My Imporssibe Quest for Archival Information in Zambia, trouble with Air Namibia, and some interesting thoughts for the future

Written October 25th, 2009)
Greetings all!
I am almost at the 5-month mark, meaning I have 3 months left. As the Zambians say “Ahhhhhhh! Eeesh!” It’s gone by incredibly quickly.
This week has been both frustrating and interesting. The petrol shortage continues, and I am no longer finding the whole thing funny, now that the price of taxis has gone up. Also, when I do take the bus, it takes (and I am by no means exaggerating) 2 hours to get anywhere. The traffic is so bad because the line-ups for petrol are insane and can block an entire stretch of road. Goodness, its annoying! But also kind of fun- as you bond with people on the bus in your complaints. I’ve had some pretty good conversations on these buses- although sometimes it gets a bit sketch- an old Egyptian guy tried to hit on me on my way here, I was not impressed!
I’ve been trying to get moving on my thesis- with little success. I want to apply to a Zambian ethics board because 2 of my supervisors are Zambian and they are hoping to have the thesis published in a medical journal here. It seems a bit unethical to do a Zambian case study, work with Zambians and seek publishing opportunities in Zambia but not get approved by ethics in Zambia. Anyways, I finally got all of the signatures I needed to get in order to submit the forms to this ethics committee. I walked a full ½ hour to get there (no minibuses in this part of town) and when I arrived, they had vanished- no longer occupying their building. Their neighbours didn’t know where they’ve gone, and neither did the real estate agent. Just my luck. The next day, I travelled to the Ministry of Health (MoH) to look for some documents. I was told that the librarian was touring the country, and to come back tomorrow and I would get help from one of the secretaries. When I turned up the next day, I found out that the library wasn’t really a library. The MoH moved buildings a few years ago after the national health reforms, and when they did, they decided to put most of their documents in STORAGE. Swell. I found absolutely nothing of use. I also travelled to the MoLA (Legal Affairs) and could only find one piece of legislature that was of any use. To top it off, the nursing council that I am working with has a library, but hasn’t had anyone to organize their documents in years, so all of their records are in disorganized piles. I offered to spend the day organizing their info and searching for sources, but that didn’t seem possible. I am very stuck- however I will be making a trip the the University of Zambia’s special collections tomorrow and will hopefully be able to locate something. If not, I’ll have to find a plan B. Also, I found the new address of the lost ethics committee, with a little help from one of my supervisors here. Keep your fingers crossed for me!
Speaking of plan Bs, I was sad to find that all flights out of Canada are booked solid for Xmas, so my family will not be here to celebrate the holidays  However, on the plus side, a fellow IDSer in Botswana is also lacking holiday plans, so it looks like we’ll be heading to Namibia together for 3 weeks! I’m actually really excited. Namibia is supposed to be amazing- red sand dunes, beaches, etc. Our plans involve sandboarding and camel riding.
Also, Happy Independence Day (although as Zambians say….what exactly are we free from?)! No one seems to know how old Zambia is now, but there were ample celebrations yesterday. It was REALLY hot, so Tom and I finally gave in and went swimming at a nearby lodge where you can swim for less than 3 bucks. Tom can’t swim, so this was a bit of an adventure, but he caught on quite well for his 1st time. After, we went out for some drinks with a few friends, and all was well until my wallet went missing. It wasn’t too much of a disaster, as I make a point of never carrying my debit card or visa with me- I only last 40$ and my house keys- it could have been much, much worse (like when I had my bike stolen, or my entire wallet, ipod, etc stolen in London last year).
And last but not least, I finally learned a decent comeback in Nyanja for all of those rude remarks that I get from men here. I’m not sure how it’s spelt, but phonetically its “Who panga chongo”- meaning “you’re just making noise”. I can’t wait to try it out!

