Borno Health Sector coordination: How to build a contemporary risk communication sub sector against mounting emergencies.

By: Bodunrin Kayode

Sometimes the speed at which journalists poke their noses into important matters that concerns the truth when government authorities are involved is welcome. Especially when it involves sensitive sectors of the economy like health and the welfare of the people and it is obvious that the managers are inept or economical with some truths, it usually annoys such powers that be when reporters refuse to mind their businesses. Some senior public servants in government in Nigeria usually do not like being challenged when they do wrongs regardless of their professional learnings. They want to be the last to speak and it should be the final like we had during the likes of a former health minister, name withheld who always wanted to assert his weight in spite of his small stature on the union leaders who refused to be intimidated by him. Speaking after they have vomited their sometimes advertent mistakes in a meeting, is a taboo especially in the medical sector where life is involved directly. A pharmacist who tries to correct the mistakes of a medical doctor is frowned upon as insubordinate. A journalist contributing to make things work in the public health sector team by trying to rectify their excessive misuse of acronyms, makes some of them angry that someone is interfering in their business.They rather prefer the obvious disunity within the medical sector to linger instead of moving as team players as is the case in sanner climes.

But sadly the world does not work that way anymore. Some of those who express these worries hardly want to think outside the books especially when it comes to their turf even when the world has gone far in the realm of “risk communication” for instance in the public health sector. And most times big mistakes are made as a result of wrong communications from the so called experts from the world bodies charged with fixing health. And that has been the bane of the risk communication sector of the Borno Health sector partners coordination meeting before the advent of Dr Lawi Meshelia as incident manager. But thank God that for the first time in the last decade, 14 pillars have been created and professionals in the meeting are meant to think in one accord which is very important for the progress of the “emergency machinery” which Governor Babagana Zulum is interested in. We now have these pillars firmly rooted including the sensitive “surveillance” who are the epidemiological secret service who go around hunting down emergencies and ensuring that the house is fully briefed. The risk communication is also being straightened up to meet emerging emergencies as they come and collaborating with the surveillance and security which I had suggested should be made a pillar in one of our meetings and the head of the police hospital should be given that task. Whenever he is busy, he can always send a representative. There are many areas still marked as dangerous which the risk communication cannot penetrate because they will walk into the insurgents and be killed so they must be escorted by the security.

Before I proceed, we must keep in mind that “risk communication is the real time exchange of information, advice and opinions between experts or officials and people who face a hazard or threat to their survival, health, or economic or social well being.” Having said that, we should be mindful of the purposes and reasons for the risk communication pillar which is very vital in reaching out to the vulnerable people we are supposed to protect in the Borno insurgent war theatre. We cannot stop cholera from moving like a dangerous wizard from one council area to another if the risk communication is as brutally divided as it is now in the state and unprotected.
The WHO and UNICEF must work together as a team under the supervision of the state ministry of health and not the other way round. What we have is two world bodies flexing their muscles in different rooms, churning what they think is best for Borno but which is usually confusion. That is a wrong and it must be reversed as quickly as possible if the risk communication should be uplifted to where it should be. You cannot because you are spending donor funds treat people as if they are beneath you. It’s not right. Whatever meetings they want to hold in their respective agencies should never rubbish the risk communication pillar meeting which should have only one head from the state ministry of health who speaks for all of us during critically challenged periods of emergencies. The cliche of he who pays the piper dictates the tune can’t work in this instance because we are talking of our shared humanity with people dying for the wrong reasons. It’s a boring cliche that has killed this country and brought us to the sickening level we find ourselves now where humanity is thrown to the dogs. It is not permissible for Unicef and WHO to speak on behalf of the state in such meetings. They speak only when asked to contribute. What happens when that fellow is transferred? The head must be a ministry staff and both agencies must answer to him. That is the law and order which the present IM Dr Lawi brought in when he took charge.

