Patience is a virtue that can be learned – in Africa

 

By Jacquelyn C.A. Meshelemiah
Associate Professor, Ohio State College of Social Work

“This is Africa!”

I have heard the expression, “This is Africa!” repeatedly over the last week while conducting research here in Gondar, Ethiopia.

I came here to collect data from Key Opinion Leaders (KOLs) on Tenofovir, a microbicide gel used to prevent HIV infection. It is in clinical trials in South Africa. The data collection is part of joint research project among Ohio State’s Colleges of Social Work and Nursing and the Department of Social Work at Gondar.

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Me (left) with Eden Begna, a 2014 social work graduate from the University of Gondar.

We most certainly hope to pilot Tenofovir in Ethiopia should the second trial in South Africa confirm the original results.  It will be a few years in coming, but we are conducting the research here to assess Ethiopia’s readiness for Tenofovir gel in the future.

The people I’ve interviewed include social workers, nurses, public health personnel, internists, HAPCO workers, OB/GYNs, health extension workers, and other relevant personnel. My colleague, Mr. Semalegne Kendie Mengesha, and I collected a lot of data!

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I’m interviewing Dr. Mengistu Mengesha

What I received was far more than rich data. I received an important lesson on time and patience.

Gathering rich data from 12 KOLs in Gondar took months of proposal writing/IRB prep work,  weeks of pre-scheduling semi-structured interviews, contacting more than 25 potential KOLs, double and triple confirmations of appointments to complete the interviews, and then bracing for the “Wait.”

Despite confirming appointments just hours or even sometimes just minutes before a confirmed appointment, Mr. Semalegne and I often found ourselves waiting, waiting, and even more waiting more than 50% of the time for participants to arrive at the agreed upon destination.

I found this pattern to be very surprising and initially very frustrating. My reference to the Biblical character Job became a daily ritual. (Job is known for his extreme patience.) Although the demands for my patience were nowhere nearly as intense as what was required for Job, I had to dig deep for my patience.

At the same time, my waiting resulted in numerous fruitful conversations about norms related to Ethiopian culture.  So, rather than perseverate over what I was repeatedly exclaiming as “Loss time!!!”   I decided to spend time trying to understand why time was relative and how waiting could be used constructively.

Eventually, I decided it was best to stay put  when a participant was running late, even if it meant waiting 20, 30, or 45 minutes for the participant to arrive.  Besides, it did not make sense to shuffle back and forth between the hospital and Taye Belay hotel in a bajaj.

Again, many participants were on time.  It was the other 50+% who showed up late or not at all that resulted in contact with more than 25 participants just to get the 12 I had intended to interview. All of the no-shows did eventually text or call within one to six hours after our appointments. That gave me some comfort and increased my patience, just a bit.

By the end of my research week, I was psychologically prepared to wait, and with patience.  I knew, based on the earlier interviews that we had completed, that we were going to get rich data and the undivided attention of the research participants once we were able to sit before them and start the tape -recording.

Now back to my point: “This is Africa!”

Yes, it is. Time is relative for most. It is not an attempt to be disrespectful or inconsiderate. It is what it is.

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From left, Solomon Getu, me, Ajanaw, and Semalegne Kendi Mengesha

I got the research done, formed some new relationships, developed some patience and learned what “This is Africa!” means.

I love Africa – all of it – even the part that makes me want me to scream and say, “Let’s start on time,” but then again, what is “on time” for me is not always the same thing for others.

“This is Africa!”

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From left, me with Addisu and Asmech.

Interviews and data collection

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Ohio State student Korbin Smith helps interview a farmer in the South Gondar region of Ethiopia.

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Ohio State student Laura Binkley and University of Gondar faculty Dr. Reta Tasfay and Mr. Dagnachew Muluye interview a health care extension nurse about rabies.

Photos by Rick Harrison, Ohio State University Communications

Data collection, shoulder dancing, and tailored suits

By Korbin Smith
Student, Ohio State College of Medicine
School of Health and Rehabilitation Sciences

The initial data collection for the project has been finished.  Our group was unable to blog or access the internet over the last week due to traveling in small towns throughout Ethiopia that don’t have internet.  To catch up, we traveled from Gondar to Woreta where we conducted interviews before moving to Debre Tabor.  It is crazy how different the climate can change Imagehere with a 40 minute drive.  Woreta has a warm climate with temperatures probably averaging around 80 degrees.  A 40 minute drive to the highland in the mountains and Debre Tabor was probably around 55-60 degrees.

