An assignment on

Health Communication in the flood prone area: Pirgachha Upazila

COURSE: Disaster, Media and Risk Communication CODE: DMC-303

SUBMITTED TO

Md. Juel Mia

Assistant Professor

Institute of Disaster Management and Vulnerability Studies (IDMVS)

University of Dhaka

SUBMITTED BY

MD. SHEFAT RUHANE SHUVO (Roll No. 41)

SHAQUIF IBRAHIM RAHMAN (Roll No. 38)

Bachelor of Disaster Management

Institute of Disaster Management and Vulnerability Studies (IDMVS)

University of Dhaka

Date of Submission: 19th January, 2023

 ABSTRACT

Health communication, in the present world, is an emerging phenomenon about the proper
healthcare facilities to the vulnerable and marginalized community. It will help us to understand
about what are the 'must do' works in case of any health related issues. Due to this, rural
community will be benefitted a lot. Presently, a large number of poor people are still unaware of
the proper health facilities and where to obtain them. This study will enable us to know what the
requirements are for health communication and how we can enhance this procedure.

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 Table of Contents

CHAPTER 01: INTRODUCTION 3

1.1 Background of the study 4
1.2 Objectives of the Study 5
1.3 Research Questions 5
CHAPTER 02: LITERATURE REVIEW 5
CHAPTER 3: FLOOD AND HEALTH 7
CHAPTER 04: METHODOLOGY 8
4.1 Selection of the Study Area 8
4.2 Sampling 8
4.3 Data Analysis 8
4.4 Limitations of the Study 9
4.5 Ethical Considerations 9
CHAPTER 05: RESULT AND DISCUSSION 10
5.1 Experiencing flood hazard 10
5.2 Suffering from diseases 10
5.3 Going to hospitals 11
5.4 Health Campaign Programme 12
5.5 Uthan Boithok 12
5.6 Role of Sastho Apa 13
5.7 Message for contaminated water 13
5.8 Special initiatives for children and women 14
5.9 Health communication medium 14
5.10 Myths about health 15
CHAPTER 6: RECOMMENDATIONS 15
CHAPTER 7: CONCLUSION 16
CHAPTER 8: REFERENCES 16

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CHAPTER 01: INTRODUCTION

Health communication is a multidisciplinary field of study and practice that uses communication
theory, strategy, evidence, and creative thinking to support behaviors, policies, and practices that
improve the health and well-being of individuals and populations (SHC, 2017). Programs, health
education, doctor-patient interactions, and others. Again, it is the study of how health
information is spread, such as through public health programs, health education, doctor-patient
interactions, and other means.
Health communication is a field of study that looks at how various communication methods can
keep people informed about their health and change their behavior to make their lives healthier.
It draws on a variety of theories and fields, such as public relations, marketing, theories of social
cognition and communication. Experts in public health agree that programs that focus on disease
prevention, health promotion, and quality of life require effective health communication. It has
the potential to significantly contribute to the advancement and enhancement of individual,
social, and community health (Health Communication: Effective Strategies| Tulane University,
2020).
One of the most significant public health challenges of the twenty-first century is health
communication, which is defined as interpersonal or mass communication activities aimed at
enhancing the health of individuals and populations. According to the Healthy People 2010
project in the United States, health communication can contribute to all aspects of disease
prevention and health promotion and is relevant to a variety of domains such as health
professional-patient relations, individuals' exposure to, search for and use of health information,
individuals' adherence to clinical recommendations and regimens, the development of public
health messages and campaigns, the dissemination of individual and population health
information (Ishikawa & Kiuchi, 2010).
By enhancing health literacy, health information dissemination aims to affect individual health
decisions. Healthcare workers can use communication skills to help the public make better
decisions and act in ways that are better for their health. Health communication is a specialized
field within healthcare.
People in rural and coastal areas of Bangladesh are falling behind when it comes to getting good
health care. Due to this, residents of those locations run the risk of becoming weak due to poor
health. Women and children in particular are far more vulnerable than others. In this

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circumstance, people's general concerns about their health and safety have increased massively.
Taking the right steps, in which the government, non-governmental organizations, and volunteer
groups can all play important roles, will help the situation a lot. They can boost the probability
that people will maintain health and hygiene practices regularly by educating people on how to
take care of their health. It is possible to hold special campaigns this way.

