Company: The Navajo Nation's HIV Prevention Program
Timeframe: On-going
This case study involves challenges related to health care communications, overcoming cultural barriers, delivering information in two languages and dealing with government
entities in Washington and in two states. The target audience is the Navajo Indian population and the PR point person is Darrell Joe, program supervisor of the Navajo Nation's
HIV Prevention Program.
But there is one significant catch here: Darrell Joe is not a PR professional. His program does not have a communications specialist. He is the PR leader by default, not
design.
"Our Navajo Nation is comparable to the size of West Virginia, yet our HIV Prevention Program is staffed by only five individuals," says Joe. "There are four HIV health
educators stationed in four strategic areas of the Navajo Nation, and my position is located in the central offices of the Navajo Nation Division of Health in Window Rock,
AZ, also the Navajo Nation capital. Annually, we serve more than 25,000 Navajo people with HIV-related prevention and education services."
Official statistics report a cumulative total of 217 cases of HIV/AIDS among the Navajos since 1985; the tribal population residing in the Navajo Nation is 200,000 (this does
not include thousands of Navajos residing elsewhere). But this territory lacks an established epidemiology office to tabulate data thoroughly, so the total number of HIV cases is
not fully known (and is suspected of being significantly higher).
Spreading The Word...Slowly
Communicating an HIV/AIDS message to a broad segment of the American population has been enough of a struggle, as many health care PR experts will attest. Yet the Navajo
community has its own distinctive barriers to overcome.
"Some of the main challenges include language," says Joe. "Since our Navajo language is still strong and the first language of choice in many of our communities and
households, it is sometimes difficult to translate some of the words into Navajo. HIV and AIDS are two different things, where one is a virus and the other is the outcome of
having the virus. That, in itself, is difficult to explain. There are also varying dialects in different parts of the communities, where one word could mean something completely
different in another community or may not have any meaning at all. So it becomes a task of trying to explain or describe what exactly that word is."
Furthermore, cultural protocol can also interfere with Joe's work. "Another challenge is denial," he continues. "Denial seems to be infiltrated by some of our cultural
taboos. One such taboo includes speaking about sensitive topics such as death or sickness. Our culture teaches us that this type of discussion invites those very issues into our
lives, our families and our communities. To talk about it means to wish for it, whether upon yourself or a loved one."
Money, Or The Lack Thereof
Then there is the problem of financing the PR message. The Navajo Nation's HIV Prevention Program is not funded by the New Mexico or Arizona State Health
Departments or the federal Centers for Disease Control and Prevention. Joe communicates with nonprofits affiliated with these agencies in order to secure financial
input, but more problems persist.
"Since funding is contingent upon actual numbers of HIV/AIDS cases among specific high risk populations (predominantly gay men and injection drug users), the Navajo Nation is
not considered a priority for funding," he notes. "We have to compete with the numbers of cases in cities such as Albuquerque and Phoenix, where there is a large population of
these high risk people and a higher number of HIV/AIDS cases."
To date, the program's financial sources are relatively limited: "Our funding is provided by the Navajo Nation and 638 funding from Navajo Area Indian Health Services,
which is funded by the federal government; 638 is the self-determination act that affords Indian people to facilitate their own health care through operating their own health
programs."
Media Access
The ironic part of this situation comes from media access to the Navajo Nation - this population is not the least bit inaccessible. Joe points out the Navajo Nation operates
its own newspaper (The Navajo Times) and a mirror Web site, plus two radio stations and a public TV station. Independent radio stations and newspapers in neighboring towns
also cover the territory. Additionally, several online news sites covers this community, but Joe observes out most homes in the Navajo Nation do not have Internet access.
Joe's target audience is bilingual and thus he needs to divide his message accordingly. "Written news is provided in the English language simply because it is easier to
understand," he says. "Radio news is provided in both Navajo and English, but our radio stations present their information primarily in the native language. The concept of
written Navajo language is foreign to many of our elder people and those who may not have had the opportunity receive education in writing the language. Therefore, to write our
communications in Navajo may not be feasible or user-friendly to most of our people."
Direct person-to-person communications have been very effective. "Most of our activities involve going out into the communities and discussing HIV at its very basic level,
which includes a general overview of HIV, how it is transmitted and how to protect oneself from becoming infected," he says.
Despite his numerous obstacle's Joe has managed to make inroads for the program. But more often than not, it can feel like a Sisyphus-worthy task.
"We utilize our local news reporting resources to create an awareness of need for the state and federal programs to recognize," he says. "The CDC currently funds programs that
provide interventions that are scientifically proven to effectively reduce high-risk behaviors, therefore reducing the number and rate of HIV infection. However, these science-
based interventions are effective for populations in urban settings, who are completely different from Navajo and other rural and reservation based programs. Despite our efforts
to convey that, it continues to go unnoticed and we continue to not receive funding."
Contact: Darrell Joe, [email protected].
Lessons Learned: Communicating To Different Cultures At Home
One of the main lessons PR professionals can learn from Darrell Joe's work with the Navajo Nation's HIV Prevention Program concerns the intricacies of communicating to
audiences beyond the mainstream society. As the multicultural demographics of America evolve, PR professionals need to be aware of how to reach different communities with their
message and information - both from a B2C and B2B perspective. Key issues to address include the following:
- One size does not fit all. America is not a homogenous society, so today's PR communications cannot be homogenous. What may be effective for one segment of
society will not necessarily appeal to others. Knowing the cultural parameters of the target market before communicating the message is crucial.
- Translate all materials correctly. If you are creating press or promotional materials for different languages, double-check the translation is correct. This entire
newsletter can be filled with anecdotes of erroneous translations resulting in surreal and scatological turns of phrase. (That's only funny when it happens to the next guy - not
to you!)
- Do extra research. Many media outlets (especially non-English radio programs) relating to specific communities are often absent from national media directories or
search engines. Be aware that compiling media lists will require additional research in this area.
- Partner with community leaders. If you lack connections with these markets, feel free to work with organizations that know the markets well. Faith-based
organizations, community groups, chambers of commerce, and even independent (non-competitive) marketers who specialize in multicultural promotions are excellent resources for
advice and guidance.