Life and Death

That is what health reporting is about.

Whether it is about living in a healthy environment, eating nourishing food, staying strong enough to achieve our goals or avoiding the communicable deadly illnesses that make this world a smaller place each day, writing about health means writing about the quality and duration of our lives. For that reason, whether you cover sports, features, business, breaking news, investigative stories, or edit the words that make print, health is part of your business. And whether you tell the story of one person’s illness, or of policies that affect the common good, writing about health gives you the chance to save and improve the lives of your readers. These bulletins are intended to help you find what you need to know to make the most of that chance.

“Failed” Clinical Trial, A Dialogue Continues, Recognition, and Front-line Reporting

HOW DOES A CLINICAL TRIAL “FAIL?”
This is just one of the questions raised by what one might call “failed” reporting of a recent clinical trial of a microbicide.

The trial was conducted to discover if a microbide gel being tested could help prevent transmission of HIV. The product was found not to be effective in preventing transmission of HIV — an important finding, that, while not good news for all of us looking for immediate solutions to the HIV epidemic, answers the question to which the trial was seeking an answer.

But media stories have repeatedly referred to the “failed” trial, without exploring the purpose, methods, and conclusions of the trial.

Worse, some reports have referred to the trial’s “disastrous results” and to the participants as “victims” — a slur on the women who participated in the trial, as well as on the researchers — without supporting these implications. This is unfortunate, because clarifying, informing, explaining — questioning, and getting answers to questions, in short — make up our mission as journalists.

Becoming well-informed is part of that.  Using words correctly and precisely is part of that. It is especially important when reporting science, if we are to retain our credibility as watchdogs of the public interest.

Health Desk is developing a page to provide definitions, sources and resources for journalists interested in reporting on research and is seeking sources, suggestions, requests and questions.

On the positive side the Times of Zambia last week had an enlightening interview with a trial participant. Other good work has been done by Post and Times reporters who spoke to a University of Zambia Ethics Committee spokesman who clarified the results of the trial.

A growing network, a continuing dialogue . . .

The miscommunications that mark much of the reporting of the recent local microbicide trial highlights the need for improved access between reporters to researchers.

An effort to address that is underway with the work of veteran journalist and media consultant Oliver Kanene with a grant from Wellcome Trust.

A three-day workshop in November, previously described here, was the beginning. In January the dialogue that began then continued with a breakfast meeting at the Intercontinental Hotel.

Dr. Lawrence Marum, Zambia director of the Centers for Disease Control and Prevention spoke about the benefits that have come, not just from research, but from its correct interpretation. Participants — reporters and researchers, as well as community artists — discussed some of the difficulties of bringing research to the public and raised some of the issues that arose during coverage of the Mazabuka microbicide trial.

More activities will be announced on Health Desk.

CONGRATULATIONS TO:

All of those recognized in the Malaria Media Awards:

THE ZAMBIA DAILY MAIL was recognized for its five-day series on Malaria

First place print:  BIVAN SALUSEKI, POST NEWSPAPERS LIMITED for his creative article: “Fighting Malaria with Mosquito Nets”.

Second place print: CHARLES CHISALA, ZAMBIA DAILY MAIL for his article: “Right Forces, Ammo Deployed Against Malaria”.

First place broadcast:  BIBIAN MWALE, RADIO CHRISTIAN VOICE for her malaria feature that looked at public awareness and rapid testing for the disease.

Second place broadcast:  EMMANUEL MULENGA, a familiar face at these awards.  His programme on prevention of malaria in pregnancy and in children aired on JOY FM.

Zambia Daily Mail Sports Editor Diana Zulu, who died in December, was recognized for her efforts to advance health reporting, and for her participation in the Zambia Daily Mail’s Malaria series.

FRONT LINE REPORTING

Pay attention to neglected diseases

“If fighting NTDs is so obvious and so cheap, why has it taken so long to act in a systematic way?” This article in Scientific American asks.

Well, as pointed out on the Bad Word List recently, calling them “NTDs” doesn’t help. These are illlnesses that have widespread and devastating impacts, affecting nearly all of those living in poverty in developing countries  and — although they are preventable and treatable — lingering for years.

