On 16th March, 2020 Somalia recorded its first case of coronavirus. By mid-April, there were over 200 cases and mostly local transmission. Prevention is the only option in Somalia, given the poor state of health capacity nationwide. This is especially true in urban settings with very high numbers of internally displaced persons living in cramped conditions and with pre-existing levels of risk to health and wellbeing.
Prevention requires mobilising the right kind of collective and community action, targeted at helping the most vulnerable. Here, risk communications and community engagement are vital, but face the challenge of trusted sources of authority and socio-cultural and religious beliefs that may distort the nature of the threat. Worse, given longstanding upheaval and insecurity, the risk of spread of misinformation about the virus and aggravating public anxieties are also alarmingly high.
And what is the right advice? Social distancing measures need to make sense amidst dense and precarious urban settings and in a highly communal society. During Ramadan, purist public health messaging around distancing is also likely to backfire. Health and behavioural change communication thus needs to be highly context relevant: free of jargon, empathetic, in local language and speech forms, and tailored to local socio-cultural identities and norm-change models. It has to start with listening to Somalis
Responding to COVID-19 in Somalia:
Interactive mass media, 1-to-1 messaging and rapid insights from citizen feedback
Photo: Stuart Price
Photo: Stuart Price
Between April 3rd and 5th, over 7,700 Somalis from South Central and Puntland responded answering an open question on their thoughts on COVID-19.
The project was a collaboration between CGHR, University of Nairobi researchers, working with the team at Africa’s Voices Foundation. It aimed to conduct a rapid diagnostic on the community questions, concerns and risk perceptions in Somalia – especially peri-urban IDP settings – concerning COVID-19.
Within four days, our team of Somali-speaking researchers analysed over 15,000 responses rich with insights. The findings are essential for any Risk Communications and Community Engagement (RCCE) programming in the wake of COVID-19 in Somalia.
In order to provide those responding to COVID19 in Somalia with a snapshot of how the people of Somalia are thinking about the epidemic in these early days, Africa’s Voices reached out using its established multimedia interactive platform called ‘Imaqal’ (‘hear me’), a gender equality and social inclusion programme funded by Somalia Stability Fund, which, besides a large national radio listenership, has engaged an audience of over 50,000 people. This followership is skewed towards urban/IDP/youth segments of the population, and has a strong representation of women, all of whom are key groups of concern with COVID-19 in the Somali context. The diagnostic asked the existing cohort of Imaqal followers a question via SMS around their thoughts and questions on COVID19.
"Dhageystaha sharafta leh ee Imaqal, Codkaaga wuxuu muhiim u yahay la tacaalidda xanuunka COVID-19. Waa maxay fikradahaaga ku aadan xanuunka Koroona fayraska?"
“Dear Imaqal Listener, your voice is important for the response to COVID-19. What are your thoughts on Coronavirus?”
The diagnostic is a component of AVF’s Somalia Risk Communications and Community Engagement (RCCE) strategy: interactive mass media, 1-to-1 messaging and rapid insights from feedback
The infographic demonstrates how interactive radio works in tandem with tailored 1-to-1 SMS communications to produce robust insights into citizen perceptions on COVID-19.
Our Imaqal Rapid Diagnostic heard from 7,747 Somalis between 3-5 April 2020, and produced findings by 9 April
Total recipients of free SMS question
Total participants - response rate
Total free SMS received
Total participants who opted in (consent given for analysis)
Total SMS analysed (from those who opted in)
Total individuals responded to using tailored 1-to-1 communications
The diagnostic sample is self-selecting, and skewed towards urban, displaced youth - the populations of primary concern.
What are Somalis thinking about COVID-19?
"Fikradaydu waxaytahay in ilaahay latala saarto hadii ilaahay latalasaarto wax walbo oo dhibaato ah waalaga badbaadayaa"
My opinion is to trust Allah and every difficulty will pass.
Female, 41, IDP, Daynile
"dadka waa iney isticmalan waxyabaha gulul sida sanjabisha filfisha iyo lendhananta waa iney iska yareyan waxyaba qabob barafka jalatada alle waxan ka baryaya inu ka badbadiyo umada musliminta qasatay umada somaliyey dawadisu waa inad alle bariyan waa iney qur.aanka aqriyan waa iney nadafada ku dadalan qasatan dadka barkacyasha ah allow umadan badbadi.""People should use spices like ginger, black pepper and lemon. They should reduce the intake of cold stuff such as ice cream. May Allah protect the Muslim community particularly the Somalis. Its cure is to pray to Allah, reciting the Koran and practice proper hygiene especially the IDPs. Allah protect the community."
"Waa nimco firkaradayda COVID-19 waa xanuunhalis ah waxaana dawo uah kaliya kahortag marka dadka haday amaawirta dawlada qataan waxaan dhihikarnaa sida hada uu ufaafayo uma faaafilahayn mahasanidin."It is a dangerous disease and its only cure is prevention. Therefore, if people follow the information given by the government; I think it wouldn't have spread and it is spreading now. Thanks.
Female, 17, Cabudwaaq
"Waxaa loga hortagi karaa karona fayriska in soomaaliya laga baxsho gaalada."
Coronavirus can be prevented in Somalia by expelling the non-believers.
Male, 19, Jiraqaale
What does an effective COVID19 RCCE response in Somalia need to do?
Recommendations based on citizen voice
Photo: Tobin Jones
Photo: Tobin Jones
Asked for their thoughts on COVID-19 Somali respondents spoke less from a health than from a religious hope/practice standpoint.
