Abstract: In this paper I examine how responses to COVID-19 by Ghana’s creative arts communities shape public understanding of the pandemic. I focus on comedy, music, textile designs, and murals created between March and August 2020, through frameworks of the social psychology of everyday knowledge and arts and health. The art forms perform three functions: health promotion (songs), improving environ-mental aesthetics (murals), and memorialising (textile designs). Similar to arts-based interventions for HIV and Ebola, Ghanaian artists translate COVID-19 information in ways that connect emotionally, create social awareness, and lay the foundation for public understanding. Artists translate COVID-19 information in ways that connect emotionally, create social awareness, and lay the foundation for public under-standing. Some offer socio-political critique, advocating social protection for poor communities, re-presenting collective memories of past health crises and inequitable policy responses, and theorising about the Western origins of COVID and coloniality of anti- African vaccination programmes. I consider the implications for COVID public health communication and interventions.Keywords: COVID-19, Ebola, HIV, creative arts, collective memory, coloniality, public understanding, public health communication, Ghana.Note on the author: Ama de-Graft Aikins is a social psychologist and a British Academy Global Professor at the Institute of Advanced Studies, University College London. She is Principal Investigator of the British Academy funded Chronicity and Care in African Contexts Project. The project aims to explore how social responses to chronic conditions can shape public engagement and intervention models for chronic care in African communities.
In March 2020, just days after partial lockdown was imposed in Ghana, a satirical video on the COVID-19 pandemic went viral on social media. The video, styled as a parody of the vox pop, featured the Ghanaian comedian and actor Clemento Suarez (real name Clement Ashiteye), playing a schoolboy called Timothy, who was walking along a road when he was suddenly accosted by a ‘journalist’ with a microphone. ‘Aha, Timothy’, the journalist said in the Akan language Twi, ‘tell me the corona ABCD’.As Schoolboy Timothy worked his way through what he called the ‘colonial ABCD’, he made you laugh and he made you think. Hidden in the funny imagery and the sly twists of Twi expressions replacing English alphabets, were the core public health messages—endorsed by the Ghana Health Service (GHS)—of social distanc-ing, handwashing, and respiratory hygiene. But he also told a nuanced story of the impact of the COVID pandemic in Ghana, picking apart the political, economic, and religious problems of the day, and placing them in historical context. Suarez’s vox pop parody joins several COVID commentaries from Ghana’s creative arts communities since the first two cases were reported on 12 March 2020. These ‘COVID art forms’ have been shared on social media, traditional media, and social networks, reaching thousands of Ghanaians at home and abroad. My British-Academy-funded project, titled Chronicity and Care in African Contexts, aims to explore how social responses to chronic conditions can shape public engagement models for chronic care. In the early weeks of the pandemic, studies showed that chronic conditions like diabetes, hypertension, heart disease, and obesity raised the risk of COVID infection.1 Now, patient accounts suggest that recovery from COVID may be slow and lead to disabling and new chronic conditions, a phenomenon labelled ‘long COVID’.2 I have been interested in the intersections between COVID and chronic conditions and evolving social responses to these in African communities on the continent and in the diaspora. Working with a team in Ghana, I am tracking and collating various art forms, including comedy skits, cartoons, songs, textile designs, and public art. These spontaneous, largely grassroots and self-funded, responses to COVID from Ghanaian artists, afford the opportunity to examine in real time what works for improving public health education and interventions, from the perspective of lay society, during the pandemic and beyond.
Arts, collective memories, and re-presenting ‘familiar alien threats’
In our everyday lives, social psychologists argue, we are often confronted with ‘familiar alien threats’. These are categories of phenomena or people, like madness or the mentally ill, that we may already know but actively ‘maintain in an unfamiliar pos-ition’, because they represent danger, chaos, or transgression.3 Whether they are excluded from, or partially anchored into, existing systems and ways of knowing, familiar alien threats reinforce established, albeit heterogeneous, meanings, identities, and relationships in society. Pandemics constitute a category of familiar alien threats. Communities make sense of each new pandemic through the collective memories of old ones, but never fully anchor them. At the same time, the practical responses demanded of the complex crises that ensue, change societies in fundamental ways. These socio-psychological and structural processes are demonstrated in Ghanaian social responses to COVID-19. For some groups, COVID has been partially anchored in recent memories of the 2014–2015 Ebola Virus Disease (EVD) pandemic in West Africa. EVD killed thousands of people and caused social and economic crises in Guinea, Liberia, and Sierra Leone. Ghana did not record Ebola cases, but rumours of suspected cases, and anticipation of infection, caused anxiety, fear, and stigma in lay and healthcare communities. The stigmatisation and exoticisation of West Africa in global media had a negative impact on travel, tourism, hospitality, and other local industries with international ties. Longstanding fears and mistrust of Western medical interventions, rooted in unethical colonial and post-colonial experimentations, fuelled protests against Ebola vaccine trials in Ghana by lay communities and sections of the local scientific community.