The impression that these illnesses “debililatate, more than they kill” is one reason they have been neglected, according to the article. But the characterization is not strictly accurate, when you look at the impact of debilitating ill health on income, maternal and child health and social strength — all of which do directly affect the course of HIV, tuberculosis and malaria.

If you want to be a well-rounded health reporter, one who looks at the importance of strengthening awareness and response to all health problems, so they can be approached as a whole — consider an article on the impact of neglected tropical diseases in your coverage area. And don’t call them “NTDs”

A  success story, a hook . . .
Proving the payoff of coordinated efforts, awareness, and determination, Zambia, once again, is a star in summary findings of the latest World Health Organisation report on malaria-fighting efforts. A link to the report is on the National Malaria Control Center Web site, and it would be nice to look for local stories of what is working here, with the report as a hook. See the item below for why this would be a good time to come up with an interesting, informative multi-source story on malaria  . . .

A contest . . .
3rd ANNUAL MEDIA
AWARDS FOR BEST
COVERAGE OF MALARIA

The Ministry of Health is pleased to announce the 3rd Annual Media Award Competition for Best Coverage of Malaria by Zambian journalists and media practitioners.  Deadline for submissions is 15 January 2010.  Winners will be recognized at a venue and date to be announced.

Categories:  Print media, Photo-journalism, Radio and Television

Eligibility:  The competition is open to all journalists and media practitioners working either for established media organisations or as freelancers.

Time frame:  Entries should have been published or broadcast in Zambia between January and December 2009.

Prizes:  To be announced.

Criteria:  Entries will be judged on the basis of their originality and understanding of malaria as a disease, as well as the diagnostic, treatment, prevention and control measures initiated by the Ministry of Health. Editorial products will not be considered. Entries should reflect creativity, factuality, accuracy and a reliance on multiple sources. Only one entry per individual.

Means of submission:  Entries must be in the form of original newspaper clipping for print media entries, cassettes or CDs for radio entries, DVDs or VHS tapes for television, and printed or digital (CD) pictures for photo-journalism entries. Proof of authorship will be required.

Where to send entries:  Submissions should be sent by post or delivered in person to:

Malaria Media Award Competition
c/o National Malaria Control Centre
Chainama Hill Hospital Grounds, Great East Road
P.O. Box 32509
Lusaka, Zambia

Deadline:  17:00 hours on 15 January 2010.

For more information:  Please send any questions to info@nmcc.org.zm or call 282455.

Good points, bad words, important columns

A few words on bad words

Imbecile

Old

Peer educator

“Full-blown” AIDS

All of these words made the Bad Word List this week because of what they imparted to readers — or failed to impart.

“Imbecile” for example, used in a recent news story to characterise an “old and blind” woman — who had been raped — imparted a demeaning image, and failed to impart that the victim of this crime suffered from age-related mental disabilities. A reporter who brought this to my attention said the use of this word also made the victim sound less worthy of respect.

A participant pointed out “old” didn’t help — as it has been used to describe women as young as the current HealthWriterZambia (52) — as well as people twice that age.

“Peer educator” has been added at a participant’s suggestion because, overused, it has come to substitute for information about who is doing what, and why. A paid employee who happens to be about the same age as a client, and lives in the same community is not necessarily a “peer educator.” A prisoner who has been trained to help communicate information about HIV to other prisoners is a peer educator — but the description of what the prisoner does is more interesting than the title “peer educator.”

“Full-blown AIDS” seems redundant and carries an air of extra stigma, a participant said, after hearing the outdated expression used at a recent conference. It certainly doesn’t add anything to readers’ understanding, implying that this is a different kind of AIDS.

In addition to the above contributions, one participant raised a problem with the premise of the Alphabet Soup list, as well as some of the other bad words, pointing out that space issues in newspapers make the shortest way of saying something often the preferable way.

This writer, whose comment is posted at the end of the Bad Word List, says she can see why the listed words are bad words for writing about health, but doubts the practicality of using longer alternatives. An important point, and one reason why one must be flexible. Also, as some people find with the other kind of bad word, a word that has the power to offend, or one that isn’t meant to be taken literally, has its place at times.

But when space for words is scarce, the words we choose should count. And if, for example “old” means 50 to one reader, and conjures up an age of biblical digits to another, a better use of the limited space would be to say “woman in her 80s.”

