Thursday 5 June 2008

Getting ready to leave... plans to get more people to come!

So, a day and a half left of the big trip. Its been a priviledge.

My research, and my experiences in Sindhudurg couldn't have been accessed without the help from Inheritance India (www.inheritanceindia.co.in) and Col. Sudhir Sawant. Phoebe's research with Saathi (www.saathi.org) was considered to be a success too.

So - now what? Can't just leave it at this, surely! I reckon that there is scope here for these organisations and individuals to take on students next year... but this time doing in a much better way... starting way early, back in September - guiding both the dissertation in December and the field research in May.

Even if people don't want to study with either of these organisations, I'm convinced that Saathi, at least, could be a brilliant way for International Health students to get acquainted with India, the NGO world and the world of health and healthcare over here...

Right - that's what I'm going to do for the next 36 hours - watch this space.

Monday 2 June 2008

Doctoring compared to international healthing...

After the last few interviews, failed focus group discussions and lots of goodbyes, I'm now in Goa... lying on a beach, recovering from the experience of the village...

I've been here for 2 days, and something quite funny has struck me. 3 groups of people, individually, have been asking me medical & biology-type questions. One bunch of Delhi guys want to know how cigarettes cause you harm, some Portuguese backpackers want to know how redbull affects the body... the list goes on.

I give my best answers to these questions, but readily acknowledge by lack of knowledge. Still, they hang on every word...checking and rechecking that they've got it right.

Now contrast this with some of my international health knowledge. Just as theoretically based, lots of my knowledge of maternal health is straight of books, journals and lectures. The same goes for my thoughts on healthcare worker migration, for example. But in these kinds of things, there is no-one (even 18 year old backpackers) hanging off my every word. These are topics that people will claim that they are the one with the answer for.

My answer is just one among many different opinions... very different to the medical example.

Thursday 29 May 2008

Interviewing the right people

Today I went to run focus groups with women at a place called Kankowli.

Upon arrival I was introduced to 'people who know' about my topic. Having been through this before, I tried my best to shake them off before getting down to the real discussion... with the women of the villages, about the problems that affect them.

It's not that I don't respect 'experts', I do. It's just that without working in the field with people, without living their lives and listening to what they say, lots of 'high-up' people like to pass comment, and even judgement on people they know little about.

My only hope can be that I do not go ahead and do the same.

Wednesday 28 May 2008

How do these things keep happening?!

Woke up early this morning... while eating breakfast I got a text from Hannah, returning home after a night out back in Newcastle... gotta love time-difference...

Anyway, I went off to run some focus groups that I'd been promised were organised and ready to go at the end of a 'function' being held in nearby Vengurla.

I'm not sure that I really like these Indian 'functions'.. at this one, there were around 400 women, sitting in rows listening to eminent speakers... they were 15 men and two women. It did seem rather strange that a group of 400 *womens self-help groups* were being lectured to by a group consisting mainly of men. Anyway, people seemed to have a good time, and who am I to complain. Just, I can't help but think that if those women were in groups of 10,20... coming up with ideas, plans for the future... being mentored... that things could work a lot better. Afterward, a leader of one of the groups was asking me about how to market her mango products - me!

Ah yes, the bit I haven't mentioned... the 'how did this happen...again'...

About half way through the 'function' I heard my name mentioned about 3 times in a couple of minutes. Quite alarmed at this, I asked the girl sitting next to me to translate a little faster! She calmed me down, and said they were just using me as an example of outside-people coming to work with the people of Sindhudurg. It turned out she was wrong...

"Sunil Bhopal, please come to the stage" cackled the microphone. I was up, and off... what else could I do?

Arriving on the stage, I was pushed towards a microphone and told to speak, in English, about how women should "make better lives for themselves"... bloody hell.

I thought about concentrating on my research, about sticking to something I knew something roughly about... in those few seconds of decision making, it seemed like the safe thing to do. But then I looked around, spotting those who had spoken before me, and the topics they had spoken on. I disagreed with lots of it, and many who had spoken didn't actually have much backing to what they were saying... so...

