Friday, April 6, 2012
Friday, May 27, 2011
Out of Africa
I am scheduling this to post after I am Out of Africa. Goodbyes are bittersweet. Here is a quote from Meryl Streep's character in Out of Africa
"It's an odd feeling, farewell. There is such envy in it. Men go off to be tested, for courage. And if we're tested at all, it's for patience, for doing without, for how well we can endure loneliness."
This is a picture I took on my last walk to work. I liked the little sign pointing the way to the hospital.
Wednesday, May 25, 2011
Toe Jam
What can you do with a pantyliner, a kleenex and a band-aid? Well, I wish I'd taken a picture before I put my sock on! Yesterday I rammed my big toe into the tile stair leading to my bedroom. You know that feeling right after to stub your toe: it really hurts, but for a moment you're not sure if it's just a minor stub or a reason to call 911. Well, there is not 911 service here, so thankfully this incident wasn't one of those, but it was pretty bad. It was a bleeder. But luckily, I got straight into the shower to clean it off.
I kept it elevated all evening and it looked pretty good this morning. However, I was worried about what to do with it during my upcoming, approximately 36 hours of traveling. My goal was to keep it clean and dry for the duration of the trip. This is where the pantyliner, kleenex and band-aid come in. I washed my whole foot with soap and water, dried it and then wrapped my big toe with a pantyliner. This created a tube of 'fresh and dry' air for my toe to exist in. Next, I wrapped the pantyliner in a kleenex to prevent my sock from catching on the sticky part and topped the whole thing off with a band-aid.
Bon Voyage!
I kept it elevated all evening and it looked pretty good this morning. However, I was worried about what to do with it during my upcoming, approximately 36 hours of traveling. My goal was to keep it clean and dry for the duration of the trip. This is where the pantyliner, kleenex and band-aid come in. I washed my whole foot with soap and water, dried it and then wrapped my big toe with a pantyliner. This created a tube of 'fresh and dry' air for my toe to exist in. Next, I wrapped the pantyliner in a kleenex to prevent my sock from catching on the sticky part and topped the whole thing off with a band-aid.
Bon Voyage!
Tuesday, May 24, 2011
Indoor plants
Have you ever wondered where all of those beautiful 'indoor' plants come from? Well, in Botswana, they are actually outdoor plants. I have been surprised to see many plants here that I had previously only seen indoors! Here is a lovely poinsettia tree that I walk by on my way to work.
Other examples of 'indoor' plants are ficus-- you know, those miniature trees that people have in their homes and offices. Except here they are HUGE and OUTDOORS!
I am looking forward to being home and experiencing the flora and fauna of my home continent, but I have enjoyed the diversity of Africa.
Hebrews 10:24-25 (NIV) Let us consider how we may spur one another on toward love and good deeds. Let us not give up meeting together, as some are in the habit of doing, but let us encourage one another-- all the more as you see the Day approaching."
Friday, May 20, 2011
Crazy Drivers
Here are a few recent examples of crazy drivers I've encountered
Cruzin’ and boozin’: I was recently walking to the petrol station near my house when a young man ‘cruzed’ (drove in a reclined position with one arm fully extended to reach the steering wheel and the window down in order to flirt with the ladies) by me while openly drinking a bottle of beer. Swoon, swoon (not really).
Buses that don’t bother to stop before expelling their passenger: I was at the bus rank when a large bus drove past me and a man jumped out of the bus in front of me while the bus was still moving.
Who’s wrong way? People seem to think it is okay to drive the wrong way down one-way streets— as long as they do so while repeatedly hooting their horns as if to announce, ‘here I come, you'd better watch out for me.’
Cruzin’ and boozin’: I was recently walking to the petrol station near my house when a young man ‘cruzed’ (drove in a reclined position with one arm fully extended to reach the steering wheel and the window down in order to flirt with the ladies) by me while openly drinking a bottle of beer. Swoon, swoon (not really).
Buses that don’t bother to stop before expelling their passenger: I was at the bus rank when a large bus drove past me and a man jumped out of the bus in front of me while the bus was still moving.
Who’s wrong way? People seem to think it is okay to drive the wrong way down one-way streets— as long as they do so while repeatedly hooting their horns as if to announce, ‘here I come, you'd better watch out for me.’