Somewhere in the paper, space can be found to accommodate that, when you take out the “full blown” in front of “AIDS,” substitute “death” for “mortality“, and save the word “innocent” for court stories.

Important columns highlight reasons behind depressing data

If you missed it, look up  Friday Dec. 11 Post‘s Soul 2 Soul with Edem Djokotoe, who notes sadly that the recently marked annual World AIDS Day has become the day when “high rollers and heavy hitters in the arena of HIV and AIDS interventionism turn out in their finery to find out who’s got the coolest and fanciest T-shirt of them all,” Then, he adds, after candle-lighting speeches – and lunch, they “congratulate themselves on the strides they have made from the previous year.” Except, he points out, the strides aren’t much to celebrate, when numbers are going up and prevalence remains tragically high.

While hundreds of millions of U.S. dollars come in to support HIV treatment and prevention measures, he writes, among them more than “640,000 voluntary counseling and testing encounters” some of those imported interventions may be missing their target because they are aimed at the wrong audience — like one in another country.

Djokotoe cites the PSP-One study: “Who Goes Where and Why? Examining Counseling and Testing Services in the Public and Private Sectors in Zambia” (also cited here), which showed most people tested for the virus that leads to AIDS in  Luapala and the Copperbelt did not receive counseling to disclose their status and reduce their number of partners. “Not a particularly encouraging research finding,” Djokotoe notes, in the face of data showing the epidemic here is driven largely by heterosexual encounters.

Djokotoe has done a service, finding a problem – one that could be addressed — in a week flooded with baffling success stories. The study he cites is in fact a success story, as it points toward hope. If those getting tested receive relevant messages – maybe the numbers would fall. Unfortunately, the report was disseminated quietly in a week when the American Thanksgiving holiday made comment hard to get. But . . .

Help is at hand

USAID likes to get word out about its work. If you need a response on USAID-funded efforts, like the study above — and staffers do need clearance to talk to press –  call:

Chris Mahoney, Development Outreach Communications 
U.S. Agency for International

Cell: +260 (978) 772538

cmahoney@usaid.gov

He should be able to facilitate your efforts, or point you in the right direction.

Another problem another solution

Also on Friday, in the Zambia Daily Mail, AIDS Matters column, Justin Mwiinga highlights the GIPA report card — an evaluation of how well Greater Involvement of People Living with HIV and AIDS is going here — in  “People living with HIV want their voice heard”

The column presents a  statement from NZP+  detailing obstacles between people living with HIV face in and the meaningful role they can take finding solutions to the epidemic here – being given marginal, token roles, being expected to work without pay among them. Another problem – another solution. Greater involvement of people most affected by HIV could lead to planning that yields results – instead of deliverables. Like Djokotoe’s column on the the PSP-One “Who goes where and why . . .” this column draws attention to the importance of genuinely local efforts that take their lead by those most affected. This is something local journalists should focus on for exactly that reason.

Mwiinga includes contact information for more information on the GIPA (Greater Involvement of People Living with HIV and AIDS) report card on the extent to which those most affected by the epidemic are included in efforts to address it.

For more information on the report card, Mwiinga says, contact Kenly Sikwese, Focal Point GIPA Report Card, Network of Zambian People Living with HIV: 0977-419888/0966-261218.

Treatment for more people living with HIV?
It will be interesting to see how the study described here, reported in the Independent strikes people currently receiving treatment for HIV — and those who provide services to them,  as well as people still waiting for treatment — and well as those trying to get treatment to remote areas. Expensive laboratory testing of blood, that is considered part of treatment for people receiving medicine for HIV, does not appear to be necessary, according to the article. And the money saved could help more people get on, and stay on life-saving treatment. A local follow of this report could inform readers of the current state of treatment in Zambia.

A look back at World AIDS Day — and a look ahead

Sometimes, for all the speeches, events, test-a-thons, and data releases, it is hard to tell one World AIDS Day apart from the one before, a sad comment when you think a year in which much could change passes between them.

This year brought bad news, with figures showing the number of HIV patients rising here, while the number of those getting tested continues to stall.

