Tuesday, October 24, 2006
Focus on Focus Groups
So I’ve decided to give you a snapshot of what my work has been like. I’ve been running focus groups in different communities in an attempt to understand how communities confront HIV/AIDS, what organizations are working with communities, and who we can recruit to help get out the prevention messages as well as find and care for the sick.
This week I was in Caia, a town of about 50,000 people. Most of those people, however, don’t live in town. They live spread out in small districts throughout the hills surrounding the town. The house groupings are by family connections. They are usually square huts with thatch roof that form into lazy circles. There are small paths weaving between the house groupings and their fields. There are some great water sources around (including a giant river—Zambezi) so there is an abundance of tomatoes, potatoes, sorghum, and plenty of grass for the goats. Because it is still the end of the rainy season the trees are very green but the grass is a lovely golden. Highlighting all of that is the rich terra cotta of the earth that you see when spaces have been beaten down for houses and paths from one group of houses to another.
The town center itself is small but growing due to a huge construction project to build a bridge over the river Zambezi. There is no plumbing in Caia, all water is drawn from wells, and electricity only comes on at 6 or 7 until 10 or 11 for those lucky enough to have generators and electricity lines. The town has wide dirt streets with whitewashed middle barriers where some scraggly trees grow. The architecture is simple here, mostly adobe or concrete, although there are some colonial-like buildings for government offices. The day that I left town there was a visit from the agriculture ambassador to promote a new way of farming so the whole center of town was covered in little colored flags strung on poles and across roads.
The place where we conducted our focus groups was in a complex called Floresta that had a basic little adobe restaurant, some rooms, and a hall for meetings and a well for drawing water to takes baths and do washing. All the buildings were cement and whitewashed walls. They all had a terra cotta stripe at the bottom about 3 feet up where the packed sandy earth had blown up and stained the whitewash. My room was in a complex of about 8 rooms that all shared a porch and a bathroom. There were basic bathroom facilities with well water in a bucket for bathing and a toilet (a nice ceramic toilet) that drained into the ground. They did have a sink with a drain but there was no plumbing so the drain just dripped onto the floor. This was generally fine except for my last night there when all of the workers for the agriculture department took up the other rooms. All men. Men make such a mess of bathrooms it’s incredible.
The hall for meeting was tinned roofed, had a cement floor, and adobe walls that went up about halfway to the roof. The structure was completed with a layer of chicken wire followed by a layer of mosquito netting. You would think that this would be great—all that fresh air…but the tin roof was baking by the afternoon and the late-afternoon brought high hot winds that lanced sand at us. We would usher the groups into the hall and point them to the seats we had set in a circle. There were plastic chairs and some fancy wooden chairs with cloth seats brought from some house near by. Invariable the people that came would humbly take the plastic chairs and would seem ill at ease if there was no space left and they had to take the wooden chairs.
We would begin the meeting introducing ourselves and explaining why we were there. Most people could understand Portuguese without a problem but were either not able, or to embarrassed to speak it. My partner speaks Sena but not as well as a local AIDS care representative who joined us the whole time and who translated for me. I would ask questions in Portuguese, he would translate them into Sena and then would translate the answers back as people spoke. Meanwhile my partner took copious notes. Overall people were shy and it took a while to get the group warmed up enough to not require prodding. By the end though, I was pleased with how the groups were going. As always, with groups of people, there are those who just won’t shut up and those who nearly refuse to speak, but I think we kept the talkers at bay and the timid we got motivated to speak. We would than all file out at the end of the session and go to the little restaurant to eat lunch or a snack.
Lunch was always roasted chicken and potatoes, or stewed goat and a corn mash (xima) that is similar to grits but thicker. The first couple of meals I ate with my fork and knife trying to cut around the little bits of bone. Finally I just got sick of how much time this would take and I started to eat with my hands. WOW! I noticed right away that my partners (including another nurse from the hospital) began to eat with their hands too. Not only that but they relaxed into their meal. I felt terrible. They had been eating with forks and knifes for my benefit. Let me tell you...it is much easier to eat meals with your fingers…and much funner too. Even the xima. People pick up a bit of xima and roll it around in their hands before dipping it in sauce and popping it in their mouth. And I’m sure most of you who eat fried chicken would agree that pulling pieces of chicken off with your fingers is really the only way to do it.
After our meal together (often in near silence because of the timidity of the people in our focus groups) we would shake hands (a polite way to shake hands here is to offer your right hand to shake while placing your left hand near the elbow of your right arm) and be on our way. The two times that people wanted to kiss cheeks was with groups of HIV+ people. In both cases one person came up and timidly kissed my cheek, when it was clear that I was happy to do that everyone came up to do the same thing. They had suffered so much and so many had been on the brink of death and shunned by their families. It was all at once tragic and lovely that they were so pleased about a little physical contact and a big smile, things that I’m lucky enough to have in abundance.