Thursday, May 19, 2011
Measurement as intervention and reflection
Researchers are often interested in how an intervention might impact a population. For example, as part of the work I am involved with, we are interested in how various HIV prevention strategies will impact HIV incidence and prevalence in Mochudi. In order to do this, we need to measure the existing incidence and prevalence of HIV. However, simply measuring these things may be considered an intervention. By providing HIV testing opportunities in the community that go above and beyond the existing HIV testing services, we are altering the environment enough to likely impact peoples’ knowledge and behaviors, and subsequently, the HIV incidence and prevalence... hopefully for the better.
This example of measurement as intervention is unavoidable. In some imaginary world, researchers might like to be able to wave an “HIV detecting wand” over a community and get a reading on the HIV prevalence and incidence. However, in the real world we don’t have that capability so we will have to use our current methods and understand that by measuring the HIV prevalence and incidence we are also providing an intervention that will likely impact the variables we are interested in... which may, in fact, be a good thing.
Other examples of "measurement as intervention" raise ethical issues where there is a conflict between the ‘purity’ of the data and providing research participants with needed care. I recently attended a presentation where the researchers, in the course of their study, identified many participants who presented with symptoms of depression. Although depression was a variable the researchers were interested in studying and may have been tempted not to ‘interfere,’ they were ethically obligated to link these participants with services to help address their depression.
During the presentation, a member of the audience challenged the researchers stating that by providing treatment for these depressed participants they were contaminating the data— as if the researchers had erred in their judgment. In essence, he was saying that if the researchers really wanted to know how depression might impact the outcome variables they need to let it ‘run its course’ without intervening.
This comment made me squirm in my chair— are some people really so concerned with the ‘quality’ of their data that they would hesitate to provide treatment to participants who need it just because intervening might complicate their data analyses? Researchers routinely bemoan how long it takes to apply for and get approvals from supervisory bodies (IRBs, etc.) and resent the fact that various entities are constantly looking over their shoulders and auditing their every move. This recent exchange helped me see why it is so important. Sometimes researchers get very focused on the needs of the study, how they can get the ‘best’ data possible and seem to lose sight of the fact that the whole reason for doing research in the first place is to improve peoples’ lives.
The more I reflected on this situation, the more I appreciated the opportunity to see this example of researchers doing the right thing even though it may have been ‘interesting’ to watch and see what happened with the depressed patients in the absence of appropriate psychological assessment and care. I thought back to my ethics courses in school and subsequent trainings. In these courses we learned about cases such as the Tuskegee syphilis experiments and gasped in horror that scientists could make such blatant ethical offenses. But, the truth is, unless we closely monitor our own behavior and allow external supervision of our work, we are likely to descend the slippery slope to similar sins. The end does not always justify the means.
This example of measurement as intervention is unavoidable. In some imaginary world, researchers might like to be able to wave an “HIV detecting wand” over a community and get a reading on the HIV prevalence and incidence. However, in the real world we don’t have that capability so we will have to use our current methods and understand that by measuring the HIV prevalence and incidence we are also providing an intervention that will likely impact the variables we are interested in... which may, in fact, be a good thing.
Other examples of "measurement as intervention" raise ethical issues where there is a conflict between the ‘purity’ of the data and providing research participants with needed care. I recently attended a presentation where the researchers, in the course of their study, identified many participants who presented with symptoms of depression. Although depression was a variable the researchers were interested in studying and may have been tempted not to ‘interfere,’ they were ethically obligated to link these participants with services to help address their depression.
During the presentation, a member of the audience challenged the researchers stating that by providing treatment for these depressed participants they were contaminating the data— as if the researchers had erred in their judgment. In essence, he was saying that if the researchers really wanted to know how depression might impact the outcome variables they need to let it ‘run its course’ without intervening.
This comment made me squirm in my chair— are some people really so concerned with the ‘quality’ of their data that they would hesitate to provide treatment to participants who need it just because intervening might complicate their data analyses? Researchers routinely bemoan how long it takes to apply for and get approvals from supervisory bodies (IRBs, etc.) and resent the fact that various entities are constantly looking over their shoulders and auditing their every move. This recent exchange helped me see why it is so important. Sometimes researchers get very focused on the needs of the study, how they can get the ‘best’ data possible and seem to lose sight of the fact that the whole reason for doing research in the first place is to improve peoples’ lives.
