HIV/AIDS IN THE SOUTH PACIFIC: A DIFFICULT STORY TO REPORT

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Reverend Dr. Trevor Cullen from Queensland University reports on some of the findings of his PhD research on press coverage of HIV/AIDS in Papua New Guinea and the South Pacific. He highlights several obstacles that editors face and suggests some possible solutions.

The adage ‘Why fix it if is not broken’ is closely linked to press coverage of HIV/AIDS in the South Pacific region. Some countries like Vanuatu have no recorded case while in other countries the figures for HIV/AIDS are so low they hardly warrant mention. So why all the fuss about HIV/AIDS especially from non-government organizations? Other illnesses such as malaria, diabetes and heart disease are more widespread and of immediate concern to the lives of people in the region. Besides, political and economic survival far outweighs consideration of a disease that is far removed and seemingly exaggerated in its importance.

Most editors remain unconvinced about the threat of AIDS.

Interviews conducted by the author from July 1999 to December 2000 with 25 newspaper and magazine editors in seven South Pacific countries (PNG, Fiji, Tonga, Samoa, New Caledonia, Tahiti and the Federated States of Micronesia) reveal that many editors are not convinced that HIV/AIDS is a serious public threat that can seriously damage the social and economic development of their respective countries. Up until December 2000 more than 75 per cent of the editors considered malaria to be a greater threat than HIV/AIDS.

For this reason the majority of editors were, for the most part, unwilling to lead public debate on HIV/AIDS for fear of exaggerating its presence and influence. This might explain the lack of front-page stories and editorial columns. None of the editors had an editorial policy on the disease, only 8 percent employed a health reporter and 16 percent had a health page. This is probably more indicative of the lack of ‘newsworthiness’ attributed to health issues in the South Pacific. Politics and sport remain the real ‘hot’ topics.

Only a few editors, touched by others who are living with HIV/AIDS, think differently and fear for the future. Some editors, however, interviewed by the author in 1999 and again in 2000 had, in the space of one year, shifted from a purely reactive approach - where waiting for information and stories became the norm - to a more pro-active stance with a strong determination to go out and get the story and preferably one with a human-interest angle. Many editors readily admitted their ignorance and lack of thought on the topic. Only 12 percent said they were satisfied with their knowledge of HIV/AIDS.

Every editor mentioned the lack of trained health reporters as a stumbling block for future coverage. Despite a general willingness to increase the educational content of news items, the editors, for the most part, remain unconvinced that a HIV/AIDS epidemic will eventuate because of the low numbers of HIV/AIDS cases.

Many editors may also be influenced by what Mayer (1968) refers to as the ‘quantitative view of importance.’ This lack of awareness and urgency among the majority of editors in the South Pacific region concerning the wider health, social and economic consequences of an HIV/AIDS epidemic needs to be addressed.

This ambivalence on the part of the editors towards an HIV/AIDS epidemic sits in stark contrast to the views expressed in 1996, by former Fijian Prime Minister Sitiveni Rabuka, who compared HIV/AIDS in the South Pacific to a dangerously powerful storm that was forming offshore. He made an urgent appeal for the media to protect people from its ferocity and harm by providing essential information and education about the disease.

The urgency of this task was underlined by the statement of the current PNG Prime Minister, Sir Mekere Morauta. Speaking in Port Moresby at the launch of World AIDS Day on 1 December 1999, Sir Mekere described the HIV/AIDS situation in the country as a " silent catastrophe." The Prime Minister warned that there were between 10,000 and 20, 000 HIV-positive individuals in a population of four and half million people and that the rate of HIV infection could be grossly underestimated because there were an estimated 10 cases of HIV positive individuals for every diagnosed case (Morauta, 1999).

Clement Malau, director of the PNG National AIDS Council Secretariat (NAC) insists the massive epidemic of HIV/AIDS in many Sub-Saharan African countries such as Zambia, Malawi and Zimbabwe - where HIV infection rates are as high as 25 percent in each country - could be repeated in PNG.

Given the current situation in PNG, we could go the same way as many Sub-Saharan African countries; we’ve got a large sex industry and uncontrolled sexually transmitted infections; we’ve got a very young sexually active population and we’ve got to a certain extent denial in some provinces. So given that sort of setting, I think that it’s not too much of an exaggerated statement to say that PNG could end up with extremely high infections rates as has happened in these Africa countries (Malau, 1999).

