A Few Lessons in Patience

25 06 2010

I realize I have not written anything in a week- pole sana (very sorry). But unfortunately, every day I say to myself “I should write a blog entry.” and then say “wait. I did nothing worth noting today.” What a sad life.

But today, I realized that is not necessarily true. In the week that has gone by, I may not have accomplished what I would expected to accomplish, or what an employer in the US would have expected me to accomplish in a given work week. And while that fact has been getting to me (“this is going nowhere, I am failing” has been my most common thought this week….), today, my coworker/mentor commented in a way where I suddenly realized that it is my timeline that is off, not the accomplishments.

It is just not possible for me to accomplish things here as fast as I would like or would have expected. I knew that, and had experienced that in my trip two years ago…but I guess I forgot. I will write more on why this is later, but for now, let me just explain by telling you about my week.

First, I am paired with two different NIMR employees to help me with my project. My main partner is out this week in Geneva working on another NIMR project, and so a coworker of hers is working with me in her absence. On Thursday morning, we started making phone calls about my research permit. Now, this is something I applied for back in April, and managed to do a wire transfer of money to get the application processing fee paid. Then I never heard from them. After a couple unanswered phone calls, my partner decided we should just go to their offices which are just down the road. So, we head out. “Down the road” took a while, since traffic is bad in this area of the city. Once at the offices, we were bounced back and forth a bit and then finally told to come back in one week. It took several hours, and was basically my event for the work day. oye.

On Friday, my partner made arrangements for me to interview/administer surveys with employees at NIMR this week: someone on Monday and someone on Wednesday. I did stuff I could have done in the US, like review my interview instruments, set up excel templates for recording my data, printed copies of my survey. Wrote my first blog entry. Tried to make myself busy, but ultimately went home early because I didn’t have anything to do.

On Monday, I arrived in the morning and waited. We didn’t know what time the people would be meeting with me, they work in this same room too and so when they came in that morning, we could talk. So I waited, and waited…again, did little things to try to make myself seem busy. Around 12:30, I asked a coworker if he knew where they could be. A few phone calls later, he reported back to me. It appears both the person I was supposed to meet Monday, and the person for Wednesday, are actually on vacation this week. hmmm. My coworker had an idea though. There was someone who worked in the offices next to us that he thought would be good for my survey, and he knew well enough. He made some phone calls, and the man agreed. Together we walked over to the office to talk to this man’s secretary. We arranged for an interview the next morning. So, my entire day of “work” consisted of one small accomplishment: scheduling an interview with someone.

My fiance, Derek, jokingly emailed me the night before, “Kick some ass with your interview tomorrow! But not literally, that would be bad if you started beating up the interviewee.” Little did he know that is what I would feel like doing. The beginning went ok, I explained who I was and what my project was about and thanked him for participating. He seemed to find it interesting. I told him that the interview would be 1 hour, and it included both open-ended questions that we would have a conversation about and I would record the conversation, and then some questions that he would read and provide simple one or two letter answers for. He stopped me and said “You can ask me open questions and I will talk but I will not read or write anything for you. You must administer it or I will not do it.” grrr. My heart totally sank when he said that. I had this flash of “I spent months working on this and you won’t even look at it…and if you don’t look at it first, I have barely anything to ask you. I don’t know where to start.”

So I say “Ok, that is fine. We will just do those parts. Is it ok with you if I record our conversation, so that I can go back after and review what we have discussed?” To which he says….”Who will you share this with? Why would I feel uncomfortable answering your questions, what are you asking me about? I will not give you any information that you will then tell someone and I will get in trouble.” yoikes. This is going GREAAAAT. I reassured him that it was a confidential interview, reminded him what the purpose of gathering the information was, etc etc. He said ok, ask me your first question.

