(Image credit: RACGP)

The global impact of the coronavirus pandemic has reshaped societies worldwide, altering human interactions and perceptions of the world and brought unprecedented challenges, not only in terms of public health management but also in communication. Australia experienced low infection and mortality rates during the initial eight months of the pandemic compared to other regions. This success in containment has been attributed to rigorous testing, contact tracing, mandatory quarantine measures, and timely shutdowns, along with the advantageous geographical location of the country.

During this period, Australian news outlets played a crucial role in disseminating information and shaping public perceptions of the pandemic. This examination delves into the linguistic evolution of media coverage, shedding light on how risk communication strategies evolved over time. The linguistic choices in media coverage significantly influenced public response and adherence to health directives during the pandemic. The strategic changes in language helped stabilize public sentiment and enhance cooperation with health guidelines.

I conducted a study on Australian news outlets at Monash University during the peak of the pandemic. Utilizing the vital work of Mark Davies’ international corpus (Davies, 2019-), I created my own corpus, focusing on nationally recognized news outlets in Australia, such as The Age, ABC (Australian Broadcasting Corporation), and Channel 9. This resulted in a comprehensive collection from 18 outlets, comprising 5,969 articles and 961,390 words, covering the period from January to September 2020 (Munn, 2021). Articles from these sources were analyzed, focusing on key words used to frame aspects of the virus. The results of this analysis are detailed in this article.

Novel Coronavirus to COVID-19: the Linguistic Evolution

From ‘Deadly’ to ‘Wuhan’: Negative Connotations and Their Impact

When COVID-19 first became acknowledged by Australian news outlets in early January there was a noticeable use of the adjectives ‘deadly’ and ‘mysterious.’ While ‘deadly’ was quite apt in hindsight the use of negative adjectives is something the World Health Organization (WHO) heavily discourages as it can amplify undue fear in the wider public (2015). The changing and evolving information about the virus lead to a familiar pattern of different media sources reporting different and sometimes inflammatory perspectives that happened during the SARS and H1N1 outbreaks (Berry et al., 2007).

‘Wuhan’, the second-most occurring modifier, continues to exhibit a pattern of negative influence. Labelling the virus as the ‘Wuhan coronavirus’ not only implicates a specific geographical region but also inadvertently fosters discrimination against the Chinese community, contributing to a surge in racist incidents globally (Human Rights Watch, 2020).

Drawing from the research of Tang and Rundblad (2015) and WHO (2015), which emphasizes the significance of linguistic framing in risk communication, it becomes apparent that the language used in media reporting can influence public perceptions and behaviours. This observation underscores the importance of employing responsible language to mitigate fear and prevent stigmatization.

Standardization of Terms: The Introduction of ‘COVID-19’

In reaction to the growing negative connotations a new name was introduced by WHO in February 2020. COVID-19 (Corona VIrus Disease 2019) marked a pivotal moment in the risk communication of the virus. The new name was created using the guidelines presented in WHO’s “Best Practices for the Naming of New Human Infectious Disease” (2015).

This standardized nomenclature aimed to alleviate the negative connotations associated with ‘coronavirus’, thus promoting a more objective understanding of the disease and the data shows they were successful as ‘COVID-19’ showed no notable examples of the negative modifiers used with coronavirus.

The presence of the two names for the singular virus led to a spike of instances of ‘coronavirus COVID-19’ and ‘COVID-19 coronavirus’ the instances of both names used as modifiers for the other peaks in March after the introduction of ‘COVID-19’ in February. Over half of the instances of these occurrences were in the single month of March. There is a clear sense of interchangeability between the two terms that the Australian media grasped and communications to the wider public that ‘coronavirus’ and ‘COVID-19’ where the same thing, facilitating its widespread adoption.

By June, ‘COVID-19’ emerged as the preferred term, eclipsing ‘coronavirus’ in media discourse. This shift reflects a conscious effort to streamline communication and ensure consistency in messaging. This was not only the case in Australia, but Oxford English Dictionary also report the same result in their worldwide examination of words use relating to COVID-19 (Oxford English Dictionary, 2020).

Crisis Communication Narratives

Linguistic Framing: Proactive vs. Reactive

As the pandemic unfolded, media coverage shifted from solely focusing on the virus to addressing its broader societal impacts. The term ‘COVID-19’ was associated with proactive actions like understanding the cause, prevention efforts, and managing the ongoing challenges (cause, prevention, handling, etc.). In contrast, ‘coronavirus’ narratives often emphasized containment measures, warnings, and identifying hotspots (stop, warn, strain, epicentre, origin, etc.). These differing narratives reflected the multifaceted nature of the pandemic response, highlighting both proactive and reactive approaches to managing the crisis.

Handling Death

The differences in language usage between ‘coronavirus’ and ‘COVID-19’ regarding reporting on deaths attributed to the virus reveal contrasting narratives in media coverage. While ‘coronavirus’ often precedes mentions of ‘new cases’ and ‘more deaths’, emphasizing the novelty and severity of the virus. ‘COVID-19 ‘conveyed a sense of familiarity and normalization, omitting the need for such qualifiers. This distinction suggests that media outlets may unintentionally amplify fear and uncertainty when using ‘coronavirus’, while portraying ‘COVID-19’ as a manageable entity. Understanding these linguistic nuances is crucial for crafting effective risk communication strategies that promote informed decision-making and resilience among the public in navigating the ongoing challenges posed by the pandemic.

‘Fight’ against coronavirus vs ‘Battle’ against COVID-19

There were distinct linguistic nuances were observed in the portrayal of efforts to combat the virus. While both ‘fight’ and ‘battle’ were employed, ‘battle’ was exclusively associated with ‘COVID-19’, suggesting a more protracted struggle with no definitive endpoint in sight. The media viewed ‘coronavirus’ and ‘COVID-19’ as a fight, while only ‘COVID-19’ was a battle. Fighting coronavirus suggests a victory is possible, but the battle against COVID-19 has no clear victory in mind but just to struggle against the virus.

Linguistic Framing of Non-Pharmaceutical Interventions (NPIs)

Testing

The testing regime for COVID-19 emerged as a crucial strategy employed by the Australian government to curb the spread of the virus. Throughout the analyzed period, there was a discernible uptick in mentions of testing within the corpus, reflecting its increasing importance in public health discourse. Notably, spikes in discussions around testing coincided with the onset of the first and second waves of infections in Australia, underscoring its pivotal role in outbreak management.

While ‘positive tests’ remained consistently prominent, there was a notable anomaly in June, just preceding the second wave, where the frequency of ‘negative tests’ momentarily surpassed that of ‘positive tests.’ This anomaly highlights the dynamic nature of testing trends and suggests potential shifts in public health priorities or testing strategies during specific phases of the pandemic.

Lockdowns

The implementation of restrictions on the Australian public emerged as a crucial measure in controlling the spread of the virus, serving as the second major factor in virus containment. However, the timing and intensity of these restrictions displayed unexpected patterns, both preceding and following the two significant waves of COVID-19 cases in Australia, with ‘lockdown’ being most prevalent during infection peaks. During periods of easing restrictions, language referring to these measures became vaguer, reflecting a gradual relaxation of stringent policies, while during phases of enforcing restrictions, more specific terminology like ‘lockdown’ was employed, indicating a heightened urgency in response to escalating transmission rates.

Conclusion

The linguistic choices made by the Australian media in their coverage of COVID-19 significantly shaped public perceptions and actions in response to the pandemic. By moving from initial, fear-inducing language to more neutral and consistent terminology like ‘COVID-19,’ the media played a pivotal role in stabilizing public sentiment and enhancing adherence to health directives. This strategic linguistic transition underscores the profound impact of media language on public behavior during a health crisis. This observation sets the stage for further research and development of effective communication strategies. By optimizing the linguistic approach in media communication, the aim is to enhance public understanding and cooperation in emergency responses, ensuring that the gap between expert recommendations and public behavior is effectively bridged.

References

Anastasia Tsirtsakis. (2020, July 10). Australia’s COVID-19 response may have saved more than 16,000 lives. https://www1.racgp.org.au/newsgp/clinical/australia-s-covid-19-response-may-have-saved-more

Berry, T. R., Wharf-Higgins, J., & Naylor, P. J. (2007). SARS Wars: An Examination of the Quantity and Construction of Health Information in the News Media. Health Communication, 21(1), 35–44. https://doi.org/10.1080/10410230701283322

Davies, M. (2019-). The Coronavirus Corpus. https://www.english-corpora.org/corona/

Gabriella Rundblad, & Chris Tang. (2015). When Safe Means ‘Dangerous’: A Corpus Investigation of Risk Communication in the Media. Applied Linguistics, 38(5), 666–687. https://academic.oup.com/applij/article-abstract/38/5/666/2952207?redirectedFrom=fulltext

Human Rights Watch. (2020, May 12). Covid-19 Fueling Anti-Asian Racism and Xenophobia Worldwide | Human Rights Watch. https://www.hrw.org/news/2020/05/12/covid-19-fueling-anti-asian-racism-and-xenophobia-worldwide

Munn, C. (2021). What’s In a Name: A Corpus Analysis of Australian Media’s Naming Conventions and Risk Communication During the Coronavirus Pandemic [Masters]. Monash University.

Oxford English Dictionary. (2020, July 15). Using Corpora to Track the Language of Covid-19. Https://Public.Oed.Com/Blog/Using-Corpora-To-Track-The-Language-Of-Covid-19-Update-2/

Stanaway, F., Irwig, L. M., Teixeira‐Pinto, A., & Bell, K. J. (2021). COVID‐19: estimated number of deaths if Australia had experienced a similar outbreak to England and Wales. Medical Journal of Australia, 214(2), 95. https://doi.org/10.5694/mja2.50909

World Organisation for Animal Health (OIE), & Food and Agriculture Organization of the United Nations (FAO). (2015). World Health Organization best practices for the naming of new human infectious diseases (World Health Organization, Ed.). World Health Organization. https://www.who.int/publications/i/item/WHO-HSE-FOS-15.1

Flag for autism rights (Image credit: Deviantart)

In this post written for autism acceptance month, autistic anthropologist Gerald Roche discusses connections between the communication styles and life expectancy of autistic people, and encourages sociolinguists, linguistic anthropologists, and applied linguists to help work towards a better life for autistic people. 

Content warning: This post discusses suicide, sexual and physical violence, discrimination, and negative attitudes about autistic people. If you are in Australia and find this post distressing, you can call Lifeline on 13 11 14 or chat online. Lifeline offers language support services. For non-urgent information about autism, call the Australian national autism helpline on 1300 308 699.

