Oliver Meth, Communications Lead at the South African National AIDS Council Civil Society Forum and the Community Constituency COVID-19 Front

In formulating a COVID Digital response, we should not sideline the more traditional method of communicating. If we do, we sideline, a particular portion of society. 

Moderator: Tian Johnson

Complied by: Vivienne Naidoo 

Queries: info@africanalliance.org.za

Webinar Recordings & Supplementary Materials: www.africanalliance.org.zawww.thevarg.orghttps://www.dailymaverick.co.za/opinionista/2020-12-28-tailored-messaging-is-key-in-curbing-the-spread-of-covid-19-and-misinformation/https://www.iol.co.za/news/south-africa/gauteng/doctor-who-discovered-ivermectin-use-for-covid-19-was-born-in-sa-studied-at-wits-bab210ff-1c2d-491a-9970-e3c0d98aa71chttps://sanac.org.za/traditional-leaders-launch-the-communities-matter-survey-in-20-districts/

WHO  

Oliver Meth is the communications lead at the South African National AIDS Council Civil Society Forum and the Community Constituency COVID-19 Front on his communication space experiences. Since the advent of COVID-19 and the potential role of a digital COVID-19 response that centres behaviour change. Oliver focuses on public participation, Human Immunodeficiency Virus(HIV)and using alternative media as a positive advocacy tool. He has published papers on a range of development issues and research communities Socioeconomics, poverty, gender, and sexuality. Oliver has been a rapporteur for local government and higher education institutes at major conferences, contributing to several media outlets and journals. 

QUESTION AND ANSWERS*This section contains a transcribed account of the Question and Answer Session* 

Where do you go to, for this morning’s most authoritative, evidence-based information you use as a basis for communities?

Personally, my emphasis would be on various platforms online. I am then looking at various opinion pieces on more specific topics that I would like to hone to get different critical aspects from experts. We know that with any pandemic, there is always this overload of information, which ideally creates the super spreader moments that I speak about. They create panic and create fear, which creates a form of hysteria amongst society. And I think this is mainly due to the miscommunication, particularly from the government aspect. And for most of us within the civil society aspect, that is not being consistent. It does not speak to tailored messaging that specific communities want on particular issues. A much more tailored approach is in line with community-centered issues, which would minimize the panic and the fear that other people have around the pandemic. So I think more consistency and listening to the issues from the ground and formulating those issues much more to inform communities would be much more ideal. Because as I have mentioned, not many people have access to the web, as most of us have. Most of us find ourselves in a fortunate position as we have the opportunity of just googling or looking for various reputable news sites that we can tap into and look at different critical voices that we can then draw our responses, inspiration and informed decision from.

How are we bringing digital technology and information to those specific groups that have traditionally not been super comfortable, and early uptakers of technology and digital platforms to better understand their behaviour?

I do not think it is a yes or no question. I do not think we are doing it adequately. And how would I suggest that we do that adequately? And I do not have a particular answer now. But I know that various aspects of various platforms that a specific group of people aged between 50 and 65 and above actually tap into more traditional forms of technology. In formulating a COVID Digital response, we should not sideline the more traditional method in communicating. If we do, we sideline, a particular portion of society, would be disadvantaged if we did not communicate effectively using traditional and non-traditional platforms. So I think there is an elderly population that is tapping into the digital space. Still, it is a minimal number, and that digital space is ideally WhatsApp if I could say.

To what extent has your work been supported or not by the government and private sector? 

So the work that the civil society forum does, together with the Community Constituency Front, and various aspects of the communications budget has been sponsored by mainly the international development agencies, such as the United Nations(UN) family. There has been very little support or no support for comms budget from the government entities. There has been a lot of collaboration and conversation around and working mainly with Government Communication and Information System(GCIS) and the Solidarity Fund, under the Ministerial Advisory Committee on social behaviour change in crafting much more tailored messaging to inform the community-based measures we speak about as a civil society. So there is a lot of collaboration with some government departments and government entities. But there has not been direct pouring of resources at this stage into any work that we will be doing within the civil society around communicating with communities and collecting data, from communities that would inform policy and agenda for the rollout of the vaccine. 