(Written October 28th, 2009)
It been quite an eventful week- and not in such a great way. Monday was my designated thesis day, as I am beginning to get stressed out about it. I went in search of archival information about Zambian nursing policy with a feeling of motivation and inspiration. I had visited the Ministry of Health last week, as well as the Ministry of Justice with zero luck, but I continued to remain positive. I managed to locate the ethics committee that mysteriously disappeared and submitted my forms before moving on to the University of Zambia’s library of special collections. After consulting a librarian there I was told “Ah, no Madam, you must visit the medical campus library at the teaching hospital, that is where you shall find your information”. So, I hoped on 2 minibuses (at one point I got lost and this really kind lady paid for me as she could tell I was a bit lost and was ready to fight with the conductor to pay a fair price) and an hour and a half later (yes, thank you petrol shortage) I arrived at the teaching hospital (UTH). Again, I was redirected to the Medical Council of Zambia for information. I was sweating profusely in the 35 degree heat, so indulged and grabbed a taxi. I got to the Medical Council of Zambia and asked to see the archives, the secretary looked at me like I was nuts and told me that they had no archives; the Council was only responsible for registering health professionals. At this point, I had wasted more than half of my day on this quest for information, and almost began to break down in tears. A doctor who saw this whole fiasco go down in the secretary’s office told me that he was on his way to the National Archives if I wanted a lift, so I decided that I absolutely had nothing to lose and went along for the ride. I got to the archives, and they had information on nursing policy….but the latest records that they have dated back to the 1970s. I am researching a nursing policy from 1997. I tried to look through newspaper records from that time and still found nothing. In a final act of desperation, I called one of my Zambian supervisors who works for the major nursing council here. She told me that I would have to wait, I am not allowed into their archives because no one has been organizing any of the incoming documents for at least a year. AKA, their archive room consists of stacks of paper. Awesome.
So now I’m not entirely sure what to do. I have managed to get my hands on 3 documents, so its not entirely a lost cause. The next step I guess is to begin designing interview questions and be as ready as I can to contact potential participants once I get approval from ethics. I don’t want to turn back- I actually am really interested to see the outcomes of this study and I think it’s worthwhile. Keep your fingers crossed.
Tuesday was just as hectic. My fellow IDSer in Botswana and I are officially meeting up in Namibia for Christmas (3 weeks on the beach and sandboarding in the Namib desert!) so I had booked a plane ticket to Windhoek. The day before (Monday) I had gone to pick up and pay for my ticket at the agency, but was told that since Air Namibia is new to Zambia (their first flight was on Sunday) I would have to go to the airport to buy the ticket and have it issued. I had no interest in paying 60$ for a cab (its 30$ one way to the airport), so I got a friend of a friend to drive me, and offered to pay for the gas (in a petrol shortage, this is still a hefty price, but still a much better deal). I get to the airport, find the Air Namibia office, and am asked to fork over cash. “Who pays for airplane tickets in cash?” I asked. Well, they had no way to process a credit card. Luckily, there is a Barclay’s bank in the airport, so I rushed over to see if they could help. But no, their system was down, but could I come back and try again tomorrow? Haha, funny. After several other desperate attempts, I decided that I would have to use my debit card and withdraw everything bit by bit from an ATM. When I finally got the money and forked it over, they had no change to give me (and yet they only accept cash?). So it took a while to get the change. And then oh, their printer broke down so it took like 10 minutes to print it out. If some of you are shocked by this, I will have you know that this is typical Zambia. Nothing pans out the way you plan (ever), simple things become impossible, and its impossible to manage your time. And yet I still have an incredible fondness for this place.
On the plus side, all of this running around for my thesis has made me incredibly thankful for the library and information systems that we have in Canada- for real. In Toronto, U of T has the largest library in Canada, I can access everything I want, when I want ,and never once have I stopped to consider this until now. I had an interesting conversation with the director of my NGO about this the other day. I was recounting to him the events of my archival quest, which he found both amusing and frightening. “You see?” he said. “This is why this NGO is so special. There’s nothing like it. We are the only organization working to organize and collect Zambian health information. Isn’t it terrifying that doctors in Zambia can’t keep themselves informed? Isn’t it awful that they don’t have access to essential medical journals like the Lancet and BMJ?” It was then that I was very overwhelmed with gratitude for people like my boss, and fully understood what drove him to start my NGO. I am so grateful for the Canadian health system, where health professionals are able to keep themselves informed about research findings and medical breakthroughs. This is how lives are saved.
