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Address by Orlando Scott, Assistant General Secretary, Barbados Workers’ Union to 8th PAHO Annual Caribbean Media Awards For Excellence In Health Journalism, Grand Barbados, Friday, November 24, 2000

Distinguished members of the head table, ladies and gentlemen. I wish to thank Mrs. Veta Brown, Caribbean Program Coordinator of the Pan American Health Organization (PAHO) and her staff for inviting me to address this presentation ceremony - the 8th PAHO Annual Caribbean Media Awards for Excellence in Health Journalism. May I say that I am deeply honoured? I take this opportunity to congratulate most heartily those award-winning writers, and thank the co-sponsors, the Barbados Mutual Life Assurance Company, one of our outstanding corporate citizens.

We commend the PAHO for institutionalizing a Caribbean Media Awards for journalists. The competition is designed to encourage, among other objectives, the publication and the broadcast of material related to health and environmental issues in order to increase public awareness, and to recognize the contribution of journalists in placing such issues on the public agenda.

The PAHO’S initiative is praiseworthy from several points of view. One - the business of the PAHO is health promotion and Two – the mass media play the role of gatekeepers and are the most practical and efficient vehicles by which information can reach every level of our community.

This gathering is not a seminar on the power of the mass media, but it might be useful for us to spend a few moments assessing the functions of the media and what they can do to effect change.

The mass media have a number of broad functions assigned to them and these may include informing, educating, entertaining, as well as interpreting and analyzing events.

I grew up having a child-like assumption about the sanctity of the media, and like some Barbadians of my time, I, too, used to endorse any statement, which I had read in the newspapers or had heard on the radio. It was a John 3:16 sort of faith. Thankfully, I later grew to learn that opinion leaders have biases. So that in the latter half of the 1970s when I attended the Institute of Mass Communications, at Mona, my views often conflicted with those of a Professor who taught Principles of Communications. His opinion was that I ascribed more power to the mass media than they actually had. Notwithstanding his lectures, the persuasion of fellow students who were far brighter, and less argumentative, than I, as well as my reading of internationally respected communications’ scholars, I maintained my bull-like attitude regarding the power of the media. I had accepted that the theories surrounding selective perception, selective reception and people’s predisposition made much sense, but that did not dilute my belligerent and unrepentant position about the power of the media and their influences.

Let me share with you some of the reasons why I persisted with the view that the media had far stronger influences on society than my colleagues felt. As a child, I realized that those men and women, who were able to speak with authority about current events, gleaned from the then Advocate newspaper and/or the radio, were the people whom others appeared to respect and look up to. My observations may not have been based on accepted science, but they were, nonetheless, deeply held personal views.

I saw how positive and negative information played with people’s emotions. For example, as a small boy, I was amazed at the way in which men of my father’s generation sat glued to the battery-powered (private radios) as they listened to boxing matches, broadcast from the USA, in which two of boxing immortals, Joe Louis and Sugar Ray Robinson, were involved. My father and his friends saw Joe Louis as the embodiment of racial excellence and, at a time when the average wage earner could not purchase the daily newspaper, I sensed that they gave the same respect to the radio, the medium, which brought them the news.

In later years I observed how the addictive power of the television was able to substantially erode our cultural base and forever change the way we conducted our lives, from eating and dressing to recreation and even with regard to our morals.

I also saw how media “messengers” like Patrick Gollop creatively used the medium of radio to launch and sustain a particular brand of spirits. In current times, the Market Vendor lays out his tray every working day on VOB, and, occasionally is able to persuade his “friend Rommel” to get things done, for example, the repaving of the road, “Down by the Riverside”.

Should I, in order to give substance to my argument, show you how the mass media have helped in the Jah - maicanisation of Barbados and the rest of the Caribbean, using the addictive power of the mix of Rastafarianism and reggae music, preached by the High Priest Bob Marley and dished out to us, by radio and tapes?  What is more hypnotic than watching Bob Marley, in slow motion, on film, with guitar in hand and locks spreading in the air against a backdrop of mood altering stage lights and throbbing bass guitar? The media can be magic.

