I sat waiting in a cafeteria at a medical student dormitory for an hour before calling it a day. Every time a door would open I would turn around to look. I would sigh, as it was a worker coming in or leaving the kitchen. I had laid out all of my materials- notebook, audio recorder, consent forms, pens. I had been waiting for interview participants for my research project. I had been told that a group of five 5th-year medical students would be gathered when I got there so we could have a focus group session. I got to the medical school early and waited for my contact to pick me up. He was 5 minutes late but I wasn’t concerned because nothing here starts on time. On our walk up to the dorm he told me that he hadn’t actually spoken to any students but he was sure I could gather enough people at the dorm. Finals were starting the following week so I was doubtful that I could persuade anyone. As we walked up to the entrance of the dorm, my contact introduced me to several men that were there. Half way through my “hello, my name is” speech, my contact said he thought I would be okay so he was leaving. Feeling a bit nervous, I went on with my speech, asking if anyone would be interested in being interviewed.
No one volunteered. One guy asked me where my research office was. I explained that I was a student so I was interviewing participants in a variety of locations based on their convenience. Apparently that wasn’t a good answer. The same guy told me I should get my contact to organize people for me (I thought I had?) and come back. I told them I’d sit in the cafeteria adjacent to us if anyone would be interested in being interviewed. I thought, “So much for the focus group idea. At this point, I just need data whether in a focus group or individual interviews.” So, I sat and waited. One student who was in the group I spoke to came in to be interviewed. I got the feeling that he agreed out of pity for me. After our short interview I waited around. I texted my contact that no one else had showed up. He assured me again that people would once dinner started. Once dinner started? I felt like an ambulance chaser on the hunt for interview participants. However, I waited for another hour thinking dinner had to be soon. It was already 6pm by this point. Unfortunately, no one else came. Dinner must be served late. So, after an hour of waiting, I packed it in.
Interviewing participants has been incredibly difficult given students’ time constraints and the unreliability of people to show up. In the United States I live my life by a calendar. I try to be no less than 15 minutes early to everything and have my life color-coded by type of activity: work, personal, school, etc. Here in Uganda, things don’t work this way. Unpredicted situations always seem to arise and estimated travel times are never a reliable estimate. Plans are never confirmed more than 12 hours in advance because situations are constantly changing. This had made the process of gathering interviews difficult given our own limited time schedules. Despite being here 7 weeks now, I’ve still yet to adjust and plan for the delays.
Location: Kampala, Uganda
Showing posts with label research. Show all posts
Showing posts with label research. Show all posts
Thursday, May 20, 2010
Thursday, May 6, 2010
Week 5- Rakai
Our recent visit to Rakai was my favorite and most memorable trip so far. I love getting out of Kampala on these trips because the country is beautiful and green with rolling hills as you move away from the urban center. The air is cleaner and easier to breath, free of the constant dust and diesel fumes found in Kampala. This may sound a bit dramatic, but there is a marked difference between city and country pollution and I feel healthier outside the city. On our drive to Rakai we stopped along the equator and took the obligatory group picture on the equator line. Later in the day we toured Masaka Nursing School where students from both Uganda and other countries train. One of the program coordinators is currently studying there and the school is very impressive.
Leading up to our trip to Rakai, I was extremely excited to attend the lectures and learn about the HIV/AIDS cohort study that is being conducted. The HIV/AIDS epidemic in Uganda is exactly what I want to focus on while I'm here so I was thrilled to be focusing on that topic for 4 days. Before we left for our trip we had a lecture by Professor Serwada on much of the background to the epidemic that they are facing today. The picture was grim, but the progress that has been made and the pioneering advances in research and treatment that have come of the AIDS epidemic are inspiring. The time spent in Rakai made me realize that, while sky-high morbidity and mortality figures are extremely sobering, they also inspire you to have a positive impact and enact change.
Rakai Health Sciences Project is a perfect example of a project that started off small and uncertain, just like the AIDS epidemic, but developed into something phenomenal, adapting to the changing situation and pioneering new methods for research and treatment as more knowledge was acquired. While fancy, high-tech labs and research centers are common in the United States and throughout the developed world, Uganda is a different story. At least one third of the population lives on less that $1 per day and approximately 6% of the population is HIV positive. Thousands of people are dying each day from the disease, but the country has very few resources to do anything about it. Despite the overwhelming problems, Rakai seemed like a beacon of hope to me, something I wasn't sure I would find during my time in Uganda. They may not be able to treat more than a subset of the population, and they may not have found the cure for AIDS, but they are having a major impact on the epidemic. They have grown and expanded over the years, developing new protocols and new research questions to further expand knowledge on HIV. It was at Rakai that researchers conducted a study and discovered the positive, protective factor that circumcision has on contracting HIV. They have subsequently carried out thousands of circumcisions on study participants and other community members who want the procedure. Using the resources and knowledge that they have, RHSP is making a huge impact on the lives of HIV positive and negative patients in Uganda, as well as on the knowledge base regarding the disease worldwide.