I did what I do best. Opened my big fat gob, and gave my take on women, men, gender and power relations in places I'd been to in Sindhudurg. I was uber-respectful, and didn't crticise at all... just giving a few examples of things I'd seen, heard and documented.

Right decision? Well, it doesn't make any different to me - really. Has it harmed anyone? Well - perhaps... I suppose someone could repeat some opinion somewhere it's not welcome - but the probability is rare, and anyway change is happening all around. Have I helped anyone? Probably not.. but I'm pretty resigned to that at this stage...

Tuesday 27 May 2008

Not much blogging about research...

It strikes me that most of my blogging has been about funny things that have happened, or general stuff in India... not much about research... so, a few words on what it's like to conduct this type of social research in the field, in a place where I don't know the language...

It's difficult! As I knew all along, the translator really holds the key - if they're interested, it'll work. If they're not, well.. you're struggling.

But that's all standard stuff, that is fairly obvious. What is less obvious is the way in which people constantly have constantly tried to put me off carrying out my work - everyone in India seems to think they know the answer to everything...

..so when I said this morning that I'm researching about nutrition, I was told by an NGO worker

"See, Sunil - for poor women there is financial problem. For not-poor, there is no problem".

Fortunately I have learnt not to be put off/too influenced by these comments... everything is to be heard, then filtered... before being digested. I have also learnt some follow-up questions..

It is beyond doubt that money, and lack of it, is a major source of problems for nutrition in women. But is it a simple lack of money? Yes, they say. So - why is it that when I inspect random Haemoglobin levels of people in Sindhudurg (measurements taken by blood bank outreach workers), that women have much much lower levels than men? Why is it that women are of much lower weight than men? This isn't all about money, elements of distribution of that money... culture... must enter the equation.

How about the 'not-poor' having no problem? For this one, I visited a local private clinic. Speaking to the doctor, he laughed at me... the problems of low birthweight children, or anaemic mothers etc etc, he said, is prevalent throughout Sindhudurg, in all economic groups.

Many people are amused about my interest in the topic... many people find it slightly pointless. It may turn out to be... but I really think I might have some findings, and would love to see them developed further in the future. Having said that, changing behaviour is extremely difficult, and I'm completely aware of that.

Things I forgot.

A month over here in Sindhudurg - it's not much. But it is enough to get a peek into how people live, what they think, how they act (around me, around others)... it's enough to realise that this is a different world to the one I inhabit back home, but that on the whole human ambitions don't seem to vary that much...

...but in all of this, I seem to have forgotten some basic questions. What do people I meet base their understanding of the world on? TV? Internet? Travel?

Well... yesterday I met a very articulate young man - 20 years old, just a few younger than me. He had a lot to say (as do most, round here) on 'Indian' culture, 'Western' culture - the good and the bad. I would say he was reasonably astute. Anyhow, where did all of this come from - what had he seen?

I asked him if he had ever met a foreigner before? He listed off around 3 or 4 groups of varying nationalities. I couldn't quite believe this - so rephrased the question... it turned out that these were the foreigners who had ever visited his taluka. I was the first person.

What about what he has seen? Has he seen the beautiful beach at Tarkali (20 kilometres away), or the royal palace at Sawantwadi (40 kilometres away). How about the cities of Pune, Mumbai (a few hundred rupees by train).

The answer is no, he has never been out of his district. His trips out of the village are limited to one particular beach at Malvan, that he has visited a few times. Remember - this isn't the poorest of the poor... not even poor at all, really... just a standard rural guy, with parents who work in government jobs.

Why am I so surprised?

Friday 23 May 2008

Results are coming in...

I've done around 15 interviews with women (I may discard some due to low quality of responses... too much outsider input etc), and 5 with doctors and others working in the healthcare system.

The picture that's been painted makes sense. Too much sense actually. I'm quite suspicious of it, and wonder whether I've been given a picture of 'cultural norms'. However, I've used various techniques (including lots of simple observation, rephrasing of questions -including in the negative) and seem to have some answers that most of the participants, and especially the translators, think is OBVIOUS.

That's all very well, but I haven't found it published in the literature... and more importantly, when I put these findings to people working in the health service - they seem impressed. They seem to feel that there might be some techniques for improving nutrition of pregnant women coming out.

Is it possible?