***

Hi I’m simply dying to speak to you! I have so much I want to tell you about being autistic because I’ve learned so much since I found out that I’m autistic. I’d love to tell you everything I know but that would probably take too long, so let me just tell you one thing about being autistic. Let me tell you why I went online and searched up “autism life expectancy” soon after I was diagnosed.    

Around that time, I’d just published an article examining how linguistic minoritization reduces life expectancy. To write that article, I’d been reading across literatures in the anthropology of violence, genocide studies, and critical public health for several years, learning about how different minoritized populations are subject to structural violence that produces a ‘slow death’ and reduces their chances of living a long, healthy life. This creates ‘death gaps’ in the social fabric, where the ultimate benefits of privilege are additional years of existence. So when I found out that I was autistic, I had a sense that I might be living in a death gap. And I was right. 

Autistic people in Australia, where I live, have a life expectancy 20 years below the national average. Similar findings have been produced elsewhere. Studies from the UK, USA, and Sweden all show that autistic people die alarmingly early. A recent study in The Lancet has suggested that the ‘death gap’ might be closer to 7 years, showing that the figures are still being debated. But, the pattern of severely reduced life expectancy seems clear. Why is this, and what does it have to do with language?      

First, it’s important to understand that differences in communication styles and preferences are central to how autistic people experience the world. Whilst autistic people don’t speak a different language from allistic (non-autistic) people, our communicative practices are vastly different from those of allistic people. The differences are found across multiple areas of language, including acquisition, gesture, pragmatics, lexicon, and preferred modalities. Failure to acknowledge, accept, and accommodate these communicative differences plays a crucial role in reducing autistic life expectancy. 

The most direct connection between autistic communication and premature death relates to health communication. Autistic people experience increased rates of multiple chronic health conditions, including physical health problems across all organ systems, as well as increased rates of multiple mental health issues, such as anxiety and depression. The impacts of all these health conditions is multiplied by failures to accommodate autistic communicative styles and preferences in healthcare settings. For example, one study from 2022 found that many autistic people struggle to make doctors’ appointments by phone (we generally have a strong preference against using phones), and then experience difficulties communicating with doctors, often feeling misunderstood. A 2023 study from Australia found that autistic people frequently felt that healthcare providers did not take their concerns seriously. These communication issues potentially result in delayed treatment, undiagnosed conditions, misdiagnosis, healthcare avoidance, and other problems that lead to poor health.  

Beyond issues of health communication, there are also more diffuse links between communication and the premature death of autistic people. To understand these, we need to think about autistic people as a minority group who experience “exclusion due to discrimination, stigma, and their perceived inferiority.” Since communication is part of what makes us different, it is also part of what makes autistic people vulnerable as a minority. 

Like other minoritized groups, autistic people experience personal and systemic discrimination from the dominant population. The press typically reports negatively on autistic people. Derogatory views of autistic people circulate openly online. Allistic people find us to be deceptive and lacking credibility, in part because of our ‘low quality and inaccurate’ facial expressions. They judge us as less likable, trustworthy, and attractive than allistic peers, and have reduced interest in pursuing social interactions with us. Even when allistic people express explicit positive views of autistic people, psychological testing shows that their behavior is guided more by their implicit negative views. Exposure to such bias and stigma is ‘constant’ for autistic people.

Rather than simply experiencing bias and stigma in the abstract, they manifest in our lives as violence. This begins in childhood, with autistic children experiencing much higher rates of multiple forms of violence than their allistic peers. This continues into adulthood, with autistic people experiencing higher rates of several forms of violence, including sexual harassment, stalking and harassment, sexual violence and physical violence, producing a condition known as poly-victimization. One recent study found that 99.6% of autistic adults had experienced at least one form of violence. Autistic women suffer disproportionately: in one study, nine out of ten autistic women reported being victims of sexual violence. Surrounded and overwhelmed by this violence, many autistic people normalize it as an inevitable part of our life, and even blame ourselves for it. 

Allistic people are able to target us for discrimination and violence in part because our communicative difference makes us visible to them. Perhaps not surprisingly then, many autistic people engage in ‘masking’ or ‘camouflaging’ – suppressing visible signs of autism, such as stimming, and changing our communicative practices to be more acceptable to allistics. However, this only defers the direct and immediate harm of allistic discrimination and violence. In the long term, masking is bad for our mental health, leading to higher levels of depression and anxiety, as well as lower self-esteem. It also contributes to autistic burnout, a debilitating condition characterized by “exhaustion, withdrawal, executive function problems and generally reduced functioning.” 

Masking, discrimination, and violence accumulate in a form of ‘minority stress’ in autistic people that results in “diminished well-being and heightened psychological distress.” In research carried out with other minoritized populations, the impact of such chronic stress on the body has been described as a ‘weathering’ that reduces overall immune function and leads to higher incidence and severity of disease. Chronic discrimination and violence thus harm autistic people both physiologically and psychologically. 

But perhaps the most distressing and tragic impact of this violence and discrimination is autistic people’s increased risk of suicide. Numerous studies show that autistic people are more likely to think about, attempt, and commit suicide; a 2023 meta-review of this literature concluded that “suicidality is highly prevalent” in the autistic population.

When I look at all this information as an autistic person, even though I’ve only learnt the statistics recently, none of it is particularly surprising. It more or less accords with my own lived experience. However, when I look at this information as a researcher, I am surprised: not so much by the information itself, but by who produced it and how. 

We are looking here at a population that is minoritized, in part, because of communicative differences. They are then subjected to discrimination and violence, with tragic outcomes. Despite the centrality of language to this situation, research in this area is led primarily by psychologists, with some speech therapists, a few sociologists, and the occasional anthropologist. The cluster of allied disciplines that look at language and communication in relation to social justice, including applied linguistics, linguistic anthropology, and sociolinguistics, have so far had very little to say about this issue. 

It’s clear to me that our disciplines have a significant contribution to make here. We collectively know so much about the harms of language: slurs, labels, insults, jokes, and insidious discourses. We pay attention to the maldistribution of respect and resources to different language communities. We study how minoritization is produced and reproduced in everyday institutions, like schools, and how it enters into the most banal and intimate spaces and relations. We think carefully about how policy and practice stratify, exclude, and harm through and on the basis of language. And we also have plenty of ideas about what justice looks like, and the languages it uses. It therefore seems to me that we have an important part to play in conversations about what it really means to accept autistic people, and how to go about doing it. As a researcher, I know that we can, and as an autistic person, I hope that we will. Because right now, I’m dying to speak to you, and I wish that I wasn’t.    

The talk brings together three of my studies, as follows:

Study 1 (Grey and Severin, 2021)

Focus: legislation and policy about the decision-making framework and standards which might underlie multilingual government communications in Australia’s largest state, NSW.

Summary: The NSW government’s public communications are not made within a clear or informed decision-making framework as to choice of language, and do not consistently acknowledge, plan for, or manage the public’s actual linguistic diversity.

We developed a typology of laws about language choices. The most common type (40 of the 91 relevant laws) protects people by requiring that rights, obligations or information are explained to vulnerable types of people in language that they understand. Not being an English-speaker and/or literate in English is not generally recognised as a vulnerability in these laws.

Most of these require that certain government representatives communicate in an understandable way, but the standard is unclear and variously phrased: ‘plain language’, ‘ordinary language’, ‘simple language’, or ‘language likely to be understood’. There is no mention that this language may need to be a language other than English.

Another type of law that we found (merely) acknowledges linguistic diversity. The key example is the Multicultural NSW Act, which contains NSW’s Multicultural Principle that ‘all individuals and institutions should respect and make provision for the culture, language and religion of others within an Australian legal and institutional framework where English is the common language’.

Based on this Multicultural Principle and a few policies that we could locate, we conclude that there is enough of a framework in NSW that the question, how do government language choices differentially affect different language groups? should nowadays be asked when decisions about the NSW Government’s public communications are being made.

Study 2 (Grey and Severin, 2022)

Focus: web communications of 24 departments and agencies of the NSW government.

Summary: The study identifies that the NSW Government makes some effort to publicly communicate in LOTEs but also identifies problems: we found no consistency or predictability across websites in relation to the range of LOTEs used, the amount of LOTE content produced, or the steps by which it could be accessed. The image shows a table of 64 languages other than English which appeared at least once: how many of them, and for what, varied widely across the NSW government’s websites.

Overall, the actual NSW Government website communications practices we analysed did not appear to meet the standard set in the Multicultural NSW Act from which I quoted above, because provisions are not reliably or thoroughly made for non-English dominant speakers and readers.

We argue that the NSW government should not necessarily spend more money on multilingual public communications, although that may help, but rather that it should spend money on multilingual communications in an informed, strategic way, and in a way that is accountable both to policy and to the multilingual public.

Study 3 (Grey, 2023)

Focus: Covid-19 communications from the NSW government and the Australian national government.

Summary: This study finds weaknesses in multilingual Covid communications much like we found in the first two studies about general government communications, and about which I gave a preliminary report on Language on the Move.

In its final form, this study also reviews of the commentary of international organizations as to how to take a human rights-based approach to pandemic communications to fulfill certain international law obligations upon Australia (and other nations). It found expectations are emerging that governments’ multilingual health communications will be not merely partially available, but rather produced without (unreasonable) linguistic discrimination; produced with minority communities’ involvement at preparatory stages; and produced after strategic planning, which bolsters our calls in the prior studies.

The international commentary also stresses that multilingual government communications should be effective, not merely exist. In explaining what more effective multilingual communications could entail, I advocate assessing government communications’ Availability, Accessibility, Acceptability and Adaptability — that is, the ‘Four As’ recognized by the UN Committee on Economic, Social and Cultural Rights, crisis communications scholars and applied linguists (for example, Piller, Zhang and Li, 2020).

Recommendations

I conclude the webinar by suggesting ‘3 Rs’ in response to recurrent problems with how government communications reach, and represent, linguistically diverse publics:

1. (further) Research (preferably with government collaboration because important data is not publicly available / governments are best placed to collect it);
2. Redesigning communications and their access routes (for example, redesign the ‘monolingual logic’ of government websites, to use a phrase from Piller, Bruzon and Torsh, 2023); and
3. Rights-based Regulation (to uphold standards and to strategically plan communities’ input).

References

Grey, A. (2023). Communicative Justice and Covid-19: Australia‘s pandemic response and international guidance. Sydney Law Review. 45(1) 1-43
Grey, A., & Severin, A. A. (2021). An audit of NSW legislation and policy on the government’s public communications in languages other than English. Griffith Law Review, 30(1), 122-147. doi:10.1080/10383441.2021.1970873
Grey, A., & Severin, A. A. (2022). Building towards best practice for governments’ public communications in languages other than English: a case study of New South Wales, Australia. Griffith Law Review, 31(1), 25-56. doi:10.1080/10383441.2022.2031526
Piller, I., Bruzon, A. S., & Torsh, H. (2023). Monolingual school websites as barriers to parent engagement. Language and Education, 37(3), 328-345. doi:10.1080/09500782.2021.2010744
Piller, I., Zhang, J., & Li, J. (2020). Linguistic diversity in a time of crisis. Multilingua, 39(5), 503-515. doi:https://doi.org/10.1515/multi-2020-0136

You can order free hard copies of the booklet

Have you received your COVID-19 jab yet? Are you thinking about getting vaccinated? Are you confused by all the conflicting information out there?

