Teaching health communication
Launching the Wits School of Public Health’s Division of Social and Behaviour Change Communication, head of school, Professor Sharon Fonn, spoke of the difficult, but vital role that sustained communication programmes play to address the social and behavioural aspects of health.
“You don’t make major changes. You make small, incremental, sustained and on-going changes. And that is completely consistent with the notion of communication for social change. We will not make South Africa an equitous country overnight. It’s a long, hard struggle. You have to work consistently and over a long period of time to do that”, Fonn said.
“Perhaps just to digress to a story one of my staff members who came to me because his mother was ill. He told me she was an old woman – 45 – and so, he wasn’t surprised that she was ill. I was sitting there, sort of squirming. He told me the story and I listened, and I listened and I worked out, from the story, that she was HIV-positive. And I sat there, thinking to myself ‘if she had TB or hyper-tension, I wouldn’t think twice about saying I think your mother’s got TB or hyper-tension. We really need to get her seen’. But I thought twice about saying it to him. And I thought to myself ‘that’s nonsense! I have to say it. It’s the same as any other disease’. And we were at the position where we did have treatment, so it really was the same as any other disease, and so I did. I said: ‘I know she lives in a rural area, but if you bring her to stay with you I can get her into a treatment programme tomorrow. And he didn’t. She died not too much later than that”, she continued, relating an encounter from recent years to illustrate the challenges involved in health communication.
The experience made her question why the man wouldn’t access the opportunities that were available for his mother. She said such behaviour is one of many that the Masters programme in Social and Behaviour Change will seek to understand and influence.
“For me that was a very poignant moment, but I think also speaks to some of the work that the Division tries to address: How do we understand what motivates people’s actions and how do we influence that? I’m not someone who subscribes to the idea that everything is at the individual’s door and everything can be done by the individual and if they don’t choose to do it, it’s their fault. I think that that’s very short-sighted and really doesn’t understand circumstances under which people live. It’s about making a difference to the environment in which people live that’s very important to enable them to take advantage or make informed choices about what they do. For me, that’s what the Division is about”, she said.
The study of Social and Behaviour Change Communication will look at a host of health challenges, including Tuberculosis, Malaria, chronic and lifestyle diseases. Behaviour change in relation to HIV, for which a vast field of study already exists, will also form part of the curriculum. Judge Edwin Cameron, a guest speaker at the launch, spoke of the need for more intensive programmes to get rid of the stigma associated with HIV infection.
“With HIV, we stigmatise the person. That’s why we are still waiting for more public figures in Africa to come forward. Nelson Mandela did say at the end of 2005 when his son, Makgato, died: “We’re waiting for public figures themselves to say, ‘I’m living with HIV’,” so that we can get to that point where we really do treat HIV just like any other disease. And the reason I make the allusion to this overwhelming force and weight of stigma in our management, in our communication messages about the disease is that I think it’s key to prevention, it’s key to access to treatment, but it’s key to self-messaging as well. To enable people to make the right choices in this epidemic, we’ve got to reduce stigma. I believe that the normalization of the epidemic is going to assist us to get people to make proper choices”, Cameron said.
Dr Shereen Usdin, a senior executive at Soul City, said the new division was significant as there is a growing need for quality health communication interventions to ensure social and behaviour change in the southern African region.
“It will be about creating a cadre of highly-skilled people who can really take this field of study to its next level – take its rightful place as a discipline within the School of Public Health and within the field of public health, and also, to really implement and make meaningful change because this is a field that has got demonstrable impact”, she said.
The division will help develop skills to apply social and behavioural theory to a range of interventions that include social mobilization, advocacy, social marketing, edutainment and monitoring and evaluation.
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