Are there any advocacy plans that you can share, any intentions to hold those with power and resources specifically to account to support the work that you are doing, which they perhaps to some extent do not have the capacity to do? 

As the Front and civil society forum, we never shy away from calling those in power to account. We are in conversations with various stakeholders within that sphere in formulating how we can take this comms model that we have implemented around the Think Twice about COVID campaign to the district level. It needs to sync into the SANAC model that works for districts and local AIDS council districts and can filter into the different aspects within communities. There are discussions about how this model we have developed with them, will sync with the local AIDS council districts, and how that module will be funded by provinces and municipalities and districts within those provinces. There are discussions, and we hope that this discussion will be fruitful, and it is not back and forth. There have been numerous meetings some, have been postponed on multiple occasions. But we do feel that after today’s meeting, we are heading somewhere, and we should have a plan and some sort of public announcement once this happens. 

What early impressions, perceptions, data, have you seen coming out of this Think Twice About COVID-19 outreach, how is it being received? 

Our mobilizers have collected data from is the Eastern Cape, KwaZulu Natal and Gauteng provinces. Most of the data touch on demographics of people working or not working, social behaviours and social or structural barriers that prevent them from adhering to the prescribed regulations under level three.  We are finding that there is a lot of misinformation within communities. We are finding that most of the communities that have been surveyed, that COVID is not their main issue. Within those communities, people are still complaining about infrastructural issues with informal sectors. And we find that these issues around structural and informal structures and inadequate access to water and sanitation, are some of the issues that prevent most people from adhering because some people are also saying they live in corrugated iron structures. Their shacks are built at least a meter from one another, so it is impossible for them to physical distance. They cannot stay all day indoors, because it is so hot as the tin roof contracts a lot of heat. They must sit outside, and when they are outside, they socialize with other people. They use communal bathrooms and communal taps. We hope to achieve through the community-based measures and data that the COVID response for low-income communities should not just be looking at pharmaceuticals and accessing vaccines but also addressing the issues that communities face that prevent and put them at risk contracting COVID. Suppose we do not address these structural issues immediately, in that case, we could be at risk of a wider spread COVID within communities who do not have access to adequate public health care, and who do not have the means for COVID tests or to adhere to the regulations because of their non-conducive living environments within society. 

Are there any crossover similarities that struck you as opportunities that the broader sector could learn from? 

I have not thought specifically about that. But I have been thinking about many used comparisons, particularly on behaviour change within the HIV pandemic, that there was this constant messaging around fear-mongering – if you do not use a condom if you do not get tested. I feel that the first phase of our messaging, particularly around COVID, was around fear-mongering. Therefore, many people started resisting wearing masks, washing their hands because it was ingrained as a policing strategy, not as a non-policing strategy. To then educate people today to make that informed decision about the effects of not adhering and adhering, I think that is what we should be doing. Ideally, when messaging as we have initially done within the second phase of the HIV pandemic, we should not message to instil fear into people, but we should message to leave people with informed choices. And by so doing, we should give people the pros and cons of that. Given the pros and cons, I think people will be much more informed to decide or make that decision whether they would want to adhere to a prescribed regulation. Hope that was clear.

Has the work you are doing reflected on the progress and challenges the HIV space faces in understanding human behaviour and a human-centred approach? 

Yes, it surely has. Much of the work that the CSF is doing together with the Front uses the interlinkages of HIV, TB, and COVID to address it as a triple pandemic that society faces—ensuring that people are on treatment equally access to treatment during the pandemic. So we are using messaging and behaviour change to encourage people to adhere, encourage people to seek treatment and encourage people to get tested and screened and be informed and protect themselves and those around them. That is the kind of human-centred approach that we are using by centring people, and their needs and the response to access for treatment has a pivotal role within the pandemic. 