A new set of resources published by the Australian Academy of Science in collaboration with the Australian Government Department of Health provides clear and credible answers based on the best science.

The Science of Immunisation

The Science of Immunisation is a set of resources that explain what immunisation is and how vaccines work. The aim is to help people make good health decisions.

The resources cover the following topics:

1. What is immunisation?
2. What is in a vaccine?
3. Who benefits from vaccines?
4. Are vaccines safe?
5. What does the future hold for vaccination?

Additionally, you can look up explanations of pesky terms such as “adjuvants,” “herd immunity,” “pathogen,” and many more. Furthermore, the website also features several short videos clips – informative to watch and easy to share.

There is also linguistics in the science of immunisation

The expert working group behind the The Science of Immunisation includes some of Australia’s most prominent medical experts, as you would expect. Additionally, there were also three language and communications experts, and I am honored to have been one of them.

The working group paid careful attention to targeting all audiences in our linguistically and culturally diverse society. Therefore, questions of linguistic inclusion and communicative accessibility played an important role in the development of the resources.

In terms of language and communication, The Science of Immunisation is a practical outcome of the research about language challenges of the COVID-19 pandemic that we’ve been publishing here on Language-on-the-Move.

To learn more about linguistic inclusion and communicative accessibility in healthcare communication:

• Does every Australian have an equal chance to know about COVID-19 restrictions?
• Crisis communication in multilingual Australia
• More about crisis communication in multilingual Australia

Check out all Language on the Move resources about “Linguistic diversity in a time of crisis.”

Additionally, multilingual crisis communication has been the focus of the research projects conducted by Master of Applied Linguistics students at Macquarie University as part of their “Literacies” unit. We close the year by sharing some of their findings.

Here, Monica Neve explores the language requirements of registering a business as “COVID Safe” in New South Wales (NSW).

***

(Image credit: NSW Government)

As restrictions rapidly increased during the beginning of Sydney’s lockdown in March 2020, the small yoga studio, which I had been attending for a number of years, closed its doors. Not just for the period of lockdown, but for good. Without students attending class and with no rent reduction in sight, the studio owner could no longer keep the business afloat. However, in June, with restrictions easing, a new yoga teacher took a leap of faith and reopened the studio.

When it reopened, the studio was identified as “COVID Safe” and sported the NSW “COVID Safe” logo that has by now become a ubiquitous sight in the business precincts of NSW.

For my research project, I wanted to discover how a business becomes “COVID Safe” and whether all businesses have an equal chance of being registered as COVID safe.

What is “COVID Safe”?

Under NSW Public Health Orders, COVID Safe registration is mandatory for hospitality venues (including cafes, bars and restaurants), gyms, and places of public worship. Penalties of up to $55,000 apply for businesses failing to comply.

Non-mandatory registration is encouraged for all other businesses.

The COVID-safe logo

COVID Safe registration requires the creation of a COVID safety plan in which businesses explain how hygiene and safety measures are being implemented on their premises. Once registered, businesses receive a digital COVID Safe logo for use on online platforms, as well as COVID Safe hygiene posters for display.

Language and literacy skills of NSW business owners

About a third of Australian small businesses are owned by migrants who speak a language other than English, according to the Migrant Small Business Report published by the insurer CGU.

While the English language proficiency of this cohort is unknown, it is reasonable to assume that some members of this group are among those 4% of the Australian population – or 800,000 to one million people – who do not speak English well or at all (Piller, 2020a).

It is also safe to assume that a number of business owners have low levels of literacy, as about 13.7% of the Australian adult population – or approximately 2.3 million people – possess literacy levels that equate to only elementary level schooling (OECD, 2012).

Seen against this background, COVID Safe registration for businesses in NSW is also a language and literacy hurdle, for some larger than others.

Registration as COVID safe business

To gain insight into the registration process, I followed all the steps on the website (stopping just short of the final step of application submission) and developed a COVID safety plan for an imaginary business, “Monica’s Café.” I also interviewed a small business owner who had undertaken registration.

Initially, registration seems relatively straight forward. It involves providing details of the business and developing a COVID safety plan related to wellbeing of staff and customers, physical distancing, hygiene and cleaning, and record keeping.

Sample COVID safety plans are available in English as well as Arabic, Simplified Mandarin, Korean, Thai, and Vietnamese.

However, things get more complicated once you actually have to fill out the safety plan form.

Before you do, you need to work your way through the regulatory language surrounding registration, as in the following excerpt from the introductory COVID Safe registration statement:

“COVID-19 Safety Plans are comprehensive checklists designed by NSW Health and approved by the Chief Health Officer. The plans provide clear directions on how businesses and organisations should fulfil their obligations under Public Health Orders to minimise risk of transmission of COVID-19 on their premises.”

(Image credit: NSW Government)

Multisyllabic vocabulary such as comprehensive, obligations, transmission and premises, and long sentences demand a high level of English language proficiency. This is confirmed by the Flesch reading ease measure of 15, meaning this excerpt requires the reading skills of a university graduate.

The excerpt above is an example of regulatory language used in official health communication. This register – or type of language – is particularly difficult to understand for those with low levels of English language proficiency (Grey, 2020a; Grey, 2020b).

The difficulty of the overall guidelines and instructions renders the relative ease of the actual registration form void.

How can COVID safe registration be improved without compromising safety?

I suggest that the process of COVID-safe registration could be simplified and made more accessible to a readership with varying levels of English language proficiency and literacy through the implementation of the following improvements:

• Provision of simple, plain English and high-quality, comprehensive multilingual information
• Provision of English and multilingual safety plan blueprints that are easy to locate

More importantly, I suggest that communicating COVID safety online is not enough.

Providing alternative communication channels

In its current form, COVID Safe registration does not necessarily guarantee compliance. To achieve that, inspections of premises are needed.

Inspections would offer a good way of tailoring COVID safety to local needs, not only practically but also linguistically.

Inspections could be undertaken by multilingual officers. Inspections in language other than English (LOTE) would provide an opportunity to convey personalised LOTE advice relevant to a particular business. They would be a practical implementation of an approach that values NSW’s linguistic diversity as a resource.

References

Grey, A. (2020a, June 1). How to improve Australia’s public health messaging about Covid-19. Language on the Move.
Grey, A. (2020b). How do you find public health information in a language other than English. Submission to the Australian Senate’s Select Committee on COVID-19’s inquiry into the Australian Government’s response to the COVID-19 pandemic.
Piller, I. (2020a, October 13). More on crisis communication in multilingual Australia. Language on the Move.

Additionally, multilingual crisis communication has been the focus of the research projects conducted by Master of Applied Linguistics students at Macquarie University as part of their “Literacies” unit. We close the year by sharing some of their findings.

Here, Yudha Hidayat shows that the over-reliance on written communication channels in rural Indonesia has resulted in a stark lack of information about how to prevent the spread of the virus.

***

Official COVID-19 information

The information gap between urban Australia and rural Indonesia

When the COVID-19 pandemic really took off in March 2020, I called my parents, who live in a village in West Nusa Tenggara (WNT) province. I asked them how the people in my village were preparing themselves to stem the spread of the virus.

Their shocking response was that they had no idea what to do.

I explained the health protocol in detail and sent money so that villagers could buy face masks. That was all I could do while I was far away from home.

For this research, I explore how it is possible that a community is not aware of COVID-19 prevention measures. How could my parents not know what to do? It is true that they do not own smartphones and do not have internet access but they do watch a lot of TV.

Unlike most people in my village, I am a literate and educated man. Having a strong internet connection in Australia, I can access a wide range of information from different sources in English and Indonesian.

Here, I argue that the pandemic has exposed global inequalities in information delivery and that local governments need to take local communication seriously in the fight against the disease.

How COVID-19 prevention information was delivered in WNT province

The local government has relied heavily on its official website and social media as the primary tools for delivering Covid-19-related information.

Official COVID-19 information

The official website is updated weekly and provides infection lists. The website also includes a long health protocol, and provides flyers, graphics, tables, and figures. All this information is only available in Indonesian with some English words and phrases mixed in, such as “social distancing”, “lockdown”, and “contact tracing”.

Monolingual information in a multilingual context

The reliance on the Indonesian language, as the only language used for this essential information, ignores the diversity of multilingual citizens.

WNT province comprises two main islands, namely Lombok and Sumbawa, and tens of small islands. The majority of the people in this province are from three ethnic groups, namely Sasak, Bima, and Sumbawa. Each of these groups has its own language including various dialects and at least nine other languages are spoken in the province, including Bajo, Balinese, Bugis, Javanese, Madura, Makasar, Mandarin Ampenan, and Melayu.

Given low levels of education in the province, the Indonesian language proficiency of many of these speakers of other languages will not be sufficient to fully understand the public health information provided to them.

Digital written communication in a low-literacy and low-technology context

The reliance on written text and on online delivery is also problematic.

According to data from the Ministry of Education and Culture of Indonesia (2019) WNT has a low overall literacy index (i.e., 33.64). Furthermore, only a small number of citizens use digital technology to access written materials (20.48), and reading is a habit for only a minority (38.17). Another indicator shows that 12.41% of the population of WNT are illiterate.

All these facts make it clear that COVID-19-related information provided only through the written medium on a website is out of the reach of many citizens.

English loan words exacerbate the problem

The use of foreign terms, tables, and figures on the website exacerbates these problems further.

Even among those who are proficient in Indonesian and have access to the internet, not everyone will understand English. The high level of English loanwords thus acts as a further barrier.

Infection numbers remain high throughout Indonesia

The same is true for the ability to interpret tables and figures.

What can be done?

As I have shown, vital information related to COVID-19 is provided in a way that makes it inaccessible to many in WNT. Although it is true that Covid-19-related reporting can also be found on TV and in newspapers, neither of these channels address the problems of illiterate people and/or those who live in remote areas.

It is obviously impossible to lift the literacy levels of a populations during a crisis or to catch up on telecommunications infrastructure. But that does not mean that public health information cannot be communicated effectively.

The alternative method that I propose is to utilise the oral method as an additional communication channel, as has been done successfully in Taiwan (Chen, 2020). The infrastructure exists as every neighborhood has a leader (‘Ketua RT’) who could be trained and tasked with providing COVID-19 information in this manner.

