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April 2020 | Vol. 1 Issue. 10

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EXPLORING HEALTH COMMUNICATION: CASE OF LESOTHO

IN THE FACE OF THE COVID19 PANDEMIC
Eva Mukurunge 1, Tawanda Mukurunge 2, Takura Bhila 3
1ParaySchool of Nursing, maseru, Lesotho
2Limkokwing University of Creative Technology, maseru, Lesotho
3Limkokwing University of Creative Technology, maseru, Lesotho

ABSTRACT
Health communication is a challenge for third world countries under normal circumstances and can
be the disaster in emergency situations. Lesotho, like her neighbours and compatriots on the African
continent, watched the initial unfolding of the COVID-19 pandemic like it was an outbreak ravaging
some other planet remote from mother earth. This study is therefore going to explore the best
communication methods in times of health crisis in Lesotho. The focus of the study is going to be on
how best to execute communications timeously and without causing chaos, confusion, and without
withholding crucial information to the nation. The study is going to carry out interviews with
communications students, communications professionals and lecturers, as well as with health
providers in Lesotho to establish their perspectives on how best to communicate health crisis situations
in the country. Findings are going to be presented and analysed thematically.
Keyword: health communication, disaster, pandemic, COVID-19, outbreak
1. INTRODUCTION the country. Findings were presented and
analysed qualitatively.
Communication of health related issues should be
given utmost importance by authorities of any 2. BACKGROUND OF STUDY
country as disaster can be averted and lives saved
if the communications are executed well and on At the outbreak of the COVID-19 pandemic, the
time. Health authorities should be strategic in World Health Organization and governments of
times of health crises such as disease outbreaks in developed economies took this health disaster
order to contain situations that can cause seriously and went into over drive disseminating
confusion and chaos. It is particularly important in all requisite information about the virus. However,
the social media era where any citizen can be a this did not seem to be the case with Lesotho
producer and disseminator of news content which looking at the case of how the COVID-19 pandemic
can prove to be disastrous through the spread of was communicated by the authorities in the
fake news therefore causing panic. This study country. The ministry of health took time to make
explored how best to communicate pandemic any official announcements and when the minister
situations in the context of Lesotho in the face of of health made a statement, only on the 18th of
the Coronavirus (COVID-19) pandemic. The study March, it was immediately contradicted by the
looked at how the Lesotho authorities have been prime minister on the same day. The minister
handling the situation since the initial announced that the situation in Lesotho was
announcement of the outbreak of COVID-19 in under control and that the nation ought to stay
China in November 2019 by global media outlets. calm. A few hours later of the same day, the prime
The study carried out the exploration of how best minister went on national television to announce
Lesotho should communicate this disaster that the country was regarding the situation to be
through interviews of health professionals and dire and appealed to the nation to take the
communication specialists. The study is pandemic seriously. He went on to officially order
qualitative in nature as the focus was on the closure of all schools from 20 March till 20
answering how best to handle the situation April 2020. This was after the minister of Home
through communications by health authorities in Affairs had announced in an interview that
Lesotho was safe from the virus and that to
international visitors, Lesotho was a safe travel

IJARW1165 International Journal of All Research Writings 20


destination. This was despite the fact that South
Africa and other countries were closing their
borders to international visitors; placing their
countries under lockdown.
Lesotho was not adequately prepared to combat
the pandemic starting with detection of the virus
itself. For instance, a visitor of note came to
Lesotho, conducted business with the Central
Bank of Lesotho and went back to her country
only to test positive of COVID-19 and be
quarantined there. It was only after that incident
that the authorities in Lesotho started taking
action: screening the personnel who were in
contact with the lady at the central bank and
placing them in quarantine. Such information got
to the nation through the social media grapevine
and caused some trepidation in some sections of
society.
All this while the authorities in Lesotho were quiet
about the pandemic, citizens were either
wallowing in innocent ignorance or gobbling up all
the information they came across on social media
platforms; exaggerations, myths, misinformation,
outright lies and all; leading to total confusion of
the masses.
