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The Malaria-Ebola Nexus

Digba Massaquoi waits with her 5-year-old son, Lahai, who is ill, at the health clinic in Benduma, outside Bo, Sierra Leone, in July 2014. Amid fears about Ebola, many people in West Africa are choosing not to go to health clinics or hospitals for treatment of other illnesses. Photo by Mike DuBose, UMNS.

Digba Massaquoi waits with her 5-year-old son, Lahai, who is ill, at the health clinic in Benduma, outside Bo, Sierra Leone, in July 2014. Amid fears about Ebola, many people in West Africa are choosing not to go to health clinics or hospitals for treatment of illnesses. Photo by Mike DuBose, UMNS.

The World Health Organization has declared the Ebola outbreak an international health emergency, with 2,000 people infected so far and more than 1,000 deaths in Sierra Leone, Liberia, Guinea and Nigeria. As these countries frantically try to contain Ebola, fearful people are not going to health clinics or hospitals for other illnesses. These illnesses add to the burden created by Ebola.

Malaria is one of the diseases either not being treated or being treated through self-medication, which creates its own  problems. The rainy season is under way, when more malaria cases occur. This compounds the problem. Improper use of malaria medications can result in resistance to the drugs. The medications require a patient to follow a course of treatment, and failure to do so can result in a more drug-resistant parasite in the future.

Researchers suspect a highly resistant parasite now affecting people in south Asia is a result of haphazard malaria drug usage during the Vietnam War.

Both diseases disproportionately affect the poor and ill-informed. Because Ebola and malaria have common early symptoms, such as fever, headache and vomiting, there may be confusion about the cause of illness among both those who are ill and health care providers.

Life-saving messages needed

While malaria is curable, Ebola is not. But there is real concern that the mortality rate from malaria may rise because patients will not seek treatment. Therefore, it is critical to get accurate, life-saving messages to people in these areas.

Communication and education are two of the four pillars The United Methodist Church and its health workers are using in the fight against malaria and Ebola. Neglect of any disease of poverty is costly in human lives and productivity, which means costs to national economies, added burdens for weak national health services, and great human suffering and death.

This panel from an info graphic illustrates malaria's toll. Graphic by Work the World.

This panel from an info graphic illustrates malaria’s toll – as well as lives saved by international efforts. Please click on the infographic link in the narrative to see the entire infographic Graphic by Work the World.

An infographic by Work The World of the UK illustrates both the severity of the toll malaria takes and also the hopeful potential to reduce its consequences. Behavior change communication is essential to reducing the humanitarian crisis of Ebola and the ongoing crisis of malaria.

Responding to the crisis

United Methodist Communications has provided $10,000 crisis communications grants to United Methodist annual (regional) conferences in Liberia and Sierra Leone to help get out health education messages through printed fliers, banners and radio. United Methodist Communications is also networking with other church agencies and international and interreligious organizations to coordinate communications efforts. It has also provided training and software to local communicators to enable them to send broadcast text messages to local people.

Similarly, the United Methodist Committee on Relief, the Indiana Annual Conference and the United Methodist Church of the Resurrection have provided cash assistance to affected regions for medical supplies and communications.

The Foundation for United Methodist Communications has established an emergency communications fund to provide support during situations such as this one so that funding will be readily available in the event of a crisis or disaster. Your help is needed to ensure that we are able to meet these needs as they occur. You can donate here.

This situation also underlines the ongoing need to continue the malaria work the people of The United Methodist Church have supported for the past seven years. The world has made great strides in reducing deaths from malaria, but we are still working toward the goal of elimination. To give to Imagine No Malaria, visit ImagineNoMalaria.org.

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The Foundation for United Methodist Communications has established an emergency communications fund. With your help, we can provide communications support in the event of a crisis or disaster. Donate here.

 

Poverty: The Common Vector

Health worker Kadie E. Koroma (right), part of a team with the United Methodist Church's Imagine No Malaria campaign, processes a voucher that will provide mosquito nets for the family of Gbassay Foday (seated at left) for her home in Baoma village, near Bo, Sierra Leone. Photo by Mike DuBose, UMNS.

Health worker Kadie E. Koroma (right), part of a team with the United Methodist Church’s Imagine No Malaria campaign, processes a voucher that will provide mosquito nets for the family of Gbassay Foday (seated at left) for her home in Baoma village, near Bo, Sierra Leone. Photo by Mike DuBose, UMNS.

While the Ebola outbreak continues, media coverage, at least on television, seems to be waning. Print media continue to provide stories that enlarge understanding about how the crisis is being managed and its effects on people across the region. But this too will fade, and that’s part of an ongoing problem.

In this crisis, a familiar pattern of media coverage has emerged: Ebola has been presented as a mysterious viral disease with a horrific reputation. An outbreak is news. Blogger Michael Byrne, whose blog influenced the title of this post, attributes the mystery to the fact that the virus occurs in remote Africa and not in countries with facilities to provide the supportive care necessary for the body to rally its own protective measures. It’s there, not here, and it’s horrific. That’s sensational.