1.1 Background of the study

In 1975, the International Communication Association introduced the phrase "health

communication" for the first time explicitly, despite the fact that comparable communication
tactics had been employed informally for years. The American Public Health Association
acknowledged health communication as a subfield of public health education and health
promotion in 1997 (Society for Health Communication, n.d.).

In a developing country like Bangladesh, where most people have health problems, these
problems have been going on for a very long time. Specifically, the poor and underprivileged are
the most affected. As our susceptibility to a variety of calamities—floods being the most
prevalent—grows, so does the likelihood that we will become more vulnerable. Consequently,
infections spread swiftly, and child malnutrition worsens. Despite the fact that Bangladesh has
achieved amazing achievements in the health sector over the past several years, this sector
continues to face numerous obstacles for a variety of reasons. Overpopulation, a lack of
understanding, a lack of freshwater in the slums and rural regions, the growth of infectious
illnesses, uncontrolled food habits, a poorer quality of sanitation, and hunger are among the
numerous obstacles (Ministry of Health and Family Welfare, 2013).

On the other hand, health problems have gotten a lot worse because health services aren't
working well, infrastructure isn't up to par, money is tight, planning isn't good, and, most
importantly, no one is being held accountable. A substantial section of the Bangladeshi
population lacks access to adequate healthcare services. Several non-government organizations
(NGOs) are working with government organizations to improve the health care system in this
area. However, many who require the amenities are still not well-informed about the procedures
and are therefore deprived. Insufficient research on this subject is partly responsible for these

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results. For this reason, it is essential to assess health communication efforts alongside the NGOs
that are partners in Bangladesh's overall development (Zakaria et al., 2016).

1.2 Objectives of the Study

The purpose of the study is described as follows:

a. To highlight how the general people are concerned about their health during floods.

b. Identify the measures through which health communication procedures can be developed.

1.3 Research Questions

The specific questions that this study intends to answer are the following:

a. Are people capable of receiving health information easily?

b. How conscious are the marginalized community?

c. How are the related governmental agencies and NGOs taking initiatives?

d. Do the organizations take special measures for women and children?

CHAPTER 02: LITERATURE REVIEW

When talking about health communication and health education, Schiavo (2013) mentioned Clift
and Freimuth (1995) as an example of a strategy that aims to change the behavior of a number of
people in a target audience about a certain issue over a set amount of time. It also explains itself
as "the application of methods for disseminating health information and influencing people's and
communities' choices towards their health" (Thompson, 2014).
Health communication is a well-known field that has grown in both breadth and depth. This
growth of the field of health communication study can't be overstated, as many communication
scholars now work with experts and academics in public health and other fields, as well as with
government and nongovernmental organizations. Similar to that, it might be difficult to highlight
key themes and study areas in health communication due to its size. Since most of the following
themes and ideas come from the discipline's first two tracks, their presence shouldn't be seen as a
preference for the old over the new. In fact, the ideas and theories presented below should be

