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Healthscapes in the Philippines: A Linguistic Landscape Analysis

Heshell Ellaga 1 and Paolo Nino Valdez,*


1
Southern Luzon State University
2
De La Salle University, Manila, Philippines
*Corresponding Author: [email protected]

Abstract: With the recent challenges brought about by COVID-19, research from different
perspectives have given rise to examine its impact in communities. While investigations have
focused on societal response, public health response and vaccine development, the role of
language in mediating health concepts is an important aspect in addressing problems
brought about by epidemics. In this investigation which examines the healthscapes in a rural
Philippine community, argues that discourses in space can be helpful in determining the
potential of language and multimodal resources are deployed in impacting health literacy
concepts. Using a linguistic landscape approach, a total of 704 photos of signs in several
barangay health centers from rural community was used for analysis. The analysis revealed
that language and multimodal resources are used to impart transactional, territorial and
institutional discourses. These discourses do not only indicate the organization of public
health services but also the reception of its stakeholders is influenced by the institutional
order, range of services offered and intended audience of these signs. As language and
multimodal resources have instrumental functions in establishing healthscapes as an
essential component in community life, this paper can help initiate meaningful discussions in
the potential uses of linguistic landscapes in disease prevention, provision of health services.

Key Words: COVID-19; Healthscapes; Health Literacy; Linguistic Landscape;

1. INTRODUCTION with the rise of research on public health due to the


COVID-19 pandemic, the role of health literacy is an
important aspect in ensuring holistic development in
Recent research on linguistic landscapes in
communities. However, linguistic landscape research
different contexts has shown that multilingualism is
in the area of health literacy remains
a key resource in negotiating meaning, indexing
underrepresented in the literature, specifically in
power relations, and can even regulate other
developing countries.
resources among language users. As an approach
Given these points, this paper argues that
aimed at studying public signs, linguistic landscapes
the use of linguistic landscapes reveals that
can help determine the regulatory functions of
healthscapes use transactional, territorialized and
languages in specific agents of the state. Specifically,
institutional discourses in mediating public health
services in the community.

2. METHODOLOGY
Anchored on Scollon and Scollon’s (2004) nexus
analysis, this paper focuses on the discourse in place
manifested in publicly available signs. The concept of
discourses in place, which allows the discussion of LL
data in relation to context, was analyzed using 704
photographs captured in the barangay health centers
of Lucena City, Quezon. Photographs used to
represent the discourses in LL in this paper are from
a wider study relative to health literacy.

3. RESULTS AND DISCUSSION


Borne out of the discursive construction of the
health environment through LL is a healthscape (cf.
Brown, 2012). Fundamentally, the aim of a
healthscape is to communicate health information Fig. 1. Offer for free HIV testing
and services. But in the process of shaping a
landscape that will suit the primary goal of health Through the use of short imperatives, the sign
agencies, discourses that regulate operations in enforces readers to avail of the service. Below the
health stations and reflect the goals of health imperatives, a declarative statement was also used to
agencies also seem indispensable in establishing a persuade the readers. Persuasion here was made by
healthscape, as was observed in the data set. These emphasizing that HIV testing is for free, and by
discourses are then identified as transactional, guaranteeing that patient’s data is confidential.
territorial, and institutional. To ensure the comprehensibility of these
statements, the languages written on the sign are
Filipino and English. Filipino was used as the matrix
3.1 Transactional Discourse language wherein its syntax is used, and its
A health center, being a medium for the
morphology dominated English. Meanwhile, English
government to reach the communities, is the space
was used as an embedded language. This language
tasked to create an environment where health
preference may be attributed to the level of
information and services offered are communicated
proficiency of the prospective readers as a result of
for the benefit of the public (Backhaus, 2012). Thus,
the country’s bilingual policy. Hence, it could be
health centers are expected to ensure that medical
asserted that the expected proficiency in both
information and services offered are manifested in
languages was considered by sign producers to
the discourse created in signs. In consequence,
facilitate understanding of health information and
transactional discourse is ubiquitous in this state-
services.
run network of clinics because there is a prevailing
Aside from the languages used to offer the
aim for information awareness and/ or offering of
service, the picture of a male could be regarded a
services. For instance, Figure 1 offers a service under
piece of additional health information intended by
the DOH’s Communicable Diseases Program.
the sign producer since 94% of the cases were male to
male transmissions (Montemayor, 2019). However,
without the statistic indicated in the poster, HIV
may be interpreted as infecting males only, or mostly
males; thus, this could lead to misinformation.
3.2 Territorial Discourse
Signs which mark borders that require a certain 3.3 Institutional Discourse
favorable behavior point to territorialization. The Institutional discourse is manifested in the
creation of territory here, or what Jaworski and barangay health centers to present the
Yeung (2010) claimed as “gated communities (p. predetermined orientation or understanding and
154),” is inspired by the place- markings and the adapting goals and objectives between or among
socially acceptable rules specific to this particular offices. This discourse is shaped by the local or
community. central policies guiding the institution (De Los Reyes,
2014). First 1000 Days Program, for example, shows
the agencies working together in this project.

