The song starts slow, with soulful piano chords. Then a voice chimes in: “Ring the alarm, turn on the sirens. I see my people dying, but nobody’s firing.“
No, the lyrics aren’t about war or politics. About a minute in, Liberian hip-hop artists Tan Tan B and Quincy B make their message clear: “Ebola is real.”
But do people really pay attention to the lyrics?
The use of music to comment on public health issues is hardly new. Back in the 1300s, French poet and composer Guillaume de Machaut vividly described the horrors of the bubonic plague ravaging Europe in “Le Jugement du Roi de Navarre,” or “Judgment of the King of Navarre.”
But it took a few hundred years for public health experts to catch on. Inspired by the success of pamphlets, posters and motion picture propaganda for World War I, health organizations and the government began pursuing all sorts of media, including music, as a tool, says Michael Sappol, a historian at the National Library of Medicine.
The effort to put health messages in music really took off in the 1920s and early ’30s, as radio began reaching a mass audience. Songs about diseases and health became more common. In 1949, the U.S. Public Health and Services commissioned songs from Woody Guthrie as part of its anti-venereal disease campaign. Guthrie’s “V.D. City” warned people of “cold lower dungeons where the victims of syph roll and cry.”
One of the most successful public health songs was released in 1986. Johns Hopkins University developed a campaign starring Mexican American pop sensation Tatiana Palacios and Puerto Rican singer Johnny Lozado to promote sexual responsibility among young adults in Latin America. At the time, teen pregnancy rates in that region were as high as 15 percent.
One of the duo’s songs was “Cuando Estemos Juntos,” or “When We Are Together,” which featured bouncy beats and lyrics like, “You always tell me to wait; it’s not the time to give us all.”
“They did songs on adolescent reproductive health that went to the top of the charts,” says Susan Krenn, director of the Centers of Communication Programs at Johns Hopkins. The campaign also developed videos and TV ads and garnered more than a million hours of air time, according to USAID, which funded the campaign.
Follow-up surveys of more than 2,000 teens between 10 and 19 found that over half talked to a female friend about the message of the song, and a third spoke to their mother.
The key, Krenn says, is to get the conversation going; when people start talking — to families, friends or partners — they’re more likely to take action.
An important strategy, she adds, is to create a song as catchy as a chart-topping hit: “Entertainment draws, so you don’t have to go hunting people down; you can attract people to your messaging.”
For decades, the center has been promoting health messages around the world through “entertainment education.” They’ve created a lyrics contest in Mozambique to raise awareness about HIV prevention and launched a malaria campaign in Ghana with a fast-paced song called “Aha Ye De,” or “It’s Good Here” under the bed net.
“When we’re doing public health messaging, one of the expressions that we use is that ‘we’re catering to the heart and mind,’ ” she tells Goats and Soda. “While you’re trying to give people the facts of a particular issue, you also want to appeal to the emotional side so that it hits home on a personal level.”
Sometimes, songs aren’t part of campaigns, but a commentary from artists on issues that are important to them. Often, Sappol says, they focus on topics overlooked by health officials.
His favorite is the 1991 hit “Let’s Talk About Sex” from hip-hop group Salt-N-Pepa. The song encouraged women to discuss sex without feeling ashamed or embarrassed.
“They’re saying [women] got to take control and talk about it,” Sappol says.
But both Sappol and Krenn says there’s no metric to measure how effective a song is in influencing behavior. Any musical component is usually part of a bigger campaign that uses as many forms of communications as possible.
“Those that are going to be less successful are those looking at just one intervention, thinking that one is enough,” Krenn says. And it’s not as easy as jotting down lyrics and a catchy beat – you have to do your homework.
“What exactly do you want people to know and do?” she says. “And then build your messaging around that, understanding what the barriers and opportunities are.”
So a song that simply tells people to wash their hands might not resonate as much as one that has a story that people can relate to. Take, for example, the Ebola song “State of Emergency,” which reminds people how many family members, friends, neighbors and doctors have died from Ebola.
I’ve seen a mother cry; she just lost her son
I think I can help her; ’cause she needs a ride
But then my baby warned me: help her and we all die
Those words hit me hard, ripped out my heart
How many doctors die, trying to play their part
The song shares airtime in Liberia with a dance hit called “Ebola’s In Town,” which tells people to avoid touching friends to avoid the virus. In neighboring Sierra Leone, three artists got together in July to record “Di Ebola Song,” telling locals to “save yourself” by seeking medical help early.
All the Ebola songs in the world may not stop the outbreak. After all, Sappol says, media campaigns are no “magic bullet.” But our correspondents in Liberia report that everybody’s talking about them.