COVID-19: Four recommendations for inclusive risk communication
The COVID-19 virus does not discriminate; but its impact clearly does. Over a billion people in the world live with some form of disability. Most of them reside in low income, low resource settings with limited access to quality healthcare. Every day, they face environmental and societal barriers. When disaster strikes, people with disabilities are disproportionately affected because preparedness, response and recovery efforts do not address their needs. People with vision and hearing loss, as well as people with cognitive limitations or low literacy levels often cannot access risk communication during emergency events.
The consequences can be life-threatening. If they miss vital information that has been disseminated to the wider population, people with disabilities will be unable to prepare contingency plans. To ensure we leave no one behind in times of crisis, risk communication must be inclusive. Public health warnings and information on preventative measures must be accessible to vulnerable groups with diverse needs across the socioeconomic spectrum.
The World Health Organization (WHO) and some high-income countries have improved the accessibility of digital information, for example, by using captioning or a sign language interpretation. However, the efforts are still insufficient. While most of the world’s population is overwhelmed by instant updates and live news about the pandemic’s impact, people with disabilities are yet again left ill-informed due to lack of accessible information. Even worse, messages that are either unclear or unrelatable leave them confused. They often don’t know how they are supposed to follow the advice safely.
Good risk communication is clear and accurate. Messages should reach all target audiences, leaving no doubt on how to interpret them. Risk communication should aim to ease feelings of fear and panic among the affected population, not exacerbate them. The WHO guidelines on Communicating Risk in Public Health Emergencies provide some good recommendations but they are not explicit about inclusive risk communication.
Four recommendations for inclusive risk communication
Here I recommend four elements to achieve inclusive risk communication during any emergency event. These recommendations are based on a review of current risk communication guidelines (e.g. WHO, UNICEF, UK Government) and peer-reviewed articles. They also draw on my experiences and lessons learned from working with people with disabilities in low-income countries in emergency and post disaster settings.
Develop plain and clear messages that all affected population can understand and interpret in the same manner.
The first step to inclusive risk communication is to check the clarity of the message before circulating it. Every risk assessment conducted (physically or virtually) as the outbreak or crisis unfolds must include all sections of the affected population. This will help to understand the different needs of the diverse population groups and subsequently, to design the risk communication in a manner that is clear to all target audiences. Accessible communication is not about catchy slogans and jargon, nor it is about technical language. These are often barriers to successful communication with the public. Inclusive risk communication must be clear for all, including for people with learning difficulties and those with low literacy.
Disseminate messages in multiple formats to reach people with diverse needs
Risk communication and public announcement by national or international authorities during emergency should be accessible to people with disabilities with different communication needs. The key to improving accessibility in risk communication is to circulate information in multiple formats. Some of the accessible formats for people with disabilities include text captioning, sign language interpretation, braille, large print, loudspeakers, and graphic and pictorial material (like billboards, posters, pamphlets) that match the target audience.
If the message is circulated through press briefings, the person delivering the message should speak clearly and with compassion as if talking directly to the affected communities.
Engage partners to reach marginalized populations
The array of traditional, alternative and digital information sharing outlets can effectively support inclusive risk communication. However, the most accessible message is unlikely to make it to people in hard to reach and poor areas.
To bridge the last mile, governments and local authorities should engage with partners in each affected community. Disabled people’s organisations can help disseminate accessible information among hard to reach households. Other reliable partners include community health workers, teachers and other civil society organisations.
Recommend actions that are realistic for people with disabilities
If messages do not reflect the concerns and the context of people with disabilities, they will have no impact. For example the physical distancing measures are impossible to follow for people with mobility and intellectual disabilities who rely heavily on paid or unpaid caregivers. The recommended risk mitigation actions should consider the environment and the barriers that people with disabilities experience in their communities. Inclusive risk communication should promote specific actions that people with disabilities can realistically take to mitigate risk and protect their lives.
The COVID-19 pandemic has once again highlighted the persistent inequalities that affect people with disabilities. Identifying vulnerable populations and protecting them from harm is not enough. Local, national and international authorities have a duty to communicate risk to vulnerable groups so they can take measures to protect themselves from threats. Inclusion is the cornerstone of empowerment. And when disasters strike, inclusion saves lives.
Sapana Basnet Bista is a PhD researcher and module tutor at Public Health Institute at Liverpool John Moores University. Sapana is also an international expert in disability and gender inclusive humanitarian response with particular focus on assessing and strengthening of the health system and services during crisis, displacement, disaster and conflict for people living at risk, poverty and exclusion. Her research methodology expertise lies in Participatory Visual Methods, Qualitative and Appreciative Enquiry and Innovative Monitoring and Evaluation tools. Sapana’s research interest and experience also lie in localised and inclusive disaster risk management and, contextualising international tools and frameworks like SDGs and Sendai Framework for Disaster Risk Reduction.
Currently Sapana is co-leading and managing UN Trust Fun funded project on ‘Inclusive Partnership against Violence’. The project based in Nepal aims to prevent and address violence against girls and women with disability in collaboration with National Federation of the Disabled –Nepal and Green Tara Nepal.