3. STATEMENT OF PROBLEM
Health communication is handled more in the
realm of reaction rather than as something to be
executed from a proactive angle in societies such
as Lesotho. Rumour serves as a forerunner to
sensitise citizens, and government and ministry
spokes personnel react to thwart rumours and
misinformation rather than being proactive in
informing citizens in forewarning and
empowering citizens with information on
preventive measures in the face of disease
outbreaks. In most cases, it will be too late for
hapless poorer sections of society who are always
at the receiving end of such disasters.
4. STUDY AIM
The study goal is to establish the best way to
inform society on the causes and effects of COVID-
19 timeously and truthfully so that they are
empowered enough to combat the spread and
effects of the pandemic in Lesotho.
5. THEORETICAL FRAMEWORK
The study is framed and informed by the magic
bullet theory of communication; its merits in crisis
communication that requires immediate
IJARW1165 International Journal of All Research Writings
© IJARW | ISSN (O) - 2582-1008
April 2020 | Vol. 1 Issue. 10
www.ijarw.com
responses to official dissemination of information
by communities. The magic bullet/hypodermic
needle theory was introduced by Harold Lasswell
in the 1920s. The theory, Wroblewski writes
(2018), assumes that the media create messages
with a specific purpose- that is, to elicit a specific
response. People react in the same manner to a
message. The effects of the media’s “bullets” or
“syringes” are immediate and powerful, often
resulting in swift behavioural changes. This is a
theory that can best inform the formulation of a
communication model by Lesotho authorities that
can facilitate quick dissemination and quick
responses to health communications in dire
situations such as the outbreak of the COVID-19
pandemic.
6. LITERATURE REVIEW
Health communication is defined by Feeley and
Chen (2013) citing the U.S. Department of health
and Human Services (2000) as the art and
technique of informing, influencing, and
motivating individual, institutional, and public
audiences about important health issues. The crux
of health communication is to disseminate
information on disease prevention, health
promotion, health care policy, and the essentials
of health care and enhancement of the quality of
life and health of individuals within communities.
Health communication is crucial in disease
prevention. Rimal and Lapinski (2015) say that
communication is the core of who we are as
human beings as it, apart from being our way of
exchanging information, signifies our symbolic
capability. In relation to the transmission view,
which this study perceives as the best suited for
the communication of COVID-19 information to
Basotho in the 2020 health crisis, Rimal and
Lapinski emphasise that careful thought ought to
be invested into the channels through which
intervention messages are disseminated, to whom
the message is attributed, how audience members
respond and the features of messages that have
the greatest impact.
In multilayered African societies, marked by
linguistic, socio-economic, and cultural diversity,
health communication messages have to take into
account the possible different ways in which
messages will be interpreted and understood
within given contexts (Lagerwerf, Boer and
Wasserman, 2009) caution. They also add that
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‘one-size-fits-all’ messages may not reach all of
the diverse societal groups adequately.
In the context of Lesotho, it would be ideal for a
variety of approaches to be utilised at different
levels in order to communicate COVID-19 related
information adequately. Lagerwerf et al (2009)
suggest that the communication strategy should
include research at the individual, community, and
societal level. Individual psychological
approaches, mass media campaigns, and group-
based communal activities may go hand in hand
and reinforce each other, Lagerwerf et al say.
The World Health Organization (2020) writes that
on 30 December 2019, three bronchoalveolar
lavage samples were collected from a patient with
pneumonia of unknown etiology – a surveillance
definition established following the SARS
outbreak of 2002-2003 – in Wuhan Jinyintan
Hospital. Real-time PCR (RT-PCR) assays on these
samples were positive for pan-Betacoronavirus.
Using Illumina and nanopore sequencing, the
whole genome sequences of the virus were
acquired. Bioinformatic analyses indicated that
the virus had features typical of the coronavirus
family and belonged to the Betacoronavirus 2B
lineage. Alignment of the full-length genome
sequence of the COVID-19 virus and other
available genomes of Betacoronavirus showed the
closest relationship was with the bat SARS-like
coronavirus strain BatCov RaTG13, identity 96%
(WHO, 2020).