A recent study, though, showing that efforts on the very front lines of prevention are missing the target and could be better directed offers hope that if we pay attention, next World AIDS Day could be better. Links to the results and a summary of its findings can be downloaded at:

http://www.psp-one.com/content/resource/detail/5350/

The study, titled Who Goes Where and Why? Examining HIV Counseling and Testing Services in the Public and Private Sectors in Zambia was intended to compare the quality of HIV testing and counseling services offered by government, nongovernment, faith-based and private providers (including workplace initiatives as well as private clinics, doctors’ offices, and other for-profit outlets). According to the summary, researchers found “serious areas of underperformance ” across all four.

These included that when counselors had the opportunity to discuss with clients methods to reduce risks of HIV transmission, they neglected counseling to target the major driver of the epidemic here — multiple concurrent sexual partners. According to the study, counseling to disclose test results to partners was given to as few as 2 percent of clients (at private sites) and at most to 32 percent of clients (at NGO sites), and that counseling on reducing one’s number of sexual partners reached — at most just 32 percent of clients (at government-sponsored sites) .

Instead, according to the presentation given last week, clients of “VCT” centers “across the sectors” received counseling emphasizing “minimizing blood exchange, avoiding sharing of needles and sharp objects . . .” — none of which are considered significant drivers of the epidemic here.

All of this suggests that materials and information used to battle the epidemic here are not tailored to this country’s needs. This is important information, if as we mark a quarter-century of AIDS in Zambia we aim to make next World AIDS Day a little different from the one before.

The study, which was carried out in Luapula and the Copperbelt is not statistically generalizable to Zambia overall. At the same time, the summary indicates nothing that set these areas apart — one rural, one urban, from others in Zambia.

World AIDS DAY package . . .
In the meantime, the Daily Mail continued its Health Mail series of in-depth examinations of health topics with a two-page look at the HIV epidemic here, including a feature of efforts to address HIV in prisons, stagnant HIV testing rates, a church’s effort to keep HIV from tearing families apart . . .and an answer to slow condom sales.

Once again, it was my privilege to work with the people who produced it: Benedict Tembo, Paschalina Phiri, Chimwemwe Mwale, Newton Sibanda and Mwazipeza Chanda, and the management of the Zambia Daily Mail.

In Time for World AIDS Day

A resource, resourceful stories, and a solution that lies in government hands . . .

Dziwani Knowledge Centre for Health Afya Mzuri

This is an aptly named centre at Afya Mzuri because it is an invaluable resource for anyone who needs to know more about the health issues that are critical here. That includes people living with HIV, students, doctors, researchers, government and nongovernment staffers — and journalists.

The six computers in the research room are open to the public who register for free and become members. Here, you will find access to countless databases and sites from which you can download reports and other information that help inform policy and the public.

In addition you can read works on health issues — including in Braille — and see informational and training videos on the three computers in the Multi-media room.

The centre even has a reading corner for children — in itself material for an enlightening story of how information affecting the duration and quality of life are made accessible to the youngest consumers of health services.

Free membership  gets you on the email list for e-bulletin, a daily email update that includes articles from daily local papers and postings from selected Internet sites. Journalists interested in covering health and looking for story leads should subscribe by writing to:

resourcecentre@afyamzuri.org.zm

The Heroines of Majengo

Masuzyo Chakwe of the Post has written a fascinating and eloquent story about apparently HIV-resistant women in the Kenya slum Majengo, a place, as she puts it that may not mean much to most people, “but to some medical researchers . . . rings with hope.”

” . . . it does not even look close to a medical haven,” she writes, “not with its lacing of rusted shacks and haphazardly arranged mud-bricked huts, its open-air makret, salons, hawkers pitching second-hand clothes and women selling sex for the equivalent of pennies . . .”

But she points out, the place has attracted attention since 1986, when some of those women, in spite of multiple exposures to the virus that leads to AIDS, were found to have remained free of HIV.

Scientists studying these women hope to find information that will help them to find a vaccine against HIV, the best hope to containing the epidemic that continues to spread faster than efforts to treat it.

It is a study that has seen setbacks, but those, too have informed scientists who are seeking information on the factors that might lead to resistance to the virus.

This exceedingly well-put together article goes beyond Majengo, though, describing efforts to identify a vaccine in Zambia, which, with a prevalence of the virus of more than 14 percent, could play an important role in solving the puzzle of this ongoing public health crisis.

