Saturday, 13 November 2010

When free speech is a public health threat

Mozambique recently experienced (another) cholera outbreak. Soon after, rumours began to circulate about how the outbreak got started. This is not the first time this has happened. As in previous cases, health workers and community leaders supporting efforts to fight cholera were attacked by angry community members. 8 people were arrested in Mossuril District, Nampala Province, accused of being involved in spreading disinformation.


Cholera is a well-documented killer and one with which the authorities in Mozambique are all too familiar. Obviously, no-one wants it to spread. Health workers do important work and the country is trying hard to prevent deaths. Violence against people trying to help is terrible. If incitement to violence occurred in this case, it is clearly unacceptable. But what if there was no incitement, only misinformation? What are the implications of arresting people for questioning the facts presented to them by health officials and other government sources? Or INGOs for that matter?

Neighbouring South Africa not all that long ago became an international pariah when the president questioned the accepted wisdom of a clear, direct link between HIV and Aids, with reference to the correlation between poverty and HIV prevalence, particularly in South Africa. This shocked the world, and Mbeki has subsequently been held responsible by many activists and media personalities for the negligent homicides of 300 000 people. It could be argued, however, that Mbeki's stance was simply a more sophisticated, better argued example of the kind of questioning of scientific wisdom that was going on across the country (and probably the whole region) at the time. Anyone who has worked in HIV in South Africa is aware of the (often bizarre) myths and beliefs about HIV/AIDS: "AIDS is a story created by white people to stop black men having sex", "AIDS is a plot by the US government to kill black people in Africa", "you can cure AIDS by sleeping with a virgin/prayer/garlic, beetroot and African potato", "HIV transmission can be prevented by having a shower". The list goes on and on.

This misinformation has the potential to be very damaging. It is likely that these beliefs negatively affected HIV prevention efforts and that more people than otherwise would have, have contracted HIV as a result. Beliefs about curing AIDS are particularly damaging, particularly when they relate to violence against women and children and when they convince people to stop taking their medication in favour of bogus cures. Efforts have been and continue to be made in South Africa to discredit these false-hope cures but nothing is done to stop people spreading the myths and stories and false beliefs that are causing problems. Under South African law, it would be very difficult to take action against those telling others about these mistaken beliefs, particularly when these stories are spread by individuals, rather than via media outlets.

Cholera can kill, particularly in poor communities. With the correct information, however, it is relatively easily preventable. To what extent is right to question authorities - particularly important in not-all-that-free African countries - less important than the danger created by the existence of incorrect information?

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