Vaccination starts with registration and obtaining a date

Editor’s note: Last year, here on Language on the Move, we ran a series devoted to language aspects of the COVID-19 crisis, and readers will also have seen the special issue of Multilingua devoted to “Linguistic Diversity in a Time of Crisis”. We closed the series in December 2020 but, well into 2021, the language challenges of the COVID-19 crisis continue to hold our attention.

The global focus has now shifted to vaccination and we resume our series with a post by Professor Judy Kalman, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional (CINVESTAV), Mexico, about the literacy practices associated with the COVID-19 vaccination effort. Each step of the vaccination process involved using written language, circulating multimodal representations, and extensive record keeping. In this post, Professor Kalman uses the massive global vaccination effort to illustrate how entangled literacy is in every aspect of our lives.

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Eligible for vaccination? Get your papers ready!

Soldier and patient with documents at the vaccination center

At the beginning of February, Mexico announced it would soon begin vaccinating everyone 60 years and older against the Covid-19 virus. It was something my family and I had been waiting for, having sheltered in place under the #quedateencasa mandate for nearly a year. We received the news via radio, TV, and digital sources. The first instruction was to go online and register for our vaccinations, and an official would notify us of the time and day that we would get our shots. There was an immediate rush of seniors or their children to the official website, where we were instructed to type in our population ID number known as Clave Única de Registro de Población (CURP).

My husband and I recently got our first shot, and I could not help but notice how much the process involved reading and writing. Every step of the way, we—the 650,000 older adults that live in Mexico City—were asked to show official documents, fill out forms, and present written evidence of our identity, place of residence, and age.  Each document that we displayed involved, at some point in our lives, doing the necessary paperwork to obtain it, which in turn meant filling out forms, providing documents, and being approved. In a highly literate society like ours, official documents are passports for participating in many aspects of public life, receiving benefits, and being eligible for social goods. Without them, we are invisible and stymied in our efforts to go to school, get financing, procure housing, vote, and as in this case, receive healthcare (Trimbur 2020; Blommaert, 2008).

Mobilizing for vaccination is a massive literacy effort

Getting vaccinated involves filling out numerous forms

Here, the local authorities organized the distribution of vaccines by place of residence. Once the rollout began, local authorities announced the districts where vaccination would occur at the beginning of each week. General information regarding when and where to go was available to the public via the press, radio, TV, social media, and the official websites. They distributed us by the first letter of our last names and assigned vaccine centers according to neighborhoods. Knowledge regarding literacy practices such as alphabetical order, navigating web pages, reading dates, and following written instructions helped us identify and keep our appointment (Barton and Hamilton 1998; Street, 2014). By going online, we could download a specific location and time to arrive.

Much of our everyday paperwork practices are now digitally mediated by web pages, allowing us to fill out and send in forms with a click of a few keys. However, many of these reading and writing uses are grounded in procedures we used to fill in blanks with a pen (Kalman, 2001; Gitelman, 2014). What was missing from the second announcement was the list of documents that are necessary to be allowed into the vaccination center, but that information traveled swiftly over social media and messaging boards, illustrating how digital technologies enable information to flow almost instantaneously (Lankshear and Knobel, 2008). Vaccine centers were also located on maps to help us plan transportation and parking, exemplifying the multiple formats, modes of representation, and meaning-making devices used for planning and carrying out this public health campaign.  Reading and writing are complex practices, and rather than thinking of literacy in the singular, it is more precise to think of literacies in the plural.

Forms need to be checked and re-checked numerous times

Mobilizing all the seniors living in Mexico City is no small feat and making sure that the operation ran smoothly demands impeccable organization and communication strategies, but also requires a literate population and ways to replicate the information through mass media—TV spots, news coverage, online campaigns—and small media— the production of social messages directed at local and defined audiences via posters, flyers, local radio, hashtags and real-time communication software (Spitulnik 2002) – similar to the neighborhood lock-down notices I observed last year (Kalman, 2020).

Vaccination centers run on literacy almost as much as on vaccines

In our case, we were directed to a local Exposition Center, a facility run by the National University. We gathered our documents together: our official identification, a printout of our appointment, a copy of our registration, our CURP, and proof of residency. Five documents to get our shots, each connecting us to institutions, commercial enterprises, neighborhoods, and our life histories. In a literate world,  the point is not how many people read and write. Once written language is part of a community’s linguistic repertoire, it shapes the way communication is accomplished. Furthermore, it shifts the social hierarchies regarding who can read and write and who cannot, creating social expectations for literacy use (Blommaert, 2008). Who and how many people can read and write has varied over time, and historically the goal of universal literacy is a relatively recent idea (Graff, 1987).

