Donate NowIn December, 2009, New York Times columnist and global health champion Nicholas Kristof published an article in Outside Magazine called "Nicholas Kristof's Advice for Saving the World." Six months later, The Atlantic published an article by James Fallows called "How to Save the News." The authors have different rescue missions in mind—Kristof defending the world's neglected poor against widespread indifference while Fallows resurrects news reporting from the near-death of print journalism. But the terrain upon which these battles will be fought is, in large part, "the new media landscape" where global health and journalism both face new opportunities and challenges.
This week, the Nieman Foundation for Journalism and the Pulitzer Center announced a collaboration which will focus on global health reporting. The partnership will support the Nieman Foundation's two Global Health Fellows each year and will bring Pulitzer Center journalists to Harvard for annual workshops on multimedia international reporting in the dynamic milieu of new multiplatform media.
Meanwhile, global health experts are also scrutinizing the new media landscape. The recent Global Maternal Health Conference 2010 in New Delhi, India, for example, included a session called "Maternal Health Digital: Exploring Digital Tools for Maternal Health." Sessions like this, and similar ones at other global and maternal health conferences, indicate a growing urgency to better understand the rapidly changing field of journalism and new media. The Maternal Health Digital panelists discussed a variety of new technologies, from Twitter to video games, which can be utilized for maximum health outcomes. As part of the panel presentation, the Pulitzer Center provided a short video (featured above) introducing the Center's recent reporting on maternal mortality in Nigeria, India, Ethiopia, Mexico and Guinea Bissau. Hopefully, the session and the Pulitzer Center's participation will further the discussion on the ways the global health and journalism communities can collaborate successfully to achieve a shared goal. At the outset, however, it would be valuable to articulate what this shared goal is, and what it is not.
Journalism shares, at least in part, the public health goal of wanting to raise awareness about critical social issues. Foundation-supported journalism organizations are perhaps better able to prioritize that goal than commercial news outlets. As a non-profit organization, the Pulitzer Center, for example, seeks to help fill the alarming gap created by the perfect storm of a collapsing advertising base (brought on by the rise of the internet) and the economic downturn that has caused the demise of many foreign news bureaus. Global health, for its part, can only wince at the ironic sting of seeing awareness wane even as suffering and need increase.
Where the two communities diverge, however, is over the question of objectivity. Public health is all about advocacy, if not for a particular organization, then for a cause or a program or a behavior change to promote health. Media coverage, in the public health world, is seen as a means to a very specific end: an action prescribed and supported by rigorous research, shared experience, and best practices.
Journalists may hope that their work will inspire action and change as well, but for them, their job is done if they have completely and honestly told the truth about a situation. What people do with that truth is a choice left up to the individual.
Journalism's drive toward impartiality can smack of ambivalence if not indifference to an impatient and desperate aid worker for whom the appropriate action may seem obvious. At the same time, that very aid worker may seem pedantic, paternalistic and controlling to a journalist seeking to tell a balanced story. What public health professionals may not realize is that they do their cause no good by evangelizing to journalists, blocking access to NGO "competitors" or sheltering journalists from critics.
The controversy over the Lancet's report on maternal mortality released earlier this year is a case in point. Because the report indicated that overall global maternal mortality rates were falling, activists in the cause for women's health jumped to downplay the findings and highlight the real and needless death and suffering that is still occurring at deplorably high rates. Media coverage, which for the most part, reduced the complicated academic report to its most simplistic findings, only exacerbated the warranted frustration. But attempting to bury the report is counterproductive. What advocates should bear in mind is that public health has much to gain from sophisticated media coverage which they can facilitate through open dialog with journalists.
But journalists, even those sympathetic to advocates in the public health field, have to take market considerations into account. In his article, Kristof says that "humanitarians often make poor countries sound like unremittingly tragic hellholes full of starving children with flies in their eyes," and journalists tend to do the same. Kristof's search for a better approach led him to the study of social psychology and marketing which he says indicates that people respond by opening their pocketbooks to positive stories about individuals rather than stories of defeated and devastated masses. Combating this "psychic numbing" is also reportedly high on the Gates Foundation agenda. But when a presenter at the Global Health Conference in June remarked that the Gates Foundation was looking for "stories of success," the journalists in the room visibly bristled. Aside from the issue of objectivity, the truth that they live with is that while good news may inspire donors, bad news sells.
