The role of health communication has been critical in implementing the standard preventative and control measures during the Covid-19 pandemic. From addressing the unknown at the start of 2020 to cultivating norms on physical distancing, hand hygiene and use of masks and now finally getting people to vaccinate in 2021, communication has profoundly influenced the progression of this pandemic. What started as a public health crisis expanded into a global financial crisis with shocks to livelihoods and income, and recently it has turned into a vaccination frenzy.
Consequently, communication during this global crisis is no longer just about getting people to abide by public health measures. It can be argued that the secondary impacts of Covid-19 have opened or widened existing cracks in the state-citizen relationship and the relationship among citizens. Hence, it is essential to reflect upon some fundamental rules of communication while we aim to repair the loose threads in the social fabric of Nepali society.
Communication is a mind-set
Communication begins with what we think. The first rule of communication is that it is, in principle, a mindset. Therefore, it should be practised rather than drafted. In the final week of April 2021, the District Administration Office, Kathmandu, decided to impose a lockdown, citing a surge in new cases of Covid-19. The office is well within its rights to take the call, and we as citizens have a responsibility to support it. But like any other time in the past, we got to see the directives about the duration and modality of the lockdown with no clear explanation on the timing of this step, triggers that would determine the length of the lockdown, the order and the manner in which authorities plan to re-open different sectors, the mechanism to support those families and individuals who might struggle to keep themselves fed and so on. Understandably, in a crisis of this scale, authorities may not be able to reach every last person who needs help. Still, it is essential to demonstrate a transparent mindset and communicate the action plan as clearly as possible. Thus, communication is indeed a way of thinking which authorities can apply by demonstrating transparency and accountability. When things are well communicated, it empowers citizens to have a stake. Automatically, they become stakeholders. A flaw in the design of the Covid response in Nepal has been the mindset that encourages the citizens to be treated as followers and not stakeholders. As followers, people may choose to disobey the government directives and guidelines. But, as stakeholders, there will be a sense of ownership over government actions, which can help improve compliance.
Communication is trust
The issue of ownership has been contested at the government level too. Nepal’s Covid response has mainly been led and controlled by Kathmandu through an ad-hoc mechanism—the Covid-19 Crisis Management Center (CCMC). Although the mechanism has been replicated at the provincial, district and local government level, the decision-making process has been top-down, with the federal government issuing directives and guidelines. The provincial and local governments have been treated as implementing agencies in a centralised response with no representation at the apex body. Although the federal, provincial, and local governments have been working together, the sub-national governments do not have a stake in influencing the Covid-19 response independently of the federal directives. The federal government, through its actions, has quite openly communicated to the provincial and local governments that they cannot be trusted to handle the crisis. Hence, a sacred rule of communication has been broken. Effective communication requires trust, which the federal government could have used to inspire innovative sub-national responses and open opportunities for scaling up exemplary models at the national level. Furthermore, a lack of trust among the governments does not communicate confidence or breed hope among citizens in need of one.
Communication during the global pandemic crisis is no longer just about getting people to abide by public health measures.
Communication is respect
When we offer our respect to another individual, we actively communicate through our body language. This non-verbal communication includes appropriate facial expressions, gestures, bodily movement, postures and eye contact, which indicates to the next person that we are comfortable with who he/she is, respect their dissenting views, understand their context, and have our undivided attention. Moreover, failure to portray respect may end an effective communication. Communication demands respect. However, we have dared to break this cardinal rule. Amidst the pandemic, the President issued an ordinance to amend the Security of the Health Workers and Health Organizations Act, 2066 (2010). The amendment has increased the jail term and the fine amount in case of assault, picketing, offensive behavior, and vandalism in health institutions. The move has been inspired by the recent attacks on health workers, such as one on the doctors and nurses in the Covid ward of Bheri hospital. What are we trying to communicate to our brave medical personnel? Are we saying that our sudden outburst of unwarranted anger is better justified than the marathon effort of health workers to save lives? Let us breed some respect among ourselves and put up a united front.
Communication is data
Often what defines us has the audacity to break us. What defines us as a nation is our ability to unite in overcoming unprecedented circumstances created by the pandemic when anything less is not an option. But the aftershocks from the first wave of the pandemic in the country has undoubtedly dented the spirit of unity in diversity. As per a World Bank Survey, 25 percent of the economically active population in Nepal reported job losses, while 19 percent experienced absence from work for an average of 4.4 months in 2020. However, among those lucky enough to keep their jobs, 46 percent reported income losses. The survey also revealed that more women (30 percent) than men (23 percent) suffered permanent job losses. Meanwhile, a national level survey conducted in December 2020 reported that people engaged in the tourism sector, production of cash and high-value crops, sale of livestock and its products, including daily wage workers involved in off-farm activities, faced severe income losses because of the pandemic.
A flaw in the design of the Covid response in Nepal has been the mind-set that treats the citizens as followers, not stakeholders. As followers, people may choose to disobey the government directives and guidelines. But, as stakeholders, there will be a sense of ownership over government actions.
Further, as per estimates, the entire nation’s gross domestic product contracted by 1.9 percent in the fiscal year 2020. But with the economy requiring some sprinting to catch up with pre-crisis growth estimates, Nepal witnessed a surge in new cases and deaths from Covid-19 since the second half of April 2020. Probably we are all divided into pro-economy and pro-public health factions. Undoubtedly, the pandemic has impacted the Nepali population disproportionately, and it is indeed one of the most polarising issues of our time. People are sad, frustrated, and emotionally battered, and every segment of society is left with its own set of concerns, needs, and priorities.
There needs to be a localised communication strategy, ideally at the local government level, to address the differential impact from a communication viewpoint. However a localised messaging requires a learning system that feeds data about the disproportionate effect of the pandemic on communities. Therefore, communication is shaped by data, and it is essential to strengthen the local government’s ability to collect and use the data.
Communication demands self-reflection
We communicate best with ourselves, and now, more than ever, it has become essential to do some introspection. Let us ask ourselves if we have any qualms about accepting that we have ourselves to blame for the second wave of Covid -19. We acted carelessly, and now we are facing the consequences. But self-blame is the easy part. The challenging part would be to remind ourselves of the time we triumphed over life’s challenges with distinction. The pandemic has once again pushed us down. It’s time to communicate with ourselves and inspire a win.