SAO TOME AND PRINCIPE | Minding the equity gap in small island states and isolated communities

21 May 2021

Sao Tome and Principe

Geography is one of many reasons why small island states and isolated communities across the world face unique barriers in accessing critical life-saving knowledge. These limitations in access are often the difference between life and death and unnecessary suffering, and play a decisive role in the speed of recovery following a health emergency such as the COVID-19 pandemic. However, the challenges are even greater if the most widely-spoken local languages are languages other than English, and if access to technology and connectivity limitations are significant and persistent.

Language is indeed one of the biggest limiting factors for knowledge transfer and capacity development at the local level. In the best scenarios, time and responsibilities within and outside work also have an impact on engagement, which also could be mitigated by more available material in Portuguese, increasing motivation. From the onset, frontline workers and populations face constant challenges and distractions throughout the learning cycle, often related to the limited availability of technical and scientific learning materials and information in languages health care professionals understand. Each kind of obstacle makes it slightly more difficult to reach the common goal of saving lives through increased knowledge. At core of this matter is equity; it is therefore not enough to make knowledge available, but there must be a complete functioning infrastructure in place to support and promote access.

As has been the case across the world, the ongoing COVID-19 pandemic has brought to the fore what we already knew: the equity gap affects wide segments of populations, including those helping to the end the pandemic. This gap is even greater where there are already limitations, such is the case in small island states and isolated communities. A good example of this was attendance in the recently launched Introduction to the Integrated Disease Surveillance and Response Technical Guidelines 3rd Edition (IDSR) webinar series – a flagship capacity development initiative led by the WHO Regional Office for Africa (AFRO). This course brings to frontline workers advanced knowledge expertly adapted to the African context. However, while the series has proved very successful – improving capacity across the continent – its impact was tempered by the Portuguese-speaking participants' capacity to connect to the internet on a regular basis or at all.

In the words of Dr. Vilfrido Santana Gil, WHO Sao Tome and Principle: “Linguistic groups with limited access to technology face a double or triple burden when accessing critical lifesaving knowledge – they have less resources at hand to begin with and therefore every opportunity to access knowledge is so much more valuable ... we must take a holistic approach and make extra efforts to ensure that everyone can benefit from available knowledge and developments... technology must be there.”

Through the joint work of WHO Country Office Sao Tome and Principe, AFRO and the new IDSR online course series which will be available on OpenWHO.org in 2021, among others, constant efforts are being made to help bridge this gap by making courses available in Portuguese. However, in this case, as in many other efforts, technology and connectivity issues impact uptake. To date, AFRO region users represent roughly 2% of the total users who access the Portuguese resources available on OpenWHO.org.

During the ongoing COVID-19 pandemic, virtual training has been essential to strengthen the capabilities of frontline workers, which allows for enhanced surveillance of COVID-19 and other public health threats. It is essential to continue to reinforce the production and dissemination of materials in Portuguese, to allow Portuguese-speaking technicians who are not proficient in other languages to benefit in time and fairly from the materials produced. Making materials available that are mobile friendly and low bandwidth and that can be accessed offline is also critical. The joint AFRO OpenWHO IDSR online courses in Portuguese will make a major contribution to addressing this.

We must consider that access to scientific information, quickly and in a language easily understood by frontline health workers, is a powerful weapon to save lives; therefore, investing more in this area is an efficient investment to achieve the sustainable development goals.

Photo: WHO Sao Tome and Principe

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