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By Ranjit Monga It’s easy to blame the media for its disinterest in covering issues such as tuberculosis, which kills 1,000 in India every day. But the problem could be the way organisations working with TB communicate their information. Trainings in effective communication and media advocacy clearly help
Consider this: Tuberculosis claims 1,000 lives in India every single day, and 5,000 across the world. It is no longer a medieval disease lurking about unattended in resource-scarce regions; it has huge funding behind it. Governments of every country in the world are more aware of it than any other longstanding national or international issue. It enjoys some of the most active championing by civil society, not just in India but around the world, including the US and UK. Yet the media largely ignores these facts. Although news has begun emanating from more sources, and more or less reflects the current trends, it is still too little. And there are many gaps in stories reflecting the success of the government’s DOTS (Directly Observed Treatment Short Course) programme to combat the disease. DOTS is the accepted treatment for TB worldwide. In 2003, when one of the first such events was organised on behalf of Massive Effort Campaign and the Global Fund for AIDS, TB and Malaria, there was a total of six newspaper reports, three website reports, and a video release by eight TV channels during the meeting. By 2005, there was no substantial change. The World TB Day press conference that year yielded eight newspaper reports and eight website reports, and 10 TV channels carried a video release. Later that year, A R Rahman’s meeting with TB patients in Mongolpuri, a west Delhi resettlement suburb, earned him unprecedented media coverage. Rahman was worldwide TB ambassador at the time, and his visit was broadcast live by at least four television channels throughout the afternoon he spent in Mongolpuri, in September 2005. Without a celebrity to cover, and no so-called ‘news peg’, journalists ask an important question: “What’s the story?” It’s an issue that requires some soul-searching among civil society organisations. The Indian government today has the largest health programme for tuberculosis anywhere in the world, covering the entire Indian population through treatment and testing centres. This fact is much celebrated and written about in the media. But it’s one story, and once it’s out, it’s over. What would be useful is constant attention by the media to numerous offshoots of the story, the thousands of issues that are crucial in controlling and treating the disease. Also the many successes that are not reflected in the media. “Already, in the past 15 years, the rise in awareness of the media has paralleled the death rate coming down from 1,500 per day to about 1,000,” says Susan Raj, Principal Director of The Academic Advisors, Pune. “But for TB, the story doesn’t end here. There are so many factors that influence the spread of TB other than the conventional mode of transmission. Earlier, the disease spread through contact and, once cured, there was very little chance of it coming back to the same person. It generally hit those with low immunity, brought about by poor nutrition or ill health. Now it has started affecting HIV-infected people, finding a new body type to lodge itself in, as their immunity is very low. So it’s even more imperative that the media continues to report the story extensively.” The other danger is a new more deadly form of the disease called MDR or X DR TB -- multi-drug-resistant tuberculosis. Civil society organisations say that unless these issues are properly highlighted in the media, awareness will remain low resulting in inadequate ‘pressure’ on the concerned authorities. “Yes, MDR and HIV-TB co-infection are new angles to the story. But after these, what?” asks Annapurna Jha of the news agency United News of India. “The media needs new angles to report on a story each time. Otherwise the stories get edged out by other important issues like politics, security, etc.” Health is anyway considered ‘soft’ story material; if there’s nothing new in a story it is not picked up by the newspapers. But there’s always new data, new analysis, new stories from the community. It’s the media that largely ignores it, says Dr Nirmala Rajgopalan of the Bangalore-based Freedom Foundation. “The media will go overboard writing about SARS, H1N1 and bird flu which do not take that many lives. But with TB, even with 1,000 people dying every day, the stories are not adequate.” Annapurna, who has been covering the health sector for the last 15 years, agrees that coverage of TB is inadequate, and, along with malaria, stories about the disease have become ‘routine’. Yes, H1N1 and SARS are high-profile stories for the media, but they reflect the focus of international health institutions and national governments. The media only follows what their focus is, she says. “The media can have a substantial impact on policy and policymakers; that’s an established fact. The media covers topics that are of interest to their constituents, and politicians do pay attention to what is reported in the media,” says Blair Hinderliter of the Washington-based RESULTS Educational Fund (REF), an advocacy organisation working with poverty issues worldwide. “In the United States, politicians particularly pay attention to what is reported in the media in the district they represent. For example, an editorial in the Las Vegas Sun will carry particular weight for the two senators from Nevada. The MDR and XDR-TB report recently released by the World Health Organisation has led to more than 50 media articles and editorials to date, which raises awareness not only among the general public but also among politicians,” he adds. REF is a partner of ACTION, which is working on generating media coverage of issues related to TB in several countries including Australia, Canada, Japan, the UK, United States, France, Kenya, and India. This is perhaps the only effort of its kind for any disease, anywhere in the world. ACTION focuses on policymakers and civil society organisations, engaging them directly and informing them about TB; it also works with other NGOs to engage the media. Its strategy involves writing letters to editors, op-eds, and working personally with individual reporters and editors to assist in stories. But first, before going to the media, selected spokespersons of different NGOs are trained to be ‘TB advocates’! India got its first batch of such TB champions last year after an intensive week-long workshop held in Delhi. “The training opened up our eyes to the compulsions of the media, and for the first time I was able to understand why they do not cover TB so regularly,” says Rev P T Mohanadoss, Deputy Director of David and Lois Rees Hospital in Yerpedu, Andhra Pradesh, one of the people trained to be a TB champion. “Maybe somewhere we have to be more active in our presentation to the media, backing our claims with proper data and simplifying some of the technical language normally used in connection with the disease,” he says. The TB advocates’ mandate is to push TB issues not only in the media but also in government and civil society organisations. Also, funding agencies and society at large. Poonam Bose of Children International-Sahay now feels better placed to deal with the media. “I feel more confident about taking relevant issues to their doorstep. This confidence will be reflected in my organisation’s ongoing efforts with the media,” she says. Joseph M Singh of Mamta Samajik Sanstha also feels better about facing the media. “I have started using those tools while dealing with the local media in my place,” he says from Dehra Dun where he is based. A few TB champions will be personally mentored by public relations executives in the coming months. The idea of creating TB champions is to put a face to the disease. Like Lucy Cheshire, a survivor of TB/HIV co-infection, who works with the Kenya AIDS NGOs Consortium (an ACTION partner). Lucy has dedicated her life to eradicating TB. By becoming a TB champion, she is now a globally recognised spokeswomen and activist. “We need more champions like Lucy who are able to move past the stigma of TB and give those affected by TB a voice,” says Blair. Tuberculosis in India: the facts - India has 20% of the world’s TB patients.
- TB kills more people in India than HIV and STDs, malaria and other communicable diseases combined.
- More than 80% of patients are in the economically productive age-group of 15 to 54 years.
- In dollar terms, TB costs India more than $ 3.3 billion each year.
- It causes the loss of at least 100 million workdays per year due to illness alone.
- TB leads to around 100,000 women being thrown out of their homes.
- 300,000 children drop out of school every year on account of parental TB.
(Ranjit Monga is a filmmaker based in Delhi) Infochange News & Features, July 2010
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