Describing the spread of HIV/AIDS in PNG, Peter Piot, executive head of the United Nations AIDS program (UNAIDS), predicts a potentially devastating outcome if decisive action is not taken to slow the spread of HIV/AIDS.

Although, it is difficult to predict precisely the future, the potential is definitely there and it will depend on how the country is going to respond to it that will determine the course of the epidemic (Piot, 1999).

The important influence of press coverage of HIV/AIDS in the South Pacific is dependent on editors deciding to keep HIV/AIDS in the public forum and by increasing editorial comments and allocating space for information/education new items so as to lead and inform debate on the issue. Further efforts are urgently needed to convince the editors that the HIV/AIDS epidemic in the region is in its infancy and that its real impact is yet to occur.

Inadequate And Outdated Reporting Patterns.

The author discovered that the pattern of reporting HIV/AIDS in the Western press (United States, Britain, France and Australia) closely resembled what Downs (1972) described as the ‘issue-attention cycle’ - the rise, peak and decline of interest by the media in a long-established health issue.

The cycle roughly covered a period of six-years from 1982-1988 and contained three distinct chronological stages. Initially a slow response that framed the disease as limited to certain risk groups, namely gays and drug addicts (1982-1985). This was followed by increased coverage with the acknowledgment of risk to the wider heterosexual population (1986-1987). Finally, there was a gradual decrease in the number of news items on HIV/AIDS (1989 onwards). The first stage of the cycle was characterized by the stereotyping of sufferers and their lifestyle. The second and third stages of press coverage were marked by sensationalism and complacency.

This proved to be an inadequate way to report HIV/AIDS especially since the increasing rate of HIV infections in a country like United States did not correspond to the type and frequency of news items. For example, by the end of 1989, there was a decline in the number of news items on HIV/AIDS in the U.S. press. This, however, coincided with a significant increase in HIV infections throughout the country.

Meanwhile, HIV/AIDS came late to the South Pacific. However, research has shown that the press in the largest country in the region, Papua New Guinea, repeated (during the 1990s) the trends and mistakes found in the reporting of HIV/AIDS in the Western press during the 1980s (Cullen, 2000).

Findings from a 12-year quantitative content analysis of all news items on HIV/AIDS in the PNG press from 1987-1999 reveal that the press followed the ‘issue-attention cycle’ when reporting HIV/AIDS but with variations in timing and emphasis. For example, in the early 1990s the Post-Courier, PNG’s oldest and largest selling newspaper, concentrated more on HIV/AIDS in other countries than within PNG. This early emphasis that targeted foreigners as the main carriers of the virus, was not repeated by the other three PNG English newspapers, The National, The Independent and The Eastern Star which framed HIV/AIDS primarily as a local rather than a foreign news item. With the gradual realization that HIV/AIDS was spreading widely throughout the country, there was a significant increase in local news items in both The National and Post-Courier from January 1998 until June 1999. However, fewer news items appeared in these two newspapers from July 1999 until December 1999. It is uncertain if this is the beginning of a temporary or permanent decline.

HIV/AIDS Does Not Fit Existing ‘News Values’

The evident limitations of the ‘issue-attention cycle’ used by both the Western and PNG press exposes a deeper issue in relation to the reporting of HIV/AIDS. Traditional news values made it difficult for editors to view HIV/AIDS as a consistently newsworthy topic. Criteria for selecting news include aspects of sensation, conflict, mystery, celebrity, deviance, tragedy and proximity. While news items on HIV/AIDS fit some of these categories, it is a disease that has been reported by newspapers since the early 1980s. This makes it difficult to present the disease in a constantly new and interesting way. What is needed, therefore, is a new model and news value when evaluating the newsworthiness of HIV/AIDS. Without a new approach that includes additional news values such as ‘emergency public health threat’ the Western and PNG press will be handcuffed to the ‘issue-attention cycle’

HIV/AIDS, however, received substantial press coverage in PNG when compared with other illnesses such as malaria and heart disease. Yet, only a few news items referred to people who had died of the disease and this, together with the failure to put a human face of the problem, framed HIV/AIDS as more of a distant theoretical disease rather than an immediate and serious health threat. This finding matched Kasoma’s (1990 and 1996) research on press coverage of HIV/AIDS in Zambia and Pitts and Jackson’s (1993) research on the same topic in Zimbabwe.

