Working during public health emergency

Typically, the authorities and experts on public health practices are public health officials

Emergencies are major media events. Reporters—like emergency responders—have an important role to play during a crisis/disaster; they monitor the situation and provide their audiences with accurate and timely public health information. To do this, though, the media need cooperation.
The media are a valuable tool for sharing news and safety messages when a disaster happens, and they should be deliberately included in all emergency responses. Social and traditional media can help communicate life-saving messages directly to the people who need them most in a crisis.  When the organization works well with the media, more members of an affected community can get access to the information they need to protect themselves and their families.

In a recent coordination meeting (22nd July) for the Chikungunya outbreaks at the Ministry of Health and Family Welfare; the honorable Minister for Health & Family Welfare including others blamed that the media created havoc regarding chikungunya outbreaks and the published reports were far from the real situation! If we notice the report of the Prothom Alo published on 19th July referred to the numbers (18 lac people might be infected) was quoted from a public health specialist. In the report we also observed that an ex- director of the IEDCR told the reporters that up to 10 % of the population might be infected. Now the question is who is who to report the reporters? There are so many peoples in Bangladesh claims themselves as public health specialists or epidemiologists but if we look into their academic qualifications and expertise we will be horrified! The IEDCR got a Professor of Epidemiology who had no Bachelor/Master/ Post- master degree in Epidemiology but became professor and director of the institute (and acted as director for about 12 years!). But having no recruitment rules for the IEDCR since its inception in 1976, one officer having PhD (Cambridge), MPhil (DU), PG diploma (DU); and a MBBS from Dhaka Medical College with proven leadership capabilities got no promotion from Senior Scientific Officer (equivalent to Assistant Professor) to any higher position in his long 24 years of service. The position of the director was upgraded to grade 2 and retained for the long 5 years but no one moved forward to get clearance from the respective authorities as they were afraid that they were not eligible to get that grade.

Two posts of the Junior Scientific Officers of the Department of Medical Entomology were abolished as no recruitments were done timely. Anyway, the Government should authorize the respective department of the institute to comment on specific event that have the sound knowledge and background/specialty in that subject. On 27th July, the Honorable Minister for Health and Family Welfare pointed out that the two Mayors were not aware of this situation until the health authorities started alerting the people and the concerned. But the officials of the IEDCR attend meetings regularly with the health officials of the City Corporations regarding vector controls and control measures; so communication and coordination gaps exists between IEDCR & City Corporations. To most effectively protect and promote the health of the population, the nation’s entire governmental public health infrastructure—its human resources, information systems, and organizational capacity— must be revitalized and strengthened.

Typically, the authorities and experts on public health practices are public health officials. The public expects these officials to offer important health information and guidelines to prevent disease and promote good health strategies. In times of public health crisis, their authoritative voices become even more important.

Those who speak for public health—being interviewed by journalists, preparing public health alerts, producing written materials, using the broad reach of social media, or presenting at community meetings—should be clearly conscious of the importance of communication not only for raising awareness and providing needed action steps, but also for earning and maintaining trust. The careful crafting of accurate, consistent, and meaningful messages can calm the public in uncertain times, avoid perceptions of chaos, and build trust.

This article highlights principles of clear communication and insights from several decades of health literacy studies to support such efforts. Working well with the media means making sure they have the information they need. Reporters want:  (1) Equal access to information and experts, (2) timely answers that allow them to meet their deadlines, and (3) reliable, regular updates.  The authority should be proactive in providing information to the media and the public as soon as possible to establish the organization as a credible source. Communicate early and often. When communicating with the media in an emergency, we have to remember they have a job to do. We can make their job easier by: (i) Providing as much background information as possible, (ii) making points clearly and consistently; and (iii) quickly correcting any incorrect information the media release, especially if it could be harmful to people in crises.  

Keeping the media updated with correct communications can help reduce the spread of rumors and speculation. Communication specialists have highlighted the limitations as well as the strengths of awareness and education efforts. Communications cannot compensate for inadequate health systems or resources, nor can they produce sustained change in complex behaviors without support from a larger programmatic effort.

Furthermore, communications may be complicated by an intended audience’s preconceptions about the topic or the communicator. People may compare an experience to what they hoped it would be, to what they expected it to be, to other experiences they have had in the recent past, or to experiences others have had and reported. Many of these challenges may arise during a public health crisis. Consequently, it becomes even more critical to understand the intended audiences and to make sure the information provided is credible and accurate.

Even, and perhaps especially, in times of emergency, public health communicators should maintain a high standard of quality for the message. This means that the message must always exhibit accuracy (which requires it to be updated as often as necessary), clarity (with all scientific information rendered into language easily understood by a layperson), and receptivity (this means it has been tested with some members of the audience to ensure its effectiveness and revised before being released to the public).

In Bangladesh, government has a specific responsibility to strive to create the conditions in which people can be as healthy as possible and to improve the health and health care of all Bangladeshis. If the nation’s health is to continue to improve, governmental public health agencies must continue to be effective at what they currently do well, but they must also find strategies and opportunities to influence other sectors to regard population health as a mutually beneficial goal. This will require new skills that complement the traditional skills found among the governmental public health workforce and enable them to link perspectives and learn from other specialties to tackle today’s pressing community health challenges. However, these skills are not currently prioritized in the workforce or represented in most curricula in medical colleges/institutes and programs of public health.

