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In Burkina Faso, as in most other countries around the globe, the Ministry of Health announces the number of new Covid-19 tests performed, the number of confirmed cases as well as the number of Covid-19 related deaths on a daily basis. This eagerness to share and publicise health data is noteworthy, particularly in the current situation where health experts and data science specialists know that such data need to be interpreted with care. The testing capacity in most countries in sub-Saharan Africa, including Burkina Faso, is very low. It is well known that the quality of death registries in Burkina Faso is poor. Thus, the published data is not believed to depict a reliable picture of the actual situation.
One may ask who the target audience is for these daily announcements? Is the overall purpose of these daily press releases to update the population with the latest information, or is the intention rather to address an international audience such as the World Health Organization and the donor community – or perhaps both?
The demand for continuous updates on morbidity and mortality is for obvious reasons particularly urgent during epidemics. Throughout the Covid-19 pandemic, we have witnessed an almost obsessive demand for numbers both locally and globally. We have seen a strong global tendency to make uncritical comparisons of data across countries, where the daily figures are ‘lifted out’ of the local context as abstract and ‘lifted into’ a range of dashboards as facts.
In a recent study of citizens’ responses to the pandemic and to the lockdown in Bobo-Dioulasso during the early phase of the pandemic in spring 2020, we found that many people were puzzled about the daily announcements and had started to question the validity of the information and data provided by the government. Most of our interlocutors did not interpret this openness about data as a gesture of transparency, rather the opposite. As expressed by Yaya, a 43-year-old small-scale business man at the market in Bobo-Dioulasso: ‘the number of cases they announce, I am sure that it is not correct. It is just not right. It is falsified figures even though the disease is here … what I can say is, that the disease is here, but it is not as alarming as they want us to believe. They just want money to do their campaigns (for the upcoming elections), but they already have money. Their bags are full of money.’
Martin, a 36-year-old bartender said that because the government has not been able to demonstrate any proof of the existence of Covid-19 on the television, many people had started to doubt its existence in Burkina Faso. He, himself, had no doubts about the actual existence of Covid-19: ‘No, I have no doubt. What I doubt, and here I want to be precise with you, I have doubts about the number of cases, the number of sick and the number of recovered, otherwise, I am convinced that the disease exists. It is their record, I doubt.’
During the first phase of the Covid-19 pandemic, the number of tests performed in Burkina was quite low. In April and May 2020, less than a hundred tests were performed daily, this increased to around 400–500 tests a day later in 2020. However, with a population of around 19 million, it was probably hard to estimate the level of the epidemic in Burkina with so few tests. Furthermore, death registries are poor in Burkina and as more than 50% of deaths take place at home with no cause of death notified, the number of Covid-19 related deaths in Burkina Faso has been extremely uncertain throughout the pandemic. Nevertheless, announcing the number of new Covid-19 cases and Covid-19 related deaths on a daily basis is what the Ministry of Health has committed itself to do.
As has been pointed out by Vincanne Adams, global health agencies and institutions increasingly commit themselves to forms of (global) knowledge that are based on universals and which only become visible through forms of data production grouped together as ‘metrics’. Funding from international donors and agencies depends to a large extent on the ability to speak the language of metrics. Agencies such as the Global Fund carefully evaluate a country’s national output indicators regarding malaria, HIV and AIDS, and TB within a performance framework. As shown by Tichenor in her analysis of a data retention strike in Senegal from 2010–13, the withholding of national health data affected the Global Fund’s assessment of the country’s capacity to perform and to deliver data on its malaria intervention programmes triggering uncertainties about the Global Fund’s willingness to continue funding the national malaria programme. Thus the motivation to secure a flow of data from local to global levels is strong for many governments in the global South, where the health care systems to a large extent depend on grants from international donors and funds. The risk of not being able to present data might be too big, even though the quality of the submitted data could be questioned.
While it is positive that the Ministry of Health is transparent about the number of Covid-19 tests, cases and deaths – and one could argue, that some data is better than no data – it did not appear to impress the local population. On the contrary, local scepticism about the officially presented metrics seemed to grow during the pandemic.
However, the Covid-19 metrics spoke to the global discourse where daily data announcements quickly turned into a global standard. The government of Burkina Faso managed to adjust to this global discourse and perhaps it helped the government in attracting various kinds of funding (for testing facilities, vaccines, protective equipment etc.) from international agencies – despite the fact, that the facts– the data – did not convey a correct picture of the actual Covid-19 situation in Burkina Faso. In this fetishisation of Covid-19 metrics, numbers are endowed with a life and a value of their own, a value, which is ‘lifted out’ of the specific local context into a global discourse, where the numbers (as imprecise as they are) are legitimised, and may serve as symbolic tokens for the Burkinabé government to emerge as an international partner worth supporting. As indicated above, the national discourse on Covid-19 metrics seems more complex.
Our study among citizens in Bobo-Dioulasso found that mistrust in the government’s handling of the Coronavirus was growing during the first phase of the pandemic. This growing discontent, we argue, should be understood in a wider context of the everyday precariousness of many people in Burkina Faso, where the government of Roch Mark Kaboré, elected in 2015 after 27 years of Blaise Compaoré, and re-elected in 2020, has not yet managed to meet popular demand for political change and improvement of living conditions. Growing insecurity, with numerous attacks from jihadist groups inside the country, has further spurred the critique of the government for its incapacity to provide security.
Thus, while the daily Covid-19 announcements seem to resonate well with a globalised perception of metrics as a form of universal ‘knowledge’, they almost have the opposite effect at the local level. Our interlocutors in Bobo-Dioulasso perceived the daily announcements more as tactical manoeuvres instigated by the politicians to attract funding for their political campaigns than as up-to-date information about the pandemic.
Chitungo, I. et al. (2020) ‘Covid 19: Unpacking the low number of cases in Africa’. Public Health in Practice 1: 100038.
Lankoande, Y. B. (2016) ‘Monitoring adult mortality by type of residence in the absence of death registration: a perspective from Burkina Faso’, International Journal of Population Studies 2 (1): 21–37. The issue of poor data quality was addressed in ‘Bulletin d’épidémiologie et d’information sanitaire’, 36 ième Edition, Ministère de la Santé, Burkina Faso, August 2018.
Giddens, A. (1991) Modernity and Self-Identity: Self and Society in the Late Modern Age, Stanford, CA: Stanford University Press.
This study was part of a larger project entitled: ’Emerging Epidemics: Improving Preparedness in Burkina Faso’, funded by the Ministry of Foreign Affairs, Denmark (project no. 17-06-KU), https://anthropology.ku.dk/research/research-projects/current-projects/improving-preparedness-in-burkina-faso/.
Bado, A. R., Kouanda, S. and Haddad, S. (2016) ‘Lieu du décès au Burkina: influence des caractéristiques sociodémographiques et environnementales’, African Population Studies 30 (1), May.
Adams, V. (2016) Metrics: What Counts in Global Health, Durham, NC: Duke University Press, p. 6.
Tichenor, M. (2016) ‘The Power of Data: Global Malaria Governance and the Senegalese Data Retention Strike’, in Adams, V. (ed.) Metrics: What Counts in Global Health, Durham, NC: Duke University Press, p. 120.
Bourdieu, P. (1991) Language and Symbolic Power, Cambridge: Polity Press.
Samuelsen, H. and Toé, L.P. (2021) ’Covid-19 Temporalities: Ruptures of everyday life in urban Burkina Faso. Medicine Anthropology Theory 8 (1): 1–21