This is the third post in a series. You can read the first post here.
Our dented white Médecins Sans Frontières / Doctors Without Borders (MSF) minivan hurtled down the main road towards the foot of the mountain, the heat from the floor of the van quite literally melting my ankles. The driver swung a right into a tiny dirt path, largely obscured by the dust kicked up in our wake.
We had just a few more interviews left for the anthropological assessment we were doing in the villages around Sinjar, in north-eastern Iraq. COVID-19 rates are spiralling here, and the aim of the assessment was to learn more about local people’s understanding and attitudes of the virus.
A mountain farmhouse
I had left it to the newly appointed health promotion officer to arrange and schedule an appointment with who he considered to be influential religious figures within the community. Naturally, I was not sure what to expect.
The first step was to understand the perception of COVID in the community, the acceptance and awareness of this disease, and to clarify what MSF can do to support people here if they were to need it...
We entered what was essentially a family farm, a compound of several households all assembled in one tiny offshoot of the main route to the mountain. There we found three elderly men sat in a row on the floor, basking in the sun and the glory of a morning cigarette.
Despite how very clearly I stood out, they ushered us into their meeting room with kind smiles, and welcomed myself and the team like we were lifelong friends.
Family but not family
My team had heard of this man, but never met him before, yet they speak with others among their community with a familiarity, a sense of respect and mutual knowing that honestly, I have never before seen.
They are not family and yet they are; respect for elders, most especially religious leaders, is at the heart of Yezidi culture, and there is an unspoken reverence for those who lived and survived through such enduring atrocities.
One by one, five more men (all who looked to be over 70) shuffled into the outhouse behind us, until we were at capacity. We shifted to maintain distance as we sat cross legged, waiting to begin.
He explained his belief that COVID is just yet another way of God warning us of his might, and our vulnerability and fragility on this earth...
The sounds of prayers, conversations, worries and praise lazily floated and filled the room, interrupted by the clinking of teaspoons, as we each stirred the small drop of tea added to our cup of sugar. Questionable as its nutritional content may be, this sweet tea is the epitome of Iraqi hospitality and under no circumstances should a guest be offered fewer than two cups before they leave, warm and glucose-high.
Understanding of COVID
Our conversation with the religious leader began, with our translator and the health promotion team translating for me as we went along.
Despite professing that he knew nothing of COVID, despite the fact that he was almost completely deaf and required his aged son to repeat loudly into his ear at a two-millimetre distance, the religious leader spoke of the symptoms he knew to be associated with COVID-19, the factors that made people in his community vulnerable, and the challenges of getting food from the market to table during these uncertain times.
And at the heart of this, he explained his belief that COVID is just yet another way of God warning us of his might, and our vulnerability and fragility on this earth.
I was not there to question his faith, nor bombard him with the facts of COVID’s origin or zoonotic uncertainties. The first step was to understand the perception of COVID in the community, the acceptance and awareness of this disease, and to clarify what MSF can do to support people here if they were to need it.
Anthropology, MSF and the community
I was heartened by what we had heard that day with the religious leader and in the other interviews we did as part of the assessment.
Understanding the values, challenges, attitudes and beliefs that shape our "health seeking behaviour" is at the centre of effective health promotion and community engagement, and this has never been as important as it is now.
With misleading guidance and rumours abound, physical and digital communities are diluted with disinformation, and have the potential to stop people from accessing the correct knowledge and guidance they need to protect themselves during this pandemic. Undertaking an assessment to analyse and shape the way MSF operates in a community, is the first step in providing relevant and accessible COVID care.
Back home in the UK, a nano moment of reflection jolts me, as I think of this man and his family in their tiny outpost in northern Iraq, where, as I left, cases were terrifyingly high. Writing this from the middle of England, where cases are rife, it is hard to imagine many dirt paths, right turns or shadowed corners of this earth where COVID has not yet laid its claim.
N.B. Alice wrote this in late 2020. At the time of publication, the rate of infection in northern Iraq has dropped.