It has been an evening that puts just about everything into perspective.
A young 17-year old woman in the village has had a difficult labor for
the past 24 hours. Vik, a GP at the heart of BV's family planning
program, along with 2 medical students visited her this evening. The
baby is not in the right position. And they can hear no heartbeat. The
chances are the woman will die as well. For some reason, one of the most
horrible aspects of this for me is the fact that the custom here is for
women in childbirth to remain silent. She will not cry or cry out.
It is hard to process this. If it were one of "us," a helicopter would
already evacuated us. Instead, we had to have a discussion about using
the BV 4x4 to get her to the town 2 hours from here. And which project
budget would pay. The 4x4 is on its way to Morombe, but we don't know if
an anesthesiologist and surgeon are there. Imagine. It is hard to accept
that those of us fortunate to be born in a rich country will never have
to face this. The two British medical students remarked that they do not
even learn what to do in this situation because it is never allowed to
get so far. The mood is very somber.
My research mood is also dark. Two days ago, I had a very difficult
conversation with the leadership of the organization, and will have
another with my collaborator tomorrow. Things are not going smoothly. I
do not trust the data's quality or the management of the quality control
process. I suppose if I were determining the growth rate of a beetle, I
might not care so much if my results are a bit dodgy. But, we are making
policy recommendations to some of the most vulnerable and poor people on
earth. We are changing how they manage their natural resources, their
social norms, and their incomes. Our assumption is that our recommended
changes are all improvements over the status quo. We have the data to
begin to uncover some of the effects of the policies. But intellectual
integrity and research ethics both require much more disciplined
research standards than what I have perceived this summer. I believe we
can salvage a project, but some major changes are going to have to
happen. Hence the difficult conversation I will be having tomorrow morning.
Monday, September 7, 2009
A fabulous update: the woman and her baby girl survived. She went to the
hospital here in Andavadoaka and the Italian doctors, aided by an
ultrasound and sterile conditions, were able to get the baby into
position. She was too exhausted to name the baby last night.
I also had a conversation this morning with my collaborator here. I am
proud of myself for keeping it in a positive tone considering how
frustrated I am. She agreed to set up and supervise a quality control
process, and asked for help in designing it. I expressed that I needed
honest and timely communication. One more chance, I guess. I am still
hopeful that sometime this fall we will have a valid dataset. Then comes
the hard part: the analysis. I raised my concerns about her
underestimation of the work involved and the fact that I do not think
that it can happen here in Andavadoaka. We will need far more frequent
communication and she will need much more contact to bound ideas around
than this site affords. I guess we will cross that bridge when we get there.
I'm off to climb into bed again. Finally, after 2 months here, something
nailed me. I've had a fever all day ?
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