7.METHODOLOGY
The study sought to establish perceptions of
health and communications specialists on the way
the government of Lesotho communicated the
COVID-19 related information to the nation in a
bid to combat the pandemic. Qualitative methods
for gathering, presentation and analysis of the
findings were therefore used. For this study,
qualitative research was adopted because it takes
place in the natural setting, is interactive,
humanistic and fundamentally interpretive
(Cresswell, 2007). The researchers carried out
interviews telephonically with different sources
with WhatsApp being used primarily for the
interviews. Convenience sampling was used to
select interviews. Etikan, Musa and Alkassim
(2015) explain that convenience sampling is a
type of nonprobability or non-random sampling
where members of the target population that meet
certain practical criteria, such as easy accessibility,
IJARW1165 International Journal of All Research Writings
© IJARW | ISSN (O) - 2582-1008
April 2020 | Vol. 1 Issue. 10
www.ijarw.com
geographical proximity, availability at a given
time, or the willingness to participate are included
for the purpose of the study. The sample was ten
media students, ten lecturers and communication
professionals, and ten health professionals. The
health professionals were from the ten districts of
Lesotho with the communications professionals,
lecturers and students from Maseru and the
districts. This was done in an effort to get opinions
on the government communications’ effectiveness
on a nationwide scale.
8.FINDINGS
8.1. From journalism students
Journalism students opined that communication
in Lesotho is complex and has failed in many
instances due to what appears to be lack of a clear
communication policy and strategy by the
government. One student said that the focus of the
government when it comes to communications
that are meant to address the whole nation seem
to be confined to Maseru city only. The example
that the student cited is that of the prime
minister’s address to the nation concerning the
perilous danger that the nation faced from the
COVID-19 pandemic. The prime minister
addressed the nation on Lesotho Television whose
coverage is minimal as it does not reach all of the
country’s ten districts. The students were
unanimous in that the address by the prime
minister was too long in coming because a lot of
human traffic had long been transiting in and out
of Lesotho unchecked and considering lack of
proper equipment for screening of the virus in the
country, the nation could already be infected at
rates the health authorities might not have the
slightest idea about.
The students expressed shock at the minister of
tourism, Joang Molapo’s announcement that
Lesotho was a safe tourism destination in mid
March 2020 when other countries, including
South Africa, were preparing for lockdown or
were already in that state. They said it was
evidence of a government devoid of a clear
communication strategy on informing and
educating society of the dire threat of the virus.
One student went on to say Nkaku Kabi, minister
of health, tried to do damage control after the
Joang Molapo communication showing further
evidence of a government totally unaware of the
depth of the danger of the virus to society at large.
It was only the prime minister who at least gave
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the nation some assurance by saying the virus had
the potential to wipe out the whole population if
not taken seriously and prepared the nation for
lockdown by announcing closure of institutions of
learning for four weeks.
8.2. From communications lecturers
One communications lecturer said that the
government was not doing enough to combat the
COVID-19 pandemic. He gave the example of laxity
with which the screening process of travellers
entering Lesotho from the Republic of South Africa
was done. The same lecturer went on to say rural
communities were poorly informed about the
pandemic and that some government officials
were making jokes about it all. The lecturer also
observed that the communications about the virus
from the ministers of tourism and health as well
as by the prime minister betrayed evidence that
they all were not well informed about how the
virus was spread as well as how one could avoid
getting contaminated. The lecturer urged the
ministry of health to send health workers to
different villages to inform communities about the
virus. He opined that relying on the media alone
for information dissemination was not enough as
interpersonal communication can be more
effective in the context of remote rural Lesotho.
He also proposed the involvement of social
institutions such as churches in playing a part in
promoting awareness of the virus.
Another communications lecturer suggested that
the government should identify and make use of
opinion leaders, educate them on the virus in
different communities and work with them to
disseminate information about the virus. Health
specialists can also be tasked to go into
communities and educate citizens on what the
virus is, how it is spread and how to minimise the
spread. Flyers with information can be distributed
on public transport and word of mouth can be
utilised at taxi ranks. Social marketing can be used
by government ministries working with partners
in the private sector and the civil society to
educate society about the virus.