Oral communication could utilize the loudspeakers of mosques and temples that are readily available in every neighborhood. Oral announcements over loudspeakers are plausible since they can easily be delivered in local languages and are accessible regardless of literacy level and internet access.

This would not only help curb the spread of the virus but also accord local people the dignity and respect they deserve.

Reference

Chen, C-M. (2020). Public health messages about Covid-19 prevention in multilingual Taiwan. Multilingua, 39 (5), 597-606.

Editor’s note: The Covid-19 crisis has exposed fractures in the social and linguistic fabric in many contexts internationally, as we have been documenting in our series of language aspects of the COVID-19 crisis since February. This article provides yet another perspective on crisis communication in multilingual Australia. It was first published as “Lost in translation: COVID-19 leaves migrants behind” by Macquarie University’s The Lighthouse.

***

Photo: Engin Akyurt, Unsplash

Many migrants struggle to understand public health information about COVID-19. Ingrid Piller, Distinguished Professor of Applied Linguistics at Macquarie University, considers what a linguistic crisis response should look like.

Before February 11, when the World Health Organisation christened the novel coronavirus, COVID-19 was not even long-listed for most popular name.

Just as parents might choose a new baby moniker that keeps all stakeholders happy, WHO advisers were diplomatic: Co and Vi come from coronavirus, D stood for disease and 19 standing for 2019, the year the first cases were seen.

It’s fair to say that COVID-19 was delivered to the linguistic repertoire of the largest number of people after the shortest gestation period.

Naming the disease, however, has been just a minuscule part of the mass communication enveloping the pandemic.

Almost everyone in the world has had to learn about public health concepts such as ‘social distancing’, ‘droplet transmission’ or ‘flattening the curve’ to avoid getting sick.

Almost everyone has had to understand the specifics of containment measures such as lockdowns, contact tracing, or mask wearing in their jurisdiction.

And almost everyone has had to weigh into public debates that pit health against the economy, link the virus to particular social groups, or politicise the disease.

As a topic of conversation, COVID-19 is the water cooler wunderkind.

But not everyone is joining the chat. Multilingual crisis communication has emerged as a global challenge. Australia’s migrants, refugees, the aged, and those with low levels of literacy have struggled to process public health information about the virus.

More than one in five Australian households speak a language other than English. Between 800,000 and one million people in Australia either don’t speak English at all, or don’t speak it well enough to understand complex information.

What people most need is local intel. As well as symptoms to look for, they want answers to questions such as where to get tested, hotspots, new cases in the area, how many people can come to the house, whether restrictions have changed, and so on. The answers differ across jurisdictions.

The trust factor

There is a real onus on government to make this information as widely accessible as possible. But that kind of information has not kept up multilingually.

Communication isn’t always consistent. Face masks, for example, have gone from being: not a good idea … might make things worse because people touch their faces more … recommended to wear only if there are symptoms, no need to if there are none … suggest wearing one on public transport but not mandatory ….must wear one anywhere in Victoria.

How much information is available to migrants depends on which language community they belong to. Speakers of languages with sizeable numbers of practitioners – Mandarin, Arabic, Vietnamese, Cantonese or Greek – can glean information from community publications, newspapers, radio stations, Facebook groups, churches, mosques, national organisations and clubs.

Covid-19 signage in a Sydney shop

Large communities also can rely on diasporic communities like those in the US where the media is big on community TV channels. But there are smaller languages that may not be affiliated with a particular state, and they can be poorly served both at home and internationally.

Trust is key to selling COVID-19 messages and triumphing over the fake news that has proliferated during the pandemic.

But levels of trust among linguistic minorities might be influenced by a community’s mother country and attitudes of the Australian media. Some groups experience more racism than others, and that can limit the trust they have towards authorities.

Keeping it local

Physical distancing and lockdowns have disrupted our social fabric. Older generations of migrants who don’t speak English well tend to rely on family and friends to step in as language brokers or mediators for everyday information, for dealing with public services, or attending medical appointments.

Cognitive or degenerative diseases can further impact language processing. In bilingual populations, these tend to affect the weaker language more. Add to that being in lockdown in an aged care facility, where you can’t have visitors, family or a carer who speaks your language, and the isolation compounds.

What will improve the lot of linguistic minorities in this pandemic?

A communications strategy should be part of a public health strategy. One thing that has been learned about controlling COVID-19 is the importance of having local measures in place, especially around testing and contact tracing.

You need to reach people who are in high traffic places, understanding what their information needs are, and identify language communities in each suburb. Different council areas have different needs, and therefore local communications strategy is important.

The language clusters of, say, the Sydney suburbs of Marsfield, Fairfield, and Mona Vale couldn’t be more different.

In Marsfield, 54 per cent of households speak a language other than English at home, the top three being Mandarin, Cantonese, and Korean. That’s more than the Sydney average of 38 per cent but small in comparison to Fairfield, where 80 per cent of households speak a language other than English at home: the top three being Assyrian, Arabic, and Vietnamese. Mona Vale is on the other end of the spectrum, with only 13 per cent of households speaking a language other than English – the top three are Serbian, German, and Croatian.

A colleague, Dr Alexandra Grey, has done a study of the posters in the Sydney suburbs of Strathfield and Burwood, and she found there was quite a mismatch between the linguistic profiles of these communities and the language of the posters.

A mismatch between the language in which COVID-19 information is communicated and the linguistic repertoires of those who need the information exacerbates the effect of disasters like a pandemic on linguistic minorities.

Emergency preparation and crisis planning

Not having access to timely, high quality, trusted information increases vulnerability. If information is not available in a language people understand, or from a source they trust, they end up looking for answers on social media. And while that is not necessarily a bad thing, the WHO has warned that an over-abundance of COVID-19 information could be misleading and even harmful.

The ‘infodemic’ that has accompanied the pandemic, WHO warned, is just as dangerous as the virus itself.

Moroccan clinical neuropsychologist Mohamed Taibine wrote in the ‘Language on the Move’ blog last month: “Misinformation is like a carcinogenic cell that duplicates irrational and implausible facts, and then transforms them into a growth of seemingly trustworthy and verified information via social media.”

It is important we have a diversified and sophisticated communications strategy, and social media certainly needs to be part of that because that is where most people get their information.

May the force be with you…

Not only migrants have trouble interpreting complex COVID-19 messages. According to the Australian Bureau of Statistics, 13.8 per cent of Australians don’t read above primary school level.

‘A little while ago I googled ‘nsw corona/covid restrictions’. The top hits all referred to NSW Government websites. I homed in on two of them  “What you can and can’t do under the rules” and “Public Health Orders and restrictions”.’

A readability analysis using algorithms that are now built into most word processing software showed that one post required 11 years of formal education to read and the other 14 years of formal education.

In other words, at least 2.3 million Australians will not be able to read the two key texts about NSW’s COVID-19 restrictions. In a crisis where the actions of every one of us have a big impact on the course of the pandemic, this is a large number.

What Australia needs is a communications volunteer taskforce.

As the bushfires have taught us, an effective way to deal with disaster is to mobilise a volunteer force, a large segment of the population, in the same way the Rural Fire Service has a system in place for recruiting volunteers, training them, keeping them on hold, and then mobilising them.

However, for a public health crisis, you need volunteers with different skills and capabilities: people who can translate, interpret; who are willing to sit down with people filling in forms and explain things like what a postcode is (in order to find the nearest testing centre).

We have multilingual talent so we could actually do this. It’s unrealistic to expect the government to put out all the information in all the languages, so we need to shape a communications strategy and a national language policy suitable for a rapidly changing and complex information environment, one that takes into account all the communications channels including social media.

Language challenges of the Covid-19 pandemic

Visit here for the full Language on the Move coverage of language aspects of the COVID-19 crisis. The special issue of Multilingua of 12 peer-reviewed research papers about “Linguistic diversity in a time of crisis” is available here. And if you’d like to listen to a lecture about “Linguistic Diversity in a Time of Crisis” head over to YouTube.

***

Editor’s note: Covid-19 has exposed fractures in the social and linguistic fabric in many contexts internationally, as we have been documenting in our series of language aspects of the COVID-19 crisis since February. In our latest contribution, Martha Sif Karrebæk and Solvej Helleshøj Sørensen share a perspective from Denmark, where there have been obvious failures to communicate with linguistically diverse populations and, simultaneously, migrants have been scapegoated as disease carriers.

The special issue of Multilingua devoted to “Linguistic Diversity in a time of crisis”, which originally motivated the call for contributions to this series, has now been published and all the papers are available for free access.

***

Language ideological debates in Denmark

A Somali community worker hands out Covid-19 information pamphlets in Aarhus

In Denmark, as elsewhere, the COVID-pandemic has resulted in what is both an entirely new societal situation and an intensification of existing tensions and challenges, including issues associated with immigration.

The Prime Minister recently declared that all Danish citizens have received sufficient information about the virus: “The information is there and has been available for months, no one in Denmark can be in doubt about how to behave in relation to COVID-19.” The extent to which this statement is true is an open question. Rather than a description of an actual sociolinguistic fact, it must be understood as politically motivated.

Nobody knows how many residents have no or only a poor command of Danish. A 2018 report by the Ministry of Immigration and Integration estimated that between 7 and 30 percent of the 325,000 residents with non-Western backgrounds have difficulties reading and/or speaking Danish. Insufficient Danish skills are often regarded as intentional neglect and evidence of lack of willingness to “integrate” into society.

As language proficiency is widely seen as an individual issue, authorities rarely feel compelled to use any language other than Danish in official communications. Additionally, English is used in some official communications, but languages associated with (non-western) immigration are rare in public communication.

Outsourcing health communication to volunteers

As has been documented previously on Language on the Move, grassroots organisations and volunteers have played a large role in addressing the needs of linguistic minorities during the COVID-19 pandemic in many places. This is also the case in Denmark, where the state has been heavily reliant on non-governmental actors in disseminating Covid-19 related information across all communities.

We talked to the Head of Boligsocialnet, a collaboration between social housing associations and the association of Danish municipalities, Louise Buch Viftrup, who mentioned several reasons why civil society organisations (CSOs) take on the important informational tasks. For instance, they are quick to notice the needs in the community that they serve, they have employees on the ground to address them, and they can deliver at a higher speed than the authorities, who often operate with lengthy quality assurance procedures. Furthermore, community members tend to trust people that they already know which increases the rate of adherence to advice and guidelines.

Viftrup expressed satisfaction with the cooperation between the authorities and the CSOs in ensuring minority groups’ access to information regarding the pandemic.

Sådan ser informationspjecen fra Sundhedsstyrelsen ud på arabisk. (Foto: Sundhedsstyrelsen © sundhedsstyrelsen)

For example, the health authorities provided posters with pictograms and short texts describing the five key recommendations in fifteen different languages. These were displayed in social housing blocs with high concentrations of residents with immigrant backgrounds.

