Staff profile - Dipti Zachariah

Even though the whole world is experiencing the COVID-19 pandemic, the way each country and indeed each culture, has experienced it, is different.

Due to its large multicultural population, the Australian experience is also a diverse one.

Work undertaken by Western Sydney Local Health District's (WSLHD) Multicultural Health Services, has shown in order to provide effective support to different Culturally and Linguistically Diverse (CALD) communities, it's essential to understand how they have responded to the disease, as well as their specific issues, needs and concerns.

Statewide and Specialist Program, Multicultural Health Team Leader Dipti Zachariah, said, unless you have a well thought through approach that keeps community at the centre, it becomes challenging to achieve an effective COVID-19 response.

'The Pandemic has brought to the surface, gaps and inequalities CALD communities face – their vulnerability magnified further,' Ms Zachariah said.

WSLHD proactively worked alongside communities to establish an interdisciplinary COVID Communications strategic response team, early on in the pandemic. The group consisted of Multicultural Health Services, Corporate Communications, Health Promotion, Consumer Council, Youth Health and the Health Literacy hub.

The approach developed by the Multicultural Health Services team, was the 4M model, which formed the basis of the Service's COVID-19 response. The model ensures community capacity building, ownership of information given to communities, information delivered in a manner that works for communities, and the use of platforms for community to directly liaise with NSW health.

The 4M model can be applied to many communication challenges by breaking it down into four components or pillars: Mandate, Mission, Message and Messenger.

Vulnerable communities have the right to access simple, timely and easily to understand information. The success of the 4M model starts with the first pillar: the Mandate, which is to be community-centred, culturally-responsive and gender sensitive. This approach has been critical in assisting different CALD groups to incorporate COVID-19 messaging into their communities.

Early on in the pandemic, the service used rapid consultation with community leaders who were working at the grassroots, in order to find out what was happening in the various communities and to understand their concerns.

'We discovered that not all concerns were shared across communities. Different cultures have different reactions, not only to the pandemic, but they also had their own stigmas/fears/myths we needed to address,' Ms Zachariah said.

Out of this consultation, came the Mission (the second pillar of the 4M model), which is focussed on empowering the community so they are part of the solution. Communities need to be empowered to make informed decisions to keep themselves and their families safe during the pandemic.  

'The most important part of this process was to gain the trust of the communities we were working with. We had to get them to respect and appreciate what we were telling them,' Ms Zachariah said.

'We did that by giving them a voice and we did it early on.'

What the team quickly realised, was even within cultural groups a variety of subgroups existed, each with their own specific needs.

'This pandemic really exposed the diversity in the CALD community. We found not only did we have to provide information to established CALD communities, but we also discovered different approaches were needed for subgroups such as refugees, migrant workers, asylum seekers and international students,' Ms Zachariah said.

Due to the differing needs and issues of each community, the team knew the messages had to be simple.

The Message (the 3rd pillar of the 4M model) and the Messenger (the 4th pillar), became pivotal in keeping the CALD community safe.

The feedback received on community messaging, was that the messages needed to be from trusted sources and needed to be agile.

We also made sure all our messages were developed with a health literacy lens and called for action.

'Messages had to be interesting, contextual and co-designed with the community,' Ms Zachariah said.

'For example, appropriate messages about certain religious festivals such as Easter, Ramadan and Diwali, were produced in consultation with religious leaders and influencers. CALD communities are collective in nature and we wanted to enable them to have alternate options/adapt safe behaviours to their lives.'

By collaborating with community influencers, the team was also able to ensure two-way communication between communities, health and stakeholders. These community influencers have now become COVID-Safety Champions.

'Community leaders and influencers have a good understanding of their community's perceptions, concerns, beliefs, knowledge and practices. By working with these COVID-Safety Champions, we can reach community members with tailored information that works for them, and gives them ownership of the information, which they take directly to their communities,' Ms Zachariah said.

'We hope to strengthen the capacity at a grass-roots level as we progress with vaccine education and implementation, and also continue our collective response to shadow pandemics such as domestic violence

'To enable communities to positively respond to COVID-19, they need to know you are treating them as equal partners in the solution.'

In addition to the COVID-Safety Champions, the group translated messages into more than 26 community languages, developed digital resources to meet the needs of groups with low health literacy/no literacy, and created messages across social media and CALD media channels using community influencers. 

'This approach was initiated in WSLHD, but we were able to bring other local health districts on board,' Ms Zachariah said.

'The pandemic response at WSLHD involved a cross-sectoral approach and brought together a range of agencies including local councils, TAFE, schools, migrant resource centres, religious organisations and NSW Police, with the sole agenda to keep CALD communities safe.

'The pandemic has changed the way we live life, and the nature of people's concerns are also changing in response to this. Therefore, our messaging is constantly being revised to ensure current concerns are addressed.'

The 4M model has equipped the district to ensure the safety of CALD communities during the COVID-19 pandemic.

'As a district, we have been successful in bringing our communities along this journey, because we have worked alongside them from the beginning,' Ms Zachariah said.

​'Communities need to be part of the solution, only then will public health efforts be inclusive and meaningful. It is not us or them – it is we together!'