To get into the center, we were asked to show our IDs and handed a numbered card that gave us our place in line.  My number was 4352. Then we were placed in groups of ten and waited until it was our turn to go into the Expo Center. People carried their papers in envelopes, plastic shopping bags, folders, and document protectors. All along the way, monitors wearing green shirts bearing the logos for the Mexico City government lined the route and directed us where to go.

Preparing the syringes is yet another literacy activity

When we entered, we encountered a massive space filled with people coded by their military uniforms, white coats, green shirts, beige vests, and dark blue sweaters. All of them were wearing identification badges with their names, institutional affiliations, and positions, more information than we could  possibly read as we hurried to the tables to take our place in the documentation station.

Official monitors sat on one side of the table and asked us to sit in front of them. Each one had a stack of forms to be filled out: the same information was handwritten on the top half and repeated on the bottom. The form’s two parts were separated by a perforated line, similar to the checkbooks and stubs, creating a copy of the document and its recorded information—one for the patient and one for the public health staff. The staff asked us to show our ID card and then copied our names from it, checked our age, and verified our address to ensure that we were in the right vaccination center, mediating how the form was filled out. Acting as scribes, they used blue ink and clear printed manuscript letters, and all of them wrote by hand (Kalman, 199, 2009). There were no computers or screens, so the information that we had registered back in February was not available or displayed. A few monitors had mobile phones with navigating capacity, but they seemed more for personal use during downtime than for work activities.

The materiality of literacy

Literacy practices keep everyone moving and in line

Once our form was filled out, we were directed to a waiting area and then accompanied by more monitors in green shirts to take our place in line in a series of folding chairs. As I scanned the room, I saw people, pens, paper, clipboards, packaging everywhere. Accomplishing literacy also includes access and availability of the material goods for reading and writing, from something to protect printed documents to handheld digital devices. Misplacing a pen or tearing a form could hinder the vaccination recording process and perhaps require rewriting forms rather than reprinting or resending a digital one (Barton and Hamilton, 2005). Actors’ participation, the materiality of reading and writing, and processes for producing literacy are bundled together in literacy practices.

There were multiple stations where nurses were filling syringes—even these had numbered scales on them to measure the precise doses.  They seemed to be writing short notes, perhaps to keep track of the vaccination lot numbers and vials. Organizers also designated areas for those adults who needed special attention. These were signaled by a monitor carrying a red flag that said Atención Prioritaria. As we waited our turn, a monitor came up to us individually and checked our forms to make sure they were correctly filled out and that the top matched the bottom.

Each vial of our vaccine provided six shots, and we were seated in groups of six to wait for our injections. Medical personnel collected our forms, and one person at the station made annotations on the top part of each one. I am assuming (but could not see) that they were recording the information on the vial. Two vaccinators worked their way down the line of three chairs, giving us our shots one by one. When they finished, they showed us the vial and lot numbers and explained what the writing on the vial said. They made a particular point of pointing to the laboratory and reading the accompanying numbers, although we were not sure what it meant. They also told us how the vaccine works and underlined the importance of continuing to use face masks and social distancing even though we had been vaccinated. One of the monitors returned the bottom part of the form and told us to be sure not to lose it, that we would need it for our next shot. She also said that the department of health would contact us as soon as it was scheduled, and this could take from 20 to 40 days.

The text on the vaccine bottle is as important as its content

We then got up and were taken to an observation area and asked to remain there to make sure nobody had a severe reaction. After about 20 minutes, someone from the medical staff told us that we could go. As we walked out the door, monitors again checked our forms one last time to ensure all of the needed information was there. They told us once again not to lose this vital piece of paper and insisted on the importance of continuing with public health measures.

Literacy is a collective effort

All over the world, people are lining up to get vaccinated. But they are also searching in their files, organizing documents, filling out forms, registering information, keeping track of forms and syringes. This massive vaccination effort illustrates how entangled our activities are with literacy and how reading and writing is a situated practice. Dominant versions of reading and writing underline their individual nature, but here we see how producing and interpreting texts and circulating knowledge are collectively organized and shared activities. And while we have become accustomed to thinking in terms of keyboards and screens, this process also reminds us of the power of pen and paper. Writing technologies coexist and are mobilized into action as our practices and purposes demand them.