Within the almost comatose health sector which existed in Borno from 2009 when the war started, health practitioners must be called to account to the people they claim to be dishing out dividends of democracy to even if it is on a humanitarian level which makes it free. And I believe it’s because of this accountability that the sector partners meeting was formed to evaluate and make progress.
It’s about ten years now into the rebuilding of the Borno emergency health sector and some of us who have been around since then can gladly say well done to all the managers who have passed through the system till date injecting their own expertise in one way or the other. The world bodies inclusive and the non governmental organizations.

Attracting more media practitioners into the risk communication

Colleagues, of a truth, the media practitioner is not out to witch hunt anyone but purely to ensure that every one accounts for his stewardship as leaders in the sector. A practitioner’s presence in the risk communication like myself or even Madam Pauline in the polio sub sector is to assist in disseminating the good news when there is need to do so. If Cholera has killed hundreds in the last ten years, we say so. Why? So that the people will take corrections from the way they have been living to what the health authorities have designed for them to stay alive. This is because no Commissioner of Health or trained doctor wants his patients to die out of ignorance. So they need the risk communication which is definitely tied to latest skills in contemporary media practice. And if you lack knowledge of the workings of the media even if you are from the world health organization (WHO) or United Nations Children’s Fund (UNICEF) you will surely fail in most of your plannings as it concerns the people. Media related practice is needed in every profession that is involved in communication. From security to teaching to medicine. You cannot succeed in modern medicine without effective communication or even the media. And when I emphasize media, I am not talking about radio which is believed to be the widely used to hear from government by the northern illiterates in the country. The so called radio which is believed to reach at least 50% of the population is a luxurious instrument now in Borno because at least 40% of that 50 or 60% which could be reached if their surrounding transmitters have not been blown off by boko haram cannot afford to buy a mini radio of N1000. With the floating of the naira, this figure may even be an understatement in the market.
TV is ruled out for the most vulnerable who even if you give a free radio set to listen to cholera or covid jingles will rather sell same to buy his immediate needs. So how do we correct these lapses? Simple.
Ensure that over 60%of your communication is interpersonal by using megaphones and Outside broadcast vans to reach the vulnerables. It is the most reliable means for communication in Borno for now till the war ends.
And for the radio which the old fashioned people still hold on to, more practitioners should be attracted to health.
We should involve the media more proactively by creating of health desks in the media houses. Health desks cannot be just one person. I made this point during a round table at the NUJ in maiduguri recently and someone showed me a health correspondent in a radio station. The fellow obviously does not know the difference between an ideal health desk and just one correspondent. For maiduguri, just one correspondent covering emergencies and the entire health ministry is not right. In fact, that is a huge joke as long as insurgency persists. A minimum of three to five persons should form the fulcrum of a functioning health desk. A senior correspondent or line editor and a bevy of reporters ready to cover the primary, secondary and tertiary centres where things happen daily. One person is just a correspondent not a desk and is grossly inhibited. You do not parade just one person to handle emergencies and non emergencies it’s a sick joke that can fly anywhere without a war but not in Borno or Yobe because of our peculiarities and sometimes high mortality rates from infectious diseases. The creation of health desks in the near future will produce a massive army of professionals ready to handle the risk communication even in the entire BAY states. That is the ideal. And it is very much possible to handle if the Commissioner visits the general managers and advocates for their creation with support from them. Getting a sound professional as information officer in the parent ministry of health will also help because it is he who will be the go between after the courtesy calls which speaks more than a mere memo.

The voice of the journalist as the fourth estate of the realm is equally the voice of the people. So when they call for accountability within the news managers about the health sector for instance to appear before them in the Press Centre, they are simply saying account for your stewardship before the people. They do not mean to disrespect anyone who is a “big man” who may not want to appear before the gentlemen of the media as if they are before their Lordships in a court of law as it were.