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viewed as merely a glimpse of the depth that public health has to offer on a theoretical level (Hu,
2015).
Over the years, the study of human and mediated communication in health care delivery and
health promotion has blossomed into a vibrant and significant field of study known as health
communication. An exciting area of applied behavioral science research is health
communication inquiry. It is an applied field of study not only because it investigates the
pragmatic effects of human communication on the provision of health care and the promotion of
public health, but also because the research conducted in this field is frequently utilized to
improve the quality of health care delivery and health promotion. As a result, health
communication inquiry tends to be problem-based, focusing on locating, analyzing, and
resolving issues related to health care and health promotion. Communication is conceived of as
the central social process in the provision of health care and the promotion of public health
within the field of health communication. The ubiquitous roles that communication plays in the
production, collection, and dissemination of "health information" underpin the centrality of the
communication process. Because it is essential in guiding strategic health behaviors, treatments,
and decisions, health information is the most important resource in health care and health
promotion (Kreps, 1988).
Due to its geographical location and environmental circumstances, Bangladesh is a nation that is
prone to natural disasters and experiences an increase in the frequency and severity of these
disasters. The country's vulnerability is made worse by climate change, and it ranks sixth among
the top 10 countries most affected by extreme weather events over the past two decades. 26% of
its population is affected by cyclones, and 70% of its population lives in flood-prone areas. The
major health risks posed by floods in Bangladesh, including water-borne and vector-borne
diseases like diarrhea, acute respiratory infections, and dengue fever, are discussed in this
section. Floods and other effects of climate change also have an impact on agriculture and
increase malnutrition, especially in young children. Additionally, mental health, violence against
children and women, chronic diseases, the salinity of drinking water, urban health, and other
health issues impacted by disasters have received little attention; These issues are also discussed
within the context of Bangladesh, with a focus on urban flooding and the negative effects it has
on the poor population of urban areas. The country's primary health care system development
generally indicates accomplishments. Disaster management has improved significantly as a

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result of it and efforts to eradicate poverty. However, for a more coherent program to integrate
health systems, immediate action is required (Matsuyama et al., 2020).

CHAPTER 03: FLOOD AND HEALTH

The health effects of disasters such as floods are complicated and cascading, and they can have
simultaneous effects on any individual or group. In the case of flooding, diseases and epidemics
are also a significant health risk. These can manifest as waterborne infections, which are caused
by drinking or coming into contact with polluted water. Included in this category are diarrhea,
cholera, typhoid fever, and leptospirosis. Sometimes it can also be vector-borne diseases, which
are spread by species like mosquitoes that act as middlemen. Dengue fever and malaria are two
of the vector-borne illnesses brought on by floods. In 2019, Bangladesh saw its worst dengue
outbreak, with over 100,000 illnesses and 179 deaths. The outbreak was related to monsoon
season floods that year. After high rains and flooding, there have been increases in leptospirosis,
typhoid fever, and dengue in the Philippines, the third most vulnerable country to natural
disasters and one of the most at risk from climate change (Bracher, n.d.).

CHAPTER 04: METHODOLOGY

4.1 Selection of the Study Area

Pirgachha Upazila lies between latitude 25.6578° N and longitude 89.4056° E. The residents of
this upazila experience several floods each year as a result of the Teesta River. Additionally, their
vulnerability is increased by poverty and illiteracy, and during the flood season, their health is in
grave danger. Besides, a lack of sufficient awareness is also one of the factors that increases their
probability of being vulnerable.

4.2 Sampling

Health communication has been taken as a sampling unit for this study. The members who are
from a field survey. Secondary data have been collected from a variety of sources, including
different websites, government agencies, and nongovernmental organizations.

Primary Data Collection: During primary data collection, this study identifies health
communication during flood hazard from field survey. Health communication depends on
socioeconomic characteristics such as age structure, household population, educational

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qualification, monthly family income etc. A total number of 10 respondents responded to the
questionnaire from which the finding has come out.

Secondary Data Collection: Secondary data, such as statistical data, reports, and maps, was
gathered from a variety of research papers, websites, Ministry of Health and Family Welfare etc.

4.3 Data Analysis

In this case, the qualitative content analysis method is used to find out what happened. We
conducted a face-to-face survey with the participants to get their opinions. The findings have
been carried out via the use of Google forms on the internet.

In this particular situation, the qualitative content analysis approach was used to gather
information. We performed a face-to-face survey with the participants to get their opinions. This
poll has been carried out via the use of Google forms on the internet. By using the Internet, we
were able to acquire the pie chart resulting from the survey. There were a total of 10 people who
answered our survey questions.

4.4 Limitations of the Study

a. A total of 10 people replied to the questionnaire from which the findings were derived.
When the sample size is compared to the population of the study area, it is difficult to
generalize the findings.

b. There is limited existing research on our issue in the context of Bangladesh, depending
on the area of our study.