But once the sensational elements have been covered, unless a new angle appears, the media moves on. And the suffering continues out of sight.

Ebola, malaria, cholera and many other diseases that plague sub-Saharan Africa and other low-income regions are diseases of poverty. Whether the disease is borne by a virus or a parasite, the common vector is poverty.

Profits, neglect and the value of life

Diseases of poverty occur in places where life expectancy is already low and well-being already compromised by inadequate health care, sanitation and economic development. They are in locations where communication and education are weak. And these conditions are long-term, ongoing results of poverty.

In addition, more than one commentator has noted that research and development of drugs to prevent and treat Ebola lags because there is little profit in saving the lives of poor people in rural Africa. For example, Sierra Leone has three doctors per 100,00 population, Liberia one per 86,275, Guinea one per 10,000 and Nigeria one per 2,879 people. Pharmaceuticals and health care follow the money.

Beyond this neglect, corruption, poor governance and wars have kept these countries from building strong economies with an informed citizenry. And, as blogger Lindsay  Hilsum writes after decades of development schemes poverty persists.

This makes it more important to tell the story of people in these circumstances as well as address the conditions that persist and affect their quality of life. Otherwise, they will continue to be overlooked until another crisis strikes.

But in the 21st century, it may be even more critical to build the communication infrastructure that will enable people to gain access to information they need to improve their own lives and to communicate with each other and the outside world.

Combating information poverty

The Ebola crisis demonstrates that information poverty is a significant contributor to the spread of infectious diseases that can destroy whole communities. It points to the need to strengthen educational systems as well as national health systems. And it points to the necessity of major international organizations and partner governments to push for accountable governance and an end to corrupt practices.

At United Methodist Communications, we are providing skills training as we introduce technology after assessing needs with local partners. Technologies can be as complex  as servers and wifi systems or as simple as solar chargers for mobile phones. The technology must fit the day-to-day realities of climate, environment, power source and maintenance. But these are not insurmountable problems. The key is skills training and appropriate solutions for long-standing problems of info poverty.

Ebola is neither mysterious nor inevitable. With information, adequate facilities and procedures, it, along with the other diseases of poverty, can be contained if not eradicated.

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The Foundation for United Methodist Communications has established an emergency communications fund. With your help, we can provide communications support in the event of a crisis or disaster. Donate here.

Response to Ebola counters fear, disbelief and cultural insensitivity

Misinformation and lack of understanding are contributing to the spread of Ebola. Photo courtesy of United Methodist Council of Bishops

Misinformation and lack of understanding are contributing to the spread of Ebola. Photo courtesy of United Methodist Council of Bishops.

The Voinjama region near the border with Guinea is in the epicenter of the Ebola crisis in Liberia.

“This area is overwhelmed with fear, disbelief, and cultural insensitivity to the disease,” the Rev. Cecilia Burke Mapleh, superintendent of the Voinjama District of The United Methodist Church in Liberia, said recently. “At the moment, most of our preaching points stand abandoned if we do not act quickly with preventive messages to and for our members.”

The Ebola crisis has exposed not only the under-resourced health systems in the economically deprived countries of West Africa but also the lack of communications infrastructure essential to everyday survival, contributing to the negative effects of misinformation, superstition and denial.

As the crisis spirals in widening circles, misinformation, mistrust and disbelief not only spread the virus but also contribute to the risk of death from other untreated diseases, as people avoid medical clinics and health care providers.

In the struggle against this virus, information and communication are significant tools.

Getting ahead of the chain

Ironically, modern transportation has contributed to greater mobility among rural peoples in isolated regions, leading to the spread of communicable diseases. Without early detection, tracking and reporting, it’s difficult to identify and isolate those infected with Ebola. Diagnosing Ebola  has been haphazard and slow. Without more health workers, it’s nearly impossible to get ahead of the transmission chain.

But as modern transport contributes to the spread of the virus, so must modern communication be used to contain it. At United Methodist Communications, we are working with African episcopal leaders and their staffs to support communications work they’re already doing and to meet new challenges. We’ve made crisis communications grants to the Sierra Leone and Liberia annual conferences, and we’re in contact with episcopal leaders in Côte d’Ivoire and Nigeria.

African religious leaders have engaged the crisis in several ways. They have prepared messages for radio, funded posters and billboard messages, conducted training for pastors to deliver messages to their congregations and distributed print materials, and they are exploring other ways to communicate accurate information. Bishops have released pastoral letters to assure people God is present with them in this crisis and not the cause of it. Bishops in Sierra Leone and Liberia are also participating in interreligious coalitions and working with national and international health organizations, in addition to local chiefs and other officials.

