacy of the recipient’s own home and provides answers to questions not yet asked. The Speaking Book offers information solutions to benefit humanity. There are no other comparable solutions to the issue of low literacy and information dissemination.
Brian M. Julius is a serial innovator and entrepreneur with experience and education gained in South Africa, the USA and the UK. His interests cover a variety of industries and interests. In 1999 Julius and his wife, Zane Wilson who work as an entrepreneurial team established a home on Hilton Head Island, South Carolina, USA.
Zane Maureen Wilson formed the South African Depression and Anxiety Group (SADAG) in 1994 to support and advise people living with mental health problems and their loved ones and communities. As founder, Wilson represents the many thousands of people who suffer from mental illness across the country – in urban, peri-urban and rural areas.
The Speaking Books are distributed in Africa in conjunction with SADAG, free of charge to the people who need and use the books.
The goal of the Speaking Books is to effectively impart critical health information to patients in hard-to-reach areas, with low levels of literacy, who may be unable to read information brochures due to literacy, illness or age. Poor and illiterate communities are often side-lined on the road to health and this initiative allows all people, regardless of area, reading ability, age or economics to gain information that will empower them and enable them to achieve health and wellness.
The Speaking Books has over 45 titles created in over 20 languages. Each is its own success story – from the time volunteered by local celebrities, to the support of the media, to the impact on each community the book touches, every Speaking Book has positively changed the lives of individuals and communities. One powerful example was the book: “Caring for your child-headed household’. The issue of orphans and vulnerable children is a massive one. Many children are looked after by slightly older siblings, many children have to balance the roles of parent and pupil.
Giving these children skills and support is a crucial area of responsibility. The book was aimed at children who are raising their siblings and gave them, not only words of comfort and support, but also practical everyday tips – hygiene, cooking, bedtimes, how to get ID books and social support grants from the government. At the back of the book are toll-free numbers the children can call for counselling, health care and support. This book was given to each child-headed household in a number of South African provinces and social workers and community caregivers were trained on the use of the book. The response was overwhelming.
The Scope and Growth
The first Speaking Book was launched in 2005 - “Suicide Shouldn’t Be a Secret” - to educate South African rural teens on suicide prevention. The Speaking Book range has grown to over 45 titles in over 20 languages and the books have been distributed in Africa, Asia and the Americas. The Speaking Books are distributed through caregivers and NGOs after training is done in the community about the topic and the use of the books as a tool. We work together with other organisations for the betterment of the community.
Research into the distribution, use, behavioural change and knowledge gain from the books; numerous studies have been undertaken with outcomes that confirm the viability of this educational tool – i.e.: an average of 27 patients per HIV and AIDS book. There was a 58% increase in understanding of the factors which may lead to suicide, from the Teen Suicide Prevention book . Pfizer conducted research into their first Speaking Book on Clinical Trials, following which they have created Speaking Books for distribution throughout Africa, and for India, China and the USA.
Titles & Languages
- Suicide Shouldn’t be a Secret (English)
- Living with HIV and AIDS Doesn’t Mean Living with Depression (English, Zulu, Pedi)
- Understanding Your Mental Health (English, Zulu)
- Caring For Your Child headed Household (English, Xhosa)
- Living Free of TB (English)
- My Body, My Choice (English)
- TB Can Be Cured (English)
- A Grant is Your Right (S.Sotho, Venda, Tswana, Zulu, English)
- Healthy Families (English, Spanish)
- Phillipe Can’t Play Today (English, Spanish, French, Mandarin)
- Moving Against Malaria (English)
- Caring For You, The Caregiver (English)
- Safe Disclosure to Children with HIV and AIDS (English, Portuguese, Zulu, Swahili, S.Sotho)
- What You need to know about HIV and AIDS (English)
- Coping with HIV and AIDS (English)
- What It Means to be Part of a Clinical Trial (English, Hindi, Telegu)
- Knowledge and Hope About Your Health (Zulu)
- Say No To Drugs (English)
- Mothers and New Born Health (Amharic)
- Stay Healthy By Not Smoking (Mandarin)
- Stay Safe From Malaria (Comorian)
- Be Safe Little One (English)
- Hypertension (English)
- The Safe Use of Medicines (English)
- Clinical Trial for Preventative Treatment of Malaria in Pregnancy (Swahili, English)
- Learning About Clinical Vaccine Trials (English)
- Protect Your Child From Pneumonia (English, Swahili)
- Living Free From Pneumonia (French and Lingala)
- Eating Well Every Day (Arabic)
- Handwashing (Swahili and English)
- Amputees and Living with Handicaps (Creole)
- The Wellness Tree (English)
Awards and Accolades for the Speaking Book
The Speaking Book has received a number of awards including: the Pan African Health Award for “Innovation, excellence and sustainability”, the CPSI Public Sector Innovations Runner Up Award in the category “Innovative Use of Information Communication Technology (ICT) for Effective Service Delivery”, and the PharmaVoice 100 honoree for patients rights and creating the Speaking Book in 2007; the Saatchi & Saatchi New York World Changing Ideas Finalist, Silver Medal CAPAM Award Barbados (Commonwealth Association for Public Administration and Management) International Innovations Awards in 2008; AfriComNet Award for Innovation in HIV and AIDS Communication, Purpose Prize Fellowship Awarded for outstanding contributions to the social good, World Medical Association General Assembly New Delhi world launch of the Speaking Books for Clinical Trials, and the Department of Public Service Ministers Award for Innovation and Sustainability in health care in 2009; the TIGA Award (Technology in Government Awards) presented by UNECA - UN Economic Commission for Africa and Government of Finland for patient education and development in Africa in 2011 .
