Abstract
Across the African continent, in countries such as Uganda, Zimbabwe, Namibia, and Ghana, female condoms are a hot commodity, but for all the wrong reasons. Rather than serving as front-line HIV prevention devices empowering women in the bedroom, they are instead fueling a new trend in fashionable bracelets. How did the campaign fall apart?
In this original and innovative study of AIDS media campaigns in Accra, Ghana, Terence McDonnell’s book Best Laid Plans: Cultural Entropy and the Unraveling of AIDS Media Campaigns examines the life course of campaign objects such as female condoms, billboard posters, and stickers from their conception to their production and, importantly, their lives after they leave designers’ offices and circulate through the landscapes of local Ghanaians. In doing this, he illustrates for the reader his key conceptual contribution: cultural entropy—”the process through which intended meanings and uses of a cultural object fracture into alternative meanings, new practices, failed interactions, and blatant disregard” (p. 2; see also Chapter 1).
A key strength of the book is McDonnell’s methodological approach, which is eclectic and effective, with each empirical chapter in the book featuring a different method (a detailed methodological appendix is offered at the end of the book). In Chapter Two, the study draws on old-fashioned ethnographic observation, exploring the Accra cityscape to capture the various settings through which healthcare is disseminated (hospitals, clinics, pharmacies, herbalists), the various institutions of influence in the city (churches, schools, bars), and the various settings in which posters, the main cultural objects of study, are placed. In addition, McDonnell also conducts a “survey of the cultural environment” (p. 61) to unpack the various beliefs and practices that ad campaigns are trying to change and which may also serve as a basis for the entropy of AIDS media campaign objects.
Chapter Three situates AIDS media campaigns within a larger, more global organizational field inhabited by four types of organizations—local AIDS NGOs, Ghanaian government agencies, international funding agencies, and local and international advertising agencies. Drawing on individual interviews with designers as well as examining the global “best practices” documents to which they rigidly adhere, McDonnell explains the shift from “uncoordinated, unsystematic campaigns” to a “rigorous, evidence-based” approach as an attempt to attain legitimacy in the battle for limited resources. Further, designers avoid evaluating the success or failure of campaigns because they “likely prefer to remain blissfully ignorant—that way they can report positive progress back to funding agencies” (p. 81).
McDonnell traces the beginnings of cultural entropy in the implementation of “best practices” in Chapter Four. In particular, he shows how the kinds of data different organizations collect (categorical survey research versus narrative focus-group research) result in different kinds of campaigns that are vulnerable to entropy; he also shows how cultural ombudsmen employed during field testing to achieve buy-in (also a “best practice”) can change their minds and support after the campaign has been launched.
Chapter Five employs particularly innovative methods to capture entropic processes as ads circulate in Ghana. McDonnell illustrates the various viewpoints from which people see media campaigns by examining objects in situ, both by interviewing passersby as well as by navigating the social landscape the way different classes of Ghanaians would—on foot, in tro tros (public transport vans), and in private cars or taxis. McDonnell argues that cultural entropy of objects happens in “patterned and systematic” ways: through the placement of the objects (e.g., they might inadvertently be virtually invisible or obscured to intended audiences), through changes in material aspects of objects that are key to their message (e.g., fading color or words), and through their displacement to unintended locations (such as from a public hair salon to a private bedroom). Passerby interviews were employed to investigate “cultural memory” of obscured, decayed, or displaced objects.
The final substantive chapter, Chapter Six, employs focus groups in an innovative and powerful way. Participants were asked to create HIV/AIDS prevention posters, and McDonnell examines the process of poster creation and the group conversation; he then interviewed the group afterwards. What is especially striking about the chapter is how it highlights the effectiveness and stickiness of old AIDS media campaigns, which depended on graphic images of death to scare people into protecting themselves from HIV. Their virtual reproduction by focus-group participants helps to underline the challenge of contemporary ad designers trying to displace these sticky cultural memories with new ads aimed to evoke compassion and attack stigma against people living with HIV/AIDS.
While the context of Ghana was certainly novel and interesting because of its low HIV prevalence, I wondered about its applicability for understanding AIDS media campaigns in the many African countries where HIV prevalence is high and where by some accounts AIDS media campaigns have been successful. The limited discussion of these other contexts made generalizing statements such as “the failed promise of AIDS communication efforts in the developing world” (p. 5) somewhat unconvincing. A more systematic and comparative discussion of other health campaigns in this setting (e.g., successful family-planning media campaigns) or of AIDS media campaigns in other African countries or developed countries (where projects do not “pack up and go” [p. 115] in quite the same way) would have been helpful to more clearly delineate the conditions under which entropy is likely to occur.
A minor quibble was that while each chapter made distinct arguments, the chapters did not always speak to each other and were not always cumulative. While this would make the book ideal in assigning chapters for class engagement, as a book it resulted in some inconsistencies and contradictions in the argument from one chapter to the next; and there were missed opportunities to build on and utilize concepts introduced in earlier chapters.
The book is sure to spark debate among scholars of culture and organizations with respect to what “culture” is, how it is utilized, and how it is transmitted. Drawing on a Geertzian definition of a cultural system (“an historically transmitted pattern of meanings embodied in symbols [or, in this case, objects], a system of inherited conceptions expressed in symbolic forms by means of which men [and women] communicate, perpetuate, and develop their knowledge about and attitudes toward life” [p. 225]), McDonnell argues that “instrumental uses of culture” and attempts to “stabilize meaning” in cultural objects by “stripping them of alternative meanings” are ultimately futile. This is because “meaning systems tend toward increasing disorder and instability” and therefore “most campaigns ultimately succumb to cultural entropy” (pp. 29, 30, 33, 80).
This implies not only that successful media campaigns are accidental (p. 5) but also, more broadly, that questions of how cultural transmission itself happens are also at stake. This includes questions about whether meaning systems are inherently unstable, how shared meaning systems are achieved and transmitted, and the conditions under which organizations (such as schools, religious institutions, and others) engaged in the business of cultural transmission succeed if cultural entropy is, in fact, the norm.
The theoretical, methodological, and empirical contributions of this book earn it a place on the bookshelves of scholars of organizations, culture, media and communications, and HIV/AIDS.