Saving lives with communications

We’re connecting church-related communicators on the ground with tools they can use for same-day, real-time communication. We’re introducing FrontlineSMS, an open source text-messaging service that allows a sender to broadcast text messages to a wide number of contacts at minimal cost. Sixty-nine percent of Liberians have cell phones, as do 67 percent of people in Sierra Leone and 38 percent in Guinea. We’re also supporting the creation of illustrated print and audio messages for those who are illiterate.

We’re networking with the major international organizations and connecting them with church communicators in the region to address both the myths and the truths of Ebola and will be used by health workers, on TV, DVD and internet video.

 We’re prepared to purchase printers and solar power supplies to print fliers for distribution by hand.

And we’re also supporting person-to-person communications. In Liberia, we’re helping with portable sound systems that local young people can carry as town criers to communicate relevant information.

We will also assess the needs of annual conference offices in the affected areas and develop plans to upgrade their communications capacity, including Internet connection.

Many health officials are saying this outbreak will take several months to get in check. We are working with producers for animated messages that can be used in the future on TV, the Internet and in local villages by health care workers with laptops to illustrate hygiene and prevention.

As important as these tools are, the crisis is revealing something even more important. Clear, accurate messages delivered by a trusted voice in a timely manner  to those who need information can save lives. Communication must be viewed for its strategic importance. It is not simply a support function; it is central to the mission of the church.

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The Foundation for United Methodist Communications has established an emergency communications fund. With your help, we can provide communications support in the event of a crisis or disaster. Donate here.

Free flow of information is critical in crisis

An educational poster about the dangers of the Ebola virus hangs in the community center at the Jaiama Bongor Chiefdom, outside Bo, Sierra Leone. Photo by Mike DuBose, UMNS.

An educational poster about the dangers of the Ebola virus hangs in the community center at the Jaiama Bongor Chiefdom, outside Bo, Sierra Leone. Photo by Mike DuBose, UMNS.

“Fear has gripped the nation.” With those words, the Rev. George Wilson of Liberia summed up the state of his country and described the cost of not allowing information to flow freely in a time of crisis.

Rev. Wilson, who is coordinating The United Methodist Church’s response to the Ebola outbreak in Liberia, said in a conference call that fear is preventing people from taking proper steps in dealing with the deadly virus.

His report was discouraging but motivating at the same time. Speaking with United Methodist Communications staff, he confirmed that hospitals are closing as workers voluntarily abandon their workplaces, and Liberians are self-medicating diseases such as malaria because they’re too afraid to go to hospitals.

An op-ed in the New York Times by journalist Wade C. L. Williams about his experience covering the Ebola crisis in Liberia for Front Page Africa is revealing, especially because the emergency has spiraled out of control.

Williams recounted his difficulty early on gaining access to important places and people to tell the story. He was blocked by government officials.

Considering his report and listening to Rev. Wilson, I recalled a telephone call on June 7 from a member of a United Methodist Communications team in Sierra Leone. The team, including a writer from United Methodist News Service, a unit of UMCom, had discovered that Ebola was present near the site of a net distribution conducted by Imagine No Malaria.

Even then, a physician on the ground warned an outbreak was imminent. The virus had already spread from Guinea to Sierra Leone. But the story had not yet been told. “Should we tell it?”  asked the UMCom staffer.

On the face of it, the answer seems clear. Of course we should tell the world.

But, as reporter Williams documents, such situations are rarely so simple. In Liberia, health ministry officials told reporters they should avoid travel to the affected area because they could spread the virus further. But the virus is not airborne and requires physical contact with the body or body fluids of an infected person, or ingesting bush food such as bats, monkeys or similar wild meat carrying the virus.

The government ministry sought to contain coverage as it released incomplete and misleading information. Rumors and misinformation can create panic. The results, as we now know, are fearsome and tragic.

Obstacles to communicating

It’s been my experience that telling stories in situations of conflict and tragedies such as this crisis can be far more complex and convoluted than what appears on the surface.

Government officials and local workers, for different reasons, may not want to reveal details of an incipient crisis. Despite their heroic efforts, health workers trying to contain this virus lack essential resources to isolate and treat affected patients. This can put them in a bad light. At ground level, workers who talk too much can lose their jobs. At a higher level, officials don’t want to look ineffectual to their supervisors. At the national level, leaders don’t want to appear unable to manage events like this.

A crisis like Ebola can harm business, affect tourism, influence investors and destabilize governments. Of course, officials consider the obvious human suffering and grief that results, but weighing all these factors takes time, and in emergencies time is critical.

In the early stages of an event like this, telling the story comes down to negotiating with, around and through obstacles to get the word out. This is true for local journalists as well as those from outside the country.

As expatriates connected with the church, we’re always aware that we are in a country as guests of the host government and our actions can affect relationships between the government and the church in multiple ways. The ability to assist with effective health care, humanitarian aid and other significant missional efforts depends on good working relationships.

Five realizations

In the case of Sierra Leone, health officials were eager to get the story to the world and we reported quickly. All Africa News Service released a story two days before United Methodist News Service and that helped our reporting.