Luckily for me, this means I now have a cold.  I am beginning to think I have a weak immune system, as I am always the only one to get sick.  From Debre Tabor we met with Dr. Gebreyes, who brought a photographer and Dr. Sauvageau, a neurosurgeon from Ohio State. It was good to see others from Ohio.  We drove to Bahir Dar which is the city that borders Lake Tana, the biggest lake in Ethiopia.  Being a fishing connoisseur, it was very neat to see the traditional fishing methods.

We celebrated finishing the data by going to a traditional Ethiopian club in which we saw many styles of “shoulder dancing.”  I think I can dance better in Ethiopia than in the U.S.  As long as you can move your shoulders to the music you can be accepted as a dancer here.  People are less inclined to judge me on my overall lack of rhythm (or if they are judging me it is in Amharic and I can’t tell).

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Once we returned to Gondar I was happy to pick up the suit that I had ordered in the city aweek ago.  Since I am a rather tall, skinny, and lengthy individual, the suits already made did not fit me.  Dr. Tamiru, a partner we have been working with, took me to his tailor who agreed to make me a suit from the cloth of my choosing for 1,900 birr.  While that might seem like a lot in the U.S. that is equivalent to 100 USD.  This is extremely inexpensive for a customized tailored suit. The suit fits excellently.

In addition to completing the data collection, I have appreciated experiencing different aspects of the culture here in Ethiopia.

Data collection in Debark

By Karissa Magnuson
Student, Ohio State College of Veterinary Medicine

For the past two days we have been in Debark, a town about 100 kilometers north of Gondar. Debark was our second data collection site for our rabies research project.

It is a common resting place for tourists who wish to visit the Simien Mountains. On our two-hour drive up to the city, we passed stunning scenery. The countryside is full of lush, rolling hills and looks like a patchwork quilt of rich coffee brown fields and vibrant green countryside.

We passed many farmers out plowing their fields with oxen and an old-fashioned plow. It was idyllic, and I felt like I had stepped back into a different time.  It was hard to go five minutes without seeing a shepherd out with his flock of goats or sheep, and there were always cows, goats, and sheep grazing in the distance. Our van had to stop or slow down a few times as wandering goats, sheep, and cattle crossed the road.

The people of Debark were very friendly and accommodating. For the project, my team was in charge of urban adults and children. It was truly a privilege to be able to walk their streets and be invited into their houses, especially since they knew nothing about me. Every house we went to, I was offered a chair or a place to sit, and a few times, they roasted a snack for me over their fire for me to eat. The hospitality here was truly amazing.

Our last day of data collection, we went up to a small neighborhood on a hill. Immediately we were surrounded by a huge group of children, all probably under the age of 10. They were all extremely friendly and asked me my name.

As my Ethiopian team members told them about the study and asked if they would like to participate, one of the little girls grabbed my hand.

All the children were eager to participate in the study. As we followed them back to their houses, my other hand was grabbed by a little boy, and I was led off down the dirt road to their homes.  Walking from one house to another, my hand was never empty. At one point, two of the children had a little disagreement about who actually got to hold my hand.

When we finished our data collection and were saying goodbye, all the children who had followed us around came over to me and shook my hand, and we touched shoulders. In Ethiopia, when you greet someone you shake hands and touch shoulders with the person. There must have been six or seven kids in line to say goodbye to me. It was truly a heartwarming and memorable experience that I will carry with me forever.

If generosity equaled power Ethiopia would control the world

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By Korbin Smith
Student, College of Medicine
School of Health and Rehabilitation Sciences

As we began our interviews with the locals I was amazed how easy it was to get people to volunteer. Everybody in this country wants to talk and help.

My group consisting of Dr. Atnaj Alebie and Tadele Atinafu have been more than helpful. They are brilliant professionals as well as very kind and humble people.

Together we were able to collect our first set of data in rural areas successfully and efficiently. Hearing what the rural adults and children believed caused rabies was truly incredible.

While many answers cause me to be concerned about their safety in an area where rabies is prevalent, it is inspiring to know that our work is needed.