Though foundation-supported journalism organizations like the Pulitzer Center (and ProPublica, the Center for Investigative Reporting, the International Reporting Project, and others) are not motivated by profit, they still have to attract and retain reader attention in an increasingly competitive media market. In order to protect their reputations, they also have to allow their journalists to report objectively in an environment free of any funder's particular agenda or slant. Global health funders could promote coverage of critical health and humanitarian issues by offering financial support to these kinds of news organizations, but they seem uncomfortable with the "firewall" these organizations create around their reporting work and the hands-off management they require.
Perhaps one reason global health funders are reluctant to give non-profit journalism organizations the freedom they request is that it's difficult to measure the impact of positive or negative media coverage on global health. Monitoring and evaluation, a key component of public health training and practice, measures its successes in numbers of lives saved (or pills administered, diseases eradicated, etc.) Journalism, on the other hand, typically measures its successes in numbers of readers, listeners or viewers reached.
Measuring the impact of media coverage on health outcomes is a worthwhile pursuit, but it's tricky. A recent report commissioned by the United States Institute of Peace (USIP) on new media and political change critiques the lack of sound research on the subject saying, "Many claims currently made about the effects of new media are blind to hidden variables, confuse output with impact, or assume causal relationships that may be spurious." This may be true in media and public health studies too. 'Stories of success' may inspire philanthropic giving, but stories of suffering and illness, human rights abuses and widespread tragedy may inspire social change, political movements and occasionally outright rebellion. Without commissioning rigorous studies using the model suggested in the USIP report, how can we know if any of these outcomes, from throwing more money at a problem to overthrowing a government, will actually improve public health?.
One final area of common ground should be the educational arena. The Pulitzer Center has devoted a large share of its human and financial resources to Global Gateway, its innovative education program. Working with high schools, colleges and universities, it brings field journalists into the classroom to inform and inspire students about international issues. It also uses available internet and digital technology to connect American students with students and citizens around the world.
This educational initiative is made possible through the expansive website the Pulitzer Center maintains. Its project pages offer an opportunity for readers to follow a continuum of reporting over a period of time. And its gateway portals pool reporting from different countries around a common theme such as maternal mortality (Dying for Life), climate change (Downstream, Heat of the Moment) and HIV/AIDS (HIV/AIDS in the Caribbean). This kind of a website is what Fallows called in "How to Save the News" a "repository of information." He reports that Google completed an extensive "Living Stories" study earlier this year indicating that readers favor the presentation of news grouped together by topic where they could follow the ongoing progression of a news story and find links to related multimedia pieces that provide cultural, political and historical background.
"The modest daily updating of the news, " Fallows said, "… matches the cycle of papers and broadcasts very well, but matches the Internet very poorly." This new media landscape has helped forge a new model of news presentation that the Pulitzer Center has adopted in its educational outreach, and in its reporting more generally. Global health should take note of developments like these and do its best to facilitate communications education in schools of public health as well as build and contribute to online living story projects.
Furthermore, reporting by independent journalists is a powerful tool for public health advocates who can enhance the global conversation about health issues by using social media to link this reporting to people across miles and disciplines. They can also spark professional news coverage by learning to photograph, record or blog about breaking stories that they observe. Citizen journalism has created a new information democracy that can benefit everyone and Fallows notes that "Amateur-produced video is perhaps the most powerful new tool of the Internet era in journalism, making the whole world a potential witness to dramas, tragedies, achievements almost anywhere."
The beauty of this kind of new media landscape, in spite of all the complicated changes it has forced upon us, is that it has greatly increased the shelf-life of news which allows all of us, in global health and in journalism, to collaborate in building momentum around complex and ongoing social issues. It also allows and demands participation from all of us. Rather than passively receiving news fed to us on the front page, the new technologies challenge us to be better—and more interactive—news consumers. Global health professionals and journalists both benefit from the cross-fertilization made possible by these new internet technologies.