This week I was in Caia, a town of about 50,000 people. Most of those people, however, don’t live in town. They live spread out in small districts throughout the hills surrounding the town. The house groupings are by family connections. They are usually square huts with thatch roof that form into lazy circles. There are small paths weaving between the house groupings and their fields. There are some great water sources around (including a giant river—Zambezi) so there is an abundance of tomatoes, potatoes, sorghum, and plenty of grass for the goats. Because it is still the end of the rainy season the trees are very green but the grass is a lovely golden. Highlighting all of that is the rich terra cotta of the earth that you see when spaces have been beaten down for houses and paths from one group of houses to another.
The town center itself is small but growing due to a huge construction project to build a bridge over the river Zambezi. There is no plumbing in Caia, all water is drawn from wells, and electricity only comes on at 6 or 7 until 10 or 11 for those lucky enough to have generators and electricity lines. The town has wide dirt streets with whitewashed middle barriers where some scraggly trees grow. The architecture is simple here, mostly adobe or concrete, although there are some colonial-like buildings for government offices. The day that I left town there was a visit from the agriculture ambassador to promote a new way of farming so the whole center of town was covered in little colored flags strung on poles and across roads.
The place where we conducted our focus groups was in a complex called Floresta that had a basic little adobe restaurant, some rooms, and a hall for meetings and a well for drawing water to takes baths and do washing. All the buildings were cement and whitewashed walls. They all had a terra cotta stripe at the bottom about 3 feet up where the packed sandy earth had blown up and stained the whitewash. My room was in a complex of about 8 rooms that all shared a porch and a bathroom. There were basic bathroom facilities with well water in a bucket for bathing and a toilet (a nice ceramic toilet) that drained into the ground. They did have a sink with a drain but there was no plumbing so the drain just dripped onto the floor. This was generally fine except for my last night there when all of the workers for the agriculture department took up the other rooms. All men. Men make such a mess of bathrooms it’s incredible.
The hall for meeting was tinned roofed, had a cement floor, and adobe walls that went up about halfway to the roof. The structure was completed with a layer of chicken wire followed by a layer of mosquito netting. You would think that this would be great—all that fresh air…but the tin roof was baking by the afternoon and the late-afternoon brought high hot winds that lanced sand at us. We would usher the groups into the hall and point them to the seats we had set in a circle. There were plastic chairs and some fancy wooden chairs with cloth seats brought from some house near by. Invariable the people that came would humbly take the plastic chairs and would seem ill at ease if there was no space left and they had to take the wooden chairs.
We would begin the meeting introducing ourselves and explaining why we were there. Most people could understand Portuguese without a problem but were either not able, or to embarrassed to speak it. My partner speaks Sena but not as well as a local AIDS care representative who joined us the whole time and who translated for me. I would ask questions in Portuguese, he would translate them into Sena and then would translate the answers back as people spoke. Meanwhile my partner took copious notes. Overall people were shy and it took a while to get the group warmed up enough to not require prodding. By the end though, I was pleased with how the groups were going. As always, with groups of people, there are those who just won’t shut up and those who nearly refuse to speak, but I think we kept the talkers at bay and the timid we got motivated to speak. We would than all file out at the end of the session and go to the little restaurant to eat lunch or a snack.
Lunch was always roasted chicken and potatoes, or stewed goat and a corn mash (xima) that is similar to grits but thicker. The first couple of meals I ate with my fork and knife trying to cut around the little bits of bone. Finally I just got sick of how much time this would take and I started to eat with my hands. WOW! I noticed right away that my partners (including another nurse from the hospital) began to eat with their hands too. Not only that but they relaxed into their meal. I felt terrible. They had been eating with forks and knifes for my benefit. Let me tell you...it is much easier to eat meals with your fingers…and much funner too. Even the xima. People pick up a bit of xima and roll it around in their hands before dipping it in sauce and popping it in their mouth. And I’m sure most of you who eat fried chicken would agree that pulling pieces of chicken off with your fingers is really the only way to do it.
After our meal together (often in near silence because of the timidity of the people in our focus groups) we would shake hands (a polite way to shake hands here is to offer your right hand to shake while placing your left hand near the elbow of your right arm) and be on our way. The two times that people wanted to kiss cheeks was with groups of HIV+ people. In both cases one person came up and timidly kissed my cheek, when it was clear that I was happy to do that everyone came up to do the same thing. They had suffered so much and so many had been on the brink of death and shunned by their families. It was all at once tragic and lovely that they were so pleased about a little physical contact and a big smile, things that I’m lucky enough to have in abundance.
# posted by Molly Louise @ 10:48 AM 
