Wednesday, October 15, 2014

Ebola Messages:the blame game when we need truth and justice

The four young women I interviewed yesterday said that the nurse who contracted Ebola  (first nurse in Texas) must have "disrespected" the medical protocols.

Well, this headline on CNN tonight will do nothing to help them and countless others taking in Ebola information broaden their perception - move it beyond the idea of "bad actors" acting badly, or irresponsibly.

And I don't hold out too much hope that the ubiquitous streaming videos  explaining how to don and doff protective medical gear aren't inadvertently reinforcing the blame model that people are developing.

I can imagine someone saying:
"If it's so clear what the nurses and doctors have to do, then [those nurses and doctors]  must not be following  the rules [protocol]. 

In public health there has always been a tension between using messages that empower people,  and blaming people for failures.  AIDS, Smoking, Diabetes, Obesity, Teen Pregnancy.....( I wrote about a while back)

What is lacking rather completely from the content and tone of just about all the messaging from experts and the media coverage of Ebola is a social or behavioral justice story.  Adler and Stewart present such a model regarding obesity (2009, Milbank).  Their study, "Reducing Obesity: Motiving Action While Not Blaming the Victim"concludes:
A behavioral justice approach to communicating can "convey the principle that individuals are responsible for engaging in health-promoting behaviors but should be held accountable only when they have adequate resources to do so. This perspective maintains both individuals' control and accountability for behaviors and society's responsibility to provide health-promoting environments."

When Ebola protocols are "disrespected"

It's Tuesday.  The day after a Texas nurse is diagnosed with Ebola. The day before the news tells us that a second healthcare worker is likely infected.

It’s a warm day and four gregarious HS seniors, young black women, indulge me as I interrupt their animated talk about some celebrity’s breakup. They’re on their way home from school.  We’re at the Harlem Meer. And I’d like to talk to them about Ebola.

Are you aware of the Ebola outbreak?  
“Yes, sure”
Do you watch the news on TV?
“Not really.” [unanimous response]
“Through the wall…my mother watches in her room and I can hear    it.”

So, where are you getting most of your information about Ebola?
         “Instagram [unanimously]. There’s a hashtag”  
At some point I mention that health officials said that the Texas nurse likely got infected because of “breaches in protocol.” And the head of a national nurse association said that,  "The protocols that should have been in place in Dallas were not in place, and that those protocols are not in place anywhere in the United States as far as we can tell."

What does a “protocol” mean to you?
They are the rules
Something mandatory
         Something that you have to follow
I don’t think it’s generally written down – not a rule of law.
One young woman explains how some people are “disrespecting the protocols of protecting everybody around them.”  She heard that a TV news journalist who is also a doctor didn’t stay home after she returned from Africa, “like she promised.”  
         She broke the rules and  “is putting everyone else in danger.”

We know that the public’s understanding is a moving target.  We take in, mull over, and make meaning relentlessly.

Protocol = rules
People who don’t follow the rules =disrespecting

Is this meaning making about to change, elaborate?

My Instagram tweets reads:

Monday, October 13, 2014

Ebola "breach in protocol" - when bandwagon terms can leave the public in the dark

Dr. Tom Frieden, Director, CDC (Sunday 10/13/14)

At some point, there was a breach in protocol, and that breach in protocol resulted in this infection.”
"The (Ebola treatment) protocols work. ... But we know that even a single lapse or breach can result in infection.”

Bandwagon Terms; Definition
When experts introduce a technical / scientific term and the media and other communicators use it widely…without every really explaining what the term means.
This commonly occurs during complex emergencies.


Term:  “Spores”
“Seven days after the terrorist attacks of Sept. 11, 2001, anonymous letters laced with deadly anthrax spores began arriving at media companies and congressional offices.”

H1N1 2009
Term:  Novel Virus

2012 Hurricane Sandy East Coast
 Term: “Storm Surge”

Dealing for Bandwagon Terms
While we want new, technical terms, to be acquired and used by the public, it's important to facilitate that learning.
       Think through what technical terms are critical in order to understand key messages,
       Decide in advance what technical terms you want the public to become familiar with
       Introduce these terms with a definition that fits the modality: speaking, writing, visuals.