So, it is the creative fashioning of the message, using the appropriate messenger and medium to convince, along with the right timing, that cause people, first to listen, and then to change behaviour. I believe that the mass media, working purposefully with health officials, can help to refashion and reshape our attitudes towards our health, at work and at home. I do get the impression that, currently, when we focus on health, the average person thinks more about illness and death than on wellness; and the media, as I am suggesting, can help to change that outlook and image.

I have spent the last few moment trying to show you, that, notwithstanding what the purists may, or may not, say about the power of the mass media, the mass media do have very strong and subtle influences - influences that are sometimes compulsive. Why else would big business invest so many billions of dollars in advertising, marketing and public relations? Why else would politicians call newsrooms and fret if they believe that some unfavourable comment is made about them, their party or their programmes?

I believe that the PAHO understands the value of the mass media as an important agent of change and that it respects and values the contributions of the men and women whose role it is to provide that information.  PAHO believes that you, who write or broadcast for the mass media, can play a fundamental part in the change of governance by educating the community and keeping it abreast of the changes within society.

The PAHO has been in the forefront in health reform, in transforming the way in which Barbadians look at their health and their environment. While we congratulate this work, we also wish to commend the health NGOs, such as the Heart Foundation, Cancer Society, Diabetes’ Association, along with the long list of doctors and nurses, and other health officials, who have worked selflessly and untiringly, over the years, to educate us on health issues and generally improve the health status of Barbadians. The list is too long.

Barbados has achieved much in a very short period in the area of health promotion. When I joined the staff of the Daily News 35 years ago, community health was given a low rating by the press. As I recall it, the Mobile Cinema was the single medium that reached out to the masses. In those days it dealt with issues such as tuberculosis and other infectious diseases. On the other hand, I don’t recall any national advocacy by the medical profession, or generally, about chronic diseases. The general populace behaved as if chronic non-communicable diseases were part of the Bajan culture. We acted as if people were supposed to suffer from ailments. The great majority of Barbadians did not know that these diseases lifestyle-based. We therefore continued to pay slight attention to nutrition, ate poorly, drank and conducted our lives, in the way the previous generations did.

As one physician pointed out, we took better care of our cars than we did of our health, and erroneously believed that “genetic factors” were the primary factors determining our quality of life and how long we lived. This was so, particularly in the case of diabetes and high blood pressure. We figured, well, my parents have it– so I might get it, too. But life has to go on!

What many of us did not know, as Dr. Neil Medley states in the book “Proof Positive:  “for the vast majority of us, our health is primarily dependent on two factors: (1) what we put into our bodies, and (2) what we do with our bodies, which, in other words, reflect lifestyle. That is to say, we have control over our lives. That is a philosophy preached by the NATION newspaper and every Health NGO in the country; and it must be a position that the media, nationally, must promote among Barbadians.

But allow me to return to the sequence of the local mass media’s position in respect to health promotion. By the early 1970s, Ulric Rice, the then Sunday Editor of the Advocate, was ahead of his time. He began writing features on the environment, which he claimed he did for personal and selfish reasons. In his peculiar blunt style, Ulric said he wrote for improvements in the environment because he wanted to live in a Barbados that was clean enough to accommodate his wife, his daughter and himself. In 1987 the United Nations Environmental Programme (UNEP) recognized his work. In the early 1970s, I was working on the Advocate’s Features’ Desk and he assigned me to write a piece about beach erosion at Silver Sands. The renowned Barbadian scientist, Dr. Graham Gooding read the article, and during the following weeks he fed us with information regarding the environmental significance of areas like Glenburnie, St. John and Turner’s Hall Woods. The Sunday Advocate featured these articles in its magazine. I heard the word environment in the green context, for the first time, then.

Since then, we have seen a tremendous leap regarding the attitude of the mass media in Barbados to health and environmental matters. In recent years the Advocate has been publishing a weekly health page;  Sanka Price of The Nation newspaper is editing “Better Health”;  Terry Ally, is highlighting matters pertaining to the environment;  STARCOM Network is featuring Doctor on Call, Dentist on Call and Health in the Morning;  CBC Radio 900 is featuring Healthy Minds, Healthy Bodies;  and 790 Gospel Radio is promoting spiritual health. So the media in Barbados have come on board and have begun to do their part in health promotion.