8.3. From communication professionals
A communications professional from the private
sector opined that even though the government of
Lesotho made a declaration through the statement
issued by the prime minister and the ministry of
health on the fight against the spread of COVID-19
and declared a state of emergency, it was
IJARW1165 International Journal of All Research Writings
© IJARW | ISSN (O) - 2582-1008
April 2020 | Vol. 1 Issue. 10
www.ijarw.com
unfortunate that nothing was done to enforce all
the suggested precautionary measures. It was also
unfortunate that the government took its time to
declare the fight against the virus. The
communicator went on to say that two weeks
prior to the statement by the prime minister,
opposition parliamentarians had called for the
suspension of all parliamentary business so as to
launch a sustained campaign against the virus but
the deputy speaker of parliament shot down the
idea. He went on to say lack of informative and
educative communications on the virus leaves
citizens with no choice apart from reliance on
social media for crucial information about the
virus. He also pointed out that no efforts were
made to train journalists on proper ways of
information dissemination and that health centres
and their personnel were unfortunately not well
informed about the virus. The communicator also
said that the mixed views aired by cabinet
ministers were a clear indication that the country
was not ready to fight the virus. He suggested that
the government should have set aside an
emergency budget for the following as a
precautionary measure: (i) all requisite
equipment for health personnel, (ii) provision of
free medical and hygiene equipment for
communities, (iii) embarking on information
dissemination workshops for the media and Non
Government Organizations, (iv) use of all media
platforms for educational purposes to empower
citizens with all the knowledge on how to take
care of themselves in the face of the pandemic, (v)
enforcement of all proposed changes on social
interaction through the engagement of law
enforcement agencies, (vi) setting up a local
national testing centre and laboratory rather than
relying a hundred percent on the Republic of
South Africa.
One journalist however said that the government
of Lesotho was doing enough communication in
the face of the pandemic considering that this was
the first time the authorities were dealing with
such a phenomenon. She said a number of press
conferences have been held and that the
government collaborated with Econet (one of the
country’s two mobile phone network providers)
where people could send COVID19 and they would
receive latest updates about the virus. She went
on to say the response by the government was
timely because any earlier pronouncements on the
way forward could have caused unnecessary panic
considering that not even a single case had been
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reported in Lesotho by the 18th of March. She also
expressed that she felt minister Molapo was
misinterpreted. She however went on to say more
of the government’s work should be on
preparations for places of quarantine and
construction of more hospitals in the event that
cases started breaking out in Lesotho.
Another journalist said there is no coordinated
communication within government and that
ministries are giving diverse versions on the
covid-19 situation because of that. She went on to
say parliament should not have closed but rather
should have been the centre for the coordinated
fight against the pandemic. She said Lesotho had
not reported any cases of infections up to the 23rd
of March simply because screenings were not
done not because cases did not exist. She said the
nation was sitting on a time bomb due to
ignorance and lack of capacity to carry out tests,
no provision of sanitizers especially in public
service complexes where business went on as
usual.
8.4. From health professionals
Health professionals pointed out that the
government announced the closure of institutions
of learning including nurse training schools which
was a mistake. They suggest that student nurses
should have been roped in to assist in the fight
against the virus by going into communities to
educate citizens on hygiene and methods on how
to combat the virus. Instead the students were
sent home and the message by the government
seems to mean in the face of danger, health
practitioners should run for cover.
One hospital superintendent with one of the
district hospitals said he observed that there was
a marked decrease in the number of patients
visiting his hospital since the outbreak of the
COVID-19 virus. He attributed that to the rumours
that patients were being screened for the virus
and if positive, they would be isolated away from
home after being placed in quarantine.
9. ANALYSIS
From the findings above, evidently, the
government of Lesotho did not communicate the
COVID-19 threat to the nation properly. Pandemic
times should be met with aggressive
communication strategies by those in power
without dilly dallying and dithering on whether
the pandemic will reach our shores or not. It is
IJARW1165 International Journal of All Research Writings
© IJARW | ISSN (O) - 2582-1008
April 2020 | Vol. 1 Issue. 10
www.ijarw.com
better to err on the side of caution rather than
reacting inadequately when it will be too late
already as was witnessed with the case of Italy.
