Earlier this winter, Hodan Guled, CEO of Briva Health, decided she wanted to do her part to help slow the transmission of COVID-19 among members of Minnesota’s East African community. The virus has hit older members of the community particularly hard, she said, and she came up with the idea of taking a counterintuitive approach to slowing the spread — by reaching out to members of the younger generation.
“When we started talking about the impact of COVID,” Guled said, “our community initially hasn’t been focused on the younger generation. Now, we realized how important young people actually are in keeping their grandparents and parents safe.”
Because people in their teens and 20s often experience relatively few symptoms when infected by the virus, they can unknowingly transmit the disease to their more vulnerable relatives and neighbors.
“A lot of our community members live together in multigenerational families,” Guled said. “Young people who live with their parents, grandparents, aunts and uncles play a big role in transmitting this disease.” Guled didn’t want to ask young people to stay away from their family members: She just wanted to encourage them to take basic precautions that could help keep everyone safe.
Correctly wearing a mask in public is considered one of the most important ways that a person can lower the risk of COVID transmission. Guled decided she had to connect with young Minnesotans of East African heritage and encourage them to mask up to help protect the whole community.
“My focus shifted to, ‘How can we best reach the young people?’” Guled said. She decided that the best way to connect with her target audience would be through the help of a group of people they look up to — high-profile individuals with more clout and influence than traditional authority figures.
“We decided, ‘Let’s create a video that showcases young influencers saying who they are masking up for,” Guled said. The video’s focus on protecting others rather than yourself, was intentional, she added: She wanted to speak to her target audience’s sense of collective community responsibility — rather than their sense of self-preservation.
“They aren’t masking up for themselves,” Guled said, “because they are at very low risk. But instead we wanted to ask them, ‘Who do they love? ‘Who do they care about?’ ‘Who do they want to protect?’”
Guled’s video, part of her organization’s work with the Minnesota Department of Health’s COVID-19 Community Coordinator program, features a group of young East Africans — a mix of cultural influencers and regular young adults — pulling on masks and answering the question “Who Are You Masking Up For?”
The project appealed to the instinct of the young people involved, Guled said. They appreciated its recognition of the important role they play in supporting the health of the entire community.
Family and community are central to East African culture, Guled said, as much as is the deeply rooted respect for elders. “The sense among our youth is, ‘I want to protect my elders,’” Guled said. “That’s something that’s part of who we are. We’re always protecting our elders. We always take care of them. When our elders get too old or sick we don’t have nursing homes for them. We bring them home and take care of them. It is part of our culture to take care of who we care about.”
Seeing older relatives, neighbors and friends hospitalized or even dying as a result of COVID-19 has had an impact on members of the younger generation, Guled said.
“We have a lot of elders, especially in the Somali community, that are getting hospitalized, that are losing their lives because of COVID,” she said. Though young people aren’t often included in larger discussions about public health issues, Guled thought it was important to create a campaign that emphasized the important role they can play in slowing community spread and saving lives: “I wanted to include them here, because they have an important role to play.”
A key part of organizing the video was recruiting participants. Guled decided that if she really wanted to influence the behavior of a younger audience the best messengers would be other young people, especially those who hold positions of respect and influence.
“We reached out to a group of young people and asked, ‘Who are the young influencers in our community?’” she said. “The young people I know introduced me to a few, including a couple of rappers, a few young politicians and some personalities that are big on Instagram.”
“Who Are You Masking Up For” participants include rapper Hanad Hashim; Mohamed Jeylani, a producer with almost 80,000 Instagram followers; rapper Nedji; and Nadia Mohamed, a St. Louis Park City Council member.
“The idea was that when they see their faces young people would recognize them,” Guled said.
Guled directed the video. When participants arrived for filming, she said she stood next to the camera and asked them, “Who do you mask up for? Is there someone in your family that means a lot to you that you don’t want to lose to this disease or be hospitalized or on a ventilator?’”
This question hit home for many of the participants, Guled said. They took the question seriously.
“We tried to touch into the emotional side of this. We tried to get at the question of, ‘Who is it that you care about that you don’t want to get hurt?’ We wanted them to realize the role they play in keeping people safe, to realize their true responsibility.”
With an eye to reaching her target audience, Guled heavily promoted the video on social media.
“It went really well on Instagram,” she said. The campaign also got a big boost when Lt. Gov. Peggy Flanagan posted links on Twitter and Facebook.