All COVID-19 prevention programming enters into a dominant Somali religious worldview. Programming must work with and through trusted sources of authority, guidance and reassurance in times of crisis. If it does not - or worse, is at odds with this worldview - it is liable to fail or to backfire.
Understanding what messaging religious leaders are giving around COVID-19 is a crucial starting point - there is no blank slate for COVID-19 RCCE messaging. A ‘public health first’ framing is misaligned with primary influences on people’s lives.
Sensitivities around curtailing religious gatherings need to be anticipated/addressed, especially during Ramadan.
(1) Work with and through religion as the dominant community framing of COVID-19, and the trusted source of authority and the key source of risk.
Respondents fall into two broad camps: Those invoking religious hope, practice and guidance as the right way forward (38.7%); those invoking community action aligned to expert/government advice with a “call for right practice” (34.1%). The religion frame grows more salient with increasing age; splits evenly between (passive) fate/hope/trust in Allah and (active) devoutness, prayer, offering. Younger age groups (notably females) are more likely to advocate for following expert/government advice on right practices.
The strong collective ‘we’ element in calls for right practice chimes with findings in Africa's Voices' previous work: Somalis repeatedly emphasise community solidarity and mobilisation as solutions to humanitarian problems.
Frames that see women as the ‘backbone’ of society and youth as the ‘pillar’ of society should be leveraged to galvanise influencers for a collective response.
(2) Leverage strong community solidarity around ‘right practice’, especially youth (notably female youth).
Photo: Tobin Jones
"Adinka iyo kuwa nilamidka aya amiinsan karoonaha shegeysin Alle ayatalo iskaleh anaka maraacno kuwa iskujeego daqadiir iyo kalada alle kabaqa kuwina dhahayo karoona ayan dadka kabadbadin Habarta ayaushegeey musqulyahoow adinka hanikudhaco covid 19."
You and people like you believe in the corona you are talking about. Allah deserves trust. We don't follow the so-called doctors and non-believers. Fear Allah those of you who are purporting to saving people from corona. Tell your mum, you sh*t. May covid19 affect you.
Male, 23, Balcad
Mida kale waxan aminsanahay somaliya inu horay usomaray asago ladhoho kadudshe ayu inukudhacay hadan inusan ina.sogaray ban aminsanahay cimiladenana kuma nolan karo marka musliminta waxan kulatalinaya kitabka ale inla.amino quran badana la.akhristo wa balaxijabe mesha wax yalahakale lasojedinayo inlafaro dhaman muslimitu quran wada akhristan asaga balaxijaba.
...also I believe Somalia has experienced it in the form of dengue fever and it has resurfaced again. It cannot survive in our climate. I therefore urge the Muslims to believe in Allah, read the Koran a lot which shields against evil. Instead of offering other advice, urge the Muslims to read the Koran which shields against evil.
Male, 23, Galkacyo
"Ma jiraan cudur wax layirahdo wayo muslim ayaan nahay dad ayaa ku tuugsanayo oo daaro ka qabya ah??"
This disease does not exist. We are Muslims; people who have incomplete buildings are using it to beg for money.
"WLL DAWO AYAN U HAYAA WAANA TABLET REVIDEN KININKA TB.DA ARINTAA HA SAHLANINA MEELWALBA GARSIIYA."
I have a medicine for it - REVIDEN Tablet, the drug that treats TB. Don't take this (info) lightly, spread it widely.
Male, 43, Garowe
Over 1 in 10 respondents expressed thoughts on COVID-19 that involve rumour, stigma or misinformation (12.2%). Over 75% of these respondents expressed negative stigma: hostility, anger or resentment. A message denying coronavirus was over twice as likely to come from a man than a woman.
There is considerable misinformation around causes of coronavirus and treatment. It needs tackling where it compounds negative practices but is not the highest concern.
(3) Mitigate significant stigma, notably hostility/anger towards COVID-19 and outsiders/non-believers/harbingers.
(4) Tackle rumour and misinformation around virus source and treatment: dengue, common cold and measles, traditional medicines.
Recently displaced were significantly more likely to express such thoughts than those who were not. In Banadir (Mogadishu area), recently displaced were twice more likely than host community respondents to express rumour, stigma or misinformation. Rumour, stigma or misinformation were also more likely from respondents from more insecure areas (due to Al-Shabaab threat) such as Bay and Lower Juba than from Banadir.
Where authorities/agencies bypass the primacy of religious authority, others are liable to step in, instrumentalising hostility, anger and resentment. This is especially a concern with vulnerable populations in Bay, Lower Juba and Banadir.
(5) Anticipate that rumour/stigma/misinformation is compounded amongst IDPs and conflict-affected communities
AN EFFECTIVE RESPONSE
With this information organizations in Somalia can begin to formulate an effective COVID-19 response that includes working with and through religion as the dominant community framing of COVID-19, leverage strong community solidarity around ‘right practice’ especially through the youth (notably female youth), and deploy empathetic engaging content, using accessible, trusted and meaningful communication channels.
Having spearheaded the initiative, CGHR will continue collaborative work with Africa's Voices, the Centre for Humanitarian Change and others, on sharing insights from listening to Somalis and effective contextually-relevant RCCE messaging.
As with everywhere the COVID-19 situation is developing quickly. For responders, humanitarian agencies and government alike, what matters the most is to listen, listen again and act.
This work benefitted from feedback and guidance from colleagues at the Centre for Humanitarian Change colleagues: Peter Hailey and Nancy Balfour, alongside Guhad Muhammad Adan, Khalif Abdulrahman and Dan Maxwell.
The diagnostic was supported by the Alborada Trust and Cambridge-Africa at the University of Cambridge, building on the Imaqal programme supported by the Somalia Stability Fund.