For the last 8 months, I’ve been running a study using data from Malawi to help explore the effectiveness of global aid. Funding from the Breman Global Health Fellowship and support from the Institute of Global Health have been key in allowing this research to continue. In July 2017, I traveled with another first-year medical student to Malawi to make arrangements for our research. We arrived in Lilongwe Malawi and then had to drive about six hours to Chitipa, a city in the northern region of the country. Chitipa was our home base and jumping off point for travel to two villages, Nthalire and Misuku, which are the control and intervention areas for our study. We are using a smartphone survey to try to capture a change in access and quality of healthcare following a large donation of supplies to the area by Project C.U.R.E.. Recently, people have begun to question whether sending supplies to a low resource area is a sustainable or sufficient solution to problems of healthcare inequity and our study was designed with these ideas in mind.
For two weeks, we were in Malawi doing all the necessary setup for our survey, which is projected to collect data into 2019. We worked every waking hour getting the smartphones ready, refining the survey, and traveling to our sites to show the volunteers how the phones and platform worked and to get their input on our survey questions (and answers!). There were so many changes I could never have predicted. For example, options for mode of transportation that we originally wrote in Los Angeles changed from “Car, Bus, Walking” to “Oxcart, Motorbike, Bicycle.” Sometimes, you just don’t know until you go and you can’t be shy about asking the people who live and work in the country where you are just a visitor.
Thanks to the incredible hard work and generous spirit of the people we met in Malawi, the project so far has been a success. But how do you keep in touch with a research team on the other side of the world? The short answer for me has been: keep in touch frequently. And openly. The study has a group chat on Whatsapp, and I make these messages a priority when they arrive. I know how frustrating it is when you are trying to fix a glitch in the survey platform and can’t get an answer so I do my best to be available (which is harder than it sounds when you’re in touch three times a week and operating on a ten hour time difference). A prompt answer might take only a minute or two but saves everyone time in the long run. It has also been so important to be collaborative. Because the team working in Malawi is doing data collection with the phones and we are working here to do the data analysis, everything has to be balanced between what’s possible on the ground and what fits our study design. So far striking this balance has been demanding and rewarding—I hope that in the future our findings will serve the communities in northern Malawi that have worked so hard to make the study a success.