One of the coolest experiences of my rural experience was conducting the research for my Community Diagnosis Survey, a field exercise attached to my Community Health Class. Recently, I had read I got from the American Public Health Association, titled “Conducting Health Research with Native American Communities”. This book is a collection of stories from researchers, many with the Indian Health Service, who have conducted research in the American Indian and Alaska Native Populations. The book talks a great deal about this idea of being an outsider conducting research, not providing direct services. I always knew that this would help frame my experience in the community, but I never thought about how much it would always be in the back of my mind.
To conduct my 11-page questionnaire, I was equipped with my papers, my pencils, and most importantly my guide and translator. This guide would be guiding me through the community and translating my questions and the answers. Usually the surveys went well but there were a few issues that arose:
· First, it was obvious that on many occasions we were given answers that would please us, but were not in practice. The biggest example of this was a question about hand-washing and when people wash their hands. People knew how to answer, but I know that they did not wash their hands every time they claimed to. They were looking to give us the right answers, and not necessarily what was in practice.
· Similar to this would be when we would ask a question regarding a pit-latrine or waste-disposal and would receive one answer then would ask to see it and see a completely different situation, again we were given answers they thought we were looking for not the truth.
One of my favorite stories from this experience was when I was sitting in a house, made of mud and straw, interviewing the head of household. It came to the point where I was asking about recent illness in the household. They explained the youngest child, 1.5 years old, was having an unknown leg pain. As I walked through my questions there was a bit of commotion and before I knew it there was a naked baby being dangled in my face while all the family members were talking and pointing out where the leg pain was. I just looked at the leg, jotted a note, and then said thanks. It was this moment that made me feel like a real public health official. A professional conducting real research, not just a student with a field study attachment.
This field study experience was one-of-a-kind. Something few other students have the opportunity to do, and an experience that will stick with me forever.
I learned so much about conducting this type of research, being an outsider, and most of all how to truly assess the needs of the community. Over the next few weeks, I will be producing an extensive report analyzing the findings and eventually making recommendations. Due to the nature of this project and to protect the community this report will not be released publicly, just to the faculty at the University of Nairobi School of Public Health and hopefully back to the community.
Throughout all of this I learned many things including: the importance of being with community members, the value of knowing about the community before, and most importantly the need for this concept presented to me in the book I referenced earlier: Community Based Participatory Research (CBPR).
This idea is just as it sounds: the community you are researching should have participation in the research. Either by having community members conduct the research, or empowering the community members to make changes per the recommendations you create. CBPR is an idea that seems straightforward, but as I discovered it is often hard and challenging because some community members may not understand what you are doing, or how to carry out the recommendations. Becoming known in the community, and being friendly to those you meet is invaluable to conducting the research.
In Public Health and Epidemiology there is this idea of Shoe-Leather Epidemiology, meaning the old-fashioned detective work wearing out your shoes because you are walking the streets. While my research in Seme will not solve any mysteries it was my first taste of shoe-leather epidemiology and I don’t think I’ve ever felt as happy as I did conducting that research (except maybe the Polio campaign – but that’s another blog post!).