On June 9, Kathy Gilbert of United Methodist News Service provided a strong first-hand account of the situation in Kenema, the epicenter of the crisis in Sierra Leone. United Methodist Bishop John K. Yambasu issued an urgent call for help on June 25, and we continued to report on the situation.

Many days later, other news services began to report. And days after that, it became clear a regional crisis had mushroomed into a global hazard. The World Health Organization declared an international public health emergency Aug. 8.

By then, however, the virus had spread and an epidemic was at hand.

From this, I hope we are coming to realize:

  1. in an interconnected world, the free flow of accurate information is essential to global well-being and even to survival of life itself;
  1. the infrastructure necessary to carry information to an informed public is an instrument for the public good, and not only for commercial and entertainment uses;
  1. that infrastructure must be built out so that everyone has access to information as a basic human right;
  1. the church should advocate for this infrastructure and help to create it;
  1. the church has a role to play to ensure that stories are told. In this case, it is the story of people in a remote, under-served and overlooked place facing a public health crisis that, unchecked, has become a global health emergency.

I’ll address that in my next post.

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The Foundation for United Methodist Communications has established an emergency communications fund. With your help, we can provide communications support in the event of a crisis or disaster. Donate here.

 

Communication is Aid–and More

Ebola Prevention Banner

Workers hang an Ebola banner in Freetown, Sierra Leone. Photos courtesy of Bishop John K. Yambasu.

Liberian Nobel laureate Leymah Gbowee writes that her mother showed up at her office recently dressed head to toe in a winter coat and headdress in 82ᴼ temperatures. Her mother explained that she wanted extra protection against the Ebola virus.

Misinformation and misunderstanding along with superstition about Ebola abound. The virus is not airborne.  According to medical experts, it spreads through contact with the body fluids of an infected individual or the body of a deceased victim.

Lack of information is the fulcrum on which the spread of the virus tilts toward epidemic. With information about sanitation, abstinence from eating bush meat, and awareness that the disease results from a virus and not from evil spells or spirits, the Ebola outbreak can be contained. But this depends on timely, accurate and effective communication.

The role of communication is being recognized as critical to the well-being of people no matter where they live in the world, and no matter how well connected to the communication networks they are.

When Hurricane Yolanda struck the Leyte region of the Philippines a year ago, one of the first needs the Philippines government identified was for the restoration of the area’s damaged communication capacity.

Similarly, the Religious Leaders Task Force on Ebola in Sierra Leone, chaired by United Methodist Bishop John K. Yambasu, listed a comprehensive communications strategy as its first priority in a longer document spelling out response to the crisis.

Religious Leaders Task Force on Ebola, Sierra Leone

United Methodists in Sierra Leone are working with the Religious Leaders Task Force on Ebola to share information.

We live in a connected world, and lack of accurate information, coupled with incomplete communications infrastructure, is a matter of life and death. Ebola, as the world now understands, is only a plane ride away, no matter where you live.

At United Methodist Communications, we live by the phrase, “a clear message saves lives.” But we also understand that the ability to communicate is equally important.

In the Philippines, we helped to restore Internet connectivity and provide aid agencies with tablets, software and training to enable them to identify where aid was needed, coordinate with each other, and communicate with and distribute aid to survivors.

In the Ebola crisis, we are supporting the efforts of those already at work disseminating accurate information in the countries affected. We are also consulting about infrastructure and distribution tools that can reach the most people with accurate information.

Today, the ability to communicate and the quality of information that is communicated are critical to well-being in local communities and to people in every other part of the world. Communication — and the ability to communicate effectively — is not a simple matter of technology, tools and software. It is a matter of strategic importance.

In many emergency situations, communication capacity precedes other forms of critical aid. In the Philippines, communication preceded material aid. Communication had to be restored to get food, medicine and construction supplies to those isolated and stranded in places cut off from others.

In the Ebola crisis, communication precedes prevention and treatment. The contagion cannot be contained without greater effort at sanitation, isolation of sick people, and proper handling and burial of the deceased. And this has to be communicated effectively and widely. In these circumstances, a clear message saves lives.

Over a lifetime of covering natural and human-caused disasters and writing stories about poverty and development, I’ve come to see that communication is more than the tools we use, more than the software that powers them, and more than the technology that drives the devices. It is a strategic asset that is important to our well-being.

In some circumstances, communication is aid, as a wonderful video produced by Infoasaid demonstrates.

And, if we believe (as I do), that it is God’s intent for all people to find meaning and purpose in life, and to flourish, then communication is actually doing theology. It is a way to fulfill our beliefs and follow our values.

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The Foundation for United Methodist Communications has established an emergency communications fund. With your help, we can provide communications support in the event of a crisis or disaster. Donate here.