Risk communication within the Borno health sector

Risk communication in Borno particularly can never succeed without the major imputes of journalists within or even outside the Health sector. This pillar equally needs the massive support of the translators in the programs department which may not necessarily be journalists but media practitioners in their own rights. We cannot go to northern Borno and be speaking English with resident internally displaced people (idps) for instance. Such messages must be knocked down into Kanuri not even hausa because these are people who do not understand the hausa language no matter how international you may think it is. These are some of the challenges that have characterized the health sector meetings. The Borno radio television can boast of translators in Shua Arab, Kanuri, kibaku, Bura, and margi languages any day we need them.
The world bodies will be harming the recipients of messages if they sit down in Abuja and draft messages for the risk communication sub sector only in English and Hausa and forgetting that there are about 15 dialects in Gwoza some of who barely understands the hausa language which was virtually forced on them by virtue of recolonization. That could be applicable in the north west of the country surely not north east and central. There are always willing hands in the media ready to help out to produce these sound bites if they make proper enquires. You do not go to Limankara in Gwoza and start speaking hausa if you want them to drop some daring wrong habits which invites killer diseases. You look for someone who understands their dialect and make him do the translation from hausa if you are one of the fixated professionals who assume wrongly that hausa is a general language in the north. It would sink better than hausa which is obviously general in the north west of the country. These are the solutions which would help us from watching people die from meningitis for instance when we could help keep them alive.

The Borno health sector is in a critical buildup situation in which some forms of basic communications must be handled by local people who studied, communication, journalism or even some form of social science or public relations. Risk communication is not something you can handle simply because you did general studies in medical school or in public health colleges. Far from it. Its something you must study to apply same so you save yourself from the pains and embarrassments being faced when it comes to the nitty gritty and you are watching people die from cholera, COVID-19 or diphtheria. That is why the intervention of the ministry of health into the various newsrooms by way of “lobby” for a health desk is very pertinent. No general manager will refuse sponsorship of reporters for refresher courses in the health sector as is applied in the more developed climes. Send them abroad for three months and by the time they come they will forget departments of politics or sports and follow health as if it was their initial calling. That is the only way we can attract more hands on deck to perfect further the myriads of mistakes being made by the risk communication pillar in the Borno health sector. I have tried severally to drag in my colleagues to join me in the sector meetings but they do not see the attraction to come in especially with the stereotypical mentality of some practitioners who do not in the speed of the social media. We have to create the attraction by following the tips I gave above. We are in an emergency and must carry a regimented mentality until all these pass us by.

Finally, now that we all know that a lot of damage has been done to our transmitters in the state rendering the capability of the old fashion radio to get to at least 50%of the population, the plan B option left to the sector is interpersonal communication as I stressed earlier and that is done by using vehicles to all the crannies of the state whenever there is an emergency to ensure that the people get to know what is going on. It’s is obvious that less than ten percent of this 50% of the affected population can afford phones. Let’s say we teach them how to tune to their radio in their phones, how many of them will be able to listen to jingles in their native dialects? When you have at least 70% of the population of the people as stark illiterates as alluded to by Governor Babagana Zulum, how then do you continue to reach out to them in English or hausa?
It is the duty of the risk communication people to size up the environment they want to penetrate and communicate in the language they will get maximum effect and not waste the scarce resources on radio stations that package programs purely for the elites. English language should be made a secondary language of communication in Borno until the war ends and emergencies subside.
Lastly, there are many areas that vehicles may not access in the local councils of Borno State. The director of health in the councils can be drafted into any of the pillars he is wired to handle. As they hold their sub sectoral meetings at council level, he should be able to produce his own army of translators who will be on standby to enter any corner where strange diseases are coming up to kill people. And they should be able to feed Mallam Modu and his team or directly to the EOC manager Dr Simon for onward transmission if they can’t get their pillar heads directly. By my assessment, risk communication volunteers in the entire council areas should not be less than 54 while that of the state should not be less than 20 very fluent in diverse languages and dialects of the people. That is the ideal. The
Commissioner of Health should be able to liaise with his colleague in transport ministry to ease the stress on the resident communicator in each council areas. By resident I mean each council area should have one personnel trained for the job because all the resident media houses in Borno cannot be able to supply enough personnel for the job even if they are just 20. The risk communication people should be given bikes and megaphones to get to those places and shout if need be to change the narrative of any wicked emergency. That is the drill my dear colleagues for excellence at these harsh emergency periods .

Borno Health Sector coordination: How to build a contemporary risk communication sub sector against mounting emergencies