However, representatives of the residents quickly pointed out that these posters were insufficient in terms of information for non-Danish speaking groups. Volunteer networks within social housing blocs additionally use social media platforms such as Facebook and Whatsapp to disseminate live translations or summaries of government press conferences.

The volunteers also answered questions in minority languages in the connected Facebook-threads and on the phone. Further examples include a YouTuber known for his online Danish-classes for Arabic speakers who did a video with phrases related to the pandemic, and an interpreting agency offering free interpreting services.

On April 06, 2020, the Danish Refugee Council established a hotline in 25 different languages for questions regarding the pandemic. Both initiatives were taken in cooperation with different CSOs and received support from private foundations such as the Novo Nordisk Foundation, while national health authorities assisted with quality assurance. Eventually, the authorities additionally issued more detailed material in other languages to complement the original posters, but it was also suggested that the linguistic quality of this material was not always high.

From translating materials to communication strategies

As pointed out by Viftrup, the challenge consists not only in creating informative content in different languages, but also ensuring that it actually reaches its target groups. Here, local efforts as those cited, have played a crucial role as “role models” spread information to specific communities. And, there was a huge need for information, as Lise Dyhr, Senior Researcher in Family Medicine, University of Copenhagen, and Morten Sodemann, Clinical Professor at Odense University Hospital’s Migrant Health Clinic discovered.

Some of their patients were frightened by the empty streets, an initial lack of basic necessities in the super-markets, and the regular appearance of a line-up of authorities (PM and health officials) on television. Others experienced gaps between home country and diaspora news and the information they received from Danish sources. This led to distrust of the Danish media. Some did not dare to go out at all, and when the educational sector gradually re-opened, they did not see how it suddenly would be safe again to send their children to school, in particular as many work places were still closed.

Some professional interpreters saw their tasks expanding. Some of our research participants, interpreters employed by a hospital, were asked to make phone calls to screen non-Danish speaking patients scheduled for other appointments for COVID-19 symptoms using a questionnaire. Some interpreters felt overwhelmed by the new responsibilities, others experienced it as an easy transition into new aspects of their work. But these interpreters had the impression that the patients were overall well-informed about the pandemic, and they believed this to be due to efficient social networks and the internet.

Minorities are more vulnerable to infection

At the same time, as we have seen in many other countries, minority citizens have been and are still over-represented in the statistics of those infected with COVID-19. By May 07, those with a migration background accounted for 18% of infected citizens although they only constitute 9% of the total population. In the week of August 03 to August 09, 70% of the 756 individuals testing positive for COVID-19 had ethnic minority backgrounds.

The factors leading to increased vulnerability include a high percentage working in particularly exposed sectors (e.g., public transportation, service and health care sectors) and large families sharing small living spaces, as well as existing underlying health conditions in this demographic.

Scapegoating

Despite these obvious reasons, the statistical over-representation – and, not least, its public announcement – has led to hostility expressed by ethnic Danes.

As an example, after recent clusters of COVID-19 cases among non-ethnic Danes in the city of Aarhus, politicians were quick to address this, among them Pia Kjærsgaard, Member of Parliament for the Danish People’s Party, a national-conservative party. She called for “a close down of the ghettoes” and accused immigrants of not taking the pandemic seriously enough.

At the same time, members of the Somali community have reported an increase in harassment and discrimination. For example, a kindergarten asked for a negative COVID-19 test for the children of a Somali family, and a public transport company reporting received requests to take Somali drivers of their shifts.

Experiences such as these problematize the publication of data concerning the ethnic backgrounds of infected individuals. On the one hand, this data can expose community specific vulnerabilities such as the ones documented by the DIHR report and allow for targeted measures adapted to the needs of specific community. On the other hand, rather than addressing the underlying issues such as housing, working conditions, and access to information, specific immigrant groups are scapegoated as disease-carriers.

Pushing back on social media

There has been some resistance and efforts to reframe the debate on social media. At the initiative of the Danish-Somali advocacy group “Mediegruppen” (the Media group) the hashtags #SomalisSayNo (#Somalieresigerfra) and #NoToPublicShaming (#Nejtiludskamning) started trending. Members of “the Blue Stars”, a group of young Danes with Somali backgrounds who fight prejudices against Somalis, decried the public shaming of the community as a whole on television and expressed fears over possible future consequences.

#SomaliereSigerFra#NejTilUdskamning#dkpol
Vore demokratiske samfund bygger på pressefrihed, men denne frihed indebærer ansvarlighed. Vi vil derfor opfordre samtlige myndigheder, politikere og medier til at kæmpe for…https://t.co/YppTGiGSD8 pic.twitter.com/D32OD8W2Rw

— Mediegruppen (@mgfsdk) August 8, 2020

Furthermore, the Aarhus Somali taskforce wrote an open letter to the prime minister where they questioned the PMs statement that information had been available to all (cited in the beginning of this piece). After reviewing the Somali translations of the guidelines issued by the authorities, they found them to be mostly unintelligible, perhaps the result of a google translate effort.

Covid-19 as an opportunity to rethink linguistic diversity and social justice in Denmark?

The issue of reaching non-Danish speaking groups is not uniquely related to the Covid-19 pandemic; nor is the fact of preexisting anti-immigrant sentiments among segments of the population and their political representatives. The crisis has undeniably heightened the need for communication strategies across languages and communities and exposed its relevance to everybody, but in principle the issue is not new. Maybe the crisis will ultimately constitute an opportunity to reconsider the intersection of linguistic diversity and social justice in Danish society.

Language challenges of the Covid-19 pandemic

Visit here for the full Language on the Move coverage of language aspects of the COVID-19 crisis. The special issue of Multilingua of 12 peer-reviewed research papers about “Linguistic diversity in a time of crisis” is available here.

Readability scores of the two selected public service information texts by the NSW Government

This morning I googled “nsw corona/covid restrictions”. The top hits all refer to NSW Government websites, including these two: “What you can and can’t do under the rules” and “Public Health Orders and restrictions.”

Both sites are clearly structured with lots of subheadings and dot points. But they are also long and text-heavy, and the font on “Public Health Orders and restrictions” is so small that the page literally looks like small print.

In both cases, you need to be a fairly motivated reader to work your way through them, and “Public Health Orders and restrictions,” in particular, looks more like it is aimed at lawyers than a regular reader.

Readability statistics for both texts confirm this impression. The Flesch-Kincaid Grade Level of “What you can and can’t do under the rules” is 11.0 and that of “Public Health Orders and restrictions 14.2. The Flesch Reading Ease Score of “What you can and can’t do under the rules” is 48.1 and that of “Public Health Orders and restrictions 33.2.

What is readability?

Readability essentially refers to how easy or difficult it is too read a particular text.

There are a number of measurements of readability. For English, the two most famous of these are Flesch-Kincaid Grade Level and the Flesch Reading Ease measures. Both are algorithms that are now built into most word processing software.

The basic idea behind these two measures is twofold:

• The more words per sentence, the less readable a text is.
• The more syllables per word, the less readable a text is.

Consider the examples in the table.

Comparing the two sentences, it is obvious that the first is much easier to comprehend than the second. Although they have the same number of words, the multi-syllabic words of the second sentence require much more precise and specialized knowledge.

Source: Flesch, How to write plain English

In short, to easily read the second sentence, you need to have a much higher level of (a) English language proficiency, and (b) science knowledge than for the first.

The Flesch measurements of readability

The Flesch measurements were developed by Rudolf Flesch, an Austrian-American writing consultant.

The Flesch-Kincaid Grade Level tells us who we can expect to have the requisite knowledge to read a particular text: 1.3 means that a first grader can be expected to read “People need air.” 13.1 tells us that 13 years of formal education are required to easily read “humans require oxygen.”

The Flesch-Kincaid Grade Level follows the US system of school grades from 1 to 10. A number greater than 10 indicates the years of formal education required.

The Flesch Reading Ease Scale is also linked to grade levels and formal schooling. The higher the level, the easier the text. The 90.9 score of “People need air” tells us that the text is very easy. All that’s needed to easily read it is an elementary school education.

At the other end of the scale, a score of 6.5 suggests that a college education is required to comfortably read “humans require oxygen” (As an aside, don’t get too focused on the precise score. Measuring the readability of a 1-sentence text is problematic, and I’m doing it to make a point. All readability scores are useful indicators but there are also obvious problems, which I’ll discuss some other time.)

Why does readability matter?

Let’s now go back to the two public service messages from the NSW Government with which I started this post: one requires 11 years of formal education and the other 14 years of formal education. With a Flesch Reading Ease score of 48.1 and 33.2 both are considered difficult to read, at the reading level of a college student.

This means that a fair number of Australians will have difficulties reading these public service messages.

Australia has compulsory education and, by international standards, a fairly well-educated population, as findings from the OECD’s Programme for the International Assessment of Adult Competencies (PIAAC) show. Even so, these data also show that there is significant variation in the reading abilities of Australians.

While the PIAAC levels do not directly match the Flesch levels, one thing is for sure, and that is that those Australians who score at or below Level 1 on PIAAC will definitely not be able to read texts that requires more than 10 years of formal education.

In other words, at least 13.7% of the Australian population, probably more, will not be able to read the two key texts about NSW’s Covid-19 restrictions. This amounts to a total of at least 2,320,000 people.

In the interest of full disclosure: these are the readability stats for this blog post

In a crisis where the actions of each and every one of us have a huge impact on the overall course of the pandemic, this is a very large number.

Attention to inclusive communication has certainly increased over the course of the pandemic, and here on Language on the Move we have focused on public health communication to linguistically diverse populations. The same goes for the special issue of Multilingua devoted to “Linguistic diversity in a time of crisis,” which will be published later this week.

Despite greater attention to the important role of inclusive communication, the fact that key information about Covid-19-related restrictions are out of the reach of more than 13.7% of the Australian population – irrespective of whether English is their main language or not – is concerning.

What is even more concerning is that the two examples I have chosen are not exceptional: two recently published research papers about the readability of Covid-19 online patient education materials and public health information websites in various countries found that these materials are generally pitched at a readability level that is too difficult for significant segments of the population.

Conduct your own research

Choose an English language text about Covid-19 and assess its readability by measuring its Flesch-Kincaid Grade Level and Flesch Reading Ease Scale. You can do that by copying and pasting the text into MS Word. Include additional qualitative observations of readability and discuss whether the readability matches the reading levels of the target audience.