Cultural Taboos And Traditions.

Talking about sex or reporting someone living or dying of AIDS in the South Pacific are issues that local journalists prefer to avoid due to cultural pressures. Also, Christian and traditional beliefs in the Pacific region influence public perception and understanding of HIV/AIDS. The majority of editors interviewed by the author were hesitant to discuss these issues and this made it difficult to determine the extent of cultural influences upon editors and journalists in their approach to HIV/AIDS. However, newspaper editors in the French overseas territories of Tahiti and New Caledonia were not embarrassed to use phrases like ‘condom’ and ‘sexual intercourse’ in press reports on HIV/AIDS. This was not the case in countries like Samoa and Fiji that had lived under former British colonial rule. Further research is required to examine cultural differences and obstacles when reporting on HIV/AIDS in the South Pacific. This has important ramifications for the design and implementation of future awareness campaigns in the region.

While cultural taboos remain a major obstacle to reporting HIV/AIDS, it is not an impossible to overcome some of these barriers. The press is well placed to influence public perception of a problem especially removing the silence and stigma attached to the disease. For example, avoid headlines and news items that constantly describe HIV/AIDS as a killer disease with no cure. Inevitably, this creates a sense of hopelessness. Instead, include more positives news items about ways to prevent infection and people living rather than dying with HIV/AIDS. This demands creativity and determination.

Understandably, editors and journalists avoid using their publications for HIV/AIDS advocacy work. They can, however, adopt a more pro-active journalistic approach by going out to get the story instead of merely waiting to comment on government press releases. In this way it is possible to challenge policy decision makers to act now before the HIV/AIDS tidal waves hits shore with its intense ferocity. For example get the Prime Minister and other politicians to comment frequently on the issue. What are they doing about a disease that has the potential to seriously damage the social and economic growth of their country and constituencies? What financial and other resources will they make available? What about the availability of medicines? These are basic questions that need to be asked and answered.

Need For Clearer Information and Educational Messages.

A two-year qualitative content analysis of HIV/AIDS news items in PNG’s two largest selling daily newspapers, The National and Post-Courier from January 1998 to December - 1999 showed what Singer and Endreny (1987) had discovered about press coverage of health issues in Britain: that the media do not report ‘risks’ and ways to prevent contracting illness. Instead, they prefer to concentrate on the harmful effects of diseases such as long-term suffering. The findings from the author’s research show strong agreement with this hypothesis. Twenty-six percent of news items on the harmful effects of HIV/AIDS appeared in The National and Post Courier in 1998 and more than 20 percent in 1999. In contrast, there were no news items on risk behavior and ways to prevent HIV infection in 1998 and only five percent of news items reported risks in 1999.

Greater emphasis on ‘harms’ rather than ‘risks’ in the PNG press portrayed a sense of helplessness that there was nothing that could contain the spread of the disease. The inclusion of MI - news items about how to avoid being infected by a contagious virus like HIV - adds a sense of balance by encouraging participation and hope. The inclusion of MI, however, is closely linked to the educational role of the press, which editors agree about in theory but often fail to implement in practice. Currently, coverage of World AIDS Day on 1 December has become a popular slot for inserting news items on MI. But is this common practice sufficient, considering the increasing spread of the epidemic? Although it is difficult to calculate the influence of MI on behavioral patterns, its omission removes vital information for challenging risk behaviors.

Less emphasis should be placed on sensational language, headlines and military metaphors which tend to exaggerate and distort the reality of HIV/AIDS. Recommendations from a three-day workshop for editors and journalists in PNG on HIV/AIDS (Port Moresby 29 May - 31 May 2000) stressed the need to avoid an over-concentration on facts and figures and to include more news items on care and compassion. Other recommendations from the workshop included a commitment by the editors to increase coverage of the disease, especially editorial comments and the inclusion of more feature and news items on MI.

