Exploring the Perspectives of Persons with Visual Impairments on COVID-19 Cartoons in Malawian Newspapers

Exploring the Perspectives of Persons with Visual Impairments on COVID-19 Cartoons in Malawian Newspapers | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Exploring the Perspectives of Persons with Visual Impairments on COVID-19 Cartoons in Malawian Newspapers Harriet Kachimanga, Chimwemwe Ngoma This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5422712/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Cartooning has long served as an important instrument for communicating various social issues. However, as pictures are designed to interact and are deemed more powerful than words, persons with visual impairments could be seen as not accessing the full benefits of cartoon-based communication. In the absence of assistive technologies, persons with visual impairments rely hugely on descriptions provided by others. Despite this reliance, little is known about how persons with visual impairments engage with such media when it is described to them. This study explores how persons with visual impairments understand and interpret cartoon depictions of the COVID-19 pandemic and its effects. Using a qualitative approach and a descriptive research design, the study employed purposive sampling through the Malawi Union of the Blind to select 30 participants. Twelve cartoons from four major Malawian newspapers were analyzed. The cartoons were described to participants, and their feedback was collected through semi-structured interviews. Thematic analysis of the responses identified the following key themes including the economic impact of COVID-19, scapegoating, hypocrisy and compliance, mental health, negligence in safety measures, and the gravity of the pandemic. Media Studies Visual impairments Visual disabilities Caricature Cartoons COVID-19 Descriptions Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Points of interest This study explores how individuals with visual impairments understand and interpret editorial cartoons about the COVID-19 pandemic. The findings reveal how people with visual impairments perceive public health messages in cartoons and their thoughts on COVID-19 preventive measures. This research helps to improve the understanding of how to make health communication more inclusive and effective for people with disabilities, particularly in times of crisis. The paper highlights the importance of accessibility in media and communication during public health emergencies. It sheds light on the social, economic, and mental health impacts of the pandemic in Malawi, as seen through participants' perspectives. Introduction In 2020, the World Health Organization (WHO) announced the outbreak of COVID-19, a global pandemic that affected every segment of the society, including persons with disabilities. Among these, individuals with visual impairments faced unique challenges in accessing information, particularly visual media (Dai and Hu 2021; Khan, Abbas, and Khan 2023). Visual impairment, a condition characterized by loss of visual function (Douglas & McLinden, 2004), has crucial socio-economic drawbacks and can affect the quality of life (Marques et al., 2022 ). While people who have normal eyesight or almost normal vision can independently handle tasks with no special assistance, those with visual impairments may find problems with comprehensively performing tasks that require vision, and they often rely on alternative methods, such as descriptions or assistive technologies, to access this information (Mashiata et al., 2022 ; Muradyan, 2023 ; Snyder, 2005 ; Mulloy et al., 2014 ). These challenges arise largely because environments are designed primarily for sighted individuals, and to adapt, visually impaired individuals rely on their other senses: hearing, taste, smell, and touch (Suraweera, Jayathilaka, and Thelijjagoda 2021 ). The Malawi National Statistics Office (NSO) report for the 2018 population and housing census indicates a national prevalence of disability of 11.6% (1,556,670 people) of which 762,702 have visual disabilities (National Statistical Office, 2019). From these figures, visual impairment is the highest prevailing disability among the disability population in Malawi. Despite this, media accessibility for those with visual impairments remains limited, particularly in the realm of visual communication, which includes editorial cartoons (Gkatzola & Papadopoulos, 2023; Ahmed & Naveed, 2020). Cartoons have long served as powerful tools for addressing socio-political issues, shaping public opinion, and promoting discourse on health crises (Kennedy et al., 2014 ; Abraham, 2009 ). During the COVID-19 pandemic, cartoons were widely used to communicate critical public health messages, raise awareness, and reflect societal responses to the pandemic (Kearns & Kearns, 2020 ). However, while these visual forms of communication can be highly effective for the general population, individuals with visual impairments may be at a disadvantage. For instance, in countries like Malawi where advanced assistive technologies and braille newspapers are not widely available, individuals with visual impairments are often dependent on others to describe visual content. This presents a gap in media accessibility for this population. Existing research also emphasizes the importance of tools like braille newspapers and tactile graphics in enhancing media accessibility for persons with visual impairments (Stangl, 2019 ). Other scholars suggest that during the pandemic, public health messages may not have fully reached individuals with disabilities, including those with visual impairments, highlighting the need for more inclusive communication strategies (Suraweera, Jayathilaka, and Thelijjagoda 2021 ; Kimumwe, 2020; Kwan et al. 2023 ). Additionally, where persons with visual impairments rely on others to describe visual content for them, inadequate descriptions can lead to confusion and misunderstandings, raising questions about the effectiveness of the method in conveying complex visual messages such as those found in editorial cartoons (Zheng et al., 2020). This study aimed to explore how persons with visual impairments in Malawi understand and interpret cartoon depictions of the COVID-19 pandemic when these cartoons are described to them. Specifically, the study seeks to examine how individuals engage with these descriptions and how they decode the visual and implied meanings embedded in cartoons. To guide the analysis of how persons with visual impairments interpret cartoon depictions of COVID-19, this study draws on two key theoretical frameworks: Conversational Implicature Theory and Visual Rhetoric Theory. Conversational Implicature Theory, introduced by Grice (1981), focuses on how meaning is conveyed indirectly, beyond the literal content of communication (Feng et al., 2020). In the context of this study, this theory is particularly relevant because the participants rely on verbal descriptions to interpret cartoons, which are inherently visual. Since the cartoons carry socio-political satire, participants must infer meaning not only from the described images but also from the broader social and political context that those images represent. On the other hand, Visual Rhetoric Theory, as articulated by Foss (2005), posits that images act as persuasive tools, conveying meaning through symbolism and visual metaphors (Foss, 2004 ; García, 2016 ). Although the participants in this study cannot directly perceive the images, the verbal descriptions serve as a medium through which the visual elements of the cartoons are communicated. The study applies Visual Rhetoric Theory by examining how well the described visual cues (such as exaggerated facial expressions or symbolic imagery) are understood by participants and how these elements influence their interpretation of the socio-political messages regarding COVID-19. The theory helps explain how the audience, even without direct visual access, can engage with and derive meaning from the cartoons based on the descriptions provided. Methodology The study employed a qualitative approach with a descriptive research design to explore the perceptions of individuals with visual impairments regarding COVID-19-related editorial cartoons. This design allows for an in-depth understanding of the participants' experiences (Siedlecki, 2019 ), and interpretations of the cartoons. Sampling and sample size The target population consisted of individuals with visual impairments in Malawi. A purposive sampling technique was utilized to select 30 participants through the Malawi Union of the Blind. This sample size is considered adequate for qualitative studies focusing on similar segments of a population, as it facilitates comprehensive thematic exploration (Hennink & Kaiser, 2021 ). Participants were grouped into three categories based on their educational attainment (primary, secondary, and tertiary education) to minimize the potential influence of education on their responses. This grouping was informed by literature suggesting that educational background can affect comprehension and interpretation of visual media (Ardini et al., 2020 ). Data Collection Data was gathered through semi-structured interviews guided by an interview framework aligned with the study’s objectives. The framework included open-ended questions designed to encourage participants to articulate their interpretations of the cartoons presented to them. Initially, 45 cartoons published in four prominent newspapers; Nation, Weekend Nation, Daily Times, and Malawi News, were identified, covering the period from March 2020 to March 2021. This period was chosen as it represented the peak of the COVID-19 pandemic. The selection focused on cartoons that illustrated key public health messages, societal responses, and government interventions, with the aim of assembling a balanced sample that reflected the diversity of perspectives in Malawian media. From this pool, 12 editorial cartoons were ultimately selected for the study. Each cartoon was described in detail to the participants, who were then asked to interpret and respond to the content. The interviews were conducted in Chichewa, the participants' native language, to ensure they could express their thoughts comfortably. The audio-recorded interviews were then transcribed verbatim. After transcription, the first author translated the responses into English. Data Analysis Data from the interviews were analyzed using thematic analysis, which involved identifying and coding emerging themes from the participants' responses. The analysis process included the following steps: First, interviews were audio-recorded and transcribed verbatim then translated to English from Chichewa. Then initial codes were generated from the transcripts, focusing on recurring themes and patterns. Lastly, themes were then developed through iterative review ensuring they aligned with the study objectives and existing literature. Ethical Considerations The study was reviewed and approved by the Malawi University of Business and Applied Sciences (MUBAS) Postgraduate Research Evaluation Committee, study number MMS/21/PG/004. Participation in the study was entirely voluntary, and informed consent was obtained from all participants. Participants were provided with comprehensive information regarding the study's purpose, their rights, and the measures taken to ensure their confidentiality. Anonymity was maintained by assigning pseudonyms to all participants, and data were securely stored to prevent unauthorized access. Additionally, the research design accounted for the potential vulnerability of participants with disabilities, with steps taken to ensure a comfortable and respectful interview environment. Results The results of this study are presented in two parts; participant socio-demographics and key themes identified through the analysis of selected cartoons. The findings provide an overview of the sample characteristics and the primary thematic insights derived from participant responses Demographic characteristics This section provides an overview of the respondents' socio-demographics. Five key characteristics namely type of visual impairment, gender, age, and educational background were analyzed to unveil insights into the composition of the study participants. Participants were characterized by their type of visual impairment, with the majority being blind (22 individuals) and a smaller proportion having low vision (8 individuals). Gender distribution among the respondents was fairly balanced, with 13 males and 17 females participating in the study. The age range of participants varied, with the largest groups falling between the ages of 25 to 30 and 31 to 35, with each group consisting of 8 and 10 individuals, respectively. The 18 to 24 and 36 to 40 age brackets each included 4 and 8 individuals, respectively, indicating a diverse spread across early to mid-adulthood. In terms of educational background, a significant portion of respondents had attained secondary education (14 individuals), followed by those with tertiary education (10 individuals) and a smaller group with only primary-level education (6 individuals). Lastly, when examining access to cartoon descriptions, it was found that a majority (21 respondents) reported