Mismatched public health communication costs lives in Pakistan

Editor’s note: The language challenges of the COVID-19 crisis have held much of our attention this year. Here on Language on the Move, we have been running a series devoted to language aspects of the COVID-19 crisis since February, and readers will also have seen the special issue of Multilingua devoted to “Linguistic Diversity in a Time of Crisis”.

Additionally, multilingual crisis communication has been the focus of the research projects conducted by Master of Applied Linguistics students at Macquarie University as part of their “Literacies” unit. We close the year by sharing some of their findings.

Here, Kinza Afraz Abbasi shows how mismatched language choices and mismatched communication channels render public health communication in Pakistan’s Khyber Pakhtunkhwa province ineffective.

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In Khyber Pakhtunkhwa (KPK), one of the four provinces of Pakistan, it is widely believed that polio vaccination is a Western plot to make children infertile in their childhood with the aim to control Muslim population growth. As a result of this belief, health clinics have been torched and health care workers killed. Polio, almost eradicated elsewhere, remains a health threat in the province.

What happens in a situation such as this – where mistrust between the population and public health services is rampant – when a new public health disaster such as the COVID-19 pandemic strikes?

There is wide agreement that Pakistan’s response to the pandemic has not been effective and that the country is now in a lethal second wave.

In my research project, I set out to discover what the government has done to inform the public about the dangers of the virus and about measures to stop the spread of the virus.

The linguistic situation in KPK

KPK is located in the northwest of Pakistan and shares a border with Afghanistan. The largest ethnic group in the province are the Pashtuns, who are comprised of many tribes and clans. Tribes are independent to govern themselves and most of the population live in rural areas. In addition to Pashto, Hazara, Hindko, Kohistani, Torwali, Baluchi, Persian, and other languages are spoken in the province.

This linguistically and culturally diverse rural population of around 35 million people has a literacy rate of 50%. In some tribal areas the literacy rate is as low as 9%.

Those who are fortunate to have learned how to read and write will have done so in a language that is not native to the province, Urdu, the national language of Pakistan.

In addition to Urdu, English also enters the picture because it is a co-official language of Pakistan.

English dominates official COVID-19 communication

English has, in fact, been the preferred language of communicating official information about COVID-19. Pakistan’s official COVID-19 website is entirely in English.

The government of KPK has followed the lead of the national government and also communicated most official information in English.

I explored a number of official websites and social media feeds and determined the language of communication was almost always English, with some Urdu communications, mostly on social media. I could not discover any use at all of Pashto, or any of the other languages of KPK.

Few people follow official government information

Equally noteworthy as the mismatched language choice is the lack of attention that official government communications receive.

The official Twitter account of Pakistan’s Ministry of National Health Services, for instance, has 29,400 followers. In other words, out of a population of 212.2 million, a minuscule 0.013 percent follow official health information on Twitter.

With 1,771,291 followers, their Facebook page is slightly more popular but still under 1% of the population.

The follower numbers of the official Facebook page of the KPK government are equally dismal: 11,544 followers out of a population of 35 million, or 0.03% of the population.

Given the dismal state of telecommunications in the province and the low literacy rates, these figures are not surprising.

Private TV channels broadcasting in local languages

TV is popular in KPK and many private channels broadcast in Pashto, Saraiki, Hindko, and other languages.

Unfortunately, the information related to COVID-19 broadcast on these channels seems to be in English, too, as I discovered when researching COVID-19 messages on the Pashto-language channel AVT Khyber.

Their COVID-19 messages are directly copied from the English language messages of the World Health Organization without any adaptation or localization.

Mismatched communication costs lives

In my research I identified three key communication mismatches:

• Information is made available through the medium of English and, to a lesser degree, Urdu to a population who largely lacks proficiency in either of these languages.
• Information is made available through the written medium to a population who has one of the lowest literacy rates in the world.
• Information is made available online in a context where telecommunications infrastructure is widely lacking.

Given these mismatches, is it surprising that people in KPK do not believe that COVID-19 is real? And that it is yet another plot – by the government, by the West – to oppress and exploit them?