Week 3 (May 27-June 2)
Research Experience
Research has gone really well this week! We've done around 15 interviews—some individual ones with patients/relatives, some with Jacob with patients/relatives, and some shared with Megan and Jacob with doctors. I did a few where I asked the questions in Swahili and then the interpreter translated the responses back to me, which I think worked well because the participants got a kick out of my Swahili and it maybe made me seem more accessible. One reoccurring issue is that Jacob and I keep getting mistaken for medical students or even doctors. A doctor I shadowed this week asked me many times what I thought he should prescribe or what I thought the diagnosis should be, and even after I explained to him that I know nothing about medicine, he still called me daktari mdogo mdogo (little doctor). Patients and relatives we interview also often think we can solve their pain or problems, which we unfortunately cannot, or that we are quizzing them and they are worried about saying the wrong thing. This confusion is probably in part because we are wearing scrubs and in part because of our whiteness and our role/behavior in the hospital (there are other white Italians there who are medical students and doctors). We just keep repeating that we aren't students of medicine and explaining that we are interested in learning about people's thoughts and beliefs and that there are no right or wrong answers to our questions. I still have not done more freelisting activities, but we will be working with a new interpreter next week—our last week in Iringa :(. She has a PhD and has conducted a lot of qualitative research, so I think she will be able to help me work on that next week.
Findings
The interviews this week have provided me with new information and new things to look for during my observation and shadowing. It seems like, along with facial expressions, practitioners also rely on vital signs to determine if a patient is in pain. This was mentioned in interviews with a couple clinicians, and then I also saw it in practice a few times once I knew to look for it. When it comes to interviews with patients and relatives, interviewees have also been describing pain that they witness or experience as either 'normal pain' or 'abnormal/severe pain,' which is interesting because it then raises the question of what 'normal' pain is. Is there an accepted baseline of pain? What kinds of pain are considered 'normal' and for whom?
Another major trend we have been picking up on is the idea that people (certain groups more than others) often fake pain for various reasons. This has been mentioned with examples by many clinicians, and also confirmed by patients and relatives at the hospital. This touches on aspects of the interests of all the researchers on this project, and is something we will certainly be exploring further.