Moving Forward and Looking Back–Connecting

UMAC 2012

Wayne Rhodes, General Board of Church and Society, leads a workshop titled, “What You Need To Know About the UM Connection” at the 2012 United Methodist Association of Communicators meeting. UMNS Photo/Kathleen Barry

In this fourth post in the series, I reflect on how communications technologies make it possible to connect with people half a world away, and why that’s important.

Connecting continents

New mobile technologies make it possible to connect with others in ways that were not previously possible. In The United Methodist Church, in which I am ordained, we often speak of ourselves as a connection.

The term is not well understood. It comes from the organizational system in which clergy and laity can conduct ministry and service as part of a global system. It is not a congregational-based organization.

Congregations are connected with each other in a regional organization called a conference. The conference is led by a bishop who is elected from within a larger regional area made up of conferences, called a jurisdiction.

Connection as asset

I believe the connection is one of our greatest assets. It gives us scope and scale that allows us to carry out mission and ministry that is consequential, the kind that can make a difference because of its reach and depth. Often, it is said about some rural parts of the world that the church is in places that even government ministries don’t reach, for example.

By this, it is meant that a local faith community exists beyond the end of the road in places that are not likely to get much attention, places where isolation can lead to poverty, lack of health care, educational services, and basic services. These conditions create stress and suffering that discourage the flourishing life that I believe God intends for all persons.

It means that ideas and resources can be shared in ways that would not happen otherwise. And it means people who might not otherwise be able to do so, can share at a scope that has greater result. This is undergirded by religious values that reflect a commitment to human dignity and belief in the sacredness of all life under God.

Haiti 2013

Teacher Sylné Guerdy works with students in the computer lab at the Thomas Food Project in Thomas, Haiti. The program is part of a United Methodist Communications effort to use technology for development. UMNS photo/Mike DuBose

It is an outgrowth of our understanding of the meaning of discipleship, to follow the teachings of Jesus to care for the world and for each other because we believe we are connected by the love of God and are responsible to and for each other.

Connecting for the common good

In a world of global messaging and influence by governments and corporations, a globally connected world, the means for people of goodwill to carry out works of religious value is needed. When religion is humanizing and compassionate, it contributes to the common good, and a connectional system that can offer, through its communications capacity and through its organizational mission, a deeper understanding of our humanity, a way to reach out with compassion, and to advocate for justice, is a valuable asset.

As we grow in members around the world, we are having conversations about an emerging understanding of how we are connected globally.

At its best, this connection means that we can do more together than we can do independently of each other, as individuals or as single congregations. It  allows us to achieve scope and scale, as when we give to Imagine No Malaria, which results in the provision of medicines, bed nets and health training that can affect whole regions and nations.

It also enlarges our influence for the common good, which is a direct outcome of our commitment to follow the teachings of Jesus to heal the world and reach out to those who are sick and in prison, poor and neglected, no matter where they are.

Connecting through global mapping

About five years ago, Bishop David Yemba of the Central Congo Episcopal Area and I discussed his concern that there were local churches, as well schools and health clinics operated by the church in the Democratic Republic of the Congo, that could not be identified. Lacking a developed road system or effective communications, these facilities were unconnected.  The options available at that time to map those locations were both limited and expensive.

In the last 12 months, United Methodist Communications initiated a pilot project to map the geographic locations of churches outside the U.S. and add them to a global database available to everyone online. This effort began with the Democratic Republic of the Congo and the Philippines, and will extend to other countries within Africa, the Philippines, eastern and central Europe and Scandanavia in 2014. (United Methodist Communications began to provide communications tools and training to connect these conferences several years ago. A network of communicators has been created and the networking of conferences is continuing.)

For the first time, people looking for United Methodist churches, schools and health care facilities in Africa, Europe and the Philippines will be able to find them online and learn more about their ministries. This information is being gathered through the use of technologies that reside on mobile phones and take advantage of GPS and software called Ushahidi, an open source project that allows crowd source emergency information to be sent by mobile phones.

Screen Shot 2014-01-08 at 10.56.59 AM

Sam Perales configures link in Tacloban, Philippines to enable communication for humanitarian agencies while UMCOM representative April Mercado, and Randy Baido looks on. UMCom Photo/April Mercado

Ushahidi has never been used like this, so it’s innovation to the max. It’s also easy and cost free.

It’s important to understand where local churches and other facilities are located as we continue to grow into an understanding of ourselves as a global church. It will allow for more careful and informed planning, as well as better opportunities for sharing information, training, resources and personnel.

Global mapping is in its initial stages as I write, but as it progresses, we will have for the first time a visual database that offers a view of the geographic position of the mission and ministry of the global United Methodist Church.

Global connection is essential

There is real value in the phrase “think globally, act locally,” especially for Christians who inherit a theology spread by a global evangelist named Paul and the teachings of Jesus, who broke down regional and cultural barriers  through his actions and preaching.

Christian teaching calls us to open ourselves to our place in the world as well as our relationship to God and to each other. We are called to take responsibility for the whole of Creation. To be a follower of Jesus is to be connected through relationship with others and with God. We are called to consider the health of the entire planet and those with whom we share it, and to take action in our own communities and cities as well.