The writer Former Head, Department of Medical Sociology
Institute of Epidemiology, Disease Control & Research (IEDCR)
Dhaka, Bangladesh, E-mail: [email protected]

 

Working during public health emergency

Typically, the authorities and experts on public health practices are public health officials

Emergencies are major media events. Reporterslike emergency respondershave an important role to play during a crisis/disaster; they monitor the situation and provide their audiences with accurate and timely public health information. To do this, though, the media need cooperation. The media are a valuable tool for sharing news and safety messages when a disaster happens, and they should be deliberately included in all emergency responses. Social and traditional media can help communicate life-saving messages directly to the people who need them most in a crisis. When the organization works well with the media, more members of an affected community can get access to the information they need to protect themselves and their families. In a recent coordination meeting (22nd July) for the Chikungunya outbreaks at the Ministry of Health and Family Welfare; the honorable Minister for Health Family Welfare including others blamed that the media created havoc regarding chikungunya outbreaks and the published reports were far from the real situation! If we notice the report of the Prothom Alo published on 19th July referred to the numbers (18 lac people might be infected) was quoted from a public health specialist. In the report we also observed that an ex- director of the IEDCR told the reporters that up to 10 % of the population might be infected. Now the question is who is who to report the reporters? There are so many peoples in Bangladesh claims themselves as public health specialists or epidemiologists but if we look into their academic qualifications and expertise we will be horrified! The IEDCR got a Professor of Epidemiology who had no Bachelor/Master/ Post- master degree in Epidemiology but became professor and director of the institute (and acted as director for about 12 years!). But having no recruitment rules for the IEDCR since its inception in 1976, one officer having PhD (Cambridge), MPhil (DU), PG diploma (DU); and a MBBS from Dhaka Medical College with proven leadership capabilities got no promotion from Senior Scientific Officer (equivalent to Assistant Professor) to any higher position in his long 24 years of service. The position of the director was upgraded to grade 2 and retained for the long 5 years but no one moved forward to get clearance from the respective authorities as they were afraid that they were not eligible to get that grade. Two posts of the Junior Scientific Officers of the Department of Medical Entomology were abolished as no recruitments were done timely. Anyway, the Government should authorize the respective department of the institute to comment on specific event that have the sound knowledge and background/specialty in that subject. On 27th July, the Honorable Minister for Health and Family Welfare pointed out that the two Mayors were not aware of this situation until the health authorities started alerting the people and the concerned. But the officials of the IEDCR attend meetings regularly with the health officials of the City Corporations regarding vector controls and control measures; so communication and coordination gaps exists between IEDCR City Corporations. To most effectively protect and promote the health of the population, the nations entire governmental public health infrastructureits human resources, information systems, and organizational capacity must be revitalized and strengthened. Typically, the authorities and experts on public health practices are public health officials. The public expects these officials to offer important health information and guidelines to prevent disease and promote good health strategies. In times of public health crisis, their authoritative voices become even more important. Those who speak for public healthbeing interviewed by journalists, preparing public health alerts, producing written materials, using the broad reach of social media, or presenting at community meetingsshould be clearly conscious of the importance of communication not only for raising awareness and providing needed action steps, but also for earning and maintaining trust. The careful crafting of accurate, consistent, and meaningful messages can calm the public in uncertain times, avoid perceptions of chaos, and build trust. This article highlights principles of clear communication and insights from several decades of health literacy studies to support such efforts. Working well with the media means making sure they have the information they need. Reporters want: (1) Equal access to information and experts, (2) timely answers that allow them to meet their deadlines, and (3) reliable, regular updates. The authority should be proactive in providing information to the media and the public as soon as possible to establish the organization as a credible source. Communicate early and often. When communicating with the media in an emergency, we have to remember they have a job to do. We can make their job easier by: (i) Providing as much background information as possible, (ii) making points clearly and consistently; and (iii) quickly correcting any incorrect information the media release, especially if it could be harmful to people in crises. Keeping the media updated with correct communications can help reduce the spread of rumors and speculation. Communication specialists have highlighted the limitations as well as the strengths of awareness and education efforts. Communications cannot compensate for inadequate health systems or resources, nor can they produce sustained change in complex behaviors without support from a larger programmatic effort. Furthermore, communications may be complicated by an intended audiences preconceptions about the topic or the communicator. People may compare an experience to what they hoped it would be, to what they expected it to be, to other experiences they have had in the recent past, or to experiences others have had and reported. Many of these challenges may arise during a public health crisis. Consequently, it becomes even more critical to understand the intended audiences and to make sure the information provided is credible and accurate. Even, and perhaps especially, in times of emergency, public health communicators should maintain a high standard of quality for the message. This means that the message must always exhibit accuracy (which requires it to be updated as often as necessary), clarity (with all scientific information rendered into language easily understood by a layperson), and receptivity (this means it has been tested with some members of the audience to ensure its effectiveness and revised before being released to the public). In Bangladesh, government has a specific responsibility to strive to create the conditions in which people can be as healthy as possible and to improve the health and health care of all Bangladeshis. If the nations health is to continue to improve, governmental public health agencies must continue to be effective at what they currently do well, but they must also find strategies and opportunities to influence other sectors to regard population health as a mutually beneficial goal. This will require new skills that complement the traditional skills found among the governmental public health workforce and enable them to link perspectives and learn from other specialties to tackle todays pressing community health challenges. However, these skills are not currently prioritized in the workforce or represented in most curricula in medical colleges/institutes and programs of public health. The writer Former Head, Department of Medical Sociology Institute of Epidemiology, Disease Control Research (IEDCR) Dhaka, Bangladesh, E-mail: [email protected]