they had never had access, while only 9 participants indicated they had ever accessed such descriptions. Key themes identified from cartoon analysis Although 12 cartoons were analyzed in total, this paper focuses on 6 key cartoons that encapsulated the most prevalent and illustrative themes identified during the analysis. While the remaining cartoons were considered, their contributions either overlapped with these primary examples or did not elicit new or contrasting interpretations from the participants. Thus, the selected cartoons represent the most impactful and diverse responses, allowing for a focused and coherent thematic discussion. Theme 1: Economic Impact of COVID-19 This theme encapsulates the widespread perception among participants that Puludzu cartoon, illustrates the adverse effects of COVID-19 restrictions on the livelihoods of poor individuals. Source: Haswel Kunyenje, Daily Times, March 16, 2020. Description The cartoon shows a woman carrying a basket of items walking on a road. Behind her is a man riding a bicycle and carrying a covered basket of goods. Along the road is a signpost labelled ‘MARKET’. In front, there is a huge tree log written ‘COVID-19 RESTRICTIONS’ lying diagonally blocking the road. Behind the woman and man, there is a picture of a dog-like animal labelled ‘POVERTY’ seemingly chasing the two individuals. Interpretation After describing the cartoon to participants in their focus groups, most participants interpreted the cartoon as portraying the negative impacts of COVID-19 on poor people. In accordance to the description, most participants argued that since they know what happened during the peak of COVID-19 the message is that businesses had been affected. FBP3 from said: That time many activities were banned. It was difficult for poor people to conduct their income generating activities, making it difficult for them to escape their already existing poor conditions. People were scared to go to the markets, drinking joints were closed. It was very difficult for those that operated hand-to-mouth businesses. The same views were echoed by MLV6 who stated: It was a challenging time for Malawians. There were so many hindrances to fighting poverty. That tree-log says it all. We couldn’t do much for our livelihood due to the COVID-19 restrictions. Interestingly, some participants would go beyond what has been described for them in order to come up with interpretations just like FBS2 who commented that: The cartoon shows courage of the people. They jumped the log or used an alternative way to the market and sold their goods. Similar to the response by FBS2, FLVS4 said: We can also say it shows stubbornness of the two people. They still wanted to be out there to fight the police and the government . Theme 2: COVID-19 as a Scapegoat Many participants viewed Fingo cartoon, in Fig. 2 , as illustrating how COVID-19 became an excuse for personal and financial irresponsibility, reflecting a societal tendency to avoid accountability. Source: Haswel Kunyenje, Malawi News, May 30, 2020. Description: Fingo is passing by a drinking joint labelled “Nachithidzi Shabeen”. By the entrance, there is a poster written No MASK NO ENTRY/ OPANDA MASK AYI. A woman standing by the entrance asks Fingo “Kodi akasitomala ngongole ya chaka chatha ija mudzabweza liti? (My customer, when are you squaring last year’s bill?)”. Fingo responds by saying “Ndikumalephera Kubwera kumeneko chifukwa ndilibe mask (I’m unable to stop by because I don’t have a face mask)”. Interpretations Most participants (27) said the cartoon depicted how COVID-19 has become a scapegoat for everything. MBS6 summarized this assertion by stating that: At the peak of COVID-19, people made lame excuses for things and blamed it on COVID-19. People find it as an excuse for not repaying loans and for not fulfilling commitments. However, three other participants had different views whereby they indicated that the cartoon depicted how people were not willing to adhere to the preventive measures set by the government. For example, FBT2 participant remarked that: People had reservations about masks so they would rather not go to places prohibited without a mask than to put on one. All 30 participants had something to say about the cartoon, particularly on how COVID-19 had become a scapegoat and the negligence by citizens. Theme 3: Hypocrisy and Compliance The Fingo cartoon in Fig. 3 , highlighted hypocrisy in following COVID-19 guidelines while engaging in other risky behaviors. Participants emphasized that merely wearing masks was inadequate without broader safety measures. Source: Haswel Kunye nje, Malawi News, May 23 , 2020. Description The cartoon has two sections; one shows Fingo entering a drinking joint. At the entrance, there is a handwashing bucket and what appears to be soap on top of it. A woman pointing at the bucket says, “Sambani m’manja apa kunja kuli korona!” (Wash hands here. There is coronavirus out there). The other section show the two inside the drinking place where Fingo responds while pointing at other people in the shabeen by saying “Ndisambe m’manja, umve umachitika mu shabini mwanu muno munauona?” ( You are asking me to wash my hands. Have you seen the nasty things that happen in your shabeen ?) . Amongst the people he is pointing at is a man vomiting, another man smoking, a man and a woman kissing each other and another woman drinking what appears to be beer which is also spilling on the floor. Interpretations In the discussions, 29 participants pointed out that the cartoon highlighted hypocrisy that existed during the COVID-19 pandemic. For instance, MBS7 captured the views of the participants in line with hypocrisy by stating that: I recall that many of us and every place enforced wearing of masks but our other practices did not protect us from COVID-19. Just wearing a mask alone did not guarantee safety. Other preventive measures needed to be observed too. Theme 4: Negligence in Safety Measures The Point of Order cartoon in Fig. 4 , expressed participants' concerns about the negligence in quarantine policies for travelers entering Malawi, indicating frustration with government responses. Source: Ralph Ma wera, The Nation, August 14, 2020. Description The cartoon shows passengers disembarking from a plane labelled ‘India’. Behind the plane is a building labelled Kamuzu International Airport. From the facial features, some passengers appear to be of Indian origin. Some are putting on face masks while others are not. Some people from one side are welcoming those disembarking from the plane with hugs. A man says “Welcome to Malawi. Feel at home”. Behind is a direction sign post labelled “QUARANTINE”. At the far-right corner of the cartoon are two men conversating. One asks “Are we safe from COVID-19 with this new normal?” and the other one responds “search me”. Interpretations When asked to give their views regarding the cartoon in Fig. 4 , 22 participants had similar sentiments that the cartoon depicts the country’s negligence during the COVID-19 pandemic. MBS5 ascertained that: Malawians were not allowed to enter other countries, but we let everyone in. Despite having facilities for quarantine, people coming into the country did not go for quarantine. This is how we ended up with so many cases of COVID-19. On the other hand, eight of the participants thought the cartoon emphasized safety from the pandemic because of the dialogue, as MBS1 commented: From what the two are discussing, they were talking about how unsafe the country was . Theme 5: Mental Health Impact The interpretations of the Ayobe cartoon in Fig. 5 varied among the participants, with some relating it to the mental health toll of lockdowns, while others criticized the trivialization of serious health concerns. Source: Mawera, The Weekend Nation, April 4, 2020. Description Ayobe is sitting on a chair inside the house with his wife. He is holding his head with his right hand, looking miserable. The wife asks “Honey, you look miserable. What’s the matter? He responds by saying “Don’t you know that bars have been closed due to coronavirus?” Interpretations When asked to interpret the cartoon, participants gave different understandings. For instance, MBS3 said the cartoon illustrates the effects of COVID-19 on mental health when he indicated that: Just like Ayobe, many people were depressed due to the lockdown. Staying indoors and not associating with other people took a toll on people. On the other hand, FBP2 thought that the cartoon portrayed negligence and lack of seriousness by citizens in containing the pandemic just like one participant noted: Of all things, Ayobe is worried about closing of bars. There were more serious issues that time than closure of bars . Theme 6: Gravity of COVID-19 The Kalimalima cartoon in Fig. 6 , emphasized the seriousness of the pandemic, with participants acknowledging that safety was more important than financial gain. Source: James Kazembe, Weekend Nation, January 16, 2021. Description Kalimalima has gone to a shop labelled AGRO-DEALER GULANI MBEU FETELEZA MANKHWALA PANO. At the door, there is a man standing who is wearing a mask. The man tells Kalimalima “No maski, No here! Opanda maski osabwera pano!” (No mask, No entry). Kalimalima turns back. On his way, he meets a man who appears to be a friend and says “Koma anthu ena mani, munthu kukana kundigulitsa foteleza chifukwa sindidavale maski” (Man, imagine they have denied to sell me fertilizer just because I’m not wearing a mask). The other man responds by saying “Iwe Kalima, ngati ali kachasu ulekeretu. Matenda a COVID-19 sakuona makobili” (Kalimalima, if it’s because of alcohol, you need to stop. COVID-19 is too serious for money). Interpretations A majority (29) of the participants found the cartoon to be emphasizing the gravity of COVID-19. The sentiments were summarized by FBS2 who said: The most important thing was to save our lives. Nothing, not even money could make anyone risk their life. We were all afraid of dying and safety came first. FLV1 echoed the remarks: It was a very difficult time. I remember how strict everyone was. We were asked to wash hands everywhere; shops, offices, everywhere. The outcomes from the discussion on this cartoon reiterate what has been observed from discussions about the other cartoons. Discussion This study found that 21 participants had never received descriptions of newspaper cartoons, while only 9 participants had access to descriptions from sighted individuals, as indicated in the demographic section of the results. This indicates that the majority of respondents encountered newspaper cartoon descriptions for the first time through this study. This finding underscores a significant lack of access to visual media descriptions, highlighting a gap in inclusive communication. This lack of inclusive communication is consistent with broader research indicating barriers in accessible communication. For instance, a study on inclusive communication during the COVID-19 in China, found that government and public service providers largely failed to provide accessible and inclusive emergency communications, particularly for individuals with disabilities, and advocated for proactive measures to ensure inclusive information dissemination during crises (Dai and Hu, 2021). Similarly, scholars have emphasized the increased risk of severe illness from COVID-19 among people with disabilities, underscoring the need for easily accessible public health information (Jumreornvong et al., 2020 ). The study's thematic analysis of the participants' responses to the selected cartoons offers insights into the socio-economic and psychological impacts of COVID-19 in Malawi. The discussions surrounding the cartoons reveal a detailed understanding of public sentiment, compliance with health measures, and the broader implications of the pandemic on society. The identified themes illustrate the challenges faced by individuals and communities during the crisis. Previous studies align with these observations, suggesting that COVID-19 precautionary measures were often implemented in a disorganized manner, failing to protect all groups adequately. Additionally, in resource-limited settings, even minor impairments can increase individuals’ vulnerabilities, making accessible and inclusive communication even more important (Koca-Atabey, 2021 ; Jalali et al., 2020 ). The economic impact of COVID-19 theme underscores the economic ramifications of COVID-19 restrictions, as depicted in the Puludzu cartoon (Fig. 1 ). Participants described the struggles of low-income individuals who relied on daily activities for their survival. This finding aligns with literature highlighting that economic downturns during health crises disproportionately affect the poorest sectors of society (Backhaus et al., 2022 ; McNeely et al., 2020 ; Assefa, 2021 ). The frustrations voiced by participants reflect a broader narrative of how government-imposed restrictions, while necessary for public health, can have devastating effects on livelihoods. The interpretation of both resilience and stubbornness among participants shows a relationship with the imposed restrictions, suggesting that individuals may feel compelled to navigate the obstacles in pursuit of economic survival despite the associated risks. A comparative look at Sri