Ten years ago, it was extremely difficult for the trade unions to convince the media to feature articles on occupational health and safety or the environment. Perhaps it was because of the general negative attitude the Fourth Estate to trade unions and their work. Not even the Nation, known for its vision, helped, much. It was my old boss, Robert Best, the young and open mind of Eric Smith, and latterly, Denzil Agard, of the Advocate who published, without censure, our articles on occupational health and safety and the environment. In fact Eric Smith always said that health reporting was sadly lacking in the local media and he insisted that I write these articles and bring them to his desk.  We also used the time allotted to the Barbados Workers’ Union’s radio programme, “Workers’ Viewpoint”, on Voice of Barbados and Star Radio, to promote the discipline, and it is at that point that I would wish to publicly say “a loud thank you” to the management and staff of STARCOM Network for their cooperation. I believe that those 15 minutes on Sunday evenings may have helped the cause of health promotion, to some degree.

So where are we now? What is the state of the workplace environment and the natural environment? What are the challenges?

Thirty years ago, most trade unions in the Caribbean region had a narrow view of occupational health and safety. They saw health and safety as primarily the acquiring from employers of hard hats, boots, goggles, facemasks, gloves, and the maintenance of ladders, floors, machinery and tools. Safety was the key issue because it was easier to deal with the things we could see, matters such as injuries, cuts bruises and falls. We took some time before we dealt with occupational diseases, and even longer time to grasp the significance of tackling public health issues. Notwithstanding, the fact that the Labour Movement was sufficiently visionary to lobby for the improvement of housing and other social services, it is clear to me that we did not always see health in a holistic sense. Yet, in these circumstances, we were in advance of our Social Partners, in the sense that, even now, some of employers cannot see the worker outside of the four walls of the workplace.

Today, at the start of the 21st century, and with the reality of economic globalization, which has brought with it, the rapid development of technology and communication, and issues such as contracting out, flexibility, and working hours, the average workplace is faced with tremendous occupational health and safety challenges that range from the traditional problems, to HIV/AIDS, indoor air quality, repetitive strains, mental health disorders and cardiovascular disease. So challenging is the matter, that the XV1th World Congress on Safety and Health at Work, scheduled for Vienna in 2002, will be dealing with themes associated with this issue, such as New technologies, New Patterns of Work Organization – New Challenges for Health at Work.

In the 1960s and 1970s, asbestosis, lung cancer and other diseases associated with heavy industry, construction and agriculture were the principal maladies, and amputations, falls, burns and poisonings, caused by exposure to agrochemicals and industrial chemicals, poor workplace maintenance in manufacturing, were the major causes of death, pain and suffering, around the globe.

By the 1980s, trade unions around the Globe came face-to-face with the immense challenge of HIV/AIDS and workplace issues such as indoor air pollution and sick building syndrome.

Ten years later, in the 1990s, because of the pressures caused by the fall out from trade liberalization and globalization, we found that anxiety disorders, as well as sub clinical fear, worry, and associated stress-related disorders such as insomnia, were pervasive and increasingly prevalent in workplaces – so much so, in fact, that the Wall Street Journal referred to the 1990s as the work-related “Age of Anxiety. According to the ILO, Corporate downsizing, threats to existing benefits, lay-offs, rumours of lay-offs, global competition, skill obsolescence and de-skilling, restructuring, re-engineering, acquisitions, mergers, and similar sources of organizational turmoil, have all been trends that have eroded workers’ sense of job security and have contributed to job anxiety. Along with HIV/AIDS, which continued to throw up more challenges, trade unions were now also forced to come to grips with new issues such as work place violence and repetitive strain injuries.

Additionally, there is the persistent problem of chronic non-communicable diseases, which are the leading afflictions that cause death in Barbados.

The uninitiated may ask what right have the mass media to be involved in the business of health promotion? The answer is simple. Apart from their noble intention of wishing to see a Barbados in which the quality of life of its citizens is at its highest level, accidents, disease and death are immensely costly, in financial and in human terms, to the individual, the enterprise and the state. And we believe that the mass media, because of the peculiar role they play of informing the public, must take the lead in pointing how and where the State and the community, at large, should go, with regard to community health promotion, particularly in respect of prevention.