HealthWriterZambia does wish the article didn’t use the word “prostitutes,” to describe women such as Hidaya, who, according to the story, supported her three children by selling sex since her huband  became sick from AIDS.

The word “prostitute” sums up these women’s identities on the basis of their circumstances, and for that reason is on this site’s Bad Word List. The headline could have used the word “heroine” to characterise women who in spite of having few resources, could provide an answer to questions that have boggled researchers for more than a quarter century.

A plague that robs orphans of their culture . . .

This moving story from Irin Plus News shows what you can do to show the rippling impact of AIDS epidemic when you think beyond the obvious and ask questions. This story identifies a neglected need among orphaned children, and another way that a public health threat takes a toll on the strength of a society.

If you are interested in solutions . . .
This New York Times article on needle-exchange programs gives a good explanation of how “harm reduction” works — and how the best effectiveness of this politically sensitive approach will lie in the hands of governments. As Zambia’s Mid-term report on the country’s AIDS strategy  — which recommends revisiting laws against homosexual sex and penalties for drug use — indicates, the importance of realistic, practical approaches is beginning to be recognized here.

In Search of Answers? Try Research

Thanks for the comments . . . Feedback from Health Desk participants last week led to a thought-provoking discussion, an addition to the Bad Word list, and this important point: The public officials whose speeches and remarks often make up the bulk of health coverage, are sometimes in need information themselves. We can do them, our readers and the citizens who rely on those officials a big favor by asking questions about what they say.

A workshop with a purpose . . .In any case while rhetoric gets attention, research provides answers. That is why Wellcome Trust is supporting a workshop led by media consultant Oliver Kanene next week examining the challenges and opportunities of communicating evidence-based approaches to public health problem solving. The workshop: Maximising Health Research Communication in Zambia, will take place November 16-18 at the Hotel Intercontinental. It will, it is to be hoped, be just the beginning of an organized and collaborative approach to spreading word of important findings.  The opening ceremony, in which Microbicides Media and Communications Initiative Coordinator Deborah Baron will make a presentation, will be open to all press members for coverage.  For more information, write to neshamavalley@yahoo.com.

Numbers tell a story
While the percentage of Zambians being diagnosed with HIV has stabilised — in itself not great news, as roughly 14 percent remains too high — the actual numbers of people getting this preventable virus are going up, because of population growth, according to this story, based on data from the National AIDS Council. Low condom use is one of the reasons, and one reason for that, according to the story is an inadequate supply.

Treatment is Prevention, according to this research . . .
Availability of antiretroviral drugs can reduce HIV transmission by lowering the likelihood of infection, according to this story from Bloomberg on World Health Organization findings. While these findings don’t support the optimistic projection made last year that HIV could be virtually eliminated if everyone infected were tested and treated immediately,  they do bolster hopes that treatment and prevention can happen together.

Could research yield bilateral disease control?
Home-grown anti-malaria medicine could be the bounty of research involving efforts to grow the indigenous Chinese shrub from which artemisinisin based treatment is derived on African soil. Efforts to farm hybrids of the shrub in Tanzania, Kenya, and Nigeria have been promising according to this Reuters story. Could it happen here?

Looking for data?
Afya Mzuri, Dziwani Knowledge Centre for Health…. This is a great research resource for journalists—conveniently located right behind Manda Hill. With a video lending library, publication database searches, document delivery by email, and referrals to other organizations, it is open to the Mon. – Fri. from 9:00 to 16:00 hours. For information call 295 120/3/4, or write to: enquiries@afyamzuri.org.zm More on the centre next time . . .

Finally, numbers + vivid examples tell an engaging story . . .
As the Lusaka premiere of Shuga, a production of MTV’s Staying Alive Campaign with UNICEF support showed at the The Play House last night. The mostly convincing story lines looked at reasons why young people continue to supply the fastest growing numbers of new HIV diagnoses.

The Big Picture

The state of health care  . . .

Stories in the Post and the Times over the weekend reported Government’s concern over its shortage of nurses, other health workers and essential services. These stories suggest a wealth of quick follows that could bring both problems and solutions to light — and give a glimpse of the overall state of health care here.