References

Everyone in the waiting room is engaged in a literacy practice, even if only holding on to their paperwork

Barton, D., & Hamilton, M. (2005). Literacy, reification and the dynamics of social interaction. Beyond communities of practice: Language, power and social context, 14-35.
Blommaert, J. (2008). Grassroots literacy: Writing, identity and voice in Central Africa. Routledge.
Gitelman, L. (2014). Paper knowledge: Toward a media history of documents. Duke University Press.
Graff, H. J. (1987). The labyrinths of literacy: Reflections on literacy past and present. Psychology Press.
Kalman, J. (1999). Writing on the Plaza. Scribes and their clients in Mexico City. NJ: Hampton Press.
Kalman, J. (2001). Everyday paperwork: Literacy practices in the daily life of unschooled and underschooled women in a semiurban community of Mexico City. Linguistics and Education, 12(4), 367-391.
Kalman, J. (2009) Literacy Partnerships: Access to Reading and Writing through Mediation en: Edited by Basu, Kaushik, Bryan, Maddox and Anna Robinson-Pant. Interdisciplinary Approaches to Literacy and Development. pp. 165-178
Kalman, J. (2020). Signs of the times: Small media during Covid-19 in Mexico City. Retrieved from https://languageonthemove.com/signs-of-the-times-small-media-during-covid-19-in-mexico-city/
Lankshear, C., & Knobel, M. (Eds.). (2008). Digital literacies: Concepts, policies and practices (Vol. 30). Peter Lang.
Spitulnik, D. (2002). Alternative small media and communicative spaces. In G. Hydén, M. Leslie, & F. Ogundimu (Eds.), Media and democracy in Africa (pp. 177-205). London: Routledge.
Street, B. V. (2014). Social literacies: Critical approaches to literacy in development, ethnography and education. Routledge.
Trimbur, John. (2020). Grassroots Literacy and the Written Record: A Textual History of Asbestos Activism in South Africa. Channel View Publications.

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Susana Distancia (“Susan Distance” or “Your healthy distance”)

Since the beginning of the Covid-19 crisis, impromptu signs are showing up everywhere in my neighborhood in Mexico City. They have become a prominent resource for responding to centralized government orders and communicating changes in the organization and procedures of everyday activities to the community. With the issuing of each new directive, schools, small businesses, and organizations have turned to making and posting signs to announce ongoing transformations, showing the relevance of locally produced writing as a means of communication in the context of mass media and the internet. At the same time, the signs provide social commentary about the ways people are adapting to the pandemic, by modifying different aspects of everyday life to meet the demands of the times.

The initial cases in Mexico were reported at the end of February 2020, and the federal government’s first public health campaign promoted avoiding close contact, constant hand washing, and greeting people from afar. In a country where the saludo is highly treasured, and often includes a handshake, a hug, a pat on the back, a peck on the cheek, or a combination of all of these, this first directive caused a bit of an uproar. Waving hello from a distance to people in our lives felt awkward at first, but as the pandemic has progressed, it has become more and more natural to take several steps backward from anyone in our conversations.

Two weeks later, these directives exploded into everyday discourse via television spots, radio announcements, social media, and print. One of the first visible measures was the distribution and display of posters produced by the Secretary of Health and other official agencies in public places: clinic entrances, schools, pharmacies, public transportation, and local government offices. These centrally produced posters present clear and precise information about Covid-19 and are part of a concerted campaign. They share texts, logos, color schemes, drawings, diagrams, and contacts (such as coronavirus.gob.mx). The information varies in depth and scope, depending on who the assumed readers are. The materials posted on the front gate of a public clinic may be somewhat technical and detailed, while the content posted at a primary school entrance might be more basic and illustrated.

Dear Fathers and Mothers: Please verify your phone number in the “chat” group with your representative because this will be the way we will be sending the teachers’ programmed activities that will be evaluated during the confinement period from March 17 to April 3, 2020. Thank-you for your attention to this matter!

After this first round of printed posters, locally produced signs began popping up around Coyoacán, a colonial neighborhood in the southern end of Mexico City. Some of them were handwritten on brightly colored poster boards with black marking pens, and others were printed out on computers (black ink on white paper) and taped to window panes or doorways. This burgeoning use of small media (Spitulnik 2002)—the production of social messages directed at local and defined audiences via posters, flyers, graffiti, community radio, hashtags, and so on—provides evidence of the fast-changing situation and people’s response to the continuous new challenges posed by the pandemic. For the most part the signs are just written messages sprawled across the page, and on occasion they have more thought-out designs. Behind the local writers’ words are intentional activities and social relationships impacted by the unfolding emergency. The written displays reveal how shop owners, teachers, and others are mobilizing available semiotic resources through their production of complex multimodal signs, and at the same time, are providing sociolinguistic evidence of fast-paced changes in everyday life.