Lanka's response to COVID-19, where government provided a monthly payment to vulnerable households and people with disabilities, sheds light on how government support can mitigate the economic strain on vulnerable populations (Suraweera, Jayathilaka, and Thelijjagoda 2021 ). However, in countries with fewer resources, like Malawi, people may face the pressure to prioritize economic survival over health safety, underscoring the difficult trade-off between health and financial security during crises The COVID-19 as a scapegoat theme reveals a pervasive sentiment that COVID-19 became a convenient excuse for personal irresponsibility. Participants illustrated how individuals often used the pandemic as a justification for neglecting obligations. This insight resonates with studies indicating that crises can lead to a culture of blame and denial, where individuals redirect responsibility to external factors (Roulet & Pichler, 2020; Bursztyn et al., 2022 ). While some participants acknowledged the skepticism towards mask-wearing, their responses also reflected a broader commentary on the societal dynamics that emerged in response to COVID-19. This duality of interpretation highlights the importance of addressing both individual behaviors and systemic issues in public health messaging. The theme of hypocrisy in adhering to COVID-19 guidelines, as depicted in the Fingo cartoon (Fig. 3 ), emphasizes the contradictions in public behavior. Participants noted that while mask-wearing was enforced, other safety measures were often neglected, demonstrating a gap in comprehensive adherence to health protocols. This finding suggests that mere compliance with visible guidelines is insufficient in the absence of a holistic approach to public health. The emphasis on broader safety measures aligns with existing literature that advocates for multifaceted strategies in health communication (Slavik et al., 2021 ; Gollust et al., 2020 ; Wallerstein & Duran, 2010). Effective messaging should encourage not only compliance with specific measures but also promote an understanding of the interconnectedness of various safety practices. The concern regarding negligence in quarantine policies, as portrayed in the Point of Order cartoon (Fig. 4 ), highlights participants' frustrations with governmental responses to COVID-19. The expressed sentiments reflect a broader critique of public health systems and their efficacy in safeguarding the community. This theme is particularly relevant in discussions around global health governance, where lapses in policy enforcement can lead to significant public health challenges (Mykhalovskiy et al., 2018 ). Participants’ observations about the lack of stringent quarantine measures for incoming travelers indicate a perceived failure of the government to prioritize public health, exacerbating the spread of the virus within the country. The mental health implications of the pandemic, captured in the Ayobe cartoon (Fig. 5 ), reveal a spectrum of interpretations among participants. While some connected the character's distress to the lockdown's toll on mental well-being, others criticized the trivialization of serious health issues. This clash in opinion illustrates the interplay between public health messaging and individual perceptions. Mental health has emerged as a significant concern during the pandemic, with studies indicating a rise in anxiety and depression linked to prolonged isolation and economic uncertainty (Toquero 2021; Liu et al., 2021 ; Chaudhary et al., 2023 ). The varied responses to the Ayobe cartoon emphasize the need for public health strategies that acknowledge and address mental health alongside physical health, promoting a comprehensive approach to well-being. Lastly, the gravity of COVID-19 was a recurrent theme in the participants’ discussions surrounding the Kalimalima cartoon (Fig. 6 ). Many participants acknowledged the importance of safety over economic gain, showing a collective recognition of the pandemic's seriousness. This perspective resonates with public health literature emphasizing the importance of prioritizing life and safety in health crises (Chen et al., 2021 ; De Holanda Coelho et al., 2021). The participants' insistence that health considerations should supersede financial motivations reflects a societal shift in values during the pandemic, revealing a deeper understanding of the interconnectedness of health and economic stability. Study Limitations This study acknowledges several limitations. The purposive sampling method may introduce selection bias, as participants were recruited from a single organization, potentially affecting the generalizability of findings. Additionally, the reliance on self-reported data may be influenced by social desirability bias, where participants may respond in a manner they believe is expected. Future studies should consider employing a larger, more diverse sample to enhance the robustness of findings. Conclusion The study emphasizes the need for inclusive communication strategies, particularly for persons with visual impairments. The reliance on verbal descriptions underscores media accessibility issues, signaling the need for enhanced, inclusive tools like braille newspapers and audio descriptions. Participants' interpretations of the described cartoons revealed significant socio-economic challenges, such as the economic impact of restrictions, and highlighted behavioral inconsistencies in adhering to health measures. Additionally, the study underscores the importance of integrating mental health considerations into public health responses and calls for more accountable governance to restore public trust in times of crisis. Declarations Ethical Considerations The study was reviewed and approved by the Malawi University of Business and Applied Sciences (MUBAS) Postgraduate Research Evaluation Committee, study number MMS/21/PG/004. Participation in the study was entirely voluntary, and informed consent was obtained from all participants. Participants were provided with comprehensive information regarding the study's purpose, their rights, and the measures taken to ensure their confidentiality. Anonymity was maintained by assigning pseudonyms to all participants, and data were securely stored to prevent unauthorized access. Additionally, the research design accounted for the potential vulnerability of participants with disabilities, with steps taken to ensure a comfortable and respectful interview environment. Conflict of Interest Statement HK is an employee of the Malawi Council for Disability Affairs (MACODA), an organization that seeks to promote and protect the rights of persons with disabilities in Malawi. CN declares no competing interests. The views and opinions expressed in the contents of this paper are the sole responsibility of the authors, and should not, under any circumstances, be regarded as reflecting the positions of MACODA. Funding This research and paper development were conducted without receipt of any funding. Author Contribution The original concept for this study was conceived by HK, who also designed the study and undertook data collection. Data analysis was conducted by HK and CN. HK took the lead in composing the initial draft of this paper. Subsequently, CN and HK engaged in a critical revision process to enhance its intellectual depth. All authors participated in reviewing, reading, and endorsing the final version of the paper. Acknowledgments We would like to express our sincere gratitude to Dr. Emmanuel Ngwira of the University of Malawi for his invaluable guidance as the dissertation supervisor, and to Hastings Ndebvu of MUBAS for his thoughtful peer review. Availability of Data and Materials The data obtained from the study is accessible and can be provided by the first author upon reasonable request. References Abraham L (2009) Effectiveness of cartoons as a uniquely visual medium for orienting social issues. Journalism Communication Monogr 11(2):117–165. https://doi.org/10.1177/152263790901100202 Ahmed M, Rafiq (2020) and Muhammad Asif Naveed. Information accessibility for visually impaired students. Pakistan Journal of Information Management and Libraries , December, 16–36. https://doi.org/10.47657/1793 Ardini P, Puspa A, Biahimo R, Husain, and Hijrah Syahputra (2020) The influence of visual media and learning style on early reading ability of children of kindergarten in Gorontalo. Int J Sci Technol Res 9(10):317–320. https://www.ijstr.org/final-print/oct2020/The-Influence-Of-Visual-Media-And-Learning-Style-On-Early-Reading-Ability-Of-Children-Of-Kindergarten-In-Gorontalo.pdf Assefa M (2021) COVID-19 Lockdown restrictions and Small Business Survival Strategy: Government supporting schemes. Bus Perspect Res 11(2):227–245. https://doi.org/10.1177/22785337211045182 Backhaus I, Hoven H, Tecco CD, Iavicoli S, Conte A, and Nico Dragano (2022) Economic change and population health: lessons learnt from an umbrella review on the Great Recession. BMJ Open 12(4):e060710. https://doi.org/10.1136/bmjopen-2021-060710 Bursztyn L, Egorov G, Haaland I, Rao A (2022) and Christopher Roth. Scapegoating during Crises. AEA Papers and Proceedings 112 (May): 151–55. https://doi.org/10.1257/pandp.20221069 Chaudhary R, Rohilla M, Chauhan S, Saini M, Aman S, Singla H, Bibi A et al (2023) The pandemic’s unseen wounds: COVID-19’s profound effects on mental health. Annals Med Surg 85(10):4954–4963. https://doi.org/10.1097/ms9.0000000000001223 Chen C, Reniers G, Khakzad N, and Ming Yang (2021) Operational safety economics: Foundations, current approaches and paths for future research. Saf Sci 141:105326. https://doi.org/10.1016/j.ssci.2021.105326 Dai, Ruikai, and Luanjiao Hu (2021) Inclusive communications in COVID-19: a virtual ethnographic study of disability support network in China. Disabil Soc 37(1):3–21. https://doi.org/10.1080/09687599.2021.1933388 De Coelho H, Lins G, Paul HP, Hanel Roosevelt Vilar, Renan Pereira Monteiro, Fadja Jairles Vieira Cardoso, and Valdiney Veloso Gouveia. 2021. Who prioritizes the economy over health? The role of political orientation and human values. Pers Indiv Differ 179 (April): 110890. https://doi.org/10.1016/j.paid.2021.110890 Douglas (2004) and McLinden. Visual impairment. Dans Special teaching for special children? Pedagogies for inclusion ., 26–38. Open University Press eBooks. https://eric.ed.gov/?id=ED493257 Feng W, Hongbo Yu, and Xiaolin Zhou (2020) Understanding particularized and generalized conversational implicatures: Is theory-of-mind necessary? Brain Lang 212:104878. https://doi.org/10.1016/j.bandl.2020.104878 Foss (2004) Theory of visual rhetoric. Dans Routledge eBooks . 163–174. https://doi.org/10.4324/9781410611581-18 García ZR (2016) Visual rhetoric. Oxford Research Encyclopedia of Communication , May. https://doi.org/10.1093/acrefore/9780190228613.013.212 Gkatzola K, and Konstantinos Papadopoulos (2023) Social media actually used by people with visual impairment: A scoping review. Br J Visual Impairment 42(3):832–848. https://doi.org/10.1177/02646196231189393 Gollust SE, Rebekah H, Nagler, and Erika Franklin Fowler (2020) The emergence of COVID-19 in the US: a public health and political communication crisis. J Health Politics Policy Law 45(6):967–981. https://doi.org/10.1215/03616878-8641506 Hennink M, Kaiser BN (2021) Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Soc Sci Med 292:114523. https://doi.org/10.1016/j.socscimed.2021.114523 Jalali M, Shahabi S, Lankarani KB, Kamali M, and Parviz Mojgani (2020) COVID-19 and disabled people: perspectives from Iran. Disabil Soc 35(5):844–847. https://doi.org/10.1080/09687599.2020.1754165 Jumreornvong O, Tabacof L, Cortes M, Tosto J, Kellner CP, Herrera JE, Putrino D (2020) Ensuring equity for people living with disabilities in the age of COVID-19. Disabil Soc 35(10):1682–1687. https://doi.org/10.1080/09687599.2020.1809350 Kearns Ciléin, and Nethmi Kearns (2020) The role of comics in public health communication during the COVID-19 pandemic. J Vis Commun Med 43(3):139–149. https://doi.org/10.1080/17453054.2020.1761248 Kennedy A, Rogers A, Blickem C, Daker-White G, and Robert Bowen (2014) Developing cartoons for long-term condition self-management information. BMC Health Serv Res 14(1). https://doi.org/10.1186/1472-6963-14-60 Khan HM, Khaldon Abbas, Hamza NK (2023) Investigating the impact of COVID-19 on individuals with visual impairment. British Journal of Visual Impairment , March, 026461962311589. https://doi.org/10.1177/02646196231158919 Koca-Atabey Müjde (2021) Disability and old age: the COVID-19 pandemic in Turkey. Disabil Soc 36(5):834–839. https://doi.org/10.1080/09687599.2021.1907550 Kwan C, Kin MHY, Shum FKY, Tsui J, Cui VQM Hu, and, Rosetti Mei Ling To, March (2023) 1–21. https://doi.org/10.1080/09687599.2023.2195070 Liu X, Zhu M, Zhang R, Zhang J, Zhang C, Liu P, Feng Z, and Zhiyi Chen (2021) Public mental health problems during COVID-19 pandemic: a large-scale meta-analysis of the evidence. Translational Psychiatry 11(1). https://doi.org/10.1038/s41398-021-01501-9 Marques A, Patricia J, Ramke J, Cairns T, Butt, Justine H, Zhang I, Jones M, Jovic et al (2022) The economics of vision impairment and its leading causes: A systematic review. EClinicalMedicine 46(March):101354. https://doi.org/10.1016/j.eclinm.2022.101354 Mashiata M, Ali T, Das P, Tasneem Z et al (2022) Md. Faisal Rahman Badal, Subrata Kumar Sarker, Md. Mehedi Hasan,. Towards assisting visually impaired individuals: A review on current status and future prospects. Biosensors and Bioelectronics X 12 (October): 100265. https://doi.org/10.1016/j.biosx.2022.100265 McNeely CL, Laurie A, Schintler, and Bonnie Stabile (2020) Social Determinants and COVID-19 disparities: Differential pandemic effects and dynamics. World Med Health Policy 12(3):206–217. https://doi.org/10.1002/wmh3.370 Mulloy AM, Gevarter C, Hopkins M, Sutherland KS, Ramdoss ST (2014) Assistive Technology for Students with Visual Impairments and Blindness. Dans Autism and child psychopathology series ., 113–56. https://doi.org/10.1007/978-1-4899-8029-8_5 Muradyan S (2023) ASSISTIVE TECHNOLOGY FOR STUDENTS WITH VISUAL IMPAIRMENTS. Armen J Special Educ 7(1):77–88. https://doi.org/10.24234/se.v6i1.309 Mykhalovskiy E, Frohlich KL, Poland B, Ruggiero ED, Rock MJ, and Leigha Comer (2018) Critical social sciencewithpublic health: Agonism, critique and engagement. Crit Public Health 29(5):522–533. https://doi.org/10.1080/09581596.2018.1474174 National SO (2019) 2018 Malawi Population and Housing Census. Malawi Government. Consulté le October 23, 2024. https://malawi.unfpa.org/sites/default/files/resource-pdf/2018%20Malawi%20Population%20and%20Housing%20Census%20Main%20Report%20(1).pdf Roulet TJ, and Rasmus Pichler (2020) Blame Game Theory: Scapegoating, Whistleblowing and Discursive Struggles following Accusations of Organizational Misconduct. Organ Theory 1(4):263178772097519. https://doi.org/10.1177/2631787720975192 Siedlecki SL (2019) Understanding descriptive research designs and methods. Clin Nurse Specialist 34(1):8–12. https://doi.org/10.1097/nur.0000000000000493 Slavik CE, Darlington JC, Buttle C, Sturrock SL, and Niko Yiannakoulias (2021) Has public health messaging during the COVID-19 pandemic reflected local risks to health? A content analysis of tweeting practices across Canadian geographies. Health Place 69(April):102568. https://doi.org/10.1016/j.healthplace.2021.102568 Snyder J (2005) Audio description: The visual made verbal. Int Congr Ser 1282(September):935–939. https://doi.org/10.1016/j.ics.2005.05.215 Stangl AJ (2019) Tactile Media Consumption and Production for and by People Who Are Blind and Visually Impaired: a Design Research Investigation. Dans ProQuest LLC eBooks . https://eric.ed.gov/?q=https%3a&pg=537&id=ED597647 Suraweera T, Jayathilaka R, Thelijjagoda S (2021) A nightmare in a ‘darker’ world: persons with blindness under the Sri Lanka’s COVID-19 shutdown. Disabil Soc 36(7):1192–1196. https://doi.org/10.1080/09687599.2021.1927671 Toquero, Cathy Mae D (2021) Provision of mental health services for people with disabilities in the Philippines amid coronavirus outbreak. Disabil Soc 36(6):1026–1032. https://doi.org/10.1080/09687599.2021.1916885 Wallerstein N, and Bonnie Duran (2010) Community-Based Participatory Research Contributions to Intervention Research: The intersection of science and practice to improve health equity. Am J Public Health 100(S1):S40–46. https://doi.org/10.2105/ajph.2009.184036 Additional Declarations The authors declare potential competing interests as follows: HK is an employee of the Malawi Council for Disability Affairs (MACODA), an organization that seeks to promote and protect the rights of persons with disabilities in Malawi. CN declares no competing interests. The views and opinions expressed in the contents of this paper are the sole responsibility of the authors, and should not, under any circumstances, be regarded as reflecting the positions of MACODA. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5422712","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":376089481,"identity":"a5663da6-8061-4427-b347-7005d83f2c25","order_by":0,"name":"Harriet Kachimanga","email":"data:image/png;base64,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","orcid":"","institution":"Malawi Council for Disability Affairs, Blantyre, Malawi","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Harriet","middleName":"","lastName":"Kachimanga","suffix":""},{"id":376089482,"identity":"165b307b-509d-4711-89dc-fc078df3cd7d","order_by":1,"name":"Chimwemwe Ngoma","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCklEQVRIiWNgGAWjYDACCcYGFC4zP4hKKCBeiwW7JIifYIBPCyq3gt/gAIjGo4V/dnPrZp6KbYn90u0XH92okZA2Pr868cMDAwZ5frED2C25c7DtNs+Z24kz55wpNs45JmFsduPtZgmgwwxnzk7AqsVAIrHtdi4QbbiRkyadwyaRbHbj7AaQlgSD2/i0/Ludux+s5Z9E/eYZZzf/IKylAWiLRPox6dw2CWYD/t5teG2RuAHU8ufY7foZN3KYjXP7JJglbvBus0gwkMDpF/4Z6c9uzqi5bQxkPHyc862Omb//7OabPyps5PmlsWtBAjzQuJAAq5TAoxIO2B9ALT5AjOpRMApGwSgYQQAApdhnURR4wjwAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0001-8648-1244","institution":"Think Smart Consulting, Lilongwe, Malawi","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Chimwemwe","middleName":"","lastName":"Ngoma","suffix":""}],"badges":[],"createdAt":"2024-11-09 15:50:02","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":true,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false,"coiExplicitlySet":false},"doi":"10.21203/rs.3.rs-5422712/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5422712/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":68868779,"identity":"5e74c542-cbf8-41c1-ae0d-ec48bb9b11e7","added_by":"auto","created_at":"2024-11-13 02:33:16","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":562293,"visible":true,"origin":"","legend":"\u003cp\u003ePuludzu cartoon\u003c/p\u003e\n\u003cp\u003eSource: Haswel Kunyenje, Daily Times, March 16, 2020.\u003c/p\u003e","description":"","filename":"image1.png","url":"https://assets-eu.researchsquare.com/files/rs-5422712/v1/8d5681e59481a8ec00fa9f3b.png"},{"id":68868781,"identity":"e51634e9-b375-4ec5-adc6-6aed0d5138b2","added_by":"auto","created_at":"2024-11-13 02:33:17","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":389910,"visible":true,"origin":"","legend":"\u003cp\u003eFingo cartoon\u003c/p\u003e\n\u003cp\u003eSource: Haswel Kunyenje, Malawi News, May 30, 2020.\u003c/p\u003e","description":"","filename":"image2.png","url":"https://assets-eu.researchsquare.com/files/rs-5422712/v1/f9ede2eb0f186ea39254f453.png"},{"id":68868784,"identity":"7a29b66d-dc36-4822-8ded-aaf9d373ad5a","added_by":"auto","created_at":"2024-11-13 02:33:17","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":667021,"visible":true,"origin":"","legend":"\u003cp\u003eFingo cartoon\u003c/p\u003e\n\u003cp\u003eSource: Haswel Kunye\u003cem\u003enje, Malawi News, May 23,\u003c/em\u003e2020.\u003c/p\u003e","description":"","filename":"image3.png","url":"https://assets-eu.researchsquare.com/files/rs-5422712/v1/2cd8d88aa8a5b98fab09c440.png"},{"id":68869496,"identity":"053768ab-cffe-4390-b249-278d2b85e145","added_by":"auto","created_at":"2024-11-13 02:41:17","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":782623,"visible":true,"origin":"","legend":"\u003cp\u003ePoint of Order cartoon\u003c/p\u003e\n\u003cp\u003eSource: Ralph Ma\u003cem\u003ewera, The Nation, August 14, 2020.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image4.png","url":"https://assets-eu.researchsquare.com/files/rs-5422712/v1/d9dc5ad9fae35950d0aed178.png"},{"id":68869495,"identity":"ffa33ba3-52f6-46f5-a8af-b6499e7529b5","added_by":"auto","created_at":"2024-11-13 02:41:16","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":504645,"visible":true,"origin":"","legend":"\u003cp\u003eAyobe cartoon\u003c/p\u003e\n\u003cp\u003eSource: Mawera, The Weekend Nation, April 4, 2020.\u003c/p\u003e","description":"","filename":"image5.png","url":"https://assets-eu.researchsquare.com/files/rs-5422712/v1/fd4136f584eb52922232bd7c.png"},{"id":68868783,"identity":"039586b3-56ed-4f37-ae08-5a303941fe25","added_by":"auto","created_at":"2024-11-13 02:33:17","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":811154,"visible":true,"origin":"","legend":"\u003cp\u003eKalimalima cartoon\u003c/p\u003e\n\u003cp\u003eSource: James Kazembe, Weekend Nation, January 16, 2021.\u003c/p\u003e","description":"","filename":"image6.png","url":"https://assets-eu.researchsquare.com/files/rs-5422712/v1/17bdc8e9667617ab6a17b9f4.png"},{"id":68869671,"identity":"da72a8b1-3652-4491-a2d7-f482051c5006","added_by":"auto","created_at":"2024-11-13 02:49:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4261512,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5422712/v1/7759d89e-0921-4eaf-9e86-302051167c39.pdf"}],"financialInterests":"The authors declare potential competing interests as follows: HK is an employee of the Malawi Council for Disability Affairs (MACODA), an organization that seeks to promote and protect the rights of persons with disabilities in Malawi. CN declares no competing interests. The views and opinions expressed in the contents of this paper are the sole responsibility of the authors, and should not, under any circumstances, be regarded as reflecting the positions of MACODA.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eExploring the Perspectives of Persons with Visual Impairments on COVID-19 Cartoons in Malawian Newspapers\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Points of interest","content":"\u003cul\u003e\n \u003cli\u003eThis study explores how individuals with visual impairments understand and interpret editorial cartoons about the COVID-19 pandemic.\u003c/li\u003e\n \u003cli\u003eThe findings reveal how people with visual impairments perceive public health messages in cartoons and their thoughts on COVID-19 preventive measures.\u003c/li\u003e\n \u003cli\u003eThis research helps to improve the understanding of how to make health communication more inclusive and effective for people with disabilities, particularly in times of crisis.\u003c/li\u003e\n \u003cli\u003eThe paper highlights the importance of accessibility in media and communication during public health emergencies.\u003c/li\u003e\n \u003cli\u003eIt sheds light on the social, economic, and mental health impacts of the pandemic in Malawi, as seen through participants\u0026apos; perspectives.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cp\u003eIn 2020, the World Health Organization (WHO) announced the outbreak of COVID-19, a global pandemic that affected every segment of the society, including persons with disabilities. Among these, individuals with visual impairments faced unique challenges in accessing information, particularly visual media (Dai and Hu 2021; Khan, Abbas, and Khan 2023). Visual impairment, a condition characterized by loss of visual function (Douglas \u0026amp; McLinden, 2004), has crucial socio-economic drawbacks and can affect the quality of life (Marques et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). While people who have normal eyesight or almost normal vision can independently handle tasks with no special assistance, those with visual impairments may find problems with comprehensively performing tasks that require vision, and they often rely on alternative methods, such as descriptions or assistive technologies, to access this information (Mashiata et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Muradyan, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Snyder, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Mulloy et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). These challenges arise largely because environments are designed primarily for sighted individuals, and to adapt, visually impaired individuals rely on their other senses: hearing, taste, smell, and touch (Suraweera, Jayathilaka, and Thelijjagoda \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe Malawi National Statistics Office (NSO) report for the 2018 population and housing census indicates a national prevalence of disability of 11.6% (1,556,670 people) of which 762,702 have visual disabilities (National Statistical Office, 2019). From these figures, visual impairment is the highest prevailing disability among the disability population in Malawi. Despite this, media accessibility for those with visual impairments remains limited, particularly in the realm of visual communication, which includes editorial cartoons (Gkatzola \u0026amp; Papadopoulos, 2023; Ahmed \u0026amp; Naveed, 2020).\u003c/p\u003e \u003cp\u003eCartoons have long served as powerful tools for addressing socio-political issues, shaping public opinion, and promoting discourse on health crises (Kennedy et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Abraham, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). During the COVID-19 pandemic, cartoons were widely used to communicate critical public health messages, raise awareness, and reflect societal responses to the pandemic (Kearns \u0026amp; Kearns, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). However, while these visual forms of communication can be highly effective for the general population, individuals with visual impairments may be at a disadvantage. For instance, in countries like Malawi where advanced assistive technologies and braille newspapers are not widely available, individuals with visual impairments are often dependent on others to describe visual content. This presents a gap in media accessibility for this population. Existing research also emphasizes the importance of tools like braille newspapers and tactile graphics in enhancing media accessibility for persons with visual impairments (Stangl, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOther scholars suggest that during the pandemic, public health messages may not have fully reached individuals with disabilities, including those with visual impairments, highlighting the need for more inclusive communication strategies (Suraweera, Jayathilaka, and Thelijjagoda \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Kimumwe, 2020; Kwan et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Additionally, where persons with visual impairments rely on others to describe visual content for them, inadequate descriptions can lead to confusion and misunderstandings, raising questions about the effectiveness of the method in conveying complex visual messages such as those found in editorial cartoons (Zheng et al., 2020).