Vaccination is necessary to stop the spread of polio, which is a highly contagious illness that can result in permanent paralysis or even death. However, the relocation of people and the restricted access to war zones in Somalia make it challenging for medical professionals to reach vulnerable groups for vaccination programs. The violence in Somalia is broad and continuing. The destruction of health infrastructure further exacerbates the fall in vaccination coverage, the interruption of healthcare services, and the compromise of the safety of healthcare professionals.
In areas where there has been war, community members are less likely to participate in vaccination programs due to fears, mistrust, and the spread of false information. In addition, disruptions in supply chains and political barriers make it more challenging to plan and carry out successful immunization campaigns.
However, there is a problem that is sometimes disregarded in vaccination campaigns, and that is language comprehension. Language understanding plays a significant role since efficient communication is necessary for sharing information about vaccinations, their advantages, and the process of becoming vaccinated.
Providing local populations with messages regarding polio vaccination that are clear, culturally relevant, and translated into their native languages helps establish trust, eliminates misunderstandings, and encourages vaccine adoption within local communities. Language comprehension is also essential when administering vaccinations since it ensures that medical professionals can communicate appropriately with patients about the procedure, the potential adverse effects, and the post-vaccination care that should be administered. Misunderstandings that arise due to language issues might lead to hesitation or resistance, which in turn reduces the number of vaccinated people.
There are at least ten unique languages or dialects spoken in Mogadishu, Somalia, according to research conducted by Minority Rights Group and CLEAR Global in conjunction with three health groups operating in the city. Even though this variety is neither officially acknowledged nor extensively recorded, the study has been presented. Most of these languages do not have any form of written communication; they are not taught in schools. Despite the lack of thorough census statistics on language usage, it is known that Somalis speak Mahaatiri, which is generally spoken in many regions of North and Central Somalia, and Maay, which is commonly spoken in many sections of Southern Somalia. Mahaatiri is the primary language spoken in North and Central Somalia.
Maay is recognized as a national language. However, its principal use in government administration is concentrated in the Southwest State and broad portions of southern Somalia, with Mogadishu as an exception. Because Maay and Mahaatiri are similar languages, there is a possibility that people may assume that families moving from Maay-speaking areas to Mogadishu will have no trouble learning Mahaatiri. According to this study conducted by the Minority Rights Group, being able to comprehend and speak Maay does not directly translate into being able to understand Mahaatiri, and vice versa.
Many speakers were tested using Mahaatiri and Maay audio recordings and posters used during polio vaccination campaigns by UNICEF, the Ministry of Health (MoH), and partners. The majority of the persons who were questioned were living in camps for internally displaced people and were unable to read or write. The researchers also questioned native Maay speakers to gauge their comprehension of crucial Mahaatiri vocabulary.
According to the findings of certain researchers, native Maay speakers do not entirely comprehend polio vaccination efforts. Typically, information is communicated in Mahaatiri, which presents difficulties for Maay speakers because they frequently do not entirely comprehend what is being said. People’s expressions of irritation and their yearning for information they can comprehend are clear evidence of the existence of this language barrier. Sometimes, to overcome the language gap, informal translators, typically neighbors or friends, are depended upon. However, due to their poor health knowledge, the information they provide may not be trusted as much. The employment of interpreters during vaccination visits nevertheless leads to certain misconceptions, emphasizing the ongoing difficulties arising from language barriers and inefficient communication during health campaigns.
The investigation also revealed that native Maay speakers do not entirely comprehend the visuals and visual aids. It was challenging to understand the graphic aids on polio vaccines. Many speakers had trouble comprehending the Maahatiri text that accompanied the visuals. They attributed this problem to illiteracy or a lack of experience with Maahatiri reading. In addition, they stated that the photographs did not adequately portray the experiences that they had personally gone through.
According to the findings of the research, the fact that Maay speakers are unable to comprehend vaccination campaigns and information contributes to their sense of marginalization and prejudice. In a culture that is mainly composed of Mahaatiri speakers, those who speak Maay have historically been subjected to linguistic prejudice. Many people have the impression that the Mahaatiri language, by its practice of discrimination, contributes to the maintenance of socioeconomic inequities between those who speak Mahaatiri and those who speak other languages.
Radio Mogadishu transmitted the news in Maay and Mahaatiri throughout colonial rule (1840-1960). On the other hand, Radio Mogadishu stopped broadcasting in Maay when the country gained its independence and continued only in Mahaatiri. These past instances of prejudice contribute to the already-present feeling of marginalization among Maay speakers, which in turn influences their responses to the most recent facts about public health—a significant number of individuals related experiences of discrimination based on language in service provision and healthcare settings.
According to the research findings, having incomplete knowledge may hinder one’s belief in vaccination programs. People with limited comprehension of health facts are more likely to view polio immunizations with skepticism and suspicion. People have anxiety around vaccination programs because they may not have a complete understanding of them.
According to the study, text pho, photographs, and recordings made in Mahaatiri were more difficult to comprehend than audio recordings or audio fragments in Maay. During the research, a guy from Wadajir, Banadir, was overheard saying, “I don’t understand what the vehicles say.” He referred to a mobile polio vaccination campaign that utilized speakers and music boxes on a van illustrated with campaign themes. According to what he mentioned, it was aggravating for him.
However, because there are several Maay dialects, existing were comprehended similarly: maay-baidoa, Maay-Hamari, Maay-Bakool, Maay-Koryoley, and Maay-Awdhegle were some of the dialects spoken by the people questioned for the study. Nevertheless, any Maay dialect was far easier to understand than the Maahatiri that the health staff spoke.
The participants in the investigation had a limited understanding of the polio vaccine. Many of them did not know enough about the symptoms and warning signs of polio, how to treat it, or how to prevent getting it.
Because the information is unavailable in their language, many individuals will either be unable to receive health services or not know where to go. Consumers may seek traditional healthcare since they don’t know where else to turn for reliable medical care services.
Due to a lack of understanding regarding the transmission of the illness and limited awareness about it, individuals frequently rely on traditional treatment methods, have massages, and stay indoors when they have paralysis, as one participant in the study remarked.
Every single Maay speaker who was questioned expressed a desire for polio vaccination information to be provided in their mother tongue. They thought that having the material available in Maay would encourage more individuals to be vaccinated, given that people desire health information to be conveyed in a way that is both intelligible and respectful of their cultural and language backgrounds.
One participant said, “It would be good that people who know my language speak so that I don’t refuse whatever they do and that is how I would vaccinate the children because right now I have no idea what they are talking about.” At the same time, another asked that everything that they heard be replaced with Maay.
