CONTEXT
This project was born as a result of an approach from a group of health professionals from the Rheumatology Service of the Coimbra University Hospital / ULS Coimbra, who also work at the Coimbra University Faculty of Medicine, the Coimbra School of Nursing, and the Lisbon School of Nursing.
In recognition of Marionet’s ongoing work at the crossroads between theatre and science, particularly in the case of health sciences, in which it artistically promotes a conscious and awareness-raising approach to these issues, a proposal was made to produce theatrical creations dedicated to rheumatic diseases.
The main aim of this initiative is to encourage reflection on the invisibility of rheumatic diseases in society. Rheumatic and musculoskeletal diseases are among the most common chronic non-communicable diseases. They are the main cause of disability and comprise a group of more than 100 pathologies that affect muscles, ligaments, tendons, bones or joints. Generally, these diseases are the result of an inflammatory condition and, in some cases, autoimmune (the immune system produces antibodies that attack the body’s own healthy cells).
The EpiReumaPt study reported a prevalence in the Portuguese population of 10.2% for Osteoporosis, 1.7% for Fibromyalgia, 0.7% for Rheumatoid Arthritis and less than 1% for Systemic Sclerosis. The aim is to address rheumatic disease, taking into account the different branches of research led by the Rheumatology Service at ULS Coimbra:
– Rheumatoid Arthritis and the Dual target in the definition of remission: treatment based on one
target and the other target on the impact the disease has on the person’s life;
– Osteoporosis: assessment through FRAX, silent disease, fracture as a warning sign, little appreciation of the disease and little urgency in starting treatment by patients and other professionals (being associated with ageing in the wrong way);
– Fibromyalgia: explanatory model for pain based on a psychological perspective, an exaggerated perception of threat;
– Systemic Sclerosis, a disease of ‘cold hands’, resistant to current therapies and which largely interferes with body image and has a huge impact on a person’s quality of life.
Also, there are themes that cut across the various rheumatic diseases that may also be of interest:
– Pain, as a warning sign, present in most rheumatic diseases: subjective and difficult to characterise and define; inflammatory pain, mechanical pain, pain due to threat or even the notion of ‘no pain’ as in osteoporosis; the invisibility of pain is one of the causes of the lack of understanding by the
community (and health professionals);
– Chronic fatigue: transversal to chronic inflammatory disease, also difficult to quantify and define, it can be disabling;
– Altered body image: this can manifest itself with the typical deformed, swollen and misaligned joints, but also with increased skin thickness, altered pigmentation, digital ulcers, telangiectasias (vascular spiders that correspond to dilated blood vessels) or microstomia (decreased mouth opening amplitude) as in systemic sclerosis.
BEHIND HAPPINESS (Show + Conversation)
We strongly believe that the performing arts are a powerful tool for raising awareness and educating people in an accessible and engaging way. By presenting the experiences and challenges faced by those living with rheumatic disease, we can create empathy and understanding, contributing to greater awareness and inclusion. It was in this context that Marionet created from scratch the show “Behind Happiness”, in direct collaboration with health professionals and people suffering from rheumatological diseases, namely through interviews. It premiered at the Cerca de São Bernardo Theatre in Coimbra on 12 March 2025 and continued on stage until 16 March of the same year. After the last session, there was also an informal conversation with some of the people involved in creating the show.
BODY, IT’S ME – MARIONET DIGITAL (Digital Artistic Object)
Also part of this project is ‘Body, it’s me’, a digital art object in short video format that addresses the theme of rheumatic diseases. This is the fifth expression of Marionet Digital, which aims to be a space for artistic expression, created in formats specifically designed for digital communication.
BITE THE BULLET – MARIONET DIGITAL (Digital Artistic Object)
This is the second digital art object included in this project, which tackles the subject of rheumatic diseases, this time from a different angle, focussing on the difficulty of translating pain. ‘Bite the Pain‘ is the sixth expression of Marionet Digital, which aims to be a space for artistic expression, created in formats designed specifically for digital communication.
BEHIND HAPPINESS (Book)
This is the third volume of the Marionet Collection, which brings together a series of theatre plays produced by our company and which has found its publishing home at Edições Húmus. The official launch of this book, on April 9, 2026, will be attended by playwright/director Mário Montenegro, performers/playwrights Beatriz Boleto, Carolina Costa Andrade and Inês Dias, and professor José António Pereira da Silva, contributor to the project and author of the book’s preface, and also Maria José Pessoa, a person with rheumatic disease and also a co-author of the text.