I will now refer to a speech made by former Minister of Health Liz Thompson, who, taking the year 1995, as a point of departure, did an analysis of the statistics from the Queen Elizabeth Hospital that related to chronic non communicable diseases, ostensibly to show the terrible costs involved.

In 1995, 142 people suffered lower limb amputations as a result of diabetes. And of the 548 people who were admitted to the QEH suffering from that disease, 250 died.

762 were treated for cancer and 429 people died from that disease.

592 people suffered strokes and 343 people died from them.

Out of the 226 people who were admitted to hospital suffering from high blood pressure, 56 people died.

By far the greatest number of interventions was for heart disease. 1242 people were treated for the disease and 469 people died.

I cannot say to you know what percentage of those figures represent people who are in the workforce, because the statistics were not disaggregated to show us that. I can only assume, that the workforce represented a substantial percentage of that number. Whilst I cannot speak for the Ministry of Health, I believe the thrust behind the submission of those statistics was to show the tremendous costs associated with disease and suffering and the need for early detection, treatment and support.  Equally important is the issue raised by Ms. Thompson, which the mass media must impress on politicians, employers, labour unions, insurance companies and the general public. It is, that, associated with these diseases are other adverse impacts such as reduced productivity, loss of income, resultant inability to pay bills…And in the case of diabetes, there adverse effects like loss of vision, kidney ailments, sexual dysfunction, foot problems and occasional amputations, as you have heard …along with the financial and emotional costs to families.

Add to the above the fact that a substantial chunk of the national budget, our taxes, is allocated to the Ministry of Health – in 1995 it was 18% being allocated to the Ministry of Health and the Environment. The fact that 65% of QEH budget goes toward the treatment of the chronic diseases; and 60% of Barbados budget goes to treatment of the chronic diseases also show the tremendous costs of these maladies to the Bajan economy.

Bajans are peculiar when it comes to the revelation of their illness. As a consequence, we have traditionally treated diabetes and diabetics like discarded bedclothes. That is why I applaud the action of Sir Cliviston King, President of the Diabetes’ Association, who has boldly told the world:” I am diabetic”. I believe if more Bajans would come out of the closet of denial, speak about their disease, and seek to positively change their lifestyles, they, too, like Sir Cliviston, would lead a healthier life. In this regard the mass media should highlight the work of the Centre for Chronic Disease, and help to inform Bajans, in easily understood language how they may live with their illness.

I must state here, as a trade unionist, that, because some employers, supervisors and workers are unaware of the symptoms of those who suffer from diabetes, this lack of knowledge of the symptoms of these diseases result in industrial relations problems. For example, diabetics insist on eating on time, which, in a production push situation on the shop floor, may infuriate a supervisor, who is ignorant, and who may accuse a worker of stubbornness. These are all matters, which public education and information could solve.

While I cannot speak to any research that has been done in Barbados on workplace-related mental health disorders, at the international level, one of the tremendous challenges to labour is the growing number of workers who suffer from work-related mental ill health. But based on the number of workers who received counseling at our office, we do believe that it is a source of concern in Barbados. At the international level, a recently conducted ILO study of mental health policies and programmes affecting the workforces in five countries in the North Atlantic shows that the incidence of mental health problems is increasing, with as many as one (1) in ten (10) workers suffering from depression, anxiety, stress or burnout, which lead, in some cases, to unemployment and hospitalization.

Stress is emerging as the major mental health and occupational safety and health issue of the 21st century, and studies are showing that that the most common source of workplace stress is bullying, bossy and intimidating behaviour from employers. Recent studies in the UK estimate that up to 50% of workplace stress in Britain was caused by bullying behaviour. This aspect of psychological violence is one which is common in the Barbadian workforce and which must be stamped out.

In Barbados we were first confronted by the magnitude of repetitive strains when the Barbados Workers’ Union organized the workers, employed in the data processing sector, on the Harbour Road, in Bridgetown. New medical terms like carpal tunnel syndrome became the “buzz words”, and matters grew worse as industry, nationally, computerized their systems without giving adequate attention to training or the establishment of appropriate workstations. Musculoskeletal disorders are also a top health and safety issue in Europe and the USA.

