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Communication can be defined as the combination of the processes we implement to share and convey information. In practice, this is not so easy. Communication may be persuasive in its nature, prompting change in the receiver’s behaviours, values and beliefs; but it must also be effective in delivering information unambiguously, so that the receiver may decode it correctly.
The Seeing is Believing project, made possible by the International Agency for the Prevention of Blindness (IAPB) and executed by The Fred Hollows Foundation in Bangladesh, was undertaken from 2016 with the noble goal of facilitating accessible eye care, irrespective of gender, across the district of Barishal.
This article looks at three main ways in which the project applied behaviour change communications techniques to deliver positive eye health outcomes:
In social structures where reputation can play a big factor in community lifestyles, family members, especially household heads like fathers or husbands often rather ignore a problem than address it. But through interactive communications design such as eye camps, folk plays, miking and school screenings, incumbents within different localities were slowly sensitized to the importance of eye care, prevention and treatment. Communications materials were even customized for males so that they could assist/facilitate adoption of eye health care for female dependents in the family.
It seemed that patients had not been following post-operative instructions provided by the doctor. They were instructed not to put water in their eyes, not to engage in heavy work, and to sleep on the opposite side of the eye that has gone through surgery, among other instructions. Many patients did not correctly follow these instructions and developed associated complications. Taking their literacy standards into account, an interactive poster and associated leaflets were printed and furnished at hospitals, in and around pre and post-operative waiting spaces. These were helpful not only for patients, but for anyone accompanying them as they could help explain good hygiene and eye care practices at home. A large reason for poor post-operative care was because of religious practices of ablution before prayer. So communications material showed patients how they could circumvent such issues, for example, by using clean stone or sand instead of water, helping to add legitimacy to treatment.
Some important barriers to service uptake were identified amongst indigenous and marginalised communities i.e. the inability of indigenous peoples to leave their localities, barriers in language and understanding, reliance on spiritual healers and witch doctors as well as inaccessibility to any local medical centres or facilities. Speaking to other marginalized communities, we can also consider Dalit (untouchables) Hindu caste members who, due to restrictions rooted deeply in their own value systems, also found it difficult to approach and adopt any eye care services.
To this end, the Fred Hollows Foundation began with advocacy meetings with tribal leaders and chieftains to show good faith, orienting them with the medical procedures and vouching for the efficacy and safety of treatment. Service providers also received sensitivity training and translators were provided to help with communication between service providers and community members. The indigenous communities were also allowed to wait within their own groups – all in an effort to build trust and confidence in the service. These efforts were supplemented by billboards, leaflets and materials created with indigenous models, written in their local dialect and targeted towards women as most of these communities were matriarchies.
The work that Fred Hollows established within the Barishal region is a testament to the effectiveness of a good communications platform paired with the tenacity of human nature, reaching out for a brighter tomorrow. The Seeing Is Believing programme helped tens of thousands of patients navigate sociocultural norms, language barriers and push themselves to find the courage to take their eye health into their own hands. Perhaps this story too, can become the cornerstone for some fortunate reader – to know that sometimes a well-intentioned message can transform the lives of all who receive it and become their source of inspiration to pay it forward.
Author: Md. Nurul Siddikqi, Project Officer, The Fred Hollows Foundation