In 2007, the Acumen Fund, world pioneers in the use of philanthropic capital to make disciplined investments, invested into the Speaking Book program with funding and management expertise. Being able to partner with Acumen is both a great endorsement on the Speaking Book and their objective to support entrepreneurs to yield financial and social returns
Books of Hope – Expanding health education
One of the key gaps in many global health programs is effective consumer education. There is a critical need for effective education for illiterate or semi-literate people to complement existing health and water interventions, such as correct usage of bed nets, or adherence to HIV treatment. Low-cost paper pamphlets are commonly used to educate consumers, but are an ineffective way to reach largely illiterate populations. In-person trainers are expensive and difficult to come by, as health personnel are scarce in developing countries. As many new initiatives in public health (malaria, TB, and HIV/AIDS, etc.) are being rolled out, global health programs are asking themselves: “How do we effectively get the word out to our target customers about these life-saving programs?”
The Speaking Book addresses this key communication gap by allowing a customer to see, read, hear and understand critical healthcare messages. Each Speaking Book features 16 pages of full-color illustrations supported by straightforward and easy to understand text. For each page, there is a corresponding push button that triggers a sound track of the text, read by well-known local celebrities in the local language. A durable, laminated hard backed book, each Speaking Book is specially designed to take the reader on a step-by-step guide to wellness. Books of Hope, a US-based company, developed the Speaking Books series in partnership with a South African NGO. With 45 titles in 15 languages covering topics from HIV/AIDS to malaria, mental illness to clinical trials, smoking cessation to TB, Books of Hope is a global leader in healthcare education, meeting a critical need for healthcare education with an innovative solution.
"The WMA launched the speaking book on clinical trials during the General Assembly in Seoul 2008. This project was a collaborative effort with the South African Medical Association, the SADAG (South African Depression & Anxiety Group) and the Steve Biko Center for Bioethics in Johannesburg and the publisher "Books of Hope". The speaking book on clinical trials in English-Hindi & Telugu was launched at the 2009 General Assembly in India. The purpose of the project is to provide proper information on clinical research to illiterate populations so that they can make informed decisions about participation in clinical trials
In March 2010, Books of Hope, with the support of Pfizer, the Chinese Center of Disease Control, the Chinese Medical Doctor Association, the Chinese Association on Tobacco Control and the World Medical Association presented a speaking book on the dangers of smoking. It targets a low literacy community, which has experienced significant increases in smoking rates over the last decades, yet can not benefit from much of the written informational products on tobacco cessation and the dangers of smoking.
Each of the impressively illustrated 16 page books, with easy-to-read text easy and/or voice on command, is expected to be received by an average of 27 people as a study has shown. Thus the first 5000 books have the potential to impact 50,000 to 100,000 people. Like the other speaking books, the newest one will also be accompanied by research analyzing its impact on health literacy."
Brian Julius’s Most Compelling Speaking Book Stories:"
“The impact of our very first book was even beyond our expectations. Teen Suicide is the third biggest killer of young people in South Africa, after auto accidents and homicide . For the book we recorded the voice of Lillian Dube, a well known South African TV and radio personality. We piloted the book in Kimberley, South Africa – best known for it’s ‘Big Hole’ but in that year had lost 5 000 children to suicide. All the children were thrilled to hear a recognizable voice and were able to quote her verbatim the advice she was giving, like “Lillian told me………” and quotes like “The book was very helpful. I like the book because it learn you not to kill yourself” (Male 13 Kimberley).
Shortly after distributing the HIV and Depression Speaking Book, a home based care worker attached this note to his reply paid questionnaire: “Dearest support group. When I filled this form, it was the time when I didn't show the book to the patient. Fortunately at last, I visited one of the patients at my community. Joseph, he is sick, always he says is better to me to die. Then I went there and try to talk with him. After I take the book out, trying to explain when the messages is said out, he said to me why can't you leave this book with me even if I don't understand English, but the way you explain message to me I felt that there are people next to me. Thanks.”
- Global illiteracy - 
- Health literacy
- Speaking Books: www.speakingbooks.com . www.booksofhope.com
- Brian Julius
- Zane Wilson www.sadag.org.
- The South African Depression and Anxiety Group (SADAG): www.sadag.org
- Speaking Books /Research:  . 
- Speaking Books: www.speakingbooks.com . www.booksofhope.com
- The South African Depression and Anxiety Group (SADAG):