The more I reflected on this situation, the more I appreciated the opportunity to see this example of researchers doing the right thing even though it may have been ‘interesting’ to watch and see what happened with the depressed patients in the absence of appropriate psychological assessment and care. I thought back to my ethics courses in school and subsequent trainings. In these courses we learned about cases such as the Tuskegee syphilis experiments and gasped in horror that scientists could make such blatant ethical offenses. But, the truth is, unless we closely monitor our own behavior and allow external supervision of our work, we are likely to descend the slippery slope to similar sins. The end does not always justify the means.
Wednesday, May 18, 2011
The Strike
You may recall a few weeks ago I mentioned that government workers were threatening to strike. Well, we are presently in week three of the strike and tensions are mounting. The primary point of contention is that the government workers have not received raises in over 3 years so they demanded an immediate 16% raise. That demand has been negotiated down to something like 13%, but is still not within the range that the government is willing to consent to… so the strike goes on.
While the strike has not affected the availability of food and other necessities, it is impacting many important aspects of everyday life. Students and parents are upset about lost days of instruction and the reality that students will be ill prepared for their upcoming exams. Patients in the hospitals are reportedly suffering due to inadequate staffing and much of the work that depends on government personnel seems to have screeched to a halt—including getting responses from the Ministries related to the work I am involved with.
All of this is very inconvenient and, from as far as I can tell, the strikers don’t seem to be backing down. The office I often sit in during the day has a window overlooking the field where many of the strikers gather. They have loud set of speakers and routinely spend the whole day broadcasting music and speeches. One recent speech was primarily in Setswana, but the speaker was obviously mimicking Dr. ML King’s, “I Have a Dream” speech—I recognized the cadence and the key words, “I have a dream, that one day…”
It has been very interesting to listen to peoples’ opinions about the strike— and Batswana are very happy to share their opinions, even if you don’t ask to hear them. Most of my older colleagues are very disturbed by the strike. It is very un-like Batswana to behave this way, they say. Some of the younger generation is somewhat sympathetic- admitting that government workers are not well paid and while the cost of living continues to rise, their salaries have not. I’m not informed enough to takes sides, but it seems to me there are a lot of people around the world who have not seen raises in several years.
All of this is of heightened interest to me in light of one of the books I read during my reading spree this year: Ayn Rand’s “Atlas Shrugged,” also known as “The Strike.” The basic plot of this complex novel is that, instead of what we commonly see, the worker-bee, blue-collar employees going on strike, the innovative, movers and shakers do. This uncommon dynamic leaves the world in a perilous decline. I am no political scientist, but I can see some of the weaknesses of Botswana’s developing system being illuminated by the current strike. Hopefully it will be an opportunity for reflection and progress… only time will tell.
While the strike has not affected the availability of food and other necessities, it is impacting many important aspects of everyday life. Students and parents are upset about lost days of instruction and the reality that students will be ill prepared for their upcoming exams. Patients in the hospitals are reportedly suffering due to inadequate staffing and much of the work that depends on government personnel seems to have screeched to a halt—including getting responses from the Ministries related to the work I am involved with.
All of this is very inconvenient and, from as far as I can tell, the strikers don’t seem to be backing down. The office I often sit in during the day has a window overlooking the field where many of the strikers gather. They have loud set of speakers and routinely spend the whole day broadcasting music and speeches. One recent speech was primarily in Setswana, but the speaker was obviously mimicking Dr. ML King’s, “I Have a Dream” speech—I recognized the cadence and the key words, “I have a dream, that one day…”
It has been very interesting to listen to peoples’ opinions about the strike— and Batswana are very happy to share their opinions, even if you don’t ask to hear them. Most of my older colleagues are very disturbed by the strike. It is very un-like Batswana to behave this way, they say. Some of the younger generation is somewhat sympathetic- admitting that government workers are not well paid and while the cost of living continues to rise, their salaries have not. I’m not informed enough to takes sides, but it seems to me there are a lot of people around the world who have not seen raises in several years.
All of this is of heightened interest to me in light of one of the books I read during my reading spree this year: Ayn Rand’s “Atlas Shrugged,” also known as “The Strike.” The basic plot of this complex novel is that, instead of what we commonly see, the worker-bee, blue-collar employees going on strike, the innovative, movers and shakers do. This uncommon dynamic leaves the world in a perilous decline. I am no political scientist, but I can see some of the weaknesses of Botswana’s developing system being illuminated by the current strike. Hopefully it will be an opportunity for reflection and progress… only time will tell.
Subscribe to:
Posts (Atom)