\u003c/p\u003e \u003cp\u003eThis study aimed to explore how persons with visual impairments in Malawi understand and interpret cartoon depictions of the COVID-19 pandemic when these cartoons are described to them. Specifically, the study seeks to examine how individuals engage with these descriptions and how they decode the visual and implied meanings embedded in cartoons.\u003c/p\u003e \u003cp\u003eTo guide the analysis of how persons with visual impairments interpret cartoon depictions of COVID-19, this study draws on two key theoretical frameworks: Conversational Implicature Theory and Visual Rhetoric Theory.\u003c/p\u003e \u003cp\u003eConversational Implicature Theory, introduced by Grice (1981), focuses on how meaning is conveyed indirectly, beyond the literal content of communication (Feng et al., 2020). In the context of this study, this theory is particularly relevant because the participants rely on verbal descriptions to interpret cartoons, which are inherently visual. Since the cartoons carry socio-political satire, participants must infer meaning not only from the described images but also from the broader social and political context that those images represent.\u003c/p\u003e \u003cp\u003eOn the other hand, Visual Rhetoric Theory, as articulated by Foss (2005), posits that images act as persuasive tools, conveying meaning through symbolism and visual metaphors (Foss, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Garc\u0026iacute;a, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Although the participants in this study cannot directly perceive the images, the verbal descriptions serve as a medium through which the visual elements of the cartoons are communicated. The study applies Visual Rhetoric Theory by examining how well the described visual cues (such as exaggerated facial expressions or symbolic imagery) are understood by participants and how these elements influence their interpretation of the socio-political messages regarding COVID-19. The theory helps explain how the audience, even without direct visual access, can engage with and derive meaning from the cartoons based on the descriptions provided.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003eThe study employed a qualitative approach with a descriptive research design to explore the perceptions of individuals with visual impairments regarding COVID-19-related editorial cartoons. This design allows for an in-depth understanding of the participants' experiences (Siedlecki, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), and interpretations of the cartoons.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSampling and sample size\u003c/h2\u003e \u003cp\u003eThe target population consisted of individuals with visual impairments in Malawi. A purposive sampling technique was utilized to select 30 participants through the Malawi Union of the Blind. This sample size is considered adequate for qualitative studies focusing on similar segments of a population, as it facilitates comprehensive thematic exploration (Hennink \u0026amp; Kaiser, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eParticipants were grouped into three categories based on their educational attainment (primary, secondary, and tertiary education) to minimize the potential influence of education on their responses. This grouping was informed by literature suggesting that educational background can affect comprehension and interpretation of visual media (Ardini et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eData was gathered through semi-structured interviews guided by an interview framework aligned with the study\u0026rsquo;s objectives. The framework included open-ended questions designed to encourage participants to articulate their interpretations of the cartoons presented to them.\u003c/p\u003e \u003cp\u003eInitially, 45 cartoons published in four prominent newspapers; Nation, Weekend Nation, Daily Times, and Malawi News, were identified, covering the period from March 2020 to March 2021. This period was chosen as it represented the peak of the COVID-19 pandemic. The selection focused on cartoons that illustrated key public health messages, societal responses, and government interventions, with the aim of assembling a balanced sample that reflected the diversity of perspectives in Malawian media. From this pool, 12 editorial cartoons were ultimately selected for the study.\u003c/p\u003e \u003cp\u003eEach cartoon was described in detail to the participants, who were then asked to interpret and respond to the content. The interviews were conducted in Chichewa, the participants' native language, to ensure they could express their thoughts comfortably. The audio-recorded interviews were then transcribed verbatim. After transcription, the first author translated the responses into English.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003e Data from the interviews were analyzed using thematic analysis, which involved identifying and coding emerging themes from the participants' responses. The analysis process included the following steps: First, interviews were audio-recorded and transcribed verbatim then translated to English from Chichewa. Then initial codes were generated from the transcripts, focusing on recurring themes and patterns. Lastly, themes were then developed through iterative review ensuring they aligned with the study objectives and existing literature.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003e The study was reviewed and approved by the Malawi University of Business and Applied Sciences (MUBAS) Postgraduate Research Evaluation Committee, study number MMS/21/PG/004. Participation in the study was entirely voluntary, and informed consent was obtained from all participants. Participants were provided with comprehensive information regarding the study's purpose, their rights, and the measures taken to ensure their confidentiality. Anonymity was maintained by assigning pseudonyms to all participants, and data were securely stored to prevent unauthorized access. Additionally, the research design accounted for the potential vulnerability of participants with disabilities, with steps taken to ensure a comfortable and respectful interview environment.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe results of this study are presented in two parts; participant socio-demographics and key themes identified through the analysis of selected cartoons. The findings provide an overview of the sample characteristics and the primary thematic insights derived from participant responses\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eDemographic characteristics\u003c/h2\u003e \u003cp\u003eThis section provides an overview of the respondents' socio-demographics. Five key characteristics namely type of visual impairment, gender, age, and educational background were analyzed to unveil insights into the composition of the study participants.\u003c/p\u003e \u003cp\u003eParticipants were characterized by their type of visual impairment, with the majority being blind (22 individuals) and a smaller proportion having low vision (8 individuals). Gender distribution among the respondents was fairly balanced, with 13 males and 17 females participating in the study.\u003c/p\u003e \u003cp\u003eThe age range of participants varied, with the largest groups falling between the ages of 25 to 30 and 31 to 35, with each group consisting of 8 and 10 individuals, respectively. The 18 to 24 and 36 to 40 age brackets each included 4 and 8 individuals, respectively, indicating a diverse spread across early to mid-adulthood.\u003c/p\u003e \u003cp\u003eIn terms of educational background, a significant portion of respondents had attained secondary education (14 individuals), followed by those with tertiary education (10 individuals) and a smaller group with only primary-level education (6 individuals).\u003c/p\u003e \u003cp\u003eLastly, when examining access to cartoon descriptions, it was found that a majority (21 respondents) reported they had never had access, while only 9 participants indicated they had ever accessed such descriptions.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eKey themes identified from cartoon analysis\u003c/h3\u003e\n\u003cp\u003eAlthough 12 cartoons were analyzed in total, this paper focuses on 6 key cartoons that encapsulated the most prevalent and illustrative themes identified during the analysis. While the remaining cartoons were considered, their contributions either overlapped with these primary examples or did not elicit new or contrasting interpretations from the participants. Thus, the selected cartoons represent the most impactful and diverse responses, allowing for a focused and coherent thematic discussion.\u003c/p\u003e\n\u003ch3\u003eTheme 1: Economic Impact of COVID-19\u003c/h3\u003e\n\u003cp\u003eThis theme encapsulates the widespread perception among participants that Puludzu cartoon, illustrates the adverse effects of COVID-19 restrictions on the livelihoods of poor individuals.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSource: Haswel Kunyenje, Daily Times, March 16, 2020.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eDescription\u003c/h2\u003e \u003cp\u003eThe cartoon shows a woman carrying a basket of items walking on a road. Behind her is a man riding a bicycle and carrying a covered basket of goods. Along the road is a signpost labelled \u0026lsquo;MARKET\u0026rsquo;. In front, there is a huge tree log written \u0026lsquo;COVID-19 RESTRICTIONS\u0026rsquo; lying diagonally blocking the road. Behind the woman and man, there is a picture of a dog-like animal labelled \u0026lsquo;POVERTY\u0026rsquo; seemingly chasing the two individuals.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eInterpretation\u003c/h2\u003e \u003cp\u003eAfter describing the cartoon to participants in their focus groups, most participants interpreted the cartoon as portraying the negative impacts of COVID-19 on poor people. In accordance to the description, most participants argued that since they know what happened during the peak of COVID-19 the message is that businesses had been affected. FBP3 from said:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eThat time many activities were banned. It was difficult for poor people to conduct their income generating activities, making it difficult for them to escape their already existing poor conditions. People were scared to go to the markets, drinking joints were closed. It was very difficult for those that operated hand-to-mouth businesses.\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eThe same views were echoed by MLV6 who stated:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eIt was a challenging time for Malawians. There were so many hindrances to fighting poverty. That tree-log says it all. We couldn\u0026rsquo;t do much for our livelihood due to the COVID-19 restrictions.\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eInterestingly, some participants would go beyond what has been described for them in order to come up with interpretations just like FBS2 who commented that:\u003c/p\u003e \u003cp\u003e \u003cem\u003eThe cartoon shows courage of the people. They jumped the log or used an alternative way to the market and sold their goods.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eSimilar to the response by FBS2, FLVS4 said:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eWe can also say it shows stubbornness of the two people. They still wanted to be out there to fight the police and the government\u003c/em\u003e.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eTheme 2: COVID-19 as a Scapegoat\u003c/h2\u003e \u003cp\u003eMany participants viewed Fingo cartoon, in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e2\u003c/span\u003e, as illustrating how COVID-19 became an excuse for personal and financial irresponsibility, reflecting a societal tendency to avoid accountability.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSource: Haswel Kunyenje, Malawi News, May 30, 2020.\u003c/p\u003e \u003cp\u003eDescription: Fingo is passing by a drinking joint labelled \u0026ldquo;Nachithidzi Shabeen\u0026rdquo;. By the entrance, there is a poster written No MASK NO ENTRY/ OPANDA MASK AYI. A woman standing by the entrance asks Fingo \u0026ldquo;Kodi akasitomala ngongole ya chaka chatha ija mudzabweza liti? (My customer, when are you squaring last year\u0026rsquo;s bill?)