What is a day in a life of a nurse here like now? How have pay and benefits changed in recent years and what have been the effects of those changes?  What happens when a patient needs an ambulance at Livingstone General Hospital? And how does all of this affect people with needs for ongoing care — for high blood pressure, diabetes, heart disease, cancer –  as well as for HIV and tuberculosis? A day following one patient could offer valuable information on gaps in a system that policy makers and donors are seeking to strengthen.

That information is needed — and reporters can be the ones to provide it — if the well-publicized roll-outs of effort and resources to address malaria and HIV are to do their greatest good, and in fact, not detract from overall health services.

In the last couple of weeks reports and opinion pieces have suggested areas that would be interesting to follow here:

This piece by Mark Green, Managing Director of Malaria No More’s Malaria Policy Center in Washington, DC., argues that coordinating efforts to prevent and treat malaria with efforts to address neglected tropical diseases would help strengthen health services in general — particularly in remote areas where the gaps are the greatest now. The Tropical Disease Research Center in Ndola, which has studies neglected tropical diseases could be a good place to start.

This piece, on http://www.globalhealthmagazine.com looks at how, with urbanization, Africa “has acquired the so-called diseases of the wealthy, but without the wealth.” Examining the toll of mental illness, cardiovascular disease, diabetes, cancer  here — one of the most urbanized countries in Southern Africa — would provide essential services to readers. What are people doing differently, and what health-harming behaviors are preventable and avoidable? And of course, how does the health care system need to adapt to the rising burden of unpublicized public health threats?

Are prevention strategies working?
Finally, this New York Times story brings good news, but the reminder that while “more than a million people were put on drugs in the past year — drugs they will need for the rest of their lives — 2.7 million people were newly infected with H.I.V. in 2007, the latest year for which there were estimates” demands a local look at prevention strategies, including in health care settings.

And, an addition to the Bad Words List
” . . . he said, in a speech read for him by . . .”
Okay, that’s a combination of words, but it is a phrase that confuses me. If someone “says” something, the words come out of that person’s mouth. That person is present, and can then answer a question that may be raised by those words. But too often reporters writing stories from the transcripts of speeches don’t ask those questions — or have the opportunity to ask them — because the author of the speech being reported isn’t actually there. It would be good to make that clearer from the start: “a government spokesperson said today that . . . ” followed by “he was reading a speech from . . .” Then, ask the questions raised by the speech. The answers could always provide a good follow-up story.

The Stories Behind the Success Story

A malaria-free Zambia? That is the question Zambia Daily Mail reporters and editors asked as they examined the factors driving this country’s success in beating back its deadliest disease. Their answer, in a five-day series of stories that ended today, was yes, it’s possible if we continue to work together and work harder.

HWZ was privileged, once again, to work with the Daily Mail staffers and management who put the series together, but would like to emphasize that going behind the press conference announcement, to look at the elements of the new program, dire statistics, official pronouncement, and, as here, even examining good news — for the lessons learned and the lessons still to be learned, is something that any media house with the will and focus can do and has the duty to do.

Congratulations to Charles Chisala, Chimwemwe Mwale, Panic Chilufya, Dean Mwaanga, Wallen Simwaka, Kanyanta Katongo, Diana Zulu, Newton Sibanda,, Benedict Tembo, Paschalina Phiri, Mackson Wasamunu, Mwazipeza Chanda, Emelda Musonda and Peter Mwenda.

Catching up with Health News

The story behind the story from the Front Lines . . .

After a lengthy absence occasioned by winter/summer vacation and subsequent catching up, this September edition of Health Desk comes with a new feature: From the Front Lines.

Everyone involved in the communication of health matters has come across a story or issue that demands to be illuminated.

From the Front Lines gives readers of this newsletter the opportunity to do that. And for its debut, noted gynecologist Dr. Ameck Kamenga writes that reporters can help save lives by getting out word of Ministry of Health guidelines for safe abortion.

The Times Shows Range of Health Issues — and Reporting

Last Thursday the Times of Zambia showed some of the range that health reporting can encompass , looking at the effects of stigma, poverty and simple innovation on public health in three separate, thoughtful stories in one day – all set outside Lusaka.

