May 23 , 2020
By Tegenne Legesse ( lecturer at Hawassa University's School of Public Health. )


Throughout history, pandemics have been more devastating to human populations than wars. The Black Plague during the 14th century is estimated to have reduced the world population by a third of its size. Smallpox, the only infectious disease to have been eradicated, probably killed as many as 300 million people in the 20th century alone. A century ago, the Spanish Flu is believed to have taken the lives of up to 100 million people, far higher than the death toll of World War I, and perhaps even World War II.

Ethiopia has not had a lack of epidemics either. Cholera, HIV, measles and malaria have never been eradicated, and they flare up periodically. Many members of royal families, political dignitaries, community members, public figures and armies fell ill and died as the result of epidemics. The most devastating one came in the early 20th century, with the Spanish Flu, which was known as Yehidar Beshita.

“God first took the doctors … and then swept away the people,” a missionary wrote about the epidemic in Ethiopia, which led to the death of half of the eight medical professionals the nation had.

Churches were filled with corpses and relatives of the deceased waited day and night to bury their loved ones. It is estimated that 50,000 Ethiopians perished and that the death of political dignitaries threatened the stability of the country.


Fortunately, the current Novel Coronavirus (COVID-19) pandemic does not seem like it will leave such an adverse imprint on the country. But as the number of cases grows and it continues to ravage the world, there is reason to worry.

The first case of the virus was confirmed in China in late December 2019, and since then it has reached 4.9 million confirmed people and caused more than 320,000 deaths by May 19, 2020. In Ethiopia, as of this writing, there are 352 cases with five deaths.


Ethiopia has been striving to contain the virus by taking the following measures: obligatory quarantines, home-to-home and border entry screenings, restrictions to movement and gatherings, awareness creation about the disease, contact tracing and testing.

But these efforts leave a lot to be desired. The behaviour of all people still needs to change if this pandemic is to be tackled. Resistance to change might be due to multiple factors that should be considered.


Even though using mass media is important for alerting and changing the behaviour of the public, it has its limitations too. In focusing intervention measures on public awareness through media campaigns, people in rural areas are left out as they have little to no access to the media. It is also the case that messages from mass media are passive and result in low rates of predicted gains in the change in behaviour in the shortterm.

Beyond the media, there is the matter of health illiteracy. This is closely related to education, and Ethiopia has one of the world’s lowest rates of prevalence. As a result, many may have difficulty comprehending, appraising and applying health information they receive from the media.

It should also be taken into consideration that access to the media does not immediately translate to access to information. Ethiopia is a country where dozens of languages are spoken. If the messaging is not translated in every major language that is spoken and repeated in this manner several times, behavioural change is hard to bring about.

What shall be done?


Interventions aimed at achieving sustained behaviour change will require a diversified approach. To do this, a bit of creativity and open-mindedness is necessary.

A great place to start would be to strengthen messaging in local languages. It is crucial to remember here that intermittent notices and bulletins will not bring about behavioural change. It has to be repeated several times a day and presented in a manner that appeals to the viewer instead of a drab presentation that just presents facts.

There is also the need to engage clan leaders, influential people and community elders with the current prevention strategy and media campaign. These people will be detrimental to creating an air of legitimacy and import to the messaging on the pandemic.

There are also points that have been missing from the messaging. These include management and disposal interventions when it comes to bodily fluids and contaminated fomites. And, as a third of households in the country do not have access to improved water sources, water treatment methods should be included in the intervention package.

There is currently an awareness that messaging is critical to containing the spread of the virus. The nature of this messaging determines the extent to which an intervention is accepted and institutionalised in a given setting.



PUBLISHED ON May 23,2020 [ VOL 21 , NO 1047]


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