\u0026rdquo;. Fingo responds by saying \u0026ldquo;Ndikumalephera Kubwera kumeneko chifukwa ndilibe mask (I\u0026rsquo;m unable to stop by because I don\u0026rsquo;t have a face mask)\u0026rdquo;.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eInterpretations\u003c/h2\u003e \u003cp\u003eMost participants (27) said the cartoon depicted how COVID-19 has become a scapegoat for everything. MBS6 summarized this assertion by stating that:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eAt the peak of COVID-19, people made lame excuses for things and blamed it on COVID-19. People find it as an excuse for not repaying loans and for not fulfilling commitments.\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eHowever, three other participants had different views whereby they indicated that the cartoon depicted how people were not willing to adhere to the preventive measures set by the government. For example, FBT2 participant remarked that:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003ePeople had reservations about masks so they would rather not go to places prohibited without a mask than to put on one.\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eAll 30 participants had something to say about the cartoon, particularly on how COVID-19 had become a scapegoat and the negligence by citizens.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eTheme 3: Hypocrisy and Compliance\u003c/h2\u003e \u003cp\u003eThe Fingo cartoon in Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e3\u003c/span\u003e, highlighted hypocrisy in following COVID-19 guidelines while engaging in other risky behaviors. Participants emphasized that merely wearing masks was inadequate without broader safety measures.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSource: Haswel Kunye\u003cem\u003enje, Malawi News, May 23\u003c/em\u003e, 2020.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eDescription\u003c/h2\u003e \u003cp\u003eThe cartoon has two sections; one shows Fingo entering a drinking joint. At the entrance, there is a handwashing bucket and what appears to be soap on top of it. A woman pointing at the bucket says, \u0026ldquo;Sambani m\u0026rsquo;manja apa kunja kuli korona!\u0026rdquo; (Wash hands here. There is coronavirus out there). The other section show the two inside the drinking place where Fingo responds while pointing at other people in the shabeen by saying \u0026ldquo;Ndisambe m\u0026rsquo;manja, umve umachitika mu shabini mwanu muno munauona?\u0026rdquo; \u003cem\u003e(\u003c/em\u003eYou are asking me to wash my hands. Have you seen the nasty things that happen in your shabeen\u003cem\u003e?)\u003c/em\u003e. Amongst the people he is pointing at is a man vomiting, another man smoking, a man and a woman kissing each other and another woman drinking what appears to be beer which is also spilling on the floor.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eInterpretations\u003c/h2\u003e \u003cp\u003eIn the discussions, 29 participants pointed out that the cartoon highlighted hypocrisy that existed during the COVID-19 pandemic. For instance, MBS7 captured the views of the participants in line with hypocrisy by stating that:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eI recall that many of us and every place enforced wearing of masks but our other practices did not protect us from COVID-19. Just wearing a mask alone did not guarantee safety. Other preventive measures needed to be observed too.\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eTheme 4: Negligence in Safety Measures\u003c/h2\u003e \u003cp\u003eThe Point of Order cartoon in Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e4\u003c/span\u003e, expressed participants' concerns about the negligence in quarantine policies for travelers entering Malawi, indicating frustration with government responses.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSource: Ralph Ma\u003cem\u003ewera, The Nation, August 14, 2020.\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eDescription\u003c/h2\u003e \u003cp\u003eThe cartoon shows passengers disembarking from a plane labelled \u0026lsquo;India\u0026rsquo;. Behind the plane is a building labelled Kamuzu International Airport. From the facial features, some passengers appear to be of Indian origin. Some are putting on face masks while others are not. Some people from one side are welcoming those disembarking from the plane with hugs. A man says \u0026ldquo;Welcome to Malawi. Feel at home\u0026rdquo;. Behind is a direction sign post labelled \u0026ldquo;QUARANTINE\u0026rdquo;. At the far-right corner of the cartoon are two men conversating. One asks \u0026ldquo;Are we safe from COVID-19 with this new normal?\u0026rdquo; and the other one responds \u0026ldquo;search me\u0026rdquo;.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eInterpretations\u003c/h2\u003e \u003cp\u003eWhen asked to give their views regarding the cartoon in Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e4\u003c/span\u003e, 22 participants had similar sentiments that the cartoon depicts the country\u0026rsquo;s negligence during the COVID-19 pandemic. MBS5 ascertained that:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eMalawians were not allowed to enter other countries, but we let everyone in. Despite having facilities for quarantine, people coming into the country did not go for quarantine. This is how we ended up with so many cases of COVID-19.\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eOn the other hand, eight of the participants thought the cartoon emphasized safety from the pandemic because of the dialogue, as MBS1 commented:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eFrom what the two are discussing, they were talking about how unsafe the country was\u003c/em\u003e.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eTheme 5: Mental Health Impact\u003c/h2\u003e \u003cp\u003eThe interpretations of the Ayobe cartoon in Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e5\u003c/span\u003e varied among the participants, with some relating it to the mental health toll of lockdowns, while others criticized the trivialization of serious health concerns.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSource: Mawera, The Weekend Nation, April 4, 2020.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eDescription\u003c/h2\u003e \u003cp\u003eAyobe is sitting on a chair inside the house with his wife. He is holding his head with his right hand, looking miserable. The wife asks \u0026ldquo;Honey, you look miserable. What\u0026rsquo;s the matter? He responds by saying \u0026ldquo;Don\u0026rsquo;t you know that bars have been closed due to coronavirus?\u0026rdquo;\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eInterpretations\u003c/h2\u003e \u003cp\u003eWhen asked to interpret the cartoon, participants gave different understandings. For instance, MBS3 said the cartoon illustrates the effects of COVID-19 on mental health when he indicated that:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eJust like Ayobe, many people were depressed due to the lockdown. Staying indoors and not associating with other people took a toll on people.\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eOn the other hand, FBP2 thought that the cartoon portrayed negligence and lack of seriousness by citizens in containing the pandemic just like one participant noted:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eOf all things, Ayobe is worried about closing of bars. There were more serious issues that time than closure of bars\u003c/em\u003e.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eTheme 6: Gravity of COVID-19\u003c/h2\u003e \u003cp\u003eThe Kalimalima cartoon in Fig.\u0026nbsp;\u003cspan refid=\"Fig11\" class=\"InternalRef\"\u003e6\u003c/span\u003e, emphasized the seriousness of the pandemic, with participants acknowledging that safety was more important than financial gain.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSource: James Kazembe, Weekend Nation, January 16, 2021.\u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eDescription\u003c/h2\u003e \u003cp\u003eKalimalima has gone to a shop labelled AGRO-DEALER GULANI MBEU FETELEZA MANKHWALA PANO. At the door, there is a man standing who is wearing a mask. The man tells Kalimalima \u0026ldquo;No maski, No here! Opanda maski osabwera pano!\u0026rdquo; (No mask, No entry). Kalimalima turns back. On his way, he meets a man who appears to be a friend and says \u0026ldquo;Koma anthu ena mani, munthu kukana kundigulitsa foteleza chifukwa sindidavale maski\u0026rdquo; (Man, imagine they have denied to sell me fertilizer just because I\u0026rsquo;m not wearing a mask). The other man responds by saying \u0026ldquo;Iwe Kalima, ngati ali kachasu ulekeretu. Matenda a COVID-19 sakuona makobili\u0026rdquo; (Kalimalima, if it\u0026rsquo;s because of alcohol, you need to stop. COVID-19 is too serious for money).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003eInterpretations\u003c/h2\u003e \u003cp\u003eA majority (29) of the participants found the cartoon to be emphasizing the gravity of COVID-19. The sentiments were summarized by FBS2 who said:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eThe most important thing was to save our lives. Nothing, not even money could make anyone risk their life. We were all afraid of dying and safety came first.\u003c/em\u003e \u003c/p\u003e\u003cp\u003eFLV1 echoed the remarks:\u003c/p\u003e\u003cp\u003e \u003cem\u003eIt was a very difficult time. I remember how strict everyone was. We were asked to wash hands everywhere; shops, offices, everywhere.\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eThe outcomes from the discussion on this cartoon reiterate what has been observed from discussions about the other cartoons.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study found that 21 participants had never received descriptions of newspaper cartoons, while only 9 participants had access to descriptions from sighted individuals, as indicated in the demographic section of the results. This indicates that the majority of respondents encountered newspaper cartoon descriptions for the first time through this study. This finding underscores a significant lack of access to visual media descriptions, highlighting a gap in inclusive communication. This lack of inclusive communication is consistent with broader research indicating barriers in accessible communication. For instance, a study on inclusive communication during the COVID-19 in China, found that government and public service providers largely failed to provide accessible and inclusive emergency communications, particularly for individuals with disabilities, and advocated for proactive measures to ensure inclusive information dissemination during crises (Dai and Hu, 2021). Similarly, scholars have emphasized the increased risk of severe illness from COVID-19 among people with disabilities, underscoring the need for easily accessible public health information (Jumreornvong et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe study's thematic analysis of the participants' responses to the selected cartoons offers insights into the socio-economic and psychological impacts of COVID-19 in Malawi. The discussions surrounding the cartoons reveal a detailed understanding of public sentiment, compliance with health measures, and the broader implications of the pandemic on society. The identified themes illustrate the challenges faced by individuals and communities during the crisis. Previous studies align with these observations, suggesting that COVID-19 precautionary measures were often implemented in a disorganized manner, failing to protect all groups adequately. Additionally, in resource-limited settings, even minor impairments can increase individuals\u0026rsquo; vulnerabilities, making accessible and inclusive communication even more important (Koca-Atabey, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Jalali et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe economic impact of COVID-19 theme underscores the economic ramifications of COVID-19 restrictions, as depicted in the Puludzu cartoon (Fig.\u0026nbsp;\u003cspan refid=\"Fig12\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Participants described the struggles of low-income individuals who relied on daily activities for their survival. This finding aligns with literature highlighting that economic downturns during health crises disproportionately affect the poorest sectors of society (Backhaus et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; McNeely et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Assefa, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). The frustrations voiced by participants reflect a broader narrative of how government-imposed restrictions, while necessary for public health, can have devastating effects on livelihoods. The interpretation of both resilience and stubbornness among participants shows a relationship with the imposed restrictions, suggesting that individuals may feel compelled to navigate the obstacles in pursuit of economic survival despite the associated risks.