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Public Health Messages Can Fight Disease — If The Message Is Right


Here's a success story in the world. Guinea worm disease has been nearly eradicated. There were once nearly 3 million cases in the world, mostly in West Africa. Today, there are just two confirmed cases. Public education made the difference in getting people to understand the health threat and to alter their behavior. We're joined in our studios now by Dr. Khadidiatou Ndiaye, an assistant professor at the Milken Institute School of Public Health at the George Washington University. Thanks so much for being with us.

KHADIDIATOU NDIAYE: Thank you for having me.

SIMON: So what was the public health message they got out?

NDIAYE: One of the things that we learned from that is that there are instances where the only thing we can do is really communicate to save lives. And in that case, it was important to engage the community in getting the messages out there, putting out consequences that are set by the community. People who had Guinea worm could not use the rivers.

SIMON: Why was it important to get them out of the river?

NDIAYE: So people who were infected with Guinea worm would go into the river because there's a lot of burning sensation to relieve.

SIMON: Try to get into the river to cool off.

NDIAYE: To cool off. And by doing so, the larvae would get into the water. And then you have the potential of infecting other people.

SIMON: How do you inform so many millions of people, especially in areas of the world where what we think of as modern mass communication is spotty and limited?

NDIAYE: That's actually not a bad thing because when you look at - in a lot of places - and I'm - I'll use the example of a lot of African contacts. The mass media top-down approach may not be the way you reach people. But it's also important to start by engaging the community and doing it in their own words - so using town criers, what we call traditional newsmen, who will go around the village with a drum and share information about health issues.

SIMON: I just wonder if sometimes outsiders are regarded with skepticism.

NDIAYE: Absolutely. And you also have issues of literacy in the information that is presented. So for instance, with Ebola we use terms such as bodily fluid. That's maybe something that's understandable to people who are in the medical or public health settings, but not necessarily for the lay audiences.

SIMON: You have to be a little bit more explicit.

NDIAYE: Absolutely.

SIMON: Are there lessons that have been learned now or recently that help inform what should be done about Zika?

NDIAYE: I believe so. I think the recognition that Ebola provided a lot of lessons. One of them was first, you have to include the public health messaging early on. This cannot be an afterthought. And another lesson also has to do with rumors. You have to get those under control. So...

SIMON: ...Rumors.

NDIAYE: Yes. I can provide an example with a program that they call Dey Say. So this was a cell phone SMS app. So it's called Dey Say - D-E-Y S-A-Y. Health care providers have this app where they can report rumors. So if people thought that if they were spraying or if I use bleach this will give me Ebola, and the outside or the government is trying to give me Ebola. So that information can be then reported, then worked to make sure that that rumor was corrected and that information was passed on to local journalists to correct that rumor.

SIMON: While we have you in our studios, Dr. Ndiaye, what do you see as the biggest public health issues right now?

NDIAYE: I believe that these global health pandemics are the biggest public health - so Zika is the new one, but I think it has to - it comes down to how do we have a plan in place to make sure that we respond and we learn from our mistakes? So it feels like the wheel is reinvented several times. And when you go into places where the infrastructure just cannot support that, there needs to be some place and plan to make sure that history doesn't repeat itself.

SIMON: In our studios, Dr. Khadidiatou Ndiaye, who's an assistant professor at the Milken Institute School of Public Health at George Washington University. Thanks so much for being with us.

NDIAYE: Thank you for having me. Transcript provided by NPR, Copyright NPR.