Since the World Health Organisation declared Zika a global public health emergency in February of this year, much attention has been brought to bear on applying lessons learned during the Ebola crisis of 2014-15.
This blog draws on the lessons for the health communication sector explored through a new practice briefing from BBC Media Action, Using media and communication to respond to public health emergencies - lessons learned from Ebola, and the unique role media and communications can play in effectively tackling Zika.. In some ways, the most important lesson from the Ebola crisis has already been absorbed into the response to Zika: that public awareness of the magnitude of the problem is crucial if we are to tackle disease outbreaks early. The World Health Organization (WHO) received confirmation of a link between Zika and brain abnormalities in newborns in late January of this year. By the 1st of February, this international body swiftly declared the outbreak to be a public health emergency of international concern.
Another lesson to emerge from the Ebola crisis has been a recognition of the critical importance of providing reliable and actionable information to people at risk of infection, so that they can better protect themselves and their communities. This is very much case with Zika, if efforts to prevent the virus spreading beyond the 60 countries affected at time of writing are to succeed.
One of the failings in the communication response to Ebola – a lesson that has yet perhaps to be fully learnt – was the early reliance on simplistic, often contradictory top-down messages. In some affected countries, for example, people with Ebola-like symptoms were asked to ‘isolate’ themselves from their households when they had nowhere else to go, to attend treatment centres that didn’t always exist, or to call helplines that often didn’t function properly.
Some of the messaging around the Zika virus is similarly problematic. National governments in some Latin American countries have advised women to avoid getting pregnant. Yet this is a region where the United Nations Population Fund says 23 million women have poor or no access to modern methods of contraception and where rates of sexual violence are high. This advice ignores key realities of daily life in vulnerable communities, and could – as was the case in West Africa with Ebola – hamper efforts to handle the crisis effectively.
BBC Media Action has responded to 28 humanitarian emergencies since 1994 – including Ebola. One recurring lesson has been that interventions are most effective if the formats and technologies used to communicate give affected communities a chance to participate and have a voice. This ensures that content reflects local realities, needs and concerns. People need to be told more than just what they should or should not do. They need to be engaged in a discussion around the ‘how’ and the ‘why’. A recent study of our radio magazine programme, Kick Ebola from Liberia, found that listeners highly valued the opportunity to voice their own opinions – and this feedback helped improve the programme’s outputs.
Health communication interventions require forward planning, as well as fast reactions, from humanitarian agencies and donors alike to ensure that resources are available to deliver effective programmes like Kick Ebola. This is a yet another recurrent lesson from Kick Ebola and other BBC Media Action programming: that for communication to best reflect local voices, realities and solutions, it must be generated locally. This frequently means working through or with local and community media, as well as – or instead of – national or international media.
But for local media to respond effectively to a public health emergency, they need both training and investment, ideally before a crisis hits. They need to know how to deliver programmes that are responsive to changing needs as a public health crisis evolves, and how to use media as a platform for holding those in charge of responding to a crisis to account.
A final lesson from BBC Media Action’s work during the Ebola crisis is the need to emphasise practical, “do-able” solutions that are communicated in easily accessible language and look to empower, rather than simply to increase knowledge. For example knowing that washing hands with soap can prevent diarrhoea is very different from knowing how to wash your hands to help prevent Ebola transmission: i.e., that it needs to be under running water (cold or hot), that the soap must cover all areas of the hands, fingers and nails and that you need to rub your hands together with the soap for at least 20 seconds. Without clear, actionable and practical information, people are left disempowered and afraid, and may simply deny or ignore a situation, or adopt an attitude of fatalism.
Thousands of people lost their lives to the Ebola outbreak. The entire global public health community – including media development agencies like BBC Media Action – learned important lessons as a result of responding to that crisis. It is to be hoped those lessons – including those that were tried and tested in improving health communications – can be brought to bear in the fight against Zika.