Thursday, February 28, 2013

Cholera and health communication

Health communication is generally seen as one of the duller departments within the medical and public health enterprise. The image is conjured of dour health professionals, endeavoring to improve the understanding of health-related issues among the recalcitrant general population with (yet more) well-intentioned posters and pamphlets. But it can and should be conceived differently. Health communication is not the monopoly of health experts. We all do it, to some extent: we repeat what we hear about what is healthy or unhealthy, and tell each other what behaviors or consumables to embrace or avoid. Commercial interests barge in. Distorted or self-serving communication is also communication, as are rumor, gossip and hearsay. Every message from the Ministry of Health is set in a world of countermessages. And the release or suppression of health information -- particularly about threatening conditions -- can have all sorts of motivations.

I was reminded of this when reading about recent events in Mozambique. In the northern province of Cabo Delgado, cases of suspected cholera raise rumors of government and health care efforts to intentionally sicken the local population. The Diario de Mocambique, the daily paper from the capital Beira, reported that the latest uprising was sparked by the death of a mother and her children from some sort of diarrhoea-related disease. Relatives of the deceased believed that these were cases of cholera, and that cholera had been spread by local authorities and backed by the ruling Frelimo party. Others joined in the melee. Police and reinforcements were called: injuries, deaths and arrests ensued. This too is health communication, where health issues may be symptomatic of deep distrust between citizens and governments.

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