Many communicators observed that it looked like
the government of Lesotho was playing a wait and
see game. It is very dangerous. They could have
started rolling out information campaigns to
sensitise society at large by bombarding the
nation with all relevant information from
education on the nature of the virus, how it
spreads, its symptoms, and how to avoid it
coupled with practically enforcing people to stay
at home and prevent public gatherings. The
government of Lesotho should have set up a
sustained e-health platform: defined by the World
Health Organization (WHO) as “the combined use
of electronic communication and information
technology in the health sector” (Zimbabwe
Ministry of Health and Child Welfare, 2010). This
platform could have been used for dissemination
of the official government position on the COVID-
19 pandemic that all government officials,
including the two ministers and prime minister
criticised by interviewees for this study for lack of
knowledge, and health officials could have tapped
into in order to inform society correctly. The
government, through the ministry of health,
should be more alert and engage society through
timeous and transparent communications
restricted to just either government or ministry of
health spokespersons only because letting every
other government minister to address the media
may lead to controversial statements that will
confuse the nation. A variety of nonstop
information dissemination methods could be
harnessed beyond modern and post modern
media by augmentation with traditional methods
such as orature for communicating the virus to far
flung mountain communities who are always at
the periphery of Lesotho society. These are the
communities who do not have access to
newspapers, radio, television and the Internet and
therefore cannot benefit from government press
statements or the Econet free dial in platform.
10. CONCLUSION
The study established that health
communication’s focus is on educating and
informing society on health related issues. The
study also informs that the best communication
theory to inform strategy for communicating
disease outbreaks of the magnitude of COVID-19
by societies like Lesotho is the magic
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 © IJARW | ISSN (O) - 2582-1008
April 2020 | Vol. 1 Issue. 10
www.ijarw.com

bullet/hypodermic needle theory in order to [3] Feeley, T. H. & Chen, Y. 2013. An

channel out as much useful information to the introduction to health communication
whole country as fast as possible. The study [4] Lagerwerf, L., Boer, H. & Wasserman, H.
established that the Lesotho government did not (eds). 2009. Health communication in
have any clear cut communication strategy in the southern Africa: engaging with social and
face of the pandemic and that confusing and cultural diversity. Rosenberg
incoherent communications emanated from the Publishers/UNISA Press.
government which did not help to properly inform [5] Ministry of Health and Child Welfare.
society about the pandemic. 2010. Zimbabwe’s E- Health Strategy
2012- 2017
11. RECOMMENDATIONS [6] Rimal, R. N. & Lapinski, M. K. 2015. Why
➢ The study recommends that the Lesotho health communication is important in
government through the ministry of health in public health. Bulletin of the World Health
the face of the COVID-19 pandemic should roll Organization
out a communication campaign aggressively [7] World Health Organization (2020) Report
on all media platforms: mainstream of the WHO-China Joint Mission on
(television, radio and newspapers), social Coronavirus Disease 2019 (COVID-19)
media (whatsapp, facebook, twitter, etc) and [8] Wroblewski, M. T. (2018). What is the
by distribution of flyers, stickers, billboards, magic bullet theory of mass media.
on t-shirts, hats all over the country. Jingles Smallbusiness.chron.com
could be used for playing on all radio stations
and on television on regular intervals
emphasizing cleanliness and measures to be
taken to stop the spread repeatedly.
➢ The study also recommends the use of door to
door campaigns by health workers teaching
citizens about the virus; that is what it is, its
symptoms, how it is spread, how to minimise
its spread and what to do when suspected
cases are encountered.
➢ Music and poetry competitions could be
sponsored for diverse communities in order to
spread important messages.
➢ Rural communities to be targeted by health
personnel through distribution of flyers from
the air, door to door campaigns by health
personnel on horseback or with cars with
public address systems blasting the messages
to the citizens day and night for a sustained
period.
REFERENCES
[1] Cresswell, J. M. 2007. Qualitative inquiry &
research design: choosing among five
approaches. SAGE Publications.
[2] Etikan, I., Musa, S. A., & Alkassim, R. S.
2015. Comparison of convenience
sampling and purposive sampling.
American Journal of Theoretical and
Applied Statistics.

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