If I could spend more time in Uganda I would definitely go back to Rakai to learn more about their projects. But, after our 4 days there I feel better knowing that positive advances are being made to fight this deadly disease. I believe it is projects like Rakai, community-based studies and treatment, that will ultimately combat the epidemic most effectively. Only when you understand HIV in the context of Uganda and adapt the prevention and treatment to the environment can you really see change. I am honored to have met and listened to lectures from Professor Serwada, Professor Wabwire, Professor Sewankambo, and Doctor Kiwanuka. This program has provided me with some great opportunities to learn from the best in the field and I hope to come back and study more in the future.
Week 5 - Rakai Community Cohort Studies
Our trip to Rakai has been one of my favorite experiences here in Uganda. I found the Rakai Community Cohort Studies (RCCS) truly inspirational. The project at Rakai not only studies the prevalence and incidence of HIV/AIDS (and other health issues), but it also provides services to all of the community members in the study district.
Let me first state that RCCS involves around 12,000 participants. Now, these 12,000 participants aren't members of a single community; they are people living in several rural communities throughout the Rakai district. Keeping track of all of these people becomes a bit of trouble in any research study but especially so in a large, rural region. The researchers have to deal with people moving in and out of the communities, not showing up to the community hubs for their follow-up appointments, and impersonating study participants. To deal with these issues, the RCCS has come up with a means of tracking participants that involves catalogued photographs and home visits.
We were lucky enough to visit two of the community hubs where the research interviews are conducted and services are provided to community members. The hubs move between communities in the district, staying in each for a couple weeks before moving on to the next site. Several tents are set up at the site including one for waiting, one for testing, and several small ones for individual interviews. I was astonished by the level of organization and efficiency with which the researchers operated. I have never really seen a large research project in action in the United States and certainly have never seen research that operates at the level of the RCCS.
I think one of the most striking aspects of the research in Rakai was the dedication to the provision of services to people in the study communities. This was a topic that was emphasized heavily in our lectures. The researchers in Rakai understood the need to maintain the trust of the study community. This trust was sustained through involving the community in the design and implementation of the study, keeping cultural issues in mind, and giving back to the community in ways that exceed the parameters of the original studies. Although the researchers in Rakai cannot afford to treat everyone in the district, they have set up a great referral system and are able to provide basic treatment to some members in the community.
Ultimately, the Rakai Community Cohort Studies are research, but this project has managed to be more than just that. The researchers have gone above and beyond the call of their studies to give back to the communities. Giving back to participants and the community is not always easy, and I feel like the studies in Rakai can be used as a great model for how research should really be done.
Location: Rakai, Uganda
Let me first state that RCCS involves around 12,000 participants. Now, these 12,000 participants aren't members of a single community; they are people living in several rural communities throughout the Rakai district. Keeping track of all of these people becomes a bit of trouble in any research study but especially so in a large, rural region. The researchers have to deal with people moving in and out of the communities, not showing up to the community hubs for their follow-up appointments, and impersonating study participants. To deal with these issues, the RCCS has come up with a means of tracking participants that involves catalogued photographs and home visits.
We were lucky enough to visit two of the community hubs where the research interviews are conducted and services are provided to community members. The hubs move between communities in the district, staying in each for a couple weeks before moving on to the next site. Several tents are set up at the site including one for waiting, one for testing, and several small ones for individual interviews. I was astonished by the level of organization and efficiency with which the researchers operated. I have never really seen a large research project in action in the United States and certainly have never seen research that operates at the level of the RCCS.
I think one of the most striking aspects of the research in Rakai was the dedication to the provision of services to people in the study communities. This was a topic that was emphasized heavily in our lectures. The researchers in Rakai understood the need to maintain the trust of the study community. This trust was sustained through involving the community in the design and implementation of the study, keeping cultural issues in mind, and giving back to the community in ways that exceed the parameters of the original studies. Although the researchers in Rakai cannot afford to treat everyone in the district, they have set up a great referral system and are able to provide basic treatment to some members in the community.
Ultimately, the Rakai Community Cohort Studies are research, but this project has managed to be more than just that. The researchers have gone above and beyond the call of their studies to give back to the communities. Giving back to participants and the community is not always easy, and I feel like the studies in Rakai can be used as a great model for how research should really be done.
Location: Rakai, Uganda
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