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The Use of Video to Communicate Water, Sanitation and Hygiene in Haiti a Comparison Between SAWBO, GHMP and UNESCO’S Cholera Prevention Initiatives

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The Use of Video to Communicate Water, Sanitation and Hygiene in Haiti a Comparison Between SAWBO, GHMP and UNESCO’S Cholera Prevention Initiatives The use of video to communicate water, sanitation and hygiene in Haiti A comparison between SAWBO, GHMP and UNESCO’s cholera prevention initiatives Pau Abad Tent Communication for Development One-year master 15 Credits Autumn, 2018 Supervisor: Tobias Denskus ABSTRACT Health communication campaigns in developing countries can take many different forms and make use of a wide range of communication tools. One of these tools are multimedia resources such as videos. Initiatives like the Scientific Animations Without Borders (SAWBO) or the Global Health Media Project (GHMP) have been created for the only purpose of developing videos adapted to different cultures and languages in order to tackle a variety of health issues relevant to developing countries. The present study pretends to focus on the use of such videos for water, sanitation, and hygiene (WASH) behavior in the context of cholera epidemic which hit Haiti in late 2010. By using comparative research procedures, three videos have been selected for content analysis from three different institutions: SAWBO, GHMP, and UNESCO Haiti. The results from this analysis served as guidelines for further survey analysis carried out through field questionnaires to a sample of the video’s target audience, that is, Haitian children aged from about 10 to 13 years old. The purpose of the study was to understand and compare the impact and effectiveness of these resources in transmitting disease prevention practices to the target audience. The results indicate that the videos usually coincided in the issues to inform about cholera, but differed in most of the features portrayed within the issues. Moreover, responses to the questionnaires reflected that the messages portrayed were only retained by an average half of the participants, with more or less success depending on the topic. Keywords: Health communication, WASH, cholera, Haiti, Communication for Development, video, cartoon, multimedia 1 TABLE OF CONTENTS 1. INTRODUCTION ........................................................................................................................ 4 1.1 HAITI AND CHOLERA .......................................................................................................... 4 1.2 WATER, SANITATION AND HYGIENE IN HAITI .................................................................. 5 1.3 HEALTH COMMUNICATION AFTER THE CHOLERA OUTBREAK ......................................... 7 1.4 RESEARCH DESIGN ............................................................................................................. 8 1.4.1 RESEARCH QUESTION ................................................................................................. 9 1.4.2 UNITS OF STUDY ....................................................................................................... 10 1.4.3 COLLABORATION WITH GAIN AND COGOP ORPHANAGE & SCHOOL ..................... 12 2. LITERATURE REVIEW .............................................................................................................. 15 2.1 THEORETICAL FRAMEWORK ............................................................................................ 15 2.2 HEALTH COMMUNICATION IN DEVELOPING COUNTRIES .............................................. 19 2.3 CONTEXTUALIZED VIDEO IN HEALTH COMMUNICATION CAMPAIGNS FOR DEVELOPMENT ....................................................................................................................... 22 3. METHODOLOGY ...................................................................................................................... 26 3.1 COMPARATIVE RESEARCH ............................................................................................... 26 3.2 CONTENT ANALYSIS OF CHOLERA PREVENTION VIDEOS ............................................... 27 3.3 SURVEY ANALYSIS THROUGH QUESTIONNAIRES ........................................................... 34 3.4 DISCUSSION ON THE METHODOLOGY ............................................................................ 39 4. FINDINGS ................................................................................................................................ 41 4.1 CONTENT PORTRAYED ..................................................................................................... 41 4.2 CONTENT PERCEIVED ....................................................................................................... 43 5. LIMITATIONS........................................................................................................................... 