For those of you who need a refresher (I haven’t ever explained this very well- it’s a bit complex), my NGO (name is being omitted to maintain confidentiality) is concerned for health research and policy. Specifically, we focus on something called knowledge translation (KT). KT is a term that refers to the practice of using knowledge to make informed decisions in health- be it in designing policies, treating patients, or conducting surgery, etc. KT is also about creating a ‘knowledge culture’ where information is systematically demanded, made available and digestible to decision-makers (aka policymakers). By ‘digestible’, I mean that information needs to be packaged in special way, so that policymakers can read through the information quickly and understand how exactly to use it to design policies and interventions. This in itself is a massive task. Often, academics or KT specialists work to make information digestible by synthesizing research in the form of systematic reviews, policy briefs, literature reviews, etc upon request. KT is also about learning how to advocate for informed health-decisions, and how to communicate and influence major health decision-makers. Basically, it’s a massive field. At my NGO, we promote KT in a few ways…
1) We are currently trying to establish a Zambia-specific health library by creating a database and health library
2) We facilitate groups of researchers and policymakers who work together to generate research and ‘translate’ it into action
3) We are training researchers to become KT experts in areas such as research synthesis and systematic reviews so that evidence is made available to policymakers
4) We are running e-learning workshops so that the public health community learns how to access reliable heath information, and communicate to others about it.
Currently in Zambia, health information is not available to the public health community. Information is scattered (my archive search is an excellent demonstration of this), disorganized, and inaccessible. To me, as a Canadian, organizing information seems like a given- something that just happens or exists in society. But I’ve learned that it really isn’t something that governments just organize or universities simply take on- it’s a really big and very crucial task. Lack of information seriously limits people- they can’t remain informed about the latest findings, they can’t conduct research, etc. Anyways, the point is, I now have personal connection of what my NGO is doing and the significance of it.

(Written October 31st)
Happy Halloween! Well, no Halloween plans on my end really. But I hope everyone at home is enjoying candy, costumes, etc. Its been quite a few days for me…
Work has gotten insanely busy. I heard back from the Zambian research board- they had a few minor concerns about my proposal and needed me to make some amendments. Talk about a fast review! Hopefully I’ll have full approval by the end of next week. On Friday, I haphazardly met with my Zambian supervisors who were at my NGO for a meeting. We established a longer meeting time for next week, and set a date for me to conduct a major part of my research in December. In short- I will be conducting a workshop with approx. 6-9 nurses who participated in an advocacy for health project, and will get them to work together to recount the events, do some group work, and answer some major questions. After, I will conduct in-depth one-on-one interviews with them. For those of you who haven’t yet read about my thesis, I am doing a case study of advocacy and how it influences policymaking. Hopefully, this project will help/inspire other researchers in Zambia to advocate for knowledge translation in health. On top of thesis, the NGO has an upcoming e-learning workshop that Dan and I are responsible for organizing. I’m terrified. I’m responsible for coordinating the visit of a KT expert from Canada and running an evaluation session. After the workshop is done, I have to focus on coordinating a ‘networking meeting’ for major health institutions in Zambia.
But wait, there’s more! My supervisor from the partner NGO (and coincidently, my next-door neighbor in my hometown) is here for just over a week. I am to be his sort of assistant while he’s visiting- coordinating his schedule, going to meetings with him, writing reports, etc. Its actually going to be interesting I think. I think I also may accumulate more work- there’s a group of health people who are working on a major project with the Ministry of Health, and it looks like they may need me to do a few things for them. It looks like I may have to head to a conference for 3 days this week outside the city to sit in on one of their conferences. I’ll know by Monday.
My supervisor actually just arrived in Lusaka this morning, so we met and discussed my placement over dinner tonight. The meeting was very helpful, and he brought a care package for me from my mum (chocolate, books, photographs, and…hair elastics! Joy). Anyways, a few noteworthy things happened at this meeting.
1. I was asked if I wanted to stay on longer in Zambia. I am not entirely sure yet, but I may be here from another 2-4 months extra. I said it depends on whether there is work to do or not. I should know more on this situation soon.
2. I was asked if I wanted to join one of the partner NGO’s sub-groups as a student rep when I return. This group is working to promote KT in Canada- I would love it if this could actually happen!
3. We decided that my thesis could potentially have 3 outputs:
a) a thesis
b) an article that could be published
c) it could be used to create a sort of academic toolkit for my NGO’s KT trainees. How COOL IS THAT?
All in all, a good meeting, and a lot to think about. Part of me wants to stay on in Zambia- it seems like I could use the extra time to learn a few things , work with some interesting people, spend more time with Tom and do more research. At the same time, I was beginning to get extremely excited about the possibility of backpacking to Zanzibar and Mozambique, and then spending a summer in Toronto, catching up on some courses and spending time with friends and family. To be continued!

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