A follow-up on the death of Linda Kabengele, a Mazabuka woman driven to suicide by her community’s respsonse to her HIV status . . .

Kabengele’s death Sept. 9 raised the obvious question of how widespread the stigma she lived with remains  in a country that grappling with an HIV prevalence of at least 14 percent  more than a quarter of a century into the epidemic. The story, by Chansa Mulalami, used a variety of sources to depict not on the misery of a woman who tried to end her life by lying in a highway, before succeeding by setting her clothes on fire, but the reasons for the stigma that isolated her, emphasizing the need for continued education that HIV is “not a death sentence warranting suicide or a life of reckless abandon.”

A feature on how efforts to diagnose and treat tuberculosis, particularly among those living with HIV are complicated by poverty and hunger  . . .

This story by Sylvester Mwale is refreshing because it goes beyond the good news we get from program announcements and ribbon cuttings and looks at how “unbearably long distances to nearest health centres, poor infrastructure, coupled with the problem of inadequate human resource to attend to patients has made TB management a major challenge in much of rural Zambia.”

And an answer to “wash your hands with soap and water” . . .

Finally, on the same day, a story by Gethesemane Mwizabi, looks at how difficult following the most basic preventive health measure of washing hands with soap and water when  one has to choose between buying a bucket of maize or a tablet of soap. One answer she explores in this article, which makes excellent use of sources and data, is the “Tippy tap” a water dispenser that can be set up near a latrine pit, and wood ash as a substitute for soap.

Will right to health be decided in courts?
This story in the Washington Post shows the future of health care here as everywhere depend as much on legislation and courts as on research advances and efforts to address poverty – which tend to get more publicity than this ongoing case unfolding here. The consequences of this case –  of two Zambia air force members who say they were tested for HIV without their consent and discharged from service because their results were positive –  beg for continued, in-depth local coverage.

Stories continue as Health Communication Partnership sums up work

The most powerful stories about health are not told in official statements but in the communities where people meet deadly diseases and conditions head-on. This basic truth was illustrated by Health Communication Partnership , as the organization, which has worked with the most underserved residents of the hardest to reach districts in all nine provinces for the last five years, summed up the impact of some of its work which has been supported by USAID with input from the Zambia Ministry of Health.

Among outcomes of  HCP’s collaborations with communities — more women seeking antenatal treatment, more children sleeping under bed nets, more men getting tested for the virus that leads to AIDS, as awareness of the value of these preventive measures spread.

The lesson here, apart from the obvious links between collaboration, traction and fortitude, is that messages about health concerns are best relayed by those affected by them, a reminder of why journalists must seize opportunities to tell their own country’s stories.

Some of those stories are waiting to be told, as HCP, a partnership of Johns Hopkins University Bloomberg School of Public Health’s Center for Communication Programs, Save the Children, and the International HIV/AIDS Alliance winds up its time here, hoping that a successor will continue to use the combined power of communication and community action to help Zambians address critical health issues.

For more information on the issues and impact of HCP’s work, call Uttara Bharath Kumar at 0977758673.

An Investment

In the interests of disclosure, HWZ had the privilege of being involved in the Zambia Daily Mail’s series on cancer that ran three days this week, beginning with Sunday’s installment above.

I bring it to your attention, though, to show what can happen when a media house supports in-depth health reporting, and staff members throw their energy and knowledge into turning that support into an opportunity to make things better.

Cancer, speeded by HIV and running rampant in countries without the resources to screen for it early enough for effective treatment is causing preventable deaths, and taxing overburdened health systems in the process. This growing threat is of particular importance now that funds pouring into addressing the HIV epidemic could simultaneously be strengthening delivery of basic health services.

That cancers that are considered among the most treatable if caught early are the top three cancer killers in Zambia deserves our attention, and this series should be only the beginning.

Credit for bringing a significant problem here to a prominent place in news coverage belongs to the management of the Daily Mail for supporting this project, and to staffers Charles Chisala, Benedict Tembo, Pauline Banda, Kelvin Chongo, Paschalina Phiri, Monica Mayuni, Ndubi Mvula, Boyd Phiri, John Ngoma, Panic Chilufya, Mwazipeza Chanda, Newton Sibanda, Peter Mwenda and Emelda Mwitwa.