What if Melodies can Heal

In every relief response, each dose of vaccine or medication administered to prevent infectious diseases, every screw inside medical or water facilities, or every leaflet produced for health promotion among local people may not be grand achievements in themselves. But these efforts by our frontline field workers are all part of protecting those in urgent need of medical care, helping them to stay healthy.

And what if we tell you that our field workers will sing, dance and play music on the frontline areas struck by natural disasters, conflicts, or epidemics? Does that fit your expectations of what field workers do?

Music indeed plays a role in our work: we transform lengthy epidemic prevention information into catchy melodies and lyrics that the public can remember; we soothe wounded hearts by playing mellow songs with instruments when people are mentally exhausted and speechless after facing immense trauma; we participate in and even organise musical events to connect with the public, drawing their attention to global crises and get their support for our work of humanitarian issues; when our field workers face too many life-and-death moments with patients, they would immerse themselves in familiar songs after work to alleviate homesickness and remind themselves of their reason for being there.

Consultations, wound dressing, surgeries, drug dispensing......is that all they do routinely on the front line? In fact, lifesaving work can be delivered in the form of music.

In Kwazulu-Natal Province, South Africa, the devastating floods in May 2022 took away many lives. Some locals were still living in the shadow of the flood and were terrified when it rained – they would recall how the water flowed like boiling mud and washed away houses and people.

Themba Mncube is an MSF driver. He said after the floods, the locals were depressed because they used to work hard for themselves, but now they had to depend on aid for a living. MSF’s mental health team therefore brought music to some of the community halls and churches in which those who lost their homes have been sheltering.

“Visit some shelters, you find people there singing, trying to entertain themselves. I play piano, I direct the choir, and I thought about it, then I said, ‘Maybe we can go a long way, supporting those people.’”

While primary healthcare is scarce in South Sudan, mental health services are even more limited. In South Sudan, mental health issues are overshadowed by neglect, poverty, violence and displacement. Many people face their struggles in silence, enduring a daily battle that goes unseen and unheard. Authorities in South Sudan sometimes even imprison people with mental health issues, which may worsen their problems.

Germando Kagomba, MSF Mental Health Activity Manager in Lankien, Jonglei State, brought music therapy to the locals, and raised their awareness about mental and psychological health matters. “Responding to the different situations of the patients, we try to bring them hope and joy.”

MSF is one of the few organisations providing mental health service in South Sudan. Kagomba said MSF received patients with post-traumatic stress disorder (PTSD), depression and postpartum depression. Between January and July 2024, MSF provided more than 9,600 mental health consultations in South Sudan.

After joining the music therapy, most of the participants said that they had never tried it before. It was joyful when they sang along with the children.

Since South Sudan officially declared a cholera outbreak in October last year, the disease has spread to seven of the ten states in the country at an alarming rate. Asta Man, the Operational Support Officer in MSF Hong Kong, went to South Sudan as a Health Promoter for two months. She stayed in Juba, the capital, and Old Fangak to respond to the outbreak.

To prevent cholera, just as with many other infectious diseases, we were taught to drink and use safe water, wash our hands frequently, and seek medical attention as soon as we have watery diarrhea symptoms. A lot of people there are already aware of these measures, so why do we still “preachomote” these health messages?

People refused to seek healthcare just because they couldn’t hold in their stool

Asta added that the local people had heard misinformation about aqua tabs being bad for their kidneys, so they chose not to use them even when the team distributed the tablets. Another example is that local adults, especially men, felt ashamed about having diarrhea with loose stools because people think that only children cannot hold theirs in. This was the reason why people would choose to seek medical treatment only when their condition became very severe, and were reluctant to inform their families. Since cholera can be fatal within hours when dehydration occurs to a patient, delaying treatment is extremely dangerous.

“We always heard them say, ‘this is our culture, and you cannot change it.’ But if we understand their ‘culture’, we will know the way to find the right approach to dispel their misconceptions, rather than simply telling them all the time to wash their hands and seek medical attention promptly. Of course, it's very difficult to change their habits in a short space of time, but when you address their concerns, they will listen to you more."

Use music for health promotion when it fits the need

After engaging and interacting with the communities, Asta and the health promotion team learned a lot about their habits and what they were used to, which helped them tailor different types of health messages. While the same health message can be presented in one hundred ways, some of them might be by transforming the health message into music or other formats of popular culture?  Asta takes up the theme.

“I know that MSF has used or combined music in health promotion projects of other regions. For example, in 2014, when Ebola was rampant in Liberia, MSF invited a local musical group called ‘Talented Young Brothers’ to create a hip-hop song entitled ‘Ebola is real’ to raise awareness among the local people about Ebola symptoms, and remind people to wash their hands frequently and avoid contact with the corpses of Ebola victims.

Similarly, to deal with malnutrition in Nigeria, the MSF team there innovated ‘Tom Brown’ - a recipe of grinding up sorghum, soybeans, groundnuts and moringa leaves together and using the powder to make simple and nutritious food. So how can we help people to remember the recipe? Make that as the lyrics of a song and let them sing it aloud!
In South Sudan, people often sing at weekends to entertain themselves.

If we want to add music into our health promotion, it will really depend on what specific message the team is promoting. Then we need to sort out practical issues such as how to broadcast the music. Besides music, I believe using drama may also be an entertaining and effective method to promote health messages to the public.”

To people in need, music can be one of those "medicines that doctors can't prescribe". However, frontline field workers can also learn more about people from different cultural backgrounds through music. Jennifer Tong and Luke Chu, frontline field workers from MSF Hong Kong, tell us more about their musical experience with local people during their work.

Pong's pick:

Supper Moment - Endless
Rubber Band - Discovery
Mayday - Contentment
Mayday - Stubborn
Charmaine Fong – You are Your Legend
Fish Leong - Fly away

Tobey's pick:

Westlife - Beautiful World
Eason chan - BABY SONG
Ronald Cheng - Black Rainstorm
Beyoncé -  Halo
C AllStar - P.S.

Krystal's pick:

Serrini - Let us go then you and I
Mirror - We all are
Yoyo Sham – Always willing
Yoyo Sham - Fly 
Kiri T - You gotta screw up at least once