Our statistics are reflecting that Barbadians are also suffering from strain injuries. In Barbados, it is estimated that the National Insurance Scheme disbursed, in 1999, some $10 million in injury benefits and associated costs and it is estimated that of that amount, some $5 million were paid out in back injury and associated costs. When we begin to disaggregate our statistics, we will better able to judge where we are with regard to musculoskeletal disorders.

My remit this evening is to suggest ways in which the mass media may assist in highlighting issues of health. In this regard, I am proposing that the mass media should play the role of “cooperating partners” of the Ministry of Health and those individuals and entities that are involved in the work of health promotion. The mass media must, however, be quick, always, to safeguard their professional integrity.  While the mass media may be referred to as the Fourth Estate, journalists should not play second fiddle to any professional. The mass media must at all times exercise the right of gatekeeper, be critical when necessary and be fair, always. The media cannot renege on their duty and sit on the sideline, or give exposure only to the traditional fare of reports and opinions of local party politics, courtroom news, and gossip, the comics and sports news. They cannot do this while the Government, the medical fraternity, the employers and trade unions struggle with the enormity of the HIV/AIDS pandemic, workplace violence, the pervasiveness of chronic diseases, and the growing trend of work-related mental health disorders which have, ostensibly, resulted from the downside of globalization and trade liberalization. This, therefore, calls for weekly-informed assessments of these issues and not the twaddle of the call-in programmes.

At the same time, I would wish to suggest that journalists cannot produce reliable information if they, themselves, are uninformed. And because we would wish to see the mass media helping our population to make proper lifestyle choices, I therefore recommend that a programme of training should be provided for journalists, especially those who are assigned to the health and environment desks of the various media, at the level of universities, attachments to PAHO/WHO, the ILO and UNEP, or wherever this training could be provided.

The media must also help to demystify medicine and use terms that my grandmother can understand. Why confuse me with terms like mortality, morbidity, when you mean I sick or dead.

I have refrained this evening from dealing merely with the four walls of the workplace and have sought to widen the scope of my discussion by looking at the wider community, based on the fact that the Barbadian workplace is no more than a microcosm and a reflection of the Barbadian society. The point I am making is that a diabetic or man with HIV/AIDS does not leave his illness at home when he reaches the factory gate or the office door. So any discussion on occupational health and safety has to analyze the whole man or woman. The media therefore have to turn their attention, not only to matters that affect the workplace, but also on our wider environment. In this regard, media practitioners must keep watch on not just what goes on in the factories, but also how what goes on in those factories impact the environment and communities that they border. As a consequence, mass media practitioners must deepen and widen their knowledge on questions of national concern, and must be able to carry information that reaches every facet of our society, especially to include excluded target groups such as – the boys on the block and young people who may be influenced by other forms of media. I say that especially as this relates to HIV/AIDS which is, among our biggest health challenges.  I had hoped to comment on that this evening, but time does not permit me to fully deal with that question, and I shall look at it at a future date.

Thankfully, the mass media have already begun to show that they are more than mere disseminators of information. Matters of national concern which the media might have by-passed at an earlier period, such as fish kills occasioned by factory pollution, and the dumping of wastes from manufacturing plants, are now highlighted fearlessly and with frequency. Moreover, the Nation newspaper’s annual Healthy Lifestyles Fair held in Queen’s Park, in the month of May, demonstrates expressively how the media have been constructively shaping the minds of Barbadians in the matter of health promotion.

On the plus side, the Ministry of Health, the PAHO, together with the current generation of medical practitioners, have been seeking to demystify medicine, and have shown a determined willingness to associate with individuals, institutions and organizations of repute who wish to participate in health promotion. Barbados has earned dividends from that approach. What we now need is a deeper partnership approach, which brings representatives of the mass media, employers and trade unions in non-sensitive policy meetings, at the level of the Ministry of Health, the Ministry of the Environment and the Ministry of Labour. Civil society cannot play its part with certainty if it’s uninformed and kept in the dark. The mass media cannot do its duty, competently, of informing and educating the public, if practicing journalists received all their news on an interview basis. Informed opinions will only result if the writer is knowledgeable.