When we use information and communication technologies to connect us, they can serve as tools for ministry, and the outcomes, when they bring positive, transformational change, are ministry. I believe building an understanding of our global connection is important to the work of doing theology in the connected world of the 21st century.

Words Matter: Why Obamacare Is A Communications Disaster

Health Insurance InfogramWhen comedian Jimmy Kimmel asked people on the street whether they favored the Affordable Care Act or Obamacare, the Affordable Care Act won handily.

This confusion is not limited to Kimmel’s street prank.

Polls show that people don’t know that Obamacare and the Affordable Care Act are the same. And they react more negatively toward Obamacare than toward affordable health care.

While Kimmel was working a comedy routine, the lesson should not be lost. Words matter.

It escapes me why the Obama administration allowed opponents of the health care act to define it and, ultimately, demonize it. Even worse, some administration officials use the “Obamacare” handle themselves.

This lack of message discipline, in effect, works against the signature legislation of the President they serve.

The lessons in this communications debacle are many.

 How to Do It Better

First, tell your own story. Never leave this to others. Define yourself before others define you.

Second, keep it simple. The complexity of the legislation overwhelmed the simple message that its purpose is to make health care affordable to more people.

While the opposition defined Obamacare as complex, unworkable and economically destructive, the wound is also self-inflicted.

Communications consultant Ann Wylie analyzed four text samples in an online training manual for field workers who are assisting people to sign up for health insurance under the new law. She found the passages difficult to understand.

Wylie shows how to present complex procedures in simple language. Her suggestions:

  • Use bulleted lists
  • Break up long sentences
  • Use active rather than passive writing
  • write to the reader in the second person
  • Use short words (two syllable words are easier to read than three syllable words)
  • Use personal illustrations
  • Ask a question

Most general interest publications are written for eighth grade comprehension level, but studies show that those who can read at a higher level are not insulted by reading downward.

Therefore, simplifying doesn’t lose readers or harm communication, it can enhance comprehension.

Third, communication is a strategic function. It’s not limited to tactics.

Communication is a Strategic Asset

Communicators implement tactics, such as deciding how to package and present information, but tactics come after thoughtful consideration about the key message, or messages, and how to deliver them. This requires strategic thinking.

When communicators start with tactics and don’t give sufficient thought to strategy we reduce our role to a support function and allow others to define us by that role.

I advocate for communication to be viewed as  a strategic function, especially in the always-on, multi-media environment of the 21st century.

Strategy requires thinking about who we want to interact with and how they use media. It involves knowing if the information we’re conveying is important for them and how we will reach them.

Most importantly, it involves developing a clear message and consistently presenting it.

Learning From the Mistakes

I hope the Obama administration is learning this lesson because access to affordable health care is important.

Even before the embarrassing website fiasco, the Affordable Care Act was in trouble because it had been defined as Obamacare, and that’s an epithet to some people.

Lack of strategic communications’ planning and consistent messaging had already created a void filled by negative perceptions. Now this botched communication threatens the most significant policy initiative of the Obama presidency.

Words matter.

 

The Astounding Impact of Innovative Technology in the Developing World

Nathan Myhrvold’s TEDTalk,”Could this laser zap malaria?” is an eye-opening look at how computer science and technology can help address an ancient and persistent disease that is responsible for 655,000 deaths each year. To think that it’s possible for a laser to not only kill mosquitoes in mid-flight, but determine from their wing beat frequency whether they are females (which potentially carry malaria) or males (which do not bite) is downright astonishing.

Yet even technology that’s far more accessible than what Myhrvold describes is changing the game in Africa — not only aiding in the fight against malaria, but opening a whole new world. Mobile technologies make it possible to have access to information that is transformative, whether it’s tracking disease outbreaks or educating children.

Once I was in a remote village in northern Senegal where there were no telephones or even electricity, disconnected from the rest of the world. Back home in the U.S., my son was in need of emergency surgery and my wife, Sharon, was purposefully trying to get a message to me.

It took her an entire day to find someone who would agree to go to the village to locate me. It took a another day for that person to reach me by car — then yet another day for the two of us to navigate the poor roads to the nearest town with a post office that had phone service. Once there, I had to make an appointment to come back to use the phone the following day. By the time I was finally able to speak to her, my son was already recuperating.

Mobile technologies are empowering those who were once isolated and transforming the ways they communicate.

That’s what life was like in rural Africa before cell phones and satellites. Today, cell phone usage in Africa is commonplace, with more than 10.7 million mobile phones in Senegal alone. Mobile technologies are empowering those who were once isolated and transforming the ways they communicate.