Premed student Subeida Ismail is featured in the video. She got involved when her cousin, who works at Briva Health, called her up and asked if she’d participate. “She said,” Ismail recalled, “‘This is a cool opportunity. I know you are in the medical field. Do you want to join up with me and do the video?’”
Ismail was excited to take part. In her classes at North Hennepin Community College, she’s learned a lot about COVID transmission and the importance of protecting people with vulnerable immune systems. During filming, when Guled asked her, “Who are you masking up for?” she said, “I’m masking up for my Eedo (Aunt). She’s is diabetic and has high blood pressure.”
Taking part in the video felt important to Ismail, who’s taking her new role delivering a key health message seriously.
“It is important that you mask up,” she said. “It could be your brother, your sister, your mom, your dad that could be in these high-risk categories. I want to get that message across and solidify it with other young people.”
The importance of wearing a mask in public has been a hard sell with some Americans, Glued said, but she felt confident that as long as the message is clear that masking is something a person does to protect their loved ones, she wouldn’t have a hard time convincing other East Africans to wear masks.
“We tend to think about the community first, then the individual,” she said. “It’s just the way we look at the world.”
City Council Member Mohamed agrees. While language and cultural barriers at first slowed the delivery of the pro-mask message, she said, once the right community members started promoting the importance of wearing masks to protect others, the idea really took off. That has to do with a longstanding cultural ethic that emphasizes the welfare of the group over that of the individual, she added.
“Immigrant families, more likely than not, come from a more collectivistic society,” Mohamed said. “We do it for other people, for our families, for our parents, our children. We’re not so individualistic. American culture is very individualistic, but African people really do understand the concept of not doing just it for yourself, but doing it for other people.”
Ismail said that she and her family are deeply troubled by COVID-19’s impact on members of the Twin Cities’ East African community.
“My mom has been telling me that a large population of the inpatients in the state’s hospitals are Somali elders,” she said. “They’re diabetic or they have high blood pressure. They’ve been hard hit. It’s really sad. Later today we are going to a funeral of an elder Somali lady who died because of corona.”
Mohamed, who came to the United States from Somalia 14 years ago, when she was 10 years old, said that even though its target market is young people, Guled’s video will likely also have an impact on the older generation.
“When they look at the video, elders will see their children,” she said. “They understand that every single person in the video was telling them who they were masking up for. No one was saying, ‘I’m masking up for me.’ This makes a big difference, and will give the video more community-wide impact.”
Like the lieutenant governor, Mohamed made a point of forwarding the video to her larger social networks. She felt encouraged when she saw that many of her contacts forwarded the video on to their contacts.
“People sent the video to their personal network,” Mohamed said. “It got noticed by other people.”
Mohamed said she is painfully aware that COVID-19 doesn’t just impact the state’s East African community. Because she’s been elected to serve all residents of St. Louis Park, she thought that her answer to Guled’s question should be inclusive.
“I said, ‘I’m masking up for my fellow Minnesotans,” Mohamed said. “I have a responsibility to all my constituents to protect them and mask up for them, too.”
Spread the message — not the virus
Guled’s video has been out for a little over a month, and she’s already dreaming about producing another.
She’d like her next project to be aimed at a wider audience.
“I’ve been thinking about doing another video for a more diverse community,” she said, “I’d like to reach Caucasians, African Americans, Asians, Somalis, different communities.” She’s been working to refine the message and target participants. “I think this could have a big impact,” she said. “I’m just thinking about how.”
Even if she doesn’t end up taking on this new project, Guled hopes her original video will inspire members of other groups to make their own versions.
Ismail said that there is one other public health message that she’d like to spread to people across the state. She’s seen too many people let their masks slip down, off their nose — or, even worse, pull their mask off their mouth. She’d like to see a video that gives pointers about how to wear a mask correctly.
“When some people are talking, sometimes they feel like they can’t be heard in the mask so they take it off to speak,” Ismail said. “I hope that message gets through in the video that a mask just isn’t for some situations. You don’t need to take it off when you need to speak up.”
If there were a way to create a video that explains the importance of keeping your mask over your face at all times, especially one targeted to youth, Ismail said she’d make of point of passing that on to every single one of her contacts. It’s a simple message that she feels is not getting through to enough people.
“I don’t understand the whole thing of pulling down the mask if you really want to speak up and get your point across,” she said. “Just leave the mask over your mouth and nose. People can hear you. It’s not that difficult.”