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eA comparative look at Sri Lanka's response to COVID-19, where government provided a monthly payment to vulnerable households and people with disabilities, sheds light on how government support can mitigate the economic strain on vulnerable populations (Suraweera, Jayathilaka, and Thelijjagoda \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). However, in countries with fewer resources, like Malawi, people may face the pressure to prioritize economic survival over health safety, underscoring the difficult trade-off between health and financial security during crises\u003c/p\u003e \u003cp\u003eThe COVID-19 as a scapegoat theme reveals a pervasive sentiment that COVID-19 became a convenient excuse for personal irresponsibility. Participants illustrated how individuals often used the pandemic as a justification for neglecting obligations. This insight resonates with studies indicating that crises can lead to a culture of blame and denial, where individuals redirect responsibility to external factors (Roulet \u0026amp; Pichler, 2020; Bursztyn et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). While some participants acknowledged the skepticism towards mask-wearing, their responses also reflected a broader commentary on the societal dynamics that emerged in response to COVID-19. This duality of interpretation highlights the importance of addressing both individual behaviors and systemic issues in public health messaging.\u003c/p\u003e \u003cp\u003e The theme of hypocrisy in adhering to COVID-19 guidelines, as depicted in the Fingo cartoon (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e3\u003c/span\u003e), emphasizes the contradictions in public behavior. Participants noted that while mask-wearing was enforced, other safety measures were often neglected, demonstrating a gap in comprehensive adherence to health protocols. This finding suggests that mere compliance with visible guidelines is insufficient in the absence of a holistic approach to public health. The emphasis on broader safety measures aligns with existing literature that advocates for multifaceted strategies in health communication (Slavik et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Gollust et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Wallerstein \u0026amp; Duran, 2010). Effective messaging should encourage not only compliance with specific measures but also promote an understanding of the interconnectedness of various safety practices.\u003c/p\u003e \u003cp\u003eThe concern regarding negligence in quarantine policies, as portrayed in the Point of Order cartoon (Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e4\u003c/span\u003e), highlights participants' frustrations with governmental responses to COVID-19. The expressed sentiments reflect a broader critique of public health systems and their efficacy in safeguarding the community. This theme is particularly relevant in discussions around global health governance, where lapses in policy enforcement can lead to significant public health challenges (Mykhalovskiy et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Participants\u0026rsquo; observations about the lack of stringent quarantine measures for incoming travelers indicate a perceived failure of the government to prioritize public health, exacerbating the spread of the virus within the country.\u003c/p\u003e \u003cp\u003eThe mental health implications of the pandemic, captured in the Ayobe cartoon (Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e5\u003c/span\u003e), reveal a spectrum of interpretations among participants. While some connected the character's distress to the lockdown's toll on mental well-being, others criticized the trivialization of serious health issues. This clash in opinion illustrates the interplay between public health messaging and individual perceptions. Mental health has emerged as a significant concern during the pandemic, with studies indicating a rise in anxiety and depression linked to prolonged isolation and economic uncertainty (Toquero 2021; Liu et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Chaudhary et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The varied responses to the Ayobe cartoon emphasize the need for public health strategies that acknowledge and address mental health alongside physical health, promoting a comprehensive approach to well-being.\u003c/p\u003e \u003cp\u003eLastly, the gravity of COVID-19 was a recurrent theme in the participants\u0026rsquo; discussions surrounding the Kalimalima cartoon (Fig.\u0026nbsp;\u003cspan refid=\"Fig11\" class=\"InternalRef\"\u003e6\u003c/span\u003e). Many participants acknowledged the importance of safety over economic gain, showing a collective recognition of the pandemic's seriousness. This perspective resonates with public health literature emphasizing the importance of prioritizing life and safety in health crises (Chen et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; De Holanda Coelho et al., 2021). The participants' insistence that health considerations should supersede financial motivations reflects a societal shift in values during the pandemic, revealing a deeper understanding of the interconnectedness of health and economic stability.\u003c/p\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003eStudy Limitations\u003c/h2\u003e \u003cp\u003eThis study acknowledges several limitations. The purposive sampling method may introduce selection bias, as participants were recruited from a single organization, potentially affecting the generalizability of findings. Additionally, the reliance on self-reported data may be influenced by social desirability bias, where participants may respond in a manner they believe is expected. Future studies should consider employing a larger, more diverse sample to enhance the robustness of findings.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study emphasizes the need for inclusive communication strategies, particularly for persons with visual impairments. The reliance on verbal descriptions underscores media accessibility issues, signaling the need for enhanced, inclusive tools like braille newspapers and audio descriptions. Participants' interpretations of the described cartoons revealed significant socio-economic challenges, such as the economic impact of restrictions, and highlighted behavioral inconsistencies in adhering to health measures. Additionally, the study underscores the importance of integrating mental health considerations into public health responses and calls for more accountable governance to restore public trust in times of crisis.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003cb\u003eEthical Considerations\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe study was reviewed and approved by the Malawi University of Business and Applied Sciences (MUBAS) Postgraduate Research Evaluation Committee, study number MMS/21/PG/004. Participation in the study was entirely voluntary, and informed consent was obtained from all participants. Participants were provided with comprehensive information regarding the study's purpose, their rights, and the measures taken to ensure their confidentiality. Anonymity was maintained by assigning pseudonyms to all participants, and data were securely stored to prevent unauthorized access. Additionally, the research design accounted for the potential vulnerability of participants with disabilities, with steps taken to ensure a comfortable and respectful interview environment.\u003c/p\u003e\u003cp\u003e \u003ch2\u003eConflict of Interest Statement\u003c/h2\u003e \u003cp\u003eHK is an employee of the Malawi Council for Disability Affairs (MACODA), an organization that seeks to promote and protect the rights of persons with disabilities in Malawi. CN declares no competing interests. The views and opinions expressed in the contents of this paper are the sole responsibility of the authors, and should not, under any circumstances, be regarded as reflecting the positions of MACODA.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis research and paper development were conducted without receipt of any funding.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e \u003cp\u003eThe original concept for this study was conceived by HK, who also designed the study and undertook data collection. Data analysis was conducted by HK and CN. HK took the lead in composing the initial draft of this paper. Subsequently, CN and HK engaged in a critical revision process to enhance its intellectual depth. All authors participated in reviewing, reading, and endorsing the final version of the paper.\u003c/p\u003e\u003ch2\u003eAcknowledgments\u003c/h2\u003e \u003cp\u003e We would like to express our sincere gratitude to Dr. Emmanuel Ngwira of the University of Malawi for his invaluable guidance as the dissertation supervisor, and to Hastings Ndebvu of MUBAS for his thoughtful peer review.\u003c/p\u003e\u003ch2\u003eAvailability of Data and Materials\u003c/h2\u003e \u003cp\u003eThe data obtained from the study is accessible and can be provided by the first author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbraham L (2009) Effectiveness of cartoons as a uniquely visual medium for orienting social issues. Journalism Communication Monogr 11(2):117\u0026ndash;165. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/152263790901100202\u003c/span\u003e\u003cspan address=\"10.1177/152263790901100202\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAhmed M, Rafiq (2020) and Muhammad Asif Naveed. Information accessibility for visually impaired students. \u003cem\u003ePakistan Journal of Information Management and Libraries\u003c/em\u003e, December, 16\u0026ndash;36. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.47657/1793\u003c/span\u003e\u003cspan address=\"10.47657/1793\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArdini P, Puspa A, Biahimo R, Husain, and Hijrah Syahputra (2020) The influence of visual media and learning style on early reading ability of children of kindergarten in Gorontalo. Int J Sci Technol Res 9(10):317\u0026ndash;320. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.ijstr.org/final-print/oct2020/The-Influence-Of-Visual-Media-And-Learning-Style-On-Early-Reading-Ability-Of-Children-Of-Kindergarten-In-Gorontalo.pdf\u003c/span\u003e\u003cspan address=\"https://www.ijstr.org/final-print/oct2020/The-Influence-Of-Visual-Media-And-Learning-Style-On-Early-Reading-Ability-Of-Children-Of-Kindergarten-In-Gorontalo.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAssefa M (2021) COVID-19 Lockdown restrictions and Small Business Survival Strategy: Government supporting schemes. Bus Perspect Res 11(2):227\u0026ndash;245. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/22785337211045182\u003c/span\u003e\u003cspan address=\"10.1177/22785337211045182\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBackhaus I, Hoven H, Tecco CD, Iavicoli S, Conte A, and Nico Dragano (2022) Economic change and population health: lessons learnt from an umbrella review on the Great Recession. BMJ Open 12(4):e060710. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1136/bmjopen-2021-060710\u003c/span\u003e\u003cspan address=\"10.1136/bmjopen-2021-060710\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBursztyn L, Egorov G, Haaland I, Rao A (2022) and Christopher Roth. Scapegoating during Crises. \u003cem\u003eAEA Papers and Proceedings\u003c/em\u003e 112 (May): 151\u0026ndash;55. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1257/pandp.20221069\u003c/span\u003e\u003cspan address=\"10.1257/pandp.20221069\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChaudhary R, Rohilla M, Chauhan S, Saini M, Aman S, Singla H, Bibi A et al (2023) The pandemic\u0026rsquo;s unseen wounds: COVID-19\u0026rsquo;s profound effects on mental health. Annals Med Surg 85(10):4954\u0026ndash;4963. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/ms9.0000000000001223\u003c/span\u003e\u003cspan address=\"10.1097/ms9.0000000000001223\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen C, Reniers G, Khakzad N, and Ming Yang (2021) Operational safety economics: Foundations, current approaches and paths for future research. Saf Sci 141:105326. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ssci.2021.105326\u003c/span\u003e\u003cspan address=\"10.1016/j.ssci.2021.105326\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDai, Ruikai, and Luanjiao Hu (2021) Inclusive communications in COVID-19: a virtual ethnographic study of disability support network in China. Disabil Soc 37(1):3\u0026ndash;21. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/09687599.2021.1933388\u003c/span\u003e\u003cspan address=\"10.1080/09687599.2021.1933388\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe Coelho H, Lins G, Paul HP, Hanel Roosevelt Vilar, Renan Pereira Monteiro, Fadja Jairles Vieira Cardoso, and Valdiney Veloso Gouveia. 2021. Who prioritizes the economy over health? The role of political orientation and human values. Pers Indiv Differ 179 (April): 110890. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.paid.2021.110890\u003c/span\u003e\u003cspan address=\"10.1016/j.paid.2021.110890\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDouglas (2004) and McLinden. Visual impairment. Dans \u003cem\u003eSpecial teaching for special children? Pedagogies for inclusion\u003c/em\u003e., 26\u0026ndash;38. Open University Press eBooks. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://eric.ed.gov/?id=ED493257\u003c/span\u003e\u003cspan address=\"https://eric.ed.gov/?id=ED493257\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFeng W, Hongbo Yu, and Xiaolin Zhou (2020) Understanding particularized and generalized conversational implicatures: Is theory-of-mind necessary? Brain Lang 212:104878. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.bandl.2020.104878\u003c/span\u003e\u003cspan address=\"10.1016/j.bandl.2020.104878\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFoss (2004) Theory of visual rhetoric. Dans \u003cem\u003eRoutledge eBooks\u003c/em\u003e. 163\u0026ndash;174. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4324/9781410611581-18\u003c/span\u003e\u003cspan address=\"10.4324/9781410611581-18\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGarc\u0026iacute;a ZR (2016) Visual rhetoric. \u003cem\u003eOxford Research Encyclopedia of Communication\u003c/em\u003e, May. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1093/acrefore/9780190228613.013.212\u003c/span\u003e\u003cspan address=\"10.1093/acrefore/9780190228613.013.212\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGkatzola K, and Konstantinos Papadopoulos (2023) Social media actually used by people with visual impairment: A scoping review. Br J Visual Impairment 42(3):832\u0026ndash;848. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/02646196231189393\u003c/span\u003e\u003cspan address=\"10.1177/02646196231189393\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGollust SE, Rebekah H, Nagler, and Erika Franklin Fowler (2020) The emergence of COVID-19 in the US: a public health and political communication crisis. J Health Politics Policy Law 45(6):967\u0026ndash;981. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1215/03616878-8641506\u003c/span\u003e\u003cspan address=\"10.1215/03616878-8641506\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHennink M, Kaiser BN (2021) Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Soc Sci Med 292:114523. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.socscimed.2021.114523\u003c/span\u003e\u003cspan address=\"10.1016/j.socscimed.2021.114523\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJalali M, Shahabi S, Lankarani KB, Kamali M, and Parviz Mojgani (2020) COVID-19 and disabled people: perspectives from Iran. Disabil Soc 35(5):844\u0026ndash;847. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/09687599.2020.1754165\u003c/span\u003e\u003cspan address=\"10.1080/09687599.2020.1754165\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJumreornvong O, Tabacof L, Cortes M, Tosto J, Kellner CP, Herrera JE, Putrino D (2020) Ensuring equity for people living with disabilities in the age of COVID-19. Disabil Soc 35(10):1682\u0026ndash;1687. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/09687599.2020.1809350\u003c/span\u003e\u003cspan address=\"10.1080/09687599.2020.1809350\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKearns Cil\u0026eacute;in, and Nethmi Kearns (2020) The role of comics in public health communication during the COVID-19 pandemic. J Vis Commun Med 43(3):139\u0026ndash;149. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/17453054.2020.1761248\u003c/span\u003e\u003cspan address=\"10.1080/17453054.2020.1761248\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKennedy A, Rogers A, Blickem C, Daker-White G, and Robert Bowen (2014) Developing cartoons for long-term condition self-management information. BMC Health Serv Res 14(1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/1472-6963-14-60\u003c/span\u003e\u003cspan address=\"10.1186/1472-6963-14-60\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhan HM, Khaldon Abbas, Hamza NK (2023) Investigating the impact of COVID-19 on individuals with visual impairment. \u003cem\u003eBritish Journal of Visual Impairment\u003c/em\u003e, March, 026461962311589. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/02646196231158919\u003c/span\u003e\u003cspan address=\"10.1177/02646196231158919\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKoca-Atabey M\u0026uuml;jde (2021) Disability and old age: the COVID-19 pandemic in Turkey. Disabil Soc 36(5):834\u0026ndash;839. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/09687599.2021.1907550\u003c/span\u003e\u003cspan address=\"10.1080/09687599.2021.1907550\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKwan C, Kin MHY, Shum FKY, Tsui J, Cui VQM Hu, and, Rosetti Mei Ling To, March (2023) 1\u0026ndash;21. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/09687599.2023.2195070\u003c/span\u003e\u003cspan address=\"10.1080/09687599.2023.2195070\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu X, Zhu M, Zhang R, Zhang J, Zhang C, Liu P, Feng Z, and Zhiyi Chen (2021) Public mental health problems during COVID-19 pandemic: a large-scale meta-analysis of the evidence. Translational Psychiatry 11(1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1038/s41398-021-01501-9\u003c/span\u003e\u003cspan address=\"10.1038/s41398-021-01501-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarques A, Patricia J, Ramke J, Cairns T, Butt, Justine H, Zhang I, Jones M, Jovic et al (2022) The economics of vision impairment and its leading causes: A systematic review. EClinicalMedicine 46(March):101354. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.eclinm.2022.101354\u003c/span\u003e\u003cspan address=\"10.1016/j.eclinm.2022.101354\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMashiata M, Ali T, Das P, Tasneem Z et al (2022) Md. Faisal Rahman Badal, Subrata Kumar Sarker, Md. Mehedi Hasan,. Towards assisting visually impaired individuals: A review on current status and future prospects. \u003cem\u003eBiosensors and Bioelectronics X\u003c/em\u003e 12 (October): 100265. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.biosx.2022.100265\u003c/span\u003e\u003cspan address=\"10.1016/j.biosx.2022.100265\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcNeely CL, Laurie A, Schintler, and Bonnie Stabile (2020) Social Determinants and COVID-19 disparities: Differential pandemic effects and dynamics. World Med Health Policy 12(3):206\u0026ndash;217. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/wmh3.370\u003c/span\u003e\u003cspan address=\"10.1002/wmh3.370\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMulloy AM, Gevarter C, Hopkins M, Sutherland KS, Ramdoss ST (2014) Assistive Technology for Students with Visual Impairments and Blindness. Dans \u003cem\u003eAutism and child psychopathology series\u003c/em\u003e., 113\u0026ndash;56. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/978-1-4899-8029-8_5\u003c/span\u003e\u003cspan address=\"10.1007/978-1-4899-8029-8_5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuradyan S (2023) ASSISTIVE TECHNOLOGY FOR STUDENTS WITH VISUAL IMPAIRMENTS. Armen J Special Educ 7(1):77\u0026ndash;88. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.24234/se.v6i1.309\u003c/span\u003e\u003cspan address=\"10.24234/se.v6i1.309\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMykhalovskiy E, Frohlich KL, Poland B, Ruggiero ED, Rock MJ, and Leigha Comer (2018) Critical social sciencewithpublic health: Agonism, critique and engagement. Crit Public Health 29(5):522\u0026ndash;533. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/09581596.2018.1474174\u003c/span\u003e\u003cspan address=\"10.1080/09581596.2018.1474174\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNational SO (2019) 2018 Malawi Population and Housing Census. Malawi Government. Consult\u0026eacute; le October 23, 2024. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://malawi.unfpa.org/sites/default/files/resource-pdf/2018%20Malawi%20Population%20and%20Housing%20Census%20Main%20Report%20(1).pdf\u003c/span\u003e\u003cspan address=\"https://malawi.unfpa.org/sites/default/files/resource-pdf/2018%20Malawi%20Population%20and%20Housing%20Census%20Main%20Report%20(1).pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRoulet TJ, and Rasmus Pichler (2020) Blame Game Theory: Scapegoating, Whistleblowing and Discursive Struggles following Accusations of Organizational Misconduct. Organ Theory 1(4):263178772097519. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/2631787720975192\u003c/span\u003e\u003cspan address=\"10.1177/2631787720975192\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSiedlecki SL (2019) Understanding descriptive research designs and methods. Clin Nurse Specialist 34(1):8\u0026ndash;12. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/nur.0000000000000493\u003c/span\u003e\u003cspan address=\"10.1097/nur.0000000000000493\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSlavik CE, Darlington JC, Buttle C, Sturrock SL, and Niko Yiannakoulias (2021) Has public health messaging during the COVID-19 pandemic reflected local risks to health? A content analysis of tweeting practices across Canadian geographies. Health Place 69(April):102568. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.healthplace.2021.102568\u003c/span\u003e\u003cspan address=\"10.1016/j.healthplace.2021.102568\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSnyder J (2005) Audio description: The visual made verbal. Int Congr Ser 1282(September):935\u0026ndash;939. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ics.2005.05.215\u003c/span\u003e\u003cspan address=\"10.1016/j.ics.2005.05.215\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStangl AJ (2019) Tactile Media Consumption and Production for and by People Who Are Blind and Visually Impaired: a Design Research Investigation. Dans \u003cem\u003eProQuest LLC eBooks\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://eric.ed.gov/?q=https%3a\u0026amp;pg=537\u0026amp;id=ED597647\u003c/span\u003e\u003cspan address=\"https://eric.ed.gov/?q=https%3a\u0026amp;pg=537\u0026amp;id=ED597647\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSuraweera T, Jayathilaka R, Thelijjagoda S (2021) A nightmare in a \u0026lsquo;darker\u0026rsquo; world: persons with blindness under the Sri Lanka\u0026rsquo;s COVID-19 shutdown. Disabil Soc 36(7):1192\u0026ndash;1196. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/09687599.2021.1927671\u003c/span\u003e\u003cspan address=\"10.1080/09687599.2021.1927671\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eToquero, Cathy Mae D (2021) Provision of mental health services for people with disabilities in the Philippines amid coronavirus outbreak. Disabil Soc 36(6):1026\u0026ndash;1032. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/09687599.2021.1916885\u003c/span\u003e\u003cspan address=\"10.1080/09687599.2021.1916885\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWallerstein N, and Bonnie Duran (2010) Community-Based Participatory Research Contributions to Intervention Research: The intersection of science and practice to improve health equity. Am J Public Health 100(S1):S40\u0026ndash;46. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2105/ajph.2009.184036\u003c/span\u003e\u003cspan address=\"10.2105/ajph.2009.184036\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Visual impairments, Visual disabilities, Caricature, Cartoons, COVID-19, Descriptions","lastPublishedDoi":"10.21203/rs.3.rs-5422712/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5422712/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eCartooning has long served as an important instrument for communicating various social issues. However, as pictures are designed to interact and are deemed more powerful than words, persons with visual impairments could be seen as not accessing the full benefits of cartoon-based communication. In the absence of assistive technologies, persons with visual impairments rely hugely on descriptions provided by others. Despite this reliance, little is known about how persons with visual impairments engage with such media when it is described to them. This study explores how persons with visual impairments understand and interpret cartoon depictions of the COVID-19 pandemic and its effects. Using a qualitative approach and a descriptive research design, the study employed purposive sampling through the Malawi Union of the Blind to select 30 participants. Twelve cartoons from four major Malawian newspapers were analyzed. The cartoons were described to participants, and their feedback was collected through semi-structured interviews. Thematic analysis of the responses identified the following key themes including the economic impact of COVID-19, scapegoating, hypocrisy and compliance, mental health, negligence in safety measures, and the gravity of the pandemic.\u003c/p\u003e","manuscriptTitle":"Exploring the Perspectives of Persons with Visual Impairments on COVID-19 Cartoons in Malawian Newspapers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-13 02:33:12","doi":"10.21203/rs.3.rs-5422712/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fb17825b-8e4a-40d0-a8db-4849fede3b54","owner":[],"postedDate":"November 13th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":40050221,"name":"Media Studies"}],"tags":[],"updatedAt":"2024-11-13T02:33:12+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-13 02:33:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5422712","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5422712","identity":"rs-5422712","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}