How what can we be assured that behaviour change is in action, are we tracking the impact of this behaviour change intervention? 

That is quite tricky because behaviour change is quite tricky to track. It does not have an indicator. You cannot tell that the work you are doing impacts or has directly impacted this specific community. We measure our impact on the messaging that we are doing together with the different stakeholders we are working with, is ideally looking at the infection rate and the treatment rate within the specific communities and specific districts as a form of education and form of ensuring that our messaging is reaching a lot of people. The more tested and treated people, the more effective our messaging around testing and treating becomes within that specific space. There is no actual indicator to tell that more people are getting treated because of the program’s messaging. So there is no actual indicator, but based on the community’s progress, we hope that our messaging’s impact does speak to the work we have been doing within those spaces. 

Last night, Minister Mkhize shared how we as a country will begin to roll out this first phase. And I know the various workstreams and the MAC have been working on how we segment, stratify these different groups of people in terms of access and prioritization. What are some of your reflections on this first phase of the rollout specifically related to communication and digital outreach? 

I think the announcement was a bit too late, although it eventually happened. Because there was still a lot of confusion in terms of what the phase one rollout will look like particularly around logistics, who would be administering it, the procurement issues, accountability, and transparency. So I think now that he and his Department have eventually communicated what the rollout phase one plan looks like,  I think there should have been more work done prior to that by engaging communities and civil society organizations on what a phase one rollout plan should ideally look like for the people and not one that is imposed onto the people. So I am quite skeptical about phase one. Well, I am quite skeptical about the whole rollout plan, whether it would be effective.  I am quite skeptical on several bases, particularly around accountability, transparency, and the fact there is no exact blueprint on who would be administering it and how many per province, the timeline, etc. So there is a lot of confusion that I am trying to wrap my head around. But last night’s announcement did provide some clarity, although I still think that more needs to be done. More needs to be done in conjunction with various stakeholders within society. 

So we are about three days away from these vaccines arriving, we are about 14, most likely 20 days away from the first vaccine administered, what are your priority messages and focuses on the build-up to that? What is your messaging, communications plan, specifically digitally, to engage this group of people? 

Firstly, just a bit about what the different vaccines are and information around that. Scientific information around any side effects if any, the distinction between the one dose and two-dose, and the importance of why health care workers should ideally be receiving it first, and then debunking some of the myths and misinformation around the vaccines and COVID in general. 

What has been the most damaging piece of misinformation that you have come across thus far into the pandemic? 

Once we get injected with the vaccine, there will be a microchip inserted into us, and it will be a means for Bill Gates and the powers that be to track us and control us. But the fascinating one that I have read, I think, was about two weeks ago, which was about the DNA altering conspiracy that the West was injecting Africans on Africa to control them into slavery. And this was a colonial project that the West had initially started. And now it has been enforced through Bill Gates and Ramaphosa as a puppet of white monopoly capital. It is quite interesting to read that opinion piece on Black Opinion, written by a very prominent BLF Leader. 

Where do we start at home, with our comrades and colleagues who still have reservations and hesitancy around vaccine efficacy and safety? 

That is a tricky one because we still have a lot of resistance in the spaces we work in. Particularly to the messaging we are doing around the vaccine and resistance within the circles, particularly within the traditional health sector advocating for a much more mixed approach and giving the public more options of westernized medicine and the traditional kind of remedies available through some of those constituencies provided. So I do not know the correct answer in how we address that, but I think there is room and even more so now that the conversation is flaring up. There should be more public engagement about these different aspects and medication that people are resisting or becoming hesitant about. And engagement around how we can incorporate African medicine into our public health responses, alongside the Western and other pharmaceutical drugs and prevention required in combating the spread. So I think it is mostly based on science. I think a more scientific debate and conversation needs to happen at local levels for better understanding. We require more engagement and inclusion and inclusivity to ensure that communities are informed to make informed choices if they decide to take the vaccine or not or choose to go the traditional route by indulging in traditional remedies. 