To learn more how reading is learned and why some people never become highly proficient readers, despite going through compulsory schooling, watch this lecture:

References

Mishra, Vishala, & Dexter, Joseph P. (2020). Comparison of Readability of Official Public Health Information About COVID-19 on Websites of International Agencies and the Governments of 15 Countries. JAMA Network Open, 3(8), e2018033-e2018033. doi:10.1001/jamanetworkopen.2020.18033
Szmuda, T., Özdemir, C., Ali, S., Singh, A., Syed, M. T., & Słoniewski, P. (2020). Readability of online patient education material for the novel coronavirus disease (COVID-19): a cross-sectional health literacy study. Public Health, 185, 21-25. doi:https://doi.org/10.1016/j.puhe.2020.05.041

Language challenges of the Covid-19 pandemic

Visit here for the full Language on the Move coverage of language aspects of the COVID-19 crisis. The special issue of Multilingua with 14 peer-reviewed research papers about “Linguistic diversity in a time of crisis” will be published later this week; in the meantime, all the papers are available ahead of print here.

***

“Basic Human”: the mother tongue of humankind

One of the most memorable sentences in the King James Bible comes from a line in the Acts of the Apostles, from St Paul’s speech to the Greeks in Athens (Acts 17:26): “[God] hath made of one blood all nations of men to dwell on all the face of the earth.”

(Image credit: Evgeni Tcherkasski via Unsplash)

So, yes, we are all related by blood, as members of the same human family. But as many modern thinkers have pointed out, a deep awareness of human unity requires something else as well.

In the words of the German philosopher Karl-Otto Appel, it requires that we see all people on earth as a “universal community of communication.”

But there are six or seven thousand different languages in the world. Can a universal community of communication be established in a world divided by thousands of different languages? Here comes the good news: the world is not only divided by several thousand different languages, but also united by them. While the languages of the world are very diverse, evidence suggests that they all include a shared core, which itself is like a mini-language. This mini-language has as many versions as there are languages in the world, but in the 21^st century, for global messages the most practical of them is Minimal English.

One way of putting it is to say that at the heart of all languages there lies a mini-language which can be called “Basic Human” and which can be seen as a mother tongue of humankind. As Italian medical researcher Maria Giulia Marini said in a recent interview, people who are suffering from major depression and generally don’t talk and write, have been able to express their thoughts and wishes in the simple and transparent words and phrases of Basic Human. In Minimal English, examples might be “I can’t do anything,” “nothing good can happen to me,” “I don’t want to live anymore;” and in Minimal Italian, “non posso fare niente,” “non può succedermi niente di buono,” “non voglio vivere più.”

As these examples illustrate, in certain situations the same human messages can be conveyed through matching words and phrases of minimal languages. This fact assumes a special significance at a time like the one we are living through now, a time of pandemic. Basic Human is such a common language. It is a shared language of heart and mind, with many matching versions such as Minimal English, Minimal Russian, Minimal Chinese, and so on.

This may sound hard to believe. The “Seven Essential Messages for the Time of the Coronavirus” (first published in Russian Journal of Linguistics) prove that this is not just a utopian ideal but a reality.

There are no complex words and phrases here like “social distancing”, “self-isolation” or “quarantine”. As a number of respondents have commented, messages written in simple and transparent words of Basic Human speak directly to people’s minds and hearts. Many respondents have linked the emotional impact of such messages with  a sense of human unity. As one wrote, “The message was both moving and very clear – one for all of us, which could be understood and taken in, instantaneously, by anyone.” Another wrote: “I found these messages on the Coronavirus so very heartening. I think at the most crucial times it is this kind of simple language that touches on the essence of what is important and what is not important”. And a third: “On hearing these messages one can not only know immediately what they mean, but also, one can know that other people know the same”.

There are two overwhelming conclusions: First, that in a global crisis it becomes evident how important it is for all of us on Planet Earth to be able to speak to each other in a common language; and second, that very complex times may call for a very simple language: not only because it is accessible to everyone but also because it can have a powerful impact on people, and can even lift their hearts.

Seven Essential Messages for the time of the Coronavirus

Message 1

It is good for all of us if we think like this every day now:
This time is not like other times. Very bad things are happening to many people now.
Many people are getting very sick because of the coronavirus, many people are dying because of this.
More people can die if I do some things now as I have always done. I don’t want this.
Because of this it will be good if I can be at home all the time.
If I have to be not at home for some time, I will think like this all the time:
“I don’t want to be very near other people; I don’t want to be so near someone that I can touch them.
I don’t want to be so near someone that I can breathe some of the same air.”

Message 2

It is good for all of us if we think like this every day now:
This time is not like other times.
Very bad things are happening to many people now.
Many people feel something very very bad.
I can do some good things for some of these people; I want to do something good for them.
I want to know what I can do; I want to think about it today; I want to do something today.

Message 3

It is good for all of us if we think like this every day now:
This time is not like other times.
During this time many people can’t be with other people as before.
They can’t speak to other people like before; many people feel something very bad because of this.
I know some of these people. I want these people to know that I am thinking about them.
I want them to know that I don’t want bad things to happen to them.
I want to do something because of this.
Perhaps I can write to them, perhaps I can ring them, something like this.
I want to do something today.

Message 4

It is good for all of us if we think like this every day now:
This time is not like other times.
Very bad things can happen to me during this time, not like at other times.
At the same time, I can do some very good things during this time, not like at other times.
I can do many things “good for the soul”, not like at other times.
I can read books, listen to music, write something every day about this day, things like that.
If I pray, I can pray more; if I don’t pray, I can do something like it.
I can look at the stars at night, I can look at the sky when the sun is rising, things like that.
I want to do these things. I want to do these things today.

Message 5

It is good for all of us if we think like this every day now:
This time is not like other times.
I don’t want to think about it like this:
“Very bad things are happening now, nothing good can happen because of this”.
I want to think like this:
“I can do some very good things during this time, not like at other times.
If I do these things, after this bad time I can be not as I was before:
I can know some people better, I can love some people more. I want this.”

Message 6

It is good for all of us if we think like this every day now:
This time is not like other times.
I can’t live during this time as I lived before.
At the same time, I can think about many things more, not as before.
I can think more about things like this:
“Why do I live on earth? What do I live for? How can I live if I want to live well?
If I know that I will die soon, what do I want to do before I die?
If I think about these things more now, after this bad time I can live not as I lived before.
I can then live in another way, I can live better. I want this.”

Message 7

It is good for all of us if we think like this every day now:
This time is not like other times.
We can’t live during this time as we lived before.
At the same time, we can think about some things more now, not as before.
We can think about things like this:
“We all live with other people, none of us is like an island.
How can we live well with other people?”
We can think about the earth; we can think like this:
“We all live on earth. The earth is a good place.
We don’t want to do bad things to this place”.
At the same time, we can think like this:
“We live on earth now, many people will live on earth after us.
We don’t want very bad things to happen to these people.”
If we think about these things more now, after this bad time we can live with other people not like before; we can live better.
We want this.

Language challenges of the Covid-19 pandemic

Visit here for our full coverage of language aspects of the COVID-19 crisis.

***

Figure 1: The Year of Tolerance Pillars

Jogging along the Abu Dhabi coastline at sunrise, I see small groups of two or three people wearing masks. They are expatriates walking dogs, Emiratis in national dress strolling, fellow joggers escaping lockdown inactivity, and transnational workers clearing fallen date palm leaves from the path. Cautiously wary as I pass each group, I hear snippets of multiple languages being spoken. This is a typically diverse Abu Dhabi scene in highly atypical times.

While Arabic is the official language of the United Arab Emirates (UAE) and English is the de facto lingua franca, such labels ‘hide more than they reveal’. Rather, multilingualism and translingual practice is the norm due to its highly diverse population of approximately 200 nationalities, speaking over 100 languages as well as various dialects within diglossic languages such as Arabic. However, power attributed to these languages is far from even. Arabic and English are the most visible in society as reflected in their side-by-side presence on public signage, in education, official channels, and technology. Such a situation results in those proficient in English and Arabic having more access to information than those without. While communication barriers are important to challenge in general, in emergency situations such as the COVID-19 pandemic, the importance of linguistic inclusion is amplified.

Superdiversity and the year of tolerance in the UAE

In multilingual contexts globally, increasing attention has been given to social justice via the prevalence of the words ‘inclusion’ and ‘tolerance’. Inclusion can be defined as ‘ensuring access for all’ across many sectors. Several inclusion-based government-led initiatives have occurred in the UAE recently. One prominent initiative was the naming of 2019 as the ‘Year of Tolerance’, where all languages, backgrounds, ethnicities and abilities were to be valued. Figure 1 shows the ‘Year of Tolerance Pillars’ prominently displayed on a shopping mall billboard.

Figure 2: Bilingual COVID-19 safety sign

The seven pillars advocate tolerance in the areas of education, community, workplace, culture, legislation, and media as well as establishing the UAE as a model of tolerance. Here, the message of inclusivity as an ethical and moral value is loud and clear. However, even with carefully implemented awareness campaigns on diversity and inclusion, an unprecedented crisis such as the COVID-19 pandemic can disrupt such efforts, and rather shine a spotlight on pre-existing societal and linguistic inequities. In addition, a crisis leads to priorities shifting from ideal values to emergency messaging, where instinctual and on-the-spot decisions are made with the resources available. This is often the case with linguistic choices in public spaces where English monolingualism seems to be the preferred or default choice in a moment of crisis.

Linguistic inequalities in a crisis context

In the UAE, top-down government communication relating to the COVID-19 pandemic is suitably multilingual and inclusive. Guidelines and announcements appear in Arabic, English, Hindi, Tagalog, French, and many more languages. Neighboring Gulf states such as Qatar and countries further afield such as China have also ensured that official communication is linguistically diverse. However, it is often the bottom-up ad hoc messages in public spaces which are most visible. This is especially the case for the UAE’s large migrant worker population who may not have access to mobile devices like laptops and smartphones.

Linguistic landscaping, or the analysis of language on signage in public spaces, can tell us a lot about how languages are used and about the power certain languages have over others. ‘Every sign tells a story about who produced it, and about who is selected to consume it’, as Blommaert (2018) points out. Public signage tracks local practices as well as contributing to the COVID-19 era’s zeitgeist. In this sense, locally-produced impromptu thrown-together messages are indeed authentic ‘signs of the time’. Such signs act as sociolinguistic evidence of power dynamics existing between languages and their speakers.

In the UAE, while municipality-issued COVID-19-related messages appear in the country’s two dominant languages, Arabic and English (Figure 2), in many cases make-shift or hand-written signs appear in English only. This is similar to other English-dominant multicultural and multilingual contexts such as London and Sydney.