Racial Approaches To HIV/AIDS In The South Pacific.

The three main racial groups in the South Pacific (Melanesian, Polynesian and Micronesian) did not, from the interviews; result in any significant difference among the editors in their approach to HIV/AIDS. Newspaper editors, however, in New Caledonia and Tahiti were exposed to a very different experience compared to their counterparts in PNG, Fiji, Tonga and Micronesia. These editors had the advantage of early exposure to information on HIV/AIDS through French television coverage of the disease, which had peaked by 1991. Press coverage of HIV/AIDS in these two French overseas territories followed a similar trend with news items beginning to decline after 1991. While editors interviewed by the author in New Caledonia and Tahiti claim that initially, French television awareness campaigns had a significant impact on people’s attitudes towards the disease, further research is needed to assess the long-term effects of such coverage on attitude and behavioral change.

The Need For Health Reporters

Research on press coverage of HIV/AIDS in PNG (Cullen, 2000) revealed that from 1996, the only full-time health reporter in PNG who worked at The National and the only newspaper with a health page, The Independent, did make a difference in terms of the number of news items on health and in particular on HIV/AIDS. The lack of trained health reporters was consistently mentioned by the editors in the South Pacific as an obstacle to improving and extending coverage of HIV/AIDS. During 1998-1999, the author participated in some UN-sponsored workshops for journalists in the South Pacific, which tried to improve health reporting in the region. There is need for more short and long-term courses on health reporting and the promotion of health as an important topic of concern throughout the South Pacific.

Conclusion

Everyone in society needs to play their part in tackling the emerging HIV/AIDS epidemic in the South Pacific region. Editors, in particular, have enormous influence and can make a difference. They decide what news items are to be included or omitted from their publications, which these stories are frequently spotted and used by radio and television news editors. Moreover, they can help challenge public opinion on HIV/AIDS that is often based on ignorance, fear and prejudice. This in turn creates both stigma and results in a deafening silence on the issue. Due to its long shelf life and the ‘gloom and doom’ factor associated with HIV/AIDS, stories on the disease are frequently restricted to official government figures, workshops overseas donations and the excellent work of local volunteers.

While a number of editors in PNG and the South Pacific should be highly commended for the way they have responded to the threat of HIV in their countries, the time has come to step up coverage and allocate more space for information about prevention and to embarrass government officials into greater action. This is extremely difficult because of cultural sensitivities and financial sponsorship. But it is not impossible and will contribute hugely to a current information campaign that often sounds more like a squeaky tin whistle than a loud and continuous trumpet blast. It is time to lead from the front.

Rev. Dr. Trevor Cullen Journalism Department, Queensland University Brisbane, 4072, Australia Email: balaka@serv.net.au 

References

Cullen. T (2000), "Press Coverage of HIV/AIDS in Papua New Guinea and the South Pacific." Doctoral Thesis. Journalism Department, Queensland University.

Sitiveni Rabuka (1996), Former Fijian Prime Minister. Reported in the Pacific Islands Monthly, May 1996, page 18.

Piot Peter (1999) Executive chief of the United Nations Global Programme on HIV/AIDS (UNAIDS). Interview by the author in Kuala Lumpur, 24 October, 1999.

AIDS Update: December 2000. Published by UNAIDS/WHO, Geneva.

 

Bibliography

Cullen, Trevor. (2000), "Reporting health in the Pacific." Pacific Journalism Review 6 (1): 73 - 76.

Cullen, Trevor (2000), Repeating Past Mistakes: Press Coverage of IV/AIDS in Papua New Guinea and the South Pacific. Journalism Department. Queensland University.

Kolma, Frank (1999) editor, The National. Interview in Port Moresby, PNG, 20 May.

Koss, Michael, and James Carson, (1988) "The effectiveness of AIDS information: A National study of six media in Australia." New York State Journal of Medicine, 24 (2): 239 -245.

Kristiansen, Christina and Connie Harding. (1984),"Mobilisation of health behaviour by the press in Britain." Journalism Quarterly, 61(2): 364-370.

UNAIDS (1996), Time To Act: The Pacific Response to AIDS. UNAIDS, Suva, Fiji.

UNAIDS (1999). AIDS Epidemic Update: December 1999.

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