South Africa

EDITORIAL

Inclusive, empathetic communication will be a game-changer in Covid-19 emergency

Image by joffi from Pixabay

One of the earliest lessons taught to us by AIDS activists is that in an epidemic, the language we use is as important as physical or medical strategies we may adopt for disease prevention, treatment and care. Language needs to be accurate, affirming, empowering, non-stigmatising and inclusive.

For example, from early on, people living with HIV refused to be called “AIDS victims”. They rejected the loaded words that talked about how the disease was “spread” because “spread” implied that people with HIV, or black people or queer people, were somehow the willing agents of its transmission. Instead, they pointed out that it was an infectious virus that was the problem, not people living with it. Equally, it was societies’ (read governments’) lack of preparedness to prevent its modes of infection, or the criminalisation and marginalisation of “at risk” populations, like gay men or Haitian migrants, that abetted its transmission.

Many of these lessons are just as applicable to the language we use in relation to Covid-19. 

Since his first address to the nation on 15 March, President Cyril Ramaphosa has been justifiably lauded by many people, particularly the elites and the middle classes, for his boldness and leadership; his firm and clear advice (now instructions) on “social distancing”, hand and cough hygiene and safe ways of greeting.

We too commend the Ministry of Health and its spokesperson Lwazi Manzi for its accessibility, the regularity of communications, the initiative to start a WhatsApp group and dedicated coronavirus website.

Yet it’s clear that inasmuch as some have welcomed the President’s announcements, many poor and marginalised people have felt mainly anxiety, exclusion and even anger, as set out in this statement by Abahlali baseMjondolo.

“Social distancing” is extremely hard in a jam-packed taxi or an overcrowded shack; washing hands regularly is impossible if you can’t afford soap and have very limited access to water. These are commonly heard refrains.

As a result, another part of our social media, particularly WhatsApp groups run by social movements, trade unions and civil society have expressed a great deal of scepticism about the speeches and, more worryingly, a lack of trust in the President and conviction in the Covid-19 prevention strategy.

Everybody wants to be part of the response – unlike with HIV, nobody denies the threat posed by Covid-19 – yet the poor seem to be treated as an afterthought. Even though there is a constant reference by the President and other Cabinet ministers to the lockdown and other measures being necessary to protect the poor and our “large number of people with suppressed immunity because of HIV and TB, and high levels of poverty and malnutrition”, actual interventions to mitigate vulnerability seem hard to find at this stage.

That is why social justice and health activists have argued that we should be talking about “physical distancing” (rather than “social distancing”) and “social solidarity”. Dr Lydia Cairncross, a surgeon at Groote Schuur hospital in Cape Town, points out that “physical distancing”:

“… does not mean we stop mobilising as a community and society. In fact, we need to mobilise more as social solidarity is so important in times of crisis. Nevertheless, we do need to maintain physical space between us at least for the next few weeks, possibly a month or two, until we can contain this virus.”

For these reasons, we believe that it’s vital that in all further communications the President and others begin to show a great deal more real empathy and appreciation of the anxiety and distress that is mounting in South Africa’s poor communities.

Before we see SANDF trucks rumbling down our streets to keep law and order, we need to see delivery trucks carrying Jojos, water containers and essential goods such as soap and foodstuffs for children who are no longer getting meals at school.

Our advice to the President: recognise, respect and speak to poor people’s fears and their hearts, not only to the stock markets and urban elites.

Another example that demonstrates the necessity of inclusive language is that on both occasions when the President has spoken to the nation (on 15 March and 23 March) he has addressed us as “fellow South Africans”.

By doing so, he leaves out the millions of documented and undocumented migrants who live in our country, and who have for the whole of our history carried the burden of diseases of poverty, inequality and apartheid, including sexually transmitted infections, TB, and then HIV. Talking only to “fellow South Africans” is bad for Covid-19 control because it overlooks that refugees and migrants, who live in overcrowded and difficult conditions, are equally at risk of infection and transmission. It is also careless because there is a danger of xenophobic blaming in the weeks ahead. Why not “Dear people” or simply “friends, comrades and all people in South Africa”?’

Finally, with only days to go before the start of the 21-day lockdown, it is vital that the SABC, our public broadcaster, is turned over to continuous and effective messaging and learning on all its radio and television channels. Messages, education and information in all of our languages is crucial. Journalists need to be able to continue doing their jobs of informing the public, as an essential service, with the necessary safeguards in place. 

The Treatment Action Campaign (TAC) and others pioneered the practice of treatment literacy, as a programme to ensure that people most at risk were equipped with the scientific knowledge to prevent and treat HIV. Such an approach is just as necessary with Covid-19, but needs to happen at scale. As pointed out by TAC Chairperson Sibongile Tshabalala, there are a range of myths and misunderstandings about Covid-19, such as that it is a white people’s disease or a foreigners’ disease.

These need to be broken as soon as possible.

The truth is that, when it comes to targeting people most vulnerable to disease, our public health messaging for the last 20 years has been hopeless. It has often been handed over to consultants and communications firms who have got rich on lucrative tenders, but did next to nothing to achieve health-seeking behaviour.

So the last word of advice we would give to the government communicators is: don’t hand Covid-19 media over to another group of consultants – don’t only talk to well-heeled “professionals” bearing PowerPoints. Communities and community activists have vital wisdom and experience that needs to be respected, harvested, compensated for and placed at the heart of Covid-19 prevention messaging throughout this crisis. MC

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