47 6. CONCLUSION .......................................................................................................................... 50 BIBLIOGRAPHY ............................................................................................................................. 52 APPENDICES ................................................................................................................................ 58 2 FIGURES AND TABLES FIGURES 1. Informational poster for a cholera prevention campaign by MSPP ......................... 7 2. Knowledge rate before and after the OCV campaign (Haiti) by communication channels and type of information .............................................................................. 21 3. SAWBO’s strategy to develop educational videos to low-literate contexts .......... 23 TABLES 1. Summary of the impact of Cholera in Haiti, 2010-2018 ........................................... 4 2. Variables and values for GHMP cholera prevention video .................................... 30 3. Variables and values for UNESCO cholera prevention video................................. 32 4. Variables and values for SAWBO cholera prevention video ................................... 33 5. Common variables and values for GHMP, UNESCO and SAWBO videos ............... 41 6. Questionnaire correct answers for Group 1 (GHMP video) .................................. 44 7. Questionnaire correct answers for Group 2 (UNESCO video) ................................ 44 3 1. INTRODUCTION 1.1 HAITI AND CHOLERA Cholera “could not have emerged at a worse moment” in Haiti (Frerichs, 2016, p.2). The October 2010 cholera outbreak was neither caused by the earthquake nor by the devastating human conditions it brought about, despite the popular saying. In fact, it was proved to be brought by UN Nepali troops who were in the country since 2004 according to findings made by Renaud Piarroux, a French epidemiologist called by the Haitian government to track the origins of the epidemic. In the first 3 months only, cholera had already caused 4.100 deaths1 and 185.000 suspects of being infected. The annual evolution of cholera in Haiti can be seen below: Table 1. Summary of the impact of Cholera in Haiti, 2010-20182 Year Population Suspect Institutional Communitary Total Incidence rate cases deaths deaths deaths per 100 2010 10085214 185351 2521 1580 4101 18.38 2011 10248306 352033 1950 977 2927 34.35 2012 10413211 101503 597 311 908 9.75 2013 10579230 58574 403 184 587 5.54 2014 10745665 27392 209 88 297 2.55 2015 10911819 36045 224 98 322 3.30 2016 11078033 41421 307 140 447 3.74 2017 12201437 13681 110 49 159 1.12 20183 12542135 4437 18 21 39 0.27 Cholera has reduced drastically to only 39 deaths in the first 10 months of 2018, and 4.437 suspect cases. In 2017, most cases were detected in three main states4: Artibonite (854), Centre (774) and Ouest (561) where Port-au-Prince is, and also the 1 Data accessed from periodical cholera reports by the Haitian Public Health ministry, available at: http://mspp.gouv.ht/newsite/documentation.php 2 Idem 3 As of 27th, October 2018. It was the last data available when retrieved on 22nd November, 2018. 4 Pan American Health Organization / World Health Organization. Epidemiological Update: Cholera. 6 August 2018, Washington, D.C. PAHO/WHO, 2018, Retrieved from https://www.paho.org/hq/index.php?option=com_content&view=article&id=14544:6-august-2018- cholera-epidemiological-update&Itemid=42346&lang=es 4 area of concern for the present study: Ça-Ira (Leogane). However, the chances for a new outbreak seem to be always at stake. A first rupture with the decrease rate was in May 2014 when cholera reinvigorated after a rainy spring season, despite being at its lowest in the first months of 2014. The disease rebounded especially in areas “where little or nothing had been done to reduce local vulnerability” (Frerichs, 2016, p.4). Two years later, a third outbreak was influenced by Hurricane Matthew hitting Haiti in October 2016, which caused 546 deaths and affected 2.2 million people5. The cholera death toll raised again from 275 in the first 10 months to 447 at the end of 2016. These events showed once again that adverse weather conditions are favorable for the spread of cholera, but also proved the importance of water, sanitation and hygiene facilities “since both water and sanitation were insufficient” in Haiti at the time, and bacteria “became abundant in the aquatic environment” (Khan et al., 2017, p.902). In fact, 34 cholera treatment centers out of 212 were destroyed by the heavy winds and many cholera patients were treated alongside other patients, which increased the risk of infection6. 1.2 WATER, SANITATION AND HYGIENE IN HAITI To “ensure availability and sustainable management of water and sanitation for all” is UN’s Sustainable Development Goal no.6. Access to water and sanitation are indeed a Human Right since 20107. Still, 29% of the global population lack access to
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