Figure 3: Bilingual working hours sign and monolingual COVID-19 sign

It is easy to see a contrast between permanent signs with English and Arabic side-by-side, such as a working-hours sign in a pharmacy window (Figure 3), and an impromptu COVID-19 sign which appears only in English. In Figure 3, the latter is typed in large capital letters which fill the page, without the use of other languages, perhaps due to the urgency needed in communicating quickly. The pharmacy owner or clerk who created the sign most probably did so with a sense of emergency where lack of time and resources did not allow for consideration of the society’s linguistically-diverse population.

A further example of a make-shift monolingual COVID-19 sign can be seen in Figure 4. Here, lifeguards at an Abu Dhabi beachside community have written a message in the sand warning residents to ‘stay home, stay safe’. The manager who instructed the sign to be made on a scorching mid-March afternoon, decided to use English only. Was this perhaps due to limited space on the beach? Was it deemed impractical to write the message in several languages considering the size of the letters? Whatever the reasoning, the space which could have been used for another version of the message (e.g. Arabic), was instead given to a set of images including a house, heart and the ‘sun cross’ symbol (circle with cross inside) meaning eternity or the spiritual whole.

While the use of ‘English only’ may be appropriate in compounds renowned for ‘Jumeirah Janes’ (pampered British housewives living in English-speaking bubbles), since 2008 such monolingual communities have become less common. The beach community featured in Figure 4, for example, is linguistically diverse with Australians living next to Koreans, and Emiratis neighboring Swedes, as well as many dual nationality families, including my own (UK/Canada). Recently, nationalities which had not previously been drawn to the UAE are arriving for work opportunities. Accompanying family members sometimes have only basic English. For example, the number of Koreans living in the UAE has grown to 13,000 residents in what is known as the ‘Korean wave’. With most expatriate households being double-income, live-in nannies, who are usually from the Philippines, are also part of such communities. Despite the multilingual composition of residents, English is often the sole language used for communication in emergency contexts (Figures 3 and 4).

Inclusivity in crisis communication

Although the beach community shown in Figure 4 is home to mainly mid to high-income professionals, it is also the workplace of hundreds of laborers who are now called ‘essential workers’. Arriving on buses from the outskirts of Abu Dhabi, they spend their days working on the upkeep of existing buildings or on constructing new residential towers whose owners have deadlines to meet in order not to lose certain incentives. Figure 5 shows essential workers cleaning apartment windows while wearing masks but not perhaps social distancing, as is a government mandate. They do not have the ‘luxury’ of self-isolating, as many residents do, and it is clear that the message on the beach (Figure 4) was not intended for their eyes.

Figure 4: Covid-19 warning sign written in the sand (Photographer: Genevieve Leclerc)

Nevertheless, as laborers spend their days at their worksite, the make-shift monolingual signs in shops, lifts and  other public spaces represent their main way of accessing safety warnings. Monolingual communication in contexts of disasters or crisis has been named ‘disaster linguicism’, where linguistic minorities (not necessarily in number, but in power or prestige) are particularly vulnerable due to language-based discrimination at multiple levels.

Concerns over the lack of access laborers may have to COVID-19 warnings have been voiced on community Facebook pages as well as in national newspapers. Such concerns have led some residents to try and bridge the communication gap. For example, Indian expatriate teenager, Suchetha Satish, composed COVID-awareness songs in 21 Indian languages including Malayalam, Hindi, Bengali, Tamil, and Assamese. The songs urge people to social distance and wash hands. Such efforts are perhaps aimed at offsetting the prominence of monolingual (English) or bilingual (Arabic/ English) signs in public spaces. However, the potential success of such initiatives is debatable, due to many laborers having limited access to certain mediums. Besides, even with access to such songs, social distancing is not often an option in essential worker contexts, as seen in Figure 5.

Linguistic landscaping: An eye-opener for future action

Figure 5: Essential workers wearing masks during COVID-19 times

For those without access to official multilingual COVID-19 warnings, gaining accurate information about the crisis through a minority language can be a challenge. This highlights linguistic inequality in relation to crisis communication, as well as putting into sharper focus class divides. In top-down initiatives promoting tolerance, there is a danger of glossing over hidden exclusions in favour of celebrating ‘linguistically flexible neoliberal urbanites’. As most sociolinguistic research in the UAE focuses on the language choices and experiences of Emiratis, transnational linguistic experiences are under-researched, especially those from less privileged groups. In this exceptional time when the slogan ‘We are all in it together’ or ‘#TGether’ (as seen in Figure 2) is advocated, it is important to draw attention to the incongruities between slogans of inclusion and the reality on the ground. As Jones (2020) states, ‘Coronavirus is not some grand leveler: it is an amplifier of existing inequalities, injustices and insecurities’ or as Hurley (2020) puts it, ‘Coronavirus exacerbates the fault lines’. Although this is a time of reflection on what a new normal may look like, ‘often these seemingly revolutionarily happenings ultimately result in retrenchment of a status quo defined by durable inequalities’.

The Year of Tolerance supports including all, even those who speak languages other than English and Arabic. However, the pragmatic choices made at the height of the COVID-19 crisis show English is often the default choice. By excluding some, there are significant ramifications for the spread of the virus. Concerned looks on the faces of the diverse groups described in the opening coastline scene of this blog show us this is an issue affecting society as a whole. Thus, the need to ‘include the reality of linguistic diversity into our normal procedures and processes, including disaster preparation’ is pressing. Going forward, a critical look at the signage and warning messages in our landscapes can be eye-opening, with the goal of substantiating the priority of tolerance and inclusion.

Language challenges of the Covid-19 pandemic

Visit here for our full coverage of language aspects of the COVID-19 crisis.

Image 1: Infographic in Tagalog on ways to prevent the spread of COVID-19 infection

Editor’s note: Timely and equitable access to information for linguistically diverse populations continues to be a major linguistic challenge of the COVID-19 pandemic. In this latest contribution to our series of language aspects of the COVID-19 crisis, Loy Lising introduces three grassroots initiatives to improve multilingual service provision in the Philippines. The call for contributions to the series continues to be open.

***

The Philippines is a highly linguistically diverse country with Ethnologue listing 182 languages in use there. However, with Filipino as the constitutionally enshrined national language and English as the official second language, most of these languages are often relegated to the periphery when it comes to national activities. Their subordinate status has become salient with the COVID-19 pandemic, as it has become apparent that state public health information in Filipino and English fails to reach all the ethnolinguistic groups in the archipelago. Various NGOs and grassroots groups have stepped into the breach.

Since the initial case of COVID-19 in the Philippines in early February 2020, various grassroots-driven efforts have developed, and I, together with colleagues from the University of the Philippines, Kristina Gallego and Jesus Hernandez, are currently working to catalogue these and assess their effectiveness. As part of our ongoing investigation, we are surveying the availability of and access to COVID-19 information and prevention materials disseminated on social media since the lockdown of the capital region Metro Manila on 15 March 2020. In addition, we are interested in finding in what Philippine languages these materials are available. Our preliminary investigation has shown that insofar as COVID-19 infection prevention efforts in other Philippine languages are concerned, much of the work done are grassroots-generated rather than state-initiated, as in the following three examples.

Project #CAMPana

Through the Project #CAMPana of the College of Allied Medical Professions in the University of the Philippines, infographics on the prevention of the spread of COVID-19 were disseminated in various social media platforms immediately after the first occurrence of the virus in the country. One of these (Image 1) is an infographic for adults in Tagalog.

The infographic contains relevant information on the prevention of COVID-19 infection utilising a number of (non)linguistic modalities to make the information not only accessible but also interesting. These strategies include the use of images, colours, and mnemonics (in this image, LINIS). The Tagalog word linis means ‘clean’ or ‘being clean’ in English. In the image above, it is utilised as an easy-to-remember set of instructions to avoid contracting COVID-19: L is for linis (clean), I is for ilong (nose), N is for no, I is for iwasan (avoid), and S is for sabunin (to soap). The L instruction reminds readers to always clean frequently used objects; letter I instructs how to cover one’s nose and mouth when sneezing or coughing; letter N suggests refraining from touching one’s eyes, nose and mouth; letter I admonishes people to avoid crowded places; and S reminds readers to wash their hands or use sanitizers.

The other is an infographic for children available in eight Philippine languages: Tagalog, English, Cebuano, Ilonggo, Bikol, Iluko, Kapampangan, and Waray. Image 2 is an example in Cebuano.

Image 2: Infographic in Cebuano for children on ways to prevent the spread of COVID-19 infection

The infographic presents similar information but utilises, quite ingeniously, a strategy that makes the information not only accessible and interesting but also relevant to and attractive for children. The image juxtaposes the evil COVID-19 virus ‘crown’ image with a child superhero known as ‘Super Bata’, similar to Susana Distancia in Mexico. This clever strategy appeals to the children’s imagination and enjoins them to see themselves as superheros if they follow the eight strategies outlined in the pamphlet.

Language Warriors PH

The second grassroots effort is an initiative of the Department of Linguistics of the University of the Philippines in Diliman. They have created a working group called Language Warriors PH that aims to connect community translators and ‘language warriors’ across the Philippines to ensure COVID-19 related information is disseminated in as many indigenous languages as possible. This is a crucial step to ensure that especially those who are in the periphery, socially and geographically, have access to crucial information. This volunteer group, as of their May 08 report, has collected 927 COVID-19 related materials across 70 Philippine languages, dialects, and sociolects. The translated information spans topics on physical and mental health, socio-economic support, news and current affairs, and other miscellaneous information. The volunteer translators who have done the work of translating COVID-19 related information for various ethnolinguistic groups, which LWPH collect and help disseminate, include teachers, language enthusiasts, national government staff, local government unit staff, and private organization members.

Reading, Early Grades, Art and Language Education (REGALE)

A third truly outstanding effort worth featuring is the community-generated dictionaries for children produced by the Reading, Early Grades, Art and Language Education (REGALE) cluster from the College of Education of the University of the Philippines. In their efforts to ensure that children are kept up-to-date with information related to COVID-19 and its prevention, they have produced thus far four dictionaries for children: one in English, one in Tagalog, one in Cebuano, and the most recent one in Surigaonon. These dictionaries are also accessible in Filipino Sign Language, the link of which is embedded in the dictionary. In addition, and more recently, REGALE also produced video clips to further engage children in COVID-19 discussions. The first of these is now available.

Is public health information reaching the Philippine’s ethnolinguistic minorities?

Public dissemination of information in a multilingual ecology that is inclusive of all ethnolinguistic groups is always challenging, particularly one that involves so many languages. In the Philippines, the predominant use of Filipino and English across a number of national domains has always been motivated by the privileged position these languages hold in the country’s national language policy. The necessity, however, of ensuring the dissemination of potentially life-saving information at a time of a pandemic to as many ethnolinguistic groups as possible cannot be overemphasised. Thus far, in the country, we have seen various grassroots efforts, as exemplified above, rise to the challenge in bridging the information gap. My colleagues and I hope that once our research is concluded, we will be able to emphasize the role of grassroots efforts in the production of public health information across the archipelago to be able to influence state policies to improve information dissemination in all the languages Filipinos use and understand.

