Covid-19 awareness must speak the language of the masses

After more than three months of working from home, I came to work yesterday. It felt a bit strange to come back to the office wearing masks and follow so many protocols. It felt like going to battle wearing full combat fatigue. 

On my way back home I decided to walk the last leg of my journey. We get to see more when we walk the streets. There are many things that we do not usually notice when we use a vehicle.

In the three-km stretch of my walk, I passed by motor mechanic shops, closed Chinese restaurants and food courts, local bazar, scrap stores and mosques. The users of these facilities and its occupants are mostly people from a poor background. They are people who do not play any role in the overall policy decisions of the country. They are the people whom we tend to ignore and consider them as an automatic class to be governed.

To address a public health issue through mass awareness requires an army of healthcare professionals at the grassroot level. PHOTO: BRAC

In my entire length of the walk, I tried to gauge the percentage of people wearing masks and maintaining social distance. There was no scientific method followed here. I was another nobody on the street who was keenly observing the number of people following two basics in the fight against Covid-19. With my naked eyes, I estimated that more than 80 percent people were not wearing masks.

I saw young men riding bikes, taking pictures, children playing, parents walking with very young children - none of them wearing masks. Rickshaw-pullers, shopkeepers, restaurant workers and customers all seemed to have returned to life before Covid-19. I was feeling strange and out of place wearing a mask, hat and trying to maintain social distance. I received odd looks from some of the people.

I was wondering whether I should be relieved that life is going back to old normal from the new normal, or I should be concerned as there is no sign that Covid-19 has disappeared. In the face of the pandemic, Bangladesh has taken various measures and there are debates about the policies and measures that have been put in place. 

There are merits in some of the criticisms aimed at the overall health system and how it has come to a tipping point under tremendous pressure. This writing is not aimed at those big policy decisions.

Ever since the World Health Organization (WHO) declared Covid-19 a pandemic on March 11, Bangladesh government and other organisations took the matter more seriously (by then we lost good two months to prepare). The government of Bangladesh has prepared a document "National Preparedness and Response Plan for Covid-19, Bangladesh" which was launched on March 5, 2020. 

We have also updated the "Infectious Diseases (Prevention, Control and Elimination) Act, 2018" to have a legal framework in place. There are debates about the timing and the effectiveness of these measures which are beyond the scope of this write-up.

In a country with a fragile health system, prevention is the best option, and mass awareness is the main weapon for implementing this strategy. Therefore, a look at the communication elements of the national plan for prevention of Covid-19 through awareness is of interest here. The national plan indicated that the government aimed to create a social movement for awareness through multi-sectoral participation. This would reach out to people in the places of influence at all levels.

One component of this multi-sectoral strategy is to create mass communications using IEC materials, mass media, interpersonal communication, announcement, advertisements etc. It further planned to reach all social groups with risk communication and services, taking into account gender, age, disability, education, migration status with cultural and gender sensitivity.

The national plan also stressed that all messaging be disseminated in a way so that it does not create panic. Therefore, the government plan indicated that it is imperative to develop and standardise preventive messages packaged for different audience groups, including the general public, service providers, children, parents of the children, school teachers and religious leaders.

While it is all good and praiseworthy on paper, what has happened on the ground remains a question.

We have seen lots of awareness messaging in electronic, print and social media. There were a number of initiatives to send the message of practising safe behaviours for the prevention of the pandemic. However, according to Brac's perception survey in May 2020, more than three-fourths of respondents said that they practice coronavirus preventive behaviours, while the remaining one-fourth said they are irregular in those practices.

More than three-fourth (78 percent) respondents felt that there is no chance or very little chance for them but to get infected with the coronavirus. Respondents from rural areas (81 percent) compared to urban areas (71 percent) express more confidence in not getting infected. This was an alarming finding. People seem very relaxed and somehow believed that they are immune from it. We have to take note that this was a perception survey based on responses from 2,317 respondents.

While this survey was a good indicator it understandably does not give us the whole picture, and the bigger picture is surely not better than the findings of the survey. The Chinese team of doctors was in Bangladesh to render their expertise for strengthening the capabilities of our health professionals. On the day of their departure, they voiced their concerns and dismay at the lack of public awareness in Bangladesh. My little experience described above has also given me a frightful realisation about the state of awareness.

The penetration of print, electronic and social media in Bangladesh is still low compared to other countries despite a hike in the use of online media platforms. We must also keep in mind that the messaging is reaching a certain level of people and not reaching the people at large through these mediums.

Looking back at history- in 1971 we fought against the establishment elite of Pakistan with our own Bangladesh narrative against their religion-based narrative, through a radio station. We have seen a very successful campaign in the 1980s by Brac to fight diarrhea through the famous wordings of "Ekmuth gur, ek chimti lobon, aar aandh sher pani". 

Such simple, down to earth language captured the imagination of the people. These messages were supported by the door-to-door visits. We only had a handful of newspapers and state-run electronic media and no social media back then.

In urban areas, there is little presence of close-knit communities. Although all our planning and strategies envisage reaching the smallest grassroot units, the structure of planning and strategies are vertical. The lack of horizonality of the decision-making process is reflected in the overall messaging of all awareness campaigns.

Our failure to learn from the past has been catastrophic. To address a public health issue through mass awareness requires an army of healthcare professionals at the grassroot level that could go door-to-door and speak the language of the people in the community. But we seem to be over-relying on digital solutions which are not as widely used as it needs to be. Our failure to contextualise digital solutions has led to limited penetration of awareness messaging to the masses.

In my view, the crux of the problem is not the lack of infrastructure. We see lots of campaigns to create mass awareness in our country start with a bang but end up in a whimper. The main reason for these failures is that these campaigns do not speak the language of the masses. The messages do not encapsulate the imagination of the people.

We seem to live in two different Bangladesh. One Bangladesh speaks the language of the privileged, makes policies and protects the few and takes the other Bangladesh for granted as the eternally governed class whose life and the language they do not understand or do not try to understand.

The author is currently working as the Programme Head of Human Rights and Legal Aid Services at Brac