Towards the middle of March, the Secretary of Public Education (SEP) announced the closing of schools two weeks before the scheduled spring break. Principals at local schools placed handwritten notices to parents at the entrance informing them where to pick up homework assignments for their children or how to keep in touch with the school for updates. Written by hand in black ink on a bright yellow poster board, this sign from a middle school begins as a letter addressed to Señor padre or madre de familia (“Dear Fathers and Mothers”).

Displaying signs for parents at the school entrance is a common practice here. This one is dated March 18, one day after the school was officially closed, suggesting how quickly decisions had to be made. In the text, there are several phrases underlined in red, drawing the reader’s attention to the central imperative: parents must verify their phone number, chat application, and their representative’s contact, so that they can receive assignments for their children and other updates. Every day the SEP was insisting via messages on social media, television, radio, and directly through school authorities that these two weeks of shut down were not a vacation and that study programs should be continued at home. The distribution of homework and the red underlining attests to the intention to grade students’ work and reveals the top-down relationship of the principal’s office (and the SEP) with families and the expectation that students will comply (with the threatened sanction of a poor evaluation if they do not).

Soon came other closures. Authorities launched two interconnected campaigns, one was the creation and diffusion of the superhero character Susana Distancia, a play on words for Su-Sana-Distancia, using a homophone to simultaneously construct a proper name (“Susan Distance”) and a public health message (“Your healthy distance”). The Secretary of Health (SH) published and broadcast a wonder-woman-like cartoon whose super power consists in extending her arms to create a space that is a meter and a half wide to keep the coronavirus away. Susana Distancia then reveals that anyone can also have this same power. Susana Distancia quickly became part of conversations and social discourses via face-to-face interaction, print, digital media, television and radio. Susana Distancia appeared almost immediately in public places in a variety of ways, as in this hand-drawn poster taped to the back of an SH mobile health unit that was parked in the plaza. In a county where funding is scarce, and resources are often depleted, local adaptations like this one are common.

At the same time, the Secretary of Health announced the Jornada Nacional de Sana Distancia (National Safe Distancing Initiative) and the beginning of the shelter at home directive. This was a game changer: it closed non-essential businesses, bars, and restaurants; it cancelled public events; and all those who could work from home were instructed to do so. Immediately signs popped up everywhere. They made visible the different ways people were adhering to official policies. The sign shown here is posted on the door of an informal micro business, a family that makes tacos that neighbors can buy and eat in the doorway or take away. It reads: “Due to official orders there will be no tacos starting the 19^th of March until further notice. Thank-you for your understanding”. This hybrid message combines the very formal “Due to official orders” and “thank you for your understanding” juxtaposed to the almost comical “there will be no tacos”.

Business owners demonstrated their compliance, and at the same time, tried to salvage their livelihoods: local restaurants have organized take away services, small stores have offered home delivery, larger establishments have promoted on line services. Many bright poster boards announce these changes in operation.

As in other places, disinfectants, gloves, facemasks, and gels have become scarce and hard to find. Cottage industry production of these items is being sold by curbside entrepreneurs from the back of their cars, on the sidewalk, or taken up by businesses offering them as new merchandise. One dry cleaner advertised facemasks for six pesos by re-purposing an existing sign in their storefront, taking advantage of the dialogue balloon, but changing the message with a bright green handwritten paste-over.

The pandemic separates us but love brings us together

Other types of signs are now, at the end of April, beginning to appear. These signs point to the human side of collectively living through an emergency. Some communities are publicly displaying banners showing appreciation for health care workers. There is also a campaign to help people who have lost their jobs and are in need: in a gas station a table was set up with a well-designed cloth sign hung from a second story window sill. It reads: “The pandemic separates us but love brings us together”. Below is a table with a display that says “if you need something take it, if you can, leave something.”

These written messages are part of the local response to a worldwide health emergency and document how people are modifying their activities, forms of work, and social behaviors. The signs are at once global and local, formal and playful, formulaic and hybrid, graphocentric and multimodal. They present intertextual, hybrid texts—varying from everyday writing to formal discourse—to accomplish diverse communicative purposes. The writers simultaneously document their activities and contribute to the social construction of living through the pandemic. These visual resources record the local history and local practices, and reveal forms of organization and adaptation of the people who live there. They are a sign of the times.

Reference

Spitulnik, D. (2002). Alternative small media and communicative spaces. In G. Hydén, M. Leslie, & F. F. Ogundimu (Eds.), Media and democracy in Africa (pp. 177-205). London: Routledge.

Language challenges of the Covid-19 pandemic

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