Language challenges of the Covid-19 pandemic

Visit here for our full coverage of language aspects of the COVID-19 crisis.

***

San Miguel Tenango

There can be no question about the crucial role that good quality communication plays in health care. Clearly, the aim of any responsible health care provider is to offer services of a high standard even when multilingual and multicultural settings may present challenges to mutual understanding between doctors and patients. Hence, for years, research in social medicine has been addressing linguistic diversity mostly from the perspective of obstacles that it created for effective health care. Practical, day-to-day considerations still make health professionals focus on ‘overcoming’ or ‘removing’ language barriers rather than view language as a value in itself.

Indigenous minoritized groups worldwide are known to have a worse health profile than majority populations, and they also tend to lose their languages in favor of the languages of majority. The main source of both problems is centuries-long, institutionalized marginalization of Indigenous peoples in the countries where they dwell. Such is the case of Mexico, a country that still counts 67 living Indigenous languages although all of them are in decline.

In Mexico, as elsewhere, Indigenous languages are heavily underrepresented in health care. There are no government-sponsored medical interpreting services in Indigenous languages despite the fact that there are still many citizens that need them – especially elderly persons who have little or no command of Spanish. Medical workers, doctors and nurses alike, are not trained in cultural competence before going to work in predominantly Indigenous communities, nor are they required or even encouraged to learn the languages spoken there.

Location of Puebla state in Mexico (Image credit: Wikipedia)

In San Miguel Tenango, a Nahuatl-speaking community in the northern part of Puebla state, a clinic, or Centro de Salud (‘Health Center’), was established 35 years ago. Although it provides services that are in great demand there, contact with clinic employees has remained very complicated and, on many occasions, painful. Until recently, discrimination against patients and obvious disdain for their culture and traditions on the part of medical personnel has unfortunately been commonplace. And barely any medical worker assigned to the Tenango clinic by the state department of health could speak any Nahuatl.

The older generation of Tenango residents, who have little proficiency in Spanish, have to rely solely on the assistance of their younger, bilingual relatives and friends when they need to go to the clinic. But the presence of such ad hoc interpreters, however helpful, conceals the fact that elderly patients will almost always omit important details that they are embarrassed to share. This risk increases even more when a medical worker, seeing that such a patient comes unaccompanied, picks any random person in sight and asks them to interpret. To prevent such cases, old people who live on their own try to organize chains of assistance between themselves, so that one who speaks better Spanish can help a number of her neighbors in case of necessity.

At the terminology workshop

Another problem is that even fairly bilingual residents come into difficulties when they have to translate biomedical discourse, full of specialized terminology and unfamiliar concepts, from Spanish to Nahuatl. Not every medic has been sensitive enough to assess the gap – social, cultural, and educational – between them and the population they serve. Thus, rarely enough effort has been made to ensure that the patients understand the doctor’s words correctly.

At some point health authorities established a position of ‘health educator’ in rural communities, whose duty was to organize informational meetings with the residents. More than that, the attendance of these meetings was made obligatory for persons who receive government assistance for the poor. But in Tenango all such meetings have been conducted in Spanish by a person from outside the community, and old Nahuatl speakers, who were required to show up and sit there until the end, could hardly understand a word.

Such disregard on the part of health authorities and employees could not but lead to a lack of trust towards public health services in Tenango. Even in cases when a member of the clinic’s personnel managed to build a bond with the community, they could be reassigned to another clinic at any moment, without consulting the residents in any form. For the public health system, the people of Tenango have been no more than numb recipients of services and their language has been treated as if it was non-existent.

Bilingual poster about dehydration

Talking with the residents, we realized how little it would actually take in terms of language in order to make people feel welcome on their visit to the clinic. And yet, even basic accommodations were rarely done, even in case that did not even involve any knowledge of Nahuatl. For example, doctors who worked in Tenango used to address any patient, irrespective of their age, with tú and not with usted, which is a more polite form of address in Spanish. In Tenango, however, politeness traditionally plays a crucial role in communication. In Nahuatl, the honorific prefix -on- in a verb is almost obligatory when you are talking to an adult, and this manner of speech has also influenced the way of how the local population speaks Spanish. Even using more formal language in Spanish could go some way to make patients feel respected.

The people of Tenango do not really expect that the employees of the health center would start to learn and speak Nahuatl with them, oh no. “But”, they were telling us, “even a greeting in the language would suffice”: that simple tzinōn that you can hear anywhere you go through the green hills of this sprawling community.

This situation inspired us to launch a participatory action research project, focused on the introduction of the Nahuatl language into the work of local health services. Our main aims were, on the one hand, to enhance the prestige and functional utility of Nahuatl, and, on the other hand, to improve health communication and health literacy in Tenango and neighboring villages. We have managed to involve in this project both locals who were eager to contribute to the well-being of their community and the personnel of the health center. As an active group, we hold regular meetings where we discuss vital health issues, trying to solve misunderstandings that have long festered between medical personnel and villagers.

Our first practical step was the development and production of bilingual Nahuatl-Spanish educational posters that tackled the most acute health issues in the community: diabetes type 2, dehydration, healthy nutrition, and high blood pressure. After discussing the content of the posters with the doctors, we then worked on the Nahuatl text and carefully tested it with as many speakers as possible before preparing the final version and the design.

We were well aware that the majority of elderly patients in Tenango could not read or write, but it was important to make Nahuatl visible in the clinic for the first time. Then we could proceed to the creation of audio materials.

Bilingual poster about diabetes

That symbolic appearance of Nahuatl in the local health center provoked a lot of interest among the residents, including young people, who started to take photos of the posters and disseminate them on social networks. Some older visitors noted that it would also be good to make signs in the clinic bilingual, and we happily included this task into our project. Medical personnel, in their turn, started asking us to translate other informational materials into Nahuatl, such as questionnaires distributed by the regional department of health.

The outbreak of Covid-19 seemed to bring our project to a halt but, in fact, also provided us with new opportunities. Although we both happened to be far from Mexico when the pandemic was declared, we decided to produce an informational video about the coronavirus and precautions against it in the variety of Nahuatl spoken in Tenango. At that moment, the virus had only recently emerged in Mexico and hardly any measures had been taken to curb its spread. But the inhabitants of Tenango were excited about the video, and it got shared by tens of people and seen hundreds of times just in a few days. Two weeks later, when certain anti-coronavirus measures had come into force, the village council asked us to produce another video in Nahuatl, with updated information, which we gladly did.

In addition, Herlinda recorded an informational audio message, which was then played in communal gatherings and from a loudspeaker attached to a truck belonging to the council, making the warnings heard across the whole village.

Nothing of this sort had ever been done in this region by health authorities. For the first time, health information in Tenango was given a Nahuatl voice, but even more importantly, it was a voice that many villagers easily recognized – it was one of their own voices. The impact of these innovations is yet to be assessed, but the demand for them and the impression they have had on the community already tell a great deal.

We can only hope that the current pandemic will make health authorities in Mexico – and in linguistically diverse societies around the globe – rethink their attitudes and policies towards Indigenous people, giving Indigenous languages and their speakers an adequate role in the services provided for the communities where these languages are spoken. There is a growing awareness of the importance of language-centered approach to health. As for now, we represent only a small community project, but we also want to set an example of how things can be changed and how a healthier language can also improve societal health.

Reference

A longer account of the study of communication in health services in Sierra Norte de Puebla will be published in Multilingua shortly.

Language challenges of the Covid-19 pandemic

Visit here for our full coverage of language aspects of the COVID-19 crisis.

Exterior of a pub at an intersection in the shopping hub of Burwood, a highly diverse suburb of Sydney

Editor’s note: Do public health messages about the Covid-19 pandemic match the linguistic profile of Australia’s population? In this latest contribution to our series of language aspects of the COVID-19 crisis, Dr Alexandra Grey, Postdoctoral Research Fellow at the University of Sydney Law School, shares her submission to the Australian Senate’s Select Committee on COVID-19’s inquiry into the Australian Government’s response to the COVID-19 pandemic. The call for contributions to the series continues to be open.

***

My submission is based on my current, still ongoing research project, ‘Good Governance in Multilingual Urban Australia’. This submission addresses the important question: How do you access COVID-19-related public health information in Australia in languages other than English (LOTEs)? It is based on preliminary results of my current study and provides recommendations about better reaching the linguistically diverse Australian public with official public health communications. 

The Committee will decide which submissions to put on the public record. However, Language on the Move is making a copy of mine available here, because we believe it will be beneficial to draw attention to, discuss and even debate these recommendations. Please read the submission (11 pages plus images) or simply my 6 recommendations, which you can find on page 3, and share your perspectives in the comments below.

The submission identifies these key problems with Australia’s official COVID-19 public health communications in LOTEs, which emerge from the study:

• There are barriers to the accessibility of official public health information for those in the community who are not confident reading/able to read the English-medium public health communications on display in their local areas or available (albeit often buried) on government websites
• State and federal governments have left it to local councils to provide LOTE-medium public health communications in public areas, without any requirement on local councils to actually take up this task, and with varying outcomes even in areas with similar multilingual profiles
• There is an under-utilization of the LOTE-medium public health posters which the NSW and federal governments have specifically produced in response to the COVID-19 pandemic
• Government health agencies’ Twitter feeds have not cultivated LOTE readerships before or during the pandemic and do not appear to be engaging the LOTE-using public; these feeds are haphazard, infrequent and unreliable in their LOTE tweeting as well as in their references to LOTE resources.

Amongst various possible ways of addressing these problems, my recommendations focus on:

• Research: improving the efficacy of both physical and online official LOTE public health communications by increasing the collection and analysis of appropriate data
• Redesigning online communications: improving the efficacy of online official LOTE public health communications through simple, practical changes to government websites and tweets, including increased and consistent use of LOTEs and their scripts
• Standard setting: improving both the quality and the reliability of LOTE public health communications across government agencies through legal requirements, at federal and state levels, for government bodies to plan for, execute and monitor the effective dissemination in LOTEs of official public health information, at least during times of emergency/pandemic, with associated best practice guidelines to be developed and implemented across government. I anticipate that this last will be the most controversial, but potentially also the most impactful.

Read the submission here.

Acknowledgement

I’d like to acknowledge Dr Allie Severin and Dr Hanna Torsh for their help with data collection in this project, and the Language-on-the-Move Reading Group for insightful discussions of language aspects of the Covid-19 pandemic.

Language challenges of the Covid-19 pandemic

Visit here for our full coverage of language aspects of the COVID-19 crisis.