When I was working as an anthropologist and operational researcher in KwaZulu Natal, I conducted a lot of interviews with local ‘stakeholders’ and community members. Here are a few snippets from some of my favourite interviews. These conversations are far, far away from interviewing the VIPs of the public health world, but just as valuable…
These memorable encounters made me grateful to the people who allow me access into their lives; the people who put up with my strange questions and constant note-taking. It is these vignettes – along with books of scrawled notes – that I take with me as memories from the fields of Zululand.
1. The teenage boy with half a haircut
I was interviewing people in discordant relationships – a couple where one person is HIV negative and the other person is HIV positive. A 17 year old boy agreed to be interviewed: he was HIV negative and his pregnant 18 year old girlfriend had recently been diagnosed as HIV positive. He was worried about how they were going to tell his girlfriend’s family, and how he was going to be able to support them all financially.
It was a school day when we met, and I asked him if he should be at school rather than talking to me. He said he couldn’t go in that day as he’d started to shave his head when the electricity in his hut ran out and he was too embarrassed to go to school with a semi-haircut and wasn’t allowed to wear a cap in the classroom. He didn’t want anyone to see us talking and didn’t want to answer any questions from his grandmother, so we sat on the ground in a shady forest near his house, his baseball cap hiding his embarrassment.
2. The sangoma (traditional healer)
We drove along dirt tracks past a crumbling church, through a forest, around another bend in yet another dusty road. I passed my phone to the MSF driver every couple of minutes, asking him to talk in Zulu to the person we were looking for and get more elaborate directions. I can speak the basics and I know when someone’s talking about me, but the nuances of Zulu geography are a little out of my league. Yes, go past the church. No, not that forest, the second one. After the hut. No, not that hut…the other hut.
We finally got to the home of a local traditional healer, or sangoma. I wanted to interview her as she participated in MSF’s HIV training programme for traditional health practitioners. The training gave her and other traditional healers in the area information about HIV/AIDS and TB, including symptoms to look for, how to conduct an HIV test and how ARVs work. I sat on the cool floor of the hut with my translator. The clay walls were hung with drying plants, strings of beads… and an MSF calendar.
3. The community leader
Another day of driving, driving and more driving. I wanted to speak to this particular community leader as he was the person who could grant us access to others in his area for a research project I was doing about HIV-related stigma. We knew he was ‘very, very old’, so it was a bit of a surprise to be told ‘oh no, he’s not home…he’s out chopping wood’ by his wife.
We drove to a different forest where indeed, there was an elderly community leader chopping wood with an axe. We sat on a pile of freshly chopped wood to talk about stigma in his community and I listened as he told me how things were changing as people became more familiar with HIV testing and ARV treatment, but that it was still difficult for people to tell others that they were HIV positive. At the end of the interview, my translator told him that she was HIV positive and had experienced some of the same discrimination we had been discussing. He laughed and clapped his hands with glee, saying he would never have guessed that she was HIV positive and wouldn’t have been so accepting of her a few years ago! She smiled and shrugged, unable to judge an ‘old, old man’ for judging her.
4. The elderly couple
I interviewed an elderly couple in their hut on top of a windy hill in Zululand, wanting to learn more about their lives and experiences of HIV in their family.
They sat together on their sofa, happily telling me about when they met and what their children were doing now. About 10 minutes into the interview the wife realised her husband wasn’t wearing trousers (pants for you non-UK English speakers) and was sitting on the sofa in his pants (underwear…yes, again for the non-Brits). She whispered to him that he should change his clothes and he came back a few minutes later in his pyjamas. He sat down and we carried on talking as if the wardrobe change had never happened.
Words and voices drawn from interviews then become action for MSF. The little things that people tell me about their experiences of HIV help design local health interventions. In-depth conversations give communities the chance to voice their views about the work of MSF and the HIV epidemic affecting them. The sangoma helps us to understand how HIV is viewed by traditional healers, so that we can work with them and teach them more about how they can help people living with HIV. The teenage boy made us realise that he and his girlfriend are in urgent need of counselling to help her take her ARVs to keep their baby negative. The traditional leader shows us that his role in the community is an important one, and that if he can be more accepting of HIV, others will follow. The elderly couple teach us about communication and how families cope with HIV.
Interviews are not the only tool of an anthropologist, but they are a useful one. It doesn’t matter if a conversation takes place on the floor of a hut, in the depths of a forest or indeed with a man who forgot to put his trousers on: local words and voices are essential to the work of MSF the world over.
(Another disclaimer: this is being posted while I am in Monrovia, Liberia, working as an anthropologist on the ebola outbreak. Posts from Liberia will follow shortly…)