4.5 Ethical Considerations

From the selection of subjects and procedures to data management and dissemination, ethics is
crucial in all phases of research. Human subject research requires the most attention, as you must
consider issues of health, safety, and identity. The following ethical considerations were taken
into account when conducting the study:

a. The Validity of the Study: The study was carried out in order to provide answers to certain
survey questions. The findings of our investigation were consistent with the survey questions that
were asked at the start of the study.

b. Consent of Participants: The individual who took part in the evaluation was completely
informed about the study. Participants were told of the study's aim, expected outcomes, planned
use of the findings, potential negative effects of involvement, and who would have access to the

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information. The fundamental objective of informed consent is to enable the participant to make
a decision regarding participation in the survey. Additionally, participants had the option of
requesting extra information if they had any doubt or became frightened during the survey.

c. Confidentiality: We have not made accessible or allowed access to information about

participants or information submitted by participants to anybody other than project members.
Participants' identifying information is not stated in the study reports. The participants'
information or output is mentioned in such a way that it cannot be identified.

d. A Sampling of the Participants: Our explanation for selecting a certain set of participants for
the study's goal is included in this section.

e. Voluntary Participation: Participants were given the option to discontinue their participation at
any point during the survey's duration.

f. Accessibility to only relevant information: Our evaluations and inquiries have been limited to
those aspects and questions that are relevant to our study.

g. Do no harm: Individuals were not harmed in any way throughout the survey procedure.
(Intentional or otherwise).

h. Honesty and Integrity: We have analyzed the data from our field survey report and written up
our findings and conclusions without over-exaggerating and making up any data

CHAPTER 05: RESULT AND DISCUSSION

5.1 Experiencing flood hazard

Eighty percent of the respondents had been through a flood situation more than twice, and twenty
percent had encountered a flood event twice in their lifetimes. In the region where flooding
occurs annually, the responders had much experience dealing with the aftermath of the disaster.

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 Figure 5.1: Experiencing flood hazard

5.2 Suffering from diseases

90% of all first responders experienced illness as a result of the flooding. Only 10% of people are
disease-free. Due to their illiteracy and lack of knowledge, the indigenous population is
particularly vulnerable to flooding.

Figure 5.2: Suffering diseases

Diarrhea and cholera affected the greatest percentage of people (88.9%). Additionally prevalent
are typhoid and abdominal pain.

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 Figure 5.3: Suffering various diseases

5.3 Going to hospitals

77.8% of people who were sick chose not to go to the hospital. Financial constraints and
ignorance prevented them from going to the hospital. A small percentage visited the hospital
after receiving medical advice from a local doctor.

Figure 5.4: Going to hospitals

5.4 Health Campaign Programme

Our research revealed that a local NGO called Chars Livelihood Programme (CLP) organized a
health campaign program during a flood situation where the people received health information,
advice on what to do or not do during a flood, what to do if bitten by a snake, how to save
drowning people, what initiative should be taken to prevent drowning during flooding etc. The
locals only had one encounter with such a program. In our research, no government program was
detected during flood period.

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5.5 Uthan Boithok

We discovered "Sastho Apa" to be a fascinating topic in our study area. This region is
well-known to Sastho Apa. She counsels women and children who are experiencing health
problems. She becomes the sole option for those disadvantaged folks during floods. She arranged
Uthan Boithok during the floods. 60% of respondents indicated that Uthan Boithok had been
arranged during the flooding. 10% of them responded negatively, while 30% of them did not
know about it.

Figure 5.5: Uthan Boithok

5.6 Role of Sastho Apa

Eighty percent of them responded that sastho apa conveyed health information in the Uthan
Boithok. Of those who responded, 60% said she had warned them about waterborne illnesses.
She also measured her blood pressure, which showed up at 40%. 20% of respondents are unsure
of Sastho Apa's initiatives.

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Figure 5.6: Role of Sastho Apa

5.7 Message for contaminated water

Our research demonstrates that during floods, local doctors and Sastho Apa both issued warnings
against drinking contaminated water. Our crew noticed that during floods, everyone had
significant drinking water shortages. Out of the 9 respondents, 88.9% claimed that local
physicians or Sastho apa had warned them about tainted water. Only 11.1% responded
negatively.