For others COVID has been partially anchored in the HIV/AIDS pandemic of the 1980s, which is now considered in global health to be a mature mixed epidemic. While cases in Ghana have been lower than in other parts of Africa over the four decades of the epidemic, never rising above 5 per cent prevalence nationally, HIV/AIDS was a significant public health crisis that changed Ghanaian society and transformed the landscape of healthcare.7 Ring-fenced funding allocated to HIV/AIDS surveillance, treatment, and governance by global health donors,8 strengthened local responses to the HIV/AIDS threat. But this also weakened an already compromised system of health governance—in which power struggles between policymakers, politicians, and ‘development partners’9 complicated the processes of naming, understanding, and funding local health problems—and created hierarchies of disease and health research priorities that continue to undermine equitable healthcare today.10 A clear example is the lack of investment in the prevention and control of a chronic condition like hypertension, which has a prevalence rate ranging from 28 per cent in rural areas to 40 per cent in urban areas, and has been a leading cause of death in hospitals for the last thirty years.For some elderly Ghanaians, COVID-19 has been anchored in their family and social memories of the 1918 global flu pandemic. Introduced through sea ports by European travellers, this pandemic killed 100,000 people or more in the Gold Coast, Ashanti, and Northern territories over a six-month period.11 Slum conditions of coastal towns, chronically understaffed and underfunded medical services, poor pub-lic health education, and limited literacy were implicated in the devastating death toll. The colonial British government implemented changes in health promotion and urban town planning following appeals by Gold Coast elites. Yet, coastal communities in Accra, Cape Coast, Keta, and Sekondi, for example, which bore the brunt of 1918 global flu pandemic, remain in a state of structural neglect today and have been disproportionately affected by public health crises over the last century. More health facilities exist today, including health facilities built soon after the flu pandemic, but health services continue to be chronically underfunded, understaffed, and ill-equipped to respond to protracted health crises. Literacy rates have improved, but health pro-motion still follows a didactic English-language-based format that excludes large swathes of a national population that speaks over forty languages and ignores complex cultural representations of health and disease.Artists recognise the importance of collective memory in making sense of new public threats, and the structures within which these threats operate. The local term ‘colonial virus’ started as an inside cultural joke. Then some artists and public intel-lectuals reworked the joke as a critique of the ‘colonial mentality’ driving political and policy responses to the COVID pandemic, the HIV and Ebola pandemics and recur-ring health crises. Others reminded their audiences about past public threats: the coup years of the 1970s when curfews were enforced by the military in very similar ways to the early days of COVID lockdown in Ghanaian cities;12 the 1983 famine that caused great hardship for many Ghanaians; and the economic impact of the energy crisis the country experienced between 2012 and 2016, which Ghanaians creatively christened ‘dumsor’ (‘off and on’ in Twi) (Figure 1)
Figure 1. Tilapia da Cartoonist, ‘Dumsor-COVID-19 economy comparison’, 7 May 2020 (source: https://www.facebook.com/TilapiaCartoons/). 
Figure 2. GTP COVID designs ‘Fellow Ghanaians’ and ‘Lockdown’.
In July 2020, Ghana Textiles Printing (GTP) launched new COVID-19-inspired textile designs. Building on a long tradition of using textiles to memorialise significant national events, the designs featured recognisable symbols of the COVID pandemic: planes for airport closures, padlocks for lockdown, the medical illustration of the coronavirus, and in what appeared to be political homage, the distinctive round eyeglasses worn by Ghana’s president Nana Akufo-Addo (Figure 2). In an interview with BBC Focus on Africa, the marketing director of GTP, Mr Stephen Badu, observed:
We are a business that tells stories and we tell our stories through our designs. We believe that it [COVID] is going to leave a mark in the history of the world, and it’s important that generations that come after us get to know that once upon a time, such a phenomenon occurred.
Scholars of Ghanaian oral literature and popular culture draw attention to the ways art forms like folklore, folk songs, and cartoons use allusions, innuendo, satire, and subversive critique to channel collective memory, challenge social norms and authority, and confront taboos and sacred institutions.14 These COVID art forms function in similar ways. Whether evoking collective memories of past crises and official responses to these crises through comedy and political satire, or creating a new collective memory of COVID through textile design, Ghanaian artists facilitate anchoring of this new familiar alien threat.
Arts and pandemic health communication
Arts and pandemic health communication