Improving – and saving – lives

Pierre Omadjela, director of Communications and Development for the Central Congo Annual Conference of The United Methodist Church, is using FrontlineSMS to share health information and increase awareness about malaria prevention (a major focus for The United Methodist Church’s Imagine No Malaria initiative). FrontlineSMS is free, open-source software that can be used to send text messages to groups of people without an Internet connection that is being used in a variety of ways to improve people’s lives.

Using automated messages to mobile phones, Omadjela says they have already realized a 5 percent decrease from the work they are doing teaching people in the Democratic Republic of Congo ways to prevent malaria.

A couple of weeks ago, I was in Blantyre, Malawi, for a meeting of The United Methodist Church of Malawi. During a workshop on Transformative Communication, which included presentations from leaders at Inveneo and Medic Mobile, one workshop leader asked the group of 85 participants how many owned and use mobile phones. Virtually every hand in the place was raised.

Later, at another training conducted in Madisi, Malawi, on how to use FrontlineSMS to communicate with key groups of people, local church personnel and caseworkers who work for ZOE Ministry, a program that helps empower orphans and vulnerable children in Africa, were in attendance. As one woman sent her first FrontlineSMS text message, she shrieked with wonder. “It worked!” she marveled.

While 75 percent of the world has access to a mobile phone, smartphones make up only 15 percent of the global market. biNu is a platform that allows those with feature phones to have a smartphone-like experience through cloud-based apps and services, providing them with immediate access to email, news, books, health information and social features.

That means the world’s information library is available through not only smartphones, but also conventional mobile phones. Children are able to read books they could not afford and have access to educational information they otherwise would not.

‘All about potential’

Access to information is also giving people the means to have more control over their circumstances. In Kenya, I watched as two women used a teacup-sized satellite receiver plugged into a boom box get audio digital information that was then translated into text, allowing them to check the market price of beans so they could negotiate a fair price for their own crop. No longer must they rely solely on the price quoted by a distributor.

Microsoft CEO Steve Ballmer says, “The number one benefit of information technology is that it empowers people to do what they want to do. It lets people be creative. It lets people be productive. It lets people learn things they didn’t think they could learn before, and so in a sense it is all about potential.”

Remarkable new information technologies are unlocking the potential of developing countries in ways that are not only empowering, but revolutionary. As new innovations and new possibilities continue to be presented, the digital future is becoming the digital present. I can’t wait to see what’s next.

 

Malaria battle is not lost, but we must redouble our effort

The BBC story “Bed Nets for Malaria: Losing the Arms Race?”, which aired on NPR, created a flurry of questions about the progress against this persistent disease.

Are bed nets continuing to be effective? Are bed nets the solution? Are we in danger of falling back and giving ground to a more virulent form of the parasite?

These questions are important and deserve a careful response. They are especially relevant to United Methodists who are closing in on raising $75 million for the Imagine No Malaria campaign.

Feliciana Domingos and her daughter, Sarafine Lorenço, take shelter beneath a mosquito net at their home near Malanje, Angola, in 2006. Forty-six percent of all the deaths in Malanje are related to malaria. A UMNS file photo by Mike DuBose.

Feliciana Domingos and her daughter, Sarafine Lorenço, take shelter beneath a mosquito net at their home near Malanje, Angola, in 2006. A UMNS file photo by Mike DuBose.

From the outset of the current initiatives against malaria, it was clear that bed nets would be effective for a period of two to three years. It was also clear that resistance to existing medications and pesticides is one of the most frustrating capacities of the malaria parasite.

So the questions raised by the BBC story have been anticipated by malaria specialists for a number of years.

However, in my view the story emphasizes the importance of continuing to raise funds for several angles of attack against this resilient parasite. Bed nets do need to be replaced. Therefore, continuing to fund the manufacture and replacement of nets is part of the whole approach necessary to continue the fight. It’s not the only part but one of the multiple steps that need to be taken.

Research and education are needed

In addition, it’s important to continue to fund research into various prevention methods. Research at Vanderbilt University in Nashville, Johns Hopkins in Baltimore, and facilities in Seattle among other places must be continued and strengthened. These approaches range from finding ways to alter the reproductive abilities of the female mosquitoes that carry the parasite, to altering mosquito DNA and even to immobilizing the parasite itself through creative genetic manipulation, which goes beyond my layperson’s understanding.

It’s also necessary to continue to educate people in malaria-affected regions to keep their environment free of standing water and trash that serves to catch rainwater.

It’s important to educate children (and adults as well) about wearing clothing that will protect them from mosquitoes when the insect is most active in the morning and evening. This, along with environmental cleanup, is known in the malaria world as behavior change communication.

Those who are fighting this disease have been addressing behavior change for many years, reinforced by the communications efforts of United Methodist Communications. The task is ongoing.

It’s important to continue research into more effective pesticides because the parasite has shown an amazing ability to adapt and resist. This may be the greatest challenge.

Artemisinin resistance was identified by the World Health Organization in some regions several years ago. The agency warned of the spread of the parasite into new areas and called for increased containment efforts.