Do you think our communities are conceptually clear, number one on the existence of the national regulator South African Health Products Regulatory Authority(SAHPRA)? And number two, the role that SAHPRA is playing in terms of indigenous knowledge and medicine systems, and embrace that option for research to finally get what the West might tout as old traditional remedies to be scientifically proven to get those into people’s homes and into people’s hands? Do you think people are confident and excited about their existence, that we have this body in South Africa set up and mandated by law to precisely do that? 

I do not think people are confident. I think people are just starting to know and learn about what SAHPRA does during this pandemic. I think SAHPRA has just been a quiet body that has not been vocal in the past years. But I think now’s the time for SAHPRA to step up and include these different conversations around scientific testings and scientific methodologies around traditional medicine as well. I think this is the chance for SAHPRA. I think that SAHPRA is heavily constraint financially, as they have mentioned, and I think there is a lot of political pressure on them as we have seen with Ivermectin. There was a lot of debate around it. And it seemed as if SAHPRA was heading towards the direction of completely dismissing the use for Ivermectin as a COVID remedy. And I think with all the political pressure that then came over the past few weeks, and the advocacy and the High Court cases that were lodged against them, they amounted to political pressure to then prescribe it as a compassion drug for COVID-19. And what a compassion drug for COVID-19 is, is not clear. And I think many people within the traditional sector would say, well traditional remedies are also compassionate drugs because they address specific symptoms but do not cure COVID. I think the regulator’s integrity and bias need to be called out and need to be addressed from all social spheres. Political pressure should not amount to putting people at danger and putting people at harm. And I think traditional remedies should also be given the same platform by undergoing scientific testing, and regulation, then to inform what a compassionate remedy would look like for COVID within the space.

We can move on to two questions in the chat: We are trying to understand how the information will get to far rural areas, such as the Muldersdrift due to poor service rendered in the area. And he is speaking about this in terms of testing for COVID. It is not visible, they only see it on TV platforms, and it is only when someone dies that they do testing. So could you speak to, you have touched on it already, but could you talk a bit more in terms of your specific plans targeting the rural areas with messaging? 

So as I mentioned, the Communities Matter web-based platform, which would be turned into an app platform by June at least, is administered by a range of community mobilizers within the 25 Global funded districts across the country in all nine provinces. Once the mobilizers are at a residence and have used the screening questionnaire, they should have a questionnaire outcome. The outcome may require the interviewee to be referred to a local clinic for testing and treatment. We are using the results of the data on the app as a referral system. These old mobilizers were not trained as healthcare workers to administer whatever pharmaceutical or medical attention the respondent might need. So it has been used to derive information. We use that as a referral system, either for the healthcare workers to visit the family or for the family to seek referral at a healthcare location within their district. 

Malibongwe from TB HIV Care is asking, is your message devoid of HIV? Is it just COVID?  

No, it is not completely devoid. We add TB aspects, particularly around our advocacy and HIV and other structural barriers, such as Gender-Based Violence. So we are looking at different advocacy points within our messaging that I have highlighted, that the Front and that the Civil Society Forum looks at. So it looks at not just messaging particularly around COVID but messaging around all these barriers that interplay into COVID, so access to data, the informal economy, issues around Gender-Based Violence,  HIV and TB. So it is not entirely devoid of just COVID. But we are looking at aspects that play into society’s everyday lived realities in this time of COVID. 

Oliver, is there anything else you would like to share with us that we have not covered as a parting word? 

People can subscribe to our pages, follow us as well. We have a website as well. www. community constituency.org.za and the campaign website is ww.thinktwiceaboutcovid.co.zaOther social media platforms are available for direct linkages to there.  If organizations are doing similar campaigning, we would like to partner with them and see how we can work on synchronized messaging to reach our communities’ aspects.