Figure 5.7: Message for contaminated water

5.8 Special initiatives for children and women

During the survey, we discovered that Sastho plays a significant role in women's and children's
health both during normal times and during times of disasters. No NGO programs for women or
children were found in our survey.

5.9 Health communication medium

The local people acquire health related information by miking, Poster-flyer-banner, social media,
and by person. These are sent by local government health agencies. All the responders answered
that information is transmitted by miking. 30% said that it was leaflets, banners, and social
media. This 30% is made up of young folks. 70% responded that information is conveyed
through by person.

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 Figure 5.8: Health communication medium

5.10 Myths about health

During our research, we noticed that there are some health myths. The locals believe that if a
person is bitten by a snake, it is the result of his or her sin. They also believe that any mental
illness is caused by the presence of Jinn-bhoots or previous generation's sins. Another myth
concerning epilepsy patients is shoe sniffing. But those have no scientific basis.

CHAPTER 06: RECOMMENDATIONS

The following recommendations can be necessary for making the health communication process
more effective. These are the following:
● As maximum people experienced flood more than twice, so they can share their ideas and
experiences with the related humanitarian groups
● As most of the people of that area experienced flood, health care infrastructure and
information system to be developed rapidly.
● Infrastructure of the local medical centres and hospitals are to be increased within short
period of time
● Health campaign and demonstrations by the NGOs should be increased
● 'Uthan Boithok' in the households to be encouraged and messages to be disseminated
properly.

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 ● Supply of adequate pure drinking water to be monitored
● Children and women should be treated properly, especially those who have disabilities
● Communication to be done in multiple number of ways, like audio, video, text and
printed format
● To keep way people from all types of misconceptions

CHAPTER 07: CONCLUSION

Health Communication plays an important role for the overall development of the health sector
among the vulnerable and marginalized community. As the world is progressing with the
blessings of technology, it is also essential to upgrade the features of health communication for
proper dissemination of information. Again, health related infrastructures must be developed up
to the rural area which will enable the poor people to have easy access to all facilities. To
develop the system, proper policies and guidelines should be formulated. The health related
campaigns must be spread up to the rural regions in order to make them aware. But it is to be
remembered, language must be understandable for them. In this case, both the government and
non-government organizations must proceed forward to contribute themselves.

CHAPTER 08: REFERENCES

Beato, R. R., & Telfer, J. (2010). Communication as an essential component of environmental

health science. Journal of Environmental Health, 73(1), 24–25.

Charles, A., & Kami, S. (1979). An integrated approach to communication theory and research.
In Industrial and Commercial Training (Vol. 11, Issue 2). https://doi.org/10.1108/eb003718

Society for Health Communication. (n.d.). About Health Communication. Retrieved November
6, 2022, from https://www.societyforhealthcommunication.org/health-communication

Hu, Y. (2015). Health communication research in the digital age: A systematic review. Journal of
Communication in Healthcare, 8(4), 260–288.
https://doi.org/10.10.1080/17538068.2015.1107308

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Bracher, J. (n.d.). This is how flooding can impact our health. Wellcome. Retrieved December
19, 2022, from https://wellcome.org/news/how-flooding-can-impact-our-health

……………………………….

Matsuyama, A., Khan, F. A., & Khalequzzaman, M. (2020). Bangladesh Public Health Issues
and Implications to Flood Risk Reduction. Disaster Risk Reduction, 115–128.
https://doi.org/10.1007/978-981-15-0924-7_8

Zakaria, M. & Azad, A.K. (2016). Health Communication Activities of NGOs in Public Health
in Bangladesh: An Analysis. Asian Profile. 44. 139-150.

Ishikawa, H., & Kiuchi, T. (2010). Health Literacy and health communication. BioPsychoSocial
Medicine, 4(1), 18. https://doi.org/10.1186/1751-0759-4-18

Kreps, Gary L., & Barbara C. Thornton. (1992). Health communication: Theory and practice
(2nd ed.). Long Grove, IL: Waveland Press.

Ministry of Health and Family Welfare (MOHFW), 2013. Annual Report (2012-2013),
MOHFW, Dhaka.

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