Once we did start talking, it was good. He was informative, and I have to admit that while I have read about almost everything thing he was telling me, it was different to hear how he chose to use that information as an answer to my questions. For example, since he didn’t do my whole series of quantitative, structured questions about how effective different interventions are, I decided to open-endedly (I made that word up) ask him, “If you were to implement a prevention program using either nets or IRS in a community, and say this community is “average” for Tanzania, is there a certain percentage reduction in malaria that you would expect to see or hope to see from that intervention?” He went off on this long tangent where he started telling me figures like “if 60% of a community uses nets, the child mortality rate due to malaria will decrease four fold”. So while its not exactly the statistic I want to get from him (or other interviewees) and I have no idea what he is basing that statistic from, it is still a useful piece of information. It’s important to know that this person (and because I am being confidential as promised I can’t tell you who he is, but he is important for malaria control policy) believes that the mortality rate can decrease 4-fold if 60% of the country slept under nets. That is a piece of his “knowledge” that is driving his decisions and actions for malaria control policy. He also said things that are less quantitative but important, like “when a community starts using nets, even though they still get malaria in the community the rates of anemia decreases drastically”. I took this to indicate that to him, it is not just a question of parasite prevalence but of the effect malaria has on overall health. He measures the success of intervention on factors other than parasite prevalence! This was refreshing to hear. I’ve been saying all year (though, mainly just to myself and Derek, not to anyone important!), “There is so much focus in the field on INCIDENCE of malaria and the number of cases of malaria every year, and trying to lower that number…but the US has 36,000 cases of flu per year, which is a lot, but is anyone really concerned if they catch the flu? It’s the fact that malaria causes such a burden that is the problem, not that we have malaria at all.” Now flu might not be the best analogy, but you can get the point. We most likely can’t eradicate malaria, and there will always be mosquitoes–as there should be!! Think of how messed up the ecosystem would be without insects like mosquitoes. But there must be ways to decrease burden even without decreasing incidence.

So, frustrating, yes. But by being able to quickly set aside that frustration and work with what I was given, I ended up having an educational 30-minute conversation. I wasn’t able to collect the data I need for this project, but I did have a valuable experience. I spend Wednesday debriefing the interview (it takes a LONG time to transcribe a recording into Word. No one can type as fast as you talk, so my half-hour interview took over 2 hours to get typed out. Then some time analyzing, organizing, pulling information from it.) Ah, but yesterday and today I was back to frustration.

Thursday I went back to COSTECH as I was told to do. Long story short, I was shuffled around again, including being sent all the way out to the bank to deposit my $300 permit fee to the COSTECH account, and then told to come back today.

Today, I FINALLY got my COSTECH permit! (It did take about another hour in their office this morning. But, I have it. And I immediately made copies of it just in case.) Then, I went to the offices next door to do today’s interview. My coworker walked me over there and introduced me to the woman, then he left. She asked me to repeat my name, and then said “Can you wait 10 minutes please?”

Well, I waited alright. I read through my interview notes. 10 minutes went by. I read all the names on the phone extension list posted on the wall. 20 minutes. Looked out the window. 35. At 50 minutes, the woman walked by. “Pole Sana Kristen. I am so sorry, just a moment and I’ll be ready.” BE PATIENT! I read the labels of all the binders in the bookshelf. “Payroll 2001” “Employee Contracts 2004” “Procurement 2002” “Project Reports 1998” . Some things are so oddly interesting when you are that bored, it was the most random assortment of old files and I was trying to figure out if there was any system or organization to the bookshelf. I decided there was not. Then I stared at the wall. And the ceiling. And the Floor. I followed the pattern on my skirt. I played with my hair.

After, no exaggeration, 1 hour and 57 minutes, the woman came back and said she was ready now. I started the explanation of how the interview/survey was formatted. We then start to go through the first question. She interrupted me. “Can we do this another day? Pole sana, my mind is in other places right now and I am not understanding what you are asking.I understand your goal, but I do not get what you want me to do. Maybe leave me the document and I will read through it and try to understand better. Call me on Monday and we’ll schedule another time.”

I came back to my office feeling utterly defeated. My coworker was surprised. “Oh there you are! I was starting to wonder what had happened!! I thought maybe you were talking to everyone in the office” I sadly told him it was quite the opposite. To which he replied, “ah so you are on the right track Kristen! It is good to be introducing yourself and explaining your project to people because then they will remember you and schedule times to do your survey. And you have your research permit which is very very important! You are making good progress Kristen, I am glad.”

-Kristen Pfau

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2 responses

25 06 2010
Meg

Hi Kristen,
I saw your post to your blog on Facebook, and it’s been fun to hear about your work abroad. I’m in Cambodia now, working on a women’s health program — no research here, but the different pace of life still surprises me sometimes, even a year later!
Good luck with your work, and I hope you have a great summer abroad!
Meg

29 06 2010
Kristen

Hey Meg! Thanks 🙂

I had heard that you were in Cambodia but didn’t know details. What an impressive way to dedicate your time and talent and passion! Do you have plans to stay there for a certain amount of time or is it indefinite? It’s somewhat nice to know that the frustration and surprise I was/am feeling is not because I was naive to it.

I just-book marked your blog, I’ll have to keep reading in!

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