The end of my research

29 07 2010

When I was planning my summer, I wrote in my proposals that I would interview 15 people from various organizations and sectors in the field of malaria. I had an elaborate protocol that was created after hours of research on methods of expert elicitation, countless meetings with the MDAST research team, and several long-distance phone calls with an expert on Expert Elicitations.

When I started blogging about my project, I expressed that there seemed to be a number of unexpected hurdles. I was met with some cultural and social differences that rendered my protocol more or less inappropriate and obsolete in this setting, despite how well it was received in the setting which it was developed. I found it more difficult and time consuming than I expected to track down interviewees and set up appointments. After the struggle to identify the right organizations, (which is not that simple, it’s a lot of word-of-mouth and just know-how. You can’t just google “malaria organization in Dar es Salaam” and find all the companies’ different websites and contact information, like you might do in the US when starting a project like this. It’s a different way or working, a lot of word of mouth, explaining what you’re doing to one person only to have them say “We’re not the right one for this, but try this organization”). Then there was the task of contacting the right persons within an organization of interest. Again, you can’t necessarily go online and find an email or phone number listed under the “contact us” section of the non-existent website. One you had that contact info though, actually trying to get ahold of the person is tough too. They were always “very busy”, “not in the office today” or “on leave for the month”. Or, they wouldn’t return phone calls and emails to schedule an appointment, but the security personnel and receptionists at the offices wouldn’t let you try to drop by in person without an appointment. Those people that I did manage to speak too and who agreed to do an interview tended to be non-committal about when to meet. I often waited in the lobby of an office only to be asked, with varying ranges of apologetic politeness, to come back at a later date. Then, as the final struggle, actually sitting down for an interview did not guarantee data. The level of success with each interview varied. Some interviewees completed every section, responding in the preferred style. Others chose to go off on tangents that rounded about the question without actually addressing what I wanted, even when I pushed to get back to the original idea. Others very helpfully participated in one or two of the three sections of my interview, and declined to comment on the other sections. I am going to have a heck of a time trying to analyze this all over the next few months!

Though despite these difficulties, I have come to realize that it has been a very successful summer. I have 17 interviews total, representing 13 different organizations that cover private and public sector, non-profits, for-profits, research institutions, local and international organizations. Considering my goal was originally 15 and dropped to 8 around the second week I was here, I think I did pretty well with that! The data I have is different in nature than I expected at first, but I actually think what I ended up with is potentially more valuable and a lot more interesting. And oh my, do I have a lot of it! I have over 10 hours worth of interviews which were recorded and have been uploaded onto my computer. In transcribing the conversations into word documents (which takes absolutely forever- people talk SO much faster than I can type!), I’ve begin to see how loaded each interview was.

As a few interviews remain scheduled and formal analysis has not been conducted, it is not possible to say what the outcome of this study is. However, I can make several highly generalized comments regarding trends I have observed in the course of conducting interviews, and interesting comments that have stood out in my mind from interviewees throughout the summer.

Many of my interviewees stressed the role of the environment in contributing to malaria prevalence in a community—an aspect that I found really interesting, as an environmental student, but also was surprised by because I didn’t prompt any discussion about environment management. They pushed a need for better sanitation systems, water management, and roads in order to reduce mosquito breeding grounds and therefore reduce malaria. For example, many roads in Tanzania are not smoothly paved but are rather just dirt, and so have uneven surfaces, dips and potholes that will pool water and form nice mosquito breeding areas. Many roads also have large drainage ditches along the sides, which tend to clog with trash, dust, and other debris and so can very easily collect stagnant water, rather than provide drainage. Interviewees often cited these as examples of how the environment contributes to malaria in ways that could, and should be better managed. Many noted that while solutions like these are large-scale efforts that would take a lot of mobilization, time, and money, the actions would have large-scale results as well, providing a huge range of benefits to society that go beyond reducing malaria. They also discussed how education on land use and environmental upkeep could help decrease mosquitoes on an individual level; for example one interviewee discussed educating communities that tall grasses surrounding homes are more likely to host mosquitoes and draw insects towards their living areas, and they can reduce this by cutting back the grass.

Another trend I saw was a high number of references to the success of malaria control programs in Zanzibar. Nearly every interviewee cited Zanzibar as an example of successful malaria control, and commented on how the policy and programs implemented in Zanzibar would or would not work similarly in Tanzania mainland. Some interviewees almost expressed a sort of jealousy at the success Zanzibar has seen comparatively to the mainland, while others expressed types of role-model emotions. Still others seemed to look at Zanzibar as a hindrance to success in the mainland: by focusing on the comparison and trying to replicate their successful programs, we are ignoring the principle that that malaria control is very situational, and each region, each community, each individual even will express different variables that effect to what extent a certain type of control measure succeeds.

Finally, interviewees stressed community education and mobilization as a major factor that could inhibit or encourage success of ITNs or IRS. Interviewees strongly felt that these interventions, along with a wide range of other preventative measures, interventions, and treatment schemes, regardless of the certainty of the science and theory behind them, would not be successful if the community was not educated about the risks of malaria and motivated to make positive changes to their health. We could debate for years about which method, scientifically and theoretically, is best. But so much of it is outside the hands of science, and in the hands of the people. A net does not protect someone who doesn’t sleep under it. The community needs to be sensitized to these measures and make a personal choice to accept the measures and take responsibility for improving their own health; without this responsibility implementation of the measures will fail and poor results will ensue.

Tomorrow, Friday, is my last day of work here at NIMR. I have three interviews scheduled, with people at three organizations which I began tracking down the very first week I was here. While it would be great for my study if all three interviews are successful, in some ways, I don’t think it will be an appropriate last day unless something goes wrong!

– Kristen Pfau

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One response

29 07 2010
Alyssa

Hi Kristen,

glad to hear your research is coming together, although different, still worthwhile and more interesting than you could have anticipated. I think a transcribing software I use might be helpful for you too, you can slow down the voices and start and stop without losing your place. It’s called Express Scribe.

Looking forward to more blog posts,
Alyssa at DGHI

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