Fig. 2. Rules on the use of footwear

The figure above is a straightforward territorial Fig. 3. Poster for baby’s first 1000 days program
discourse that imposes a certain social behavior to
visitors regarding the use of shoes and slippers inside. Based on the self-referential labels on the
It regulates the behavior of people entering the space topmost portion of the tarpaulin, the City
by imposing a rule of the territory. Similar to Figure Government of Lucena, the Department of Health,
1, there is a co-occurrence of Filipino and English in the National Nutrition Council, and the City Health
this sign to safeguard its comprehensibility, which Office (from left to right) coordinate to bring into
ensures the adherence of sign readers to the rule. fruition their aspiration for city-wide health care
Consequently, one’s social behavior has to change provisions. Evidently, the goals of the national health
even before the border is crossed, i.e. before entering agency are likewise ingrained in the mission of the
the health center. Local Government Unit, and its own health unit. As
Controlling the behavior of visitors, the sign demonstrated in this sign, the programs instituted in
becomes instrumental in creating order. Moreover, it the upper-tier government agencies are
strongly projects the property-based claim of sign communicated to the small units which serve as the
producers— in this case, the health workers. Even first points of contact of the public to the government.
more so, this transcends property claims and Thus, this sign projects top-down management in the
suggests that the health workers’ jurisdiction is implementation of health programs.
justified by their expertise. As Blommaert (2005, as
cited in Hult, 2014) remarked, a particular space
creates a sense of authority and rights to property,
4. CONCLUSION
Signs could be exploited to create an LL specific
which, in this study, is created through territorial
to a particular community. In this preliminary study,
discourse.
the discourses illustrated in the signs of health Jaworski, A., & Yeung, S. (2010). Life in the Garden
centers became fundamental in creating the of Eden: the naming and imagery of residential
healthscape. First, transactional discourses help Hong Kong. In: Shohamy, E., Goldberg, Ben-
maintain the kind of environment it is designated to Rafael, E., & Barni, M (Eds), Linguistic
be as put forth by the upper-tier offices. Next, landscape in the city (153-181). Bristol:
territorialization creates an atmosphere where the Multilingual Matters.
health workers have a strong claim to space because
of their expertise and the right they were given to Scollon, R., & Scollon, S. (2004). Nexus analysis:
run the health centers. Lastly, institutional Discourse and the emerging internet. New York:
discourses aid in communicating the alignment of Routledge.
goals across health offices. Ultimately, it may be
asserted that these discourses are products of the
sign producers’ purposeful decisions in establishing a
healthscape that will foster health literacy.

6. REFERENCES

Backhaus, P. (2012). Language policy at the


municipal level. In B. Spolsky (Ed.), The
Cambridge handbook of language policy (pp. 226-
242). Cambridge: Cambridge University Press.

Brown, K. (2012). The linguistic landscape of


educational spaces: language revitalization and
schools in southeastern Estonia. In D. Gorter , H.
F. Marten, & L. Van Mensel (Eds.), Minority
languages in the linguistic landscape (pp. 281-
298). Basingstoke, UK: Palgrave-Macmillan.

De Los Reyes, R. (2014). Language of “order”: English


in the linguistic landscape of two major train
stations in the Philippines. Asian Journal of
English Language Studies (AJELS) 2, 24-49.

Hult, F. (2014). Drive-thru linguistic landscaping:


constructing linguistically dominant place in a
bilingual space. International Journal of
Bilingualism, 18(5), 507-523.

Montemayor, M. T. (2019). DOH sounds alarm over


increasing HIV prevalence among young men.
Philippine News Agency. Retrieved from
https://www.pna.gov.ph/articles/1072292.

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