Health workers in the field need to continue their efforts at quicker diagnosis and treatment of those suspected of contracting malaria. The sooner appropriate medications can be provided the more likely the worst of the disease’s effects can be addressed.

And research must continue into effective drugs for treating the disease. These efforts, as others I’ve listed above, are taking place in many locations around the world.

Lives are at stake

One of the reasons this disease has persisted is its ability to adapt, but the effectiveness of these various inputs from the highly sophisticated to the most rudimentary have resulted in significant progress in reducing deaths and suffering in recent years. But the battle is not over, and it certainly isn’t lost.

We must continue the fight, keeping our eyes wide open to the challenges the BBC has accurately identified.

And we must not lose heart and yield to the thought that the disease cannot be conquered. To do so is an invitation to an even greater calamity. The world experienced that about 30 years ago, when progress against the disease was made and the fight was abandoned prematurely.

The result was that the parasite came back even stronger and was more difficult to contain, causing many more deaths and posing a challenge that was far more difficult to treat.

The fight against this disease is challenging, but what is at stake are human lives. We have seen many places around the world, the United States and Panama for example, where malaria once claimed lives with impunity but is now under control.

This is not the time to let the challenges cause us to hesitate. It’s time to redouble our efforts to enjoin the fight.

As World Malaria Day Approaches, HBO Movie Raises Needed Awareness

This weekend, I watched the HBO premiere of “Mary and Martha,” a compelling story of two women of different ages from different countries who are drawn  together by the common experience of having their sons die from a threat they never expected: malaria.

As the pair struggle to come to grips with the untimely loss of their sons, Mary (played by Hilary Swank) and Martha (Brenda Blethyn) forge a deep friendship and become advocates in the fight against a deadly disease that kills 655,000 people every year, most of them children.

As I watched the drama unfold, I couldn’t help but hope that the movie’s message reaches people who are currently unaware that children are dying from a preventable disease at an unconscionable rate. I hope that it moves them to action.

Hassan Sesay and his wife Amindalo Sesay sit with their children Falmota, Marianne and Alice, in front of the new mosquito net they received as part of the Imagine No Malaria campaign at their home in the Gbo Chiefdom outside Bo, Sierra Leone. Photo by Mike DuBose.

Hassan Sesay and his wife, Amindalo Sesay, sit with their children in front of the mosquito net they received through Imagine No Malaria at their home outside Bo, Sierra Leone, in 2011. Photo by Mike DuBose.

Like Mary and Martha, too many people are simply not cognizant of the impact of this killer illness.

My own connection to malaria runs deep. I’ve had it twice, first in the 1980s, in Phnom Penh, Cambodia, when I walked in ankle high grass around a killing field while doing work on a film about Cambodia shortly after Pol Pot. I had another bout with the disease in Gondar, Ethiopia, a year or two later.

In both cases, I was fortunate enough to be able to get to a doctor and receive medication as soon as I began to feel symptoms—chills, fever, and listlessness.

I’ve also seen dozens of children die from malaria, and I’ve seen the grief etched on the faces of parents who have lost their children.

I recall a young mother in Honduras who brought her semi-conscious infant to a clinic, after walking miles from a small village in the rural mountains. By the time she arrived, the baby – only a few months old – was in serious danger, and the clinic lacked the medicines for an infusion for the child. As the mother sat before the nurse who attempted to treat her child, the baby died.

In a tent clinic in a refugee camp in Ethiopia, where dozens of people staggered in after a severe famine, I saw a grandmother carrying a comatose baby. Breathing heavily, the baby clearly was in desperate condition. A doctor started an infusion of medication through an IV, but it was too late.

These images are emblazoned in my memory. I cannot forget them.

Those were only two children, and those scenes are repeated in similar fashion every single day. In Africa, malaria takes the life of a child every 60 seconds.

Our children, our responsibility

In the movie, Martha stays to help for a while at the orphanage in Mozambique where her son, Ben, was a teacher. When she decides to leave, the children give her a collage that says, “We are all your children,” as a parting gift.

“We are all your children.” That’s a striking statement. The children of the world are our children. Imagine what we could accomplish if everyone made a commitment to take some responsibility toward providing a healthy life for all of God’s children.

INM_WebBanner_300x2501Programs like The United Methodist Church’s Imagine No Malaria initiative and its partner organizations are making a difference, producing life-saving results. Malaria’s impact has been cut in half in just a few short years, but the battle is still far from over.

Millions of nets have been distributed, but millions more are needed before we are able to cover every child in every village at the end of every road.  And nets are not enough. More lasting solutions are required. More health workers must be trained to recognize and treat symptoms at the outset of the disease. More health clinics are needed. More mothers and fathers need to know what they can do to prevent it.

This week on April 25, we will observe World Malaria Day. There’s no better time to join a movement that is saving lives. My prayer is that one day, there will be no malaria. My hope is that day will come soon.

For more information, visit ImagineNoMalaria.org.

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