Fieldwork Challenges in the PartoPen Project

Thank you, Heather Underwood, for sharing your story.

The problems we attempt to solve as ICTD researchers never exist in isolation. It is this complexity and vast possibility that make this field incredibly diverse, challenging, and appealing. I teach an ICTD fieldwork methods course at the University of Colorado, and while we cover methods like logframes, stakeholder analysis, surveys, and interviews, my goal is for students to leave this class with even more foundational tools: adaptability, awareness, strategic decision-making in conditions of uncertainty, and a deeper understanding of themselves as researchers in the field and how that impacts the research and the people involved.

Below are several excerpts from my initial fieldnotes on the PartoPen project that capture much of this uncertainty, excitement, surprise, confusion, bewilderment, and joy that accompany almost every ICTD project. I am glad to have the opportunity to share some of these stories for the first time, and to contribute to this dynamic and diverse community in a unique way.

March 2012 – “Dr. Kuria told me that they used to have disposable speculums, but they came with a non-profit project, and when the project was done (wipes his hands), ‘gone,’ he said. This seems to be a fairly regular occurrence, and something they expect. This will be good to keep in mind for the long-term adoption and success of the PartoPen project. Show up!”

March 2012 – “The partograph forms I saw in the charts were all incomplete or completely blank. I learned that there are several reasons for this (other than inadequate training or form complexity as originally thought): most of the patients at Kenyatta are referral patients from other hospitals and they do not come to Kenyatta with a partograph form. Most of these patients are in very bad condition upon arrival; many have already delivered. One of the doctors said that clinics often do not send the partograph with the patient because they are afraid of being reprimanded, and/or they want to keep the partograph for their own records to document that the birth took place at their clinic, and therefore get more money from the ministry of health. The same doctor (Kuria) also told me that many patients are electing to be transferred to Kenyatta now that most mothers are covered by a new insurance fund – women can now pay 160 Ksh per month and receive complete maternal care. This has resulted in an increased patient load for Kenyatta without increases in staff or resources.”

March 2012 – “Today was my last day in the labor ward. I spent tea time with the nurses and gave them a thank you note and some homemade chocolate-chip cookies. Apparently that is not a staple of Kenyan cuisine – I may have started a cookie craze at Kenyatta! I have truly appreciated their patience with me, and I have been inspired by the incredible work they do. I am really looking forward to working with them again in June.”

June 2012 – “On June 20, I arrived at the labor ward to conduct the paper surveys; however, a general strike had been initiated throughout the hospital, and patients were being turned away. The handful of nurses and doctors who were working in the ward were only accepting emergency cases. I witnessed a dozen laboring women being told to go elsewhere, and I know many of those children were born on buses or on the street outside the hospital.”

(One year later)

June 2013 – “The printer we had purchased for the KNH labor ward in 2012 needed a replacement drum, and the part was not available locally. A new printer had been purchased, which was capable of printing dot paper, but the installation of the software had failed … I learned from the records office staff that the original discontinuation of the PartoPens was a result of the printer running out of toner and replacement toner not being delivered in a timely manner. I watched as one of the records office staff members showed me how they “make the toner last” – he yanked the toner cartridge out of the printer and gave it a couple of hard shakes before reinserting the cartridge into the printer.”

June 2013 – “Overall, the PartoPen project was well maintained and sustained by the staff at KNH for nine months after the initial implementation, but complicated feedback loops between hospital departments, not a lack of enthusiasm and support, has made the process slow and inefficient.”

When I first began this work, I thought I was tackling one problem: low partograph completion rates. It quickly became apparent that there is no such thing as “one problem” in fieldwork. There will always be setbacks, but there will also be pleasant surprises, and gracefully navigating both is one of the best parts of working in ICTD; a lesson I hope I can pass on to my students and share with fellow researchers and practitioners.

Dr. Underwood is currently working as an Assistant Professor at the University of Colorado Denver’s Anschutz Medical Campus.

Can women do mobile phone repair?

Thank you, Syed Ishtiaque Ahmed, for sharing your story.

June 15, 2013
Akmal’s Mobile Phone Repairing Training Center
Nahar Plaza, Elephant Road, Dhaka (Bangladesh)

The small classroom that Akmal has now does not represent what his training center used to look like even five years ago. He often refers to that time, when he had a classroom of 30 students and he would teach 4 such classes a day, all jam packed. A list of his graduated students is kept in his personal journal lying on his old desk that still bears the memory of those golden days of his business. Akmal used to be the richest businessman in this market even until 2008. However, the noisy hot air blowers, the rusty hot irons, and the tempered forceps of today’s training center can only tell you a story of a declining mobile repair market in Dhaka, with the rapid growth in the use of cheap Chinese mobile phones. The wear and tear of the walls and the desks, the parsimoniously organized ceiling fans and electric bulbs, and the marks of repairs on the whiteboard reflect the shrinking demands of the electronic crafts that Akmal possesses and teaches others. However, the strict rules that Akmal has always maintained in his classes still remain the same, just like his cordial relationship with his students. New to his 15 years career of teaching mobile phone repair however, Akmal has been getting some female students in his class these days. In our class for example, we have Lina, a 20 year-old Higher Secondary Certificate passed young lady who aspires to get a job in one of the government’s recent projects on women empowerment. Although Akmal has all sorts of arrangements for his students to get hands-on experience in fixing broken phones, he still struggles to fix and maintain the perfect balance between the distance he thinks a female student should maintain from her male colleagues and the collaboration she needs for her work. Lina, on the other hand, does not mind much taking help from his male classmates, but is not willing to do that before Akmal. These tensions are complicated and often evident in the ways Lina and Akmal stare, talk, work, and negotiate on the learning parameters.

Today, students have to work together in pairs on a repairing technique called ‘jumpering’, and Lina and I are in the same group. Akmal, as usual, demonstrates the process first, and explains every necessary detail of it. Now, every group has an assigned motherboard on which they must perform ‘jumpering’. Akmal goes to every group to check if they are having any problems. By the time he reaches our table, Lina and I have already done the first part of the task. We have removed the defective IC and are heating the ends of the copper wire to replace it. Lina is holding the far end of the wire with her forceps, while I am heating the other end with the hot air gun. When Akmal stops by, Lina takes one step back to make a clear distance from me. Akmal asks Lina to leave the far end of the wire to him while I keep on working on the other end. I finish working on my end, and it is now Lina’s turn to solder the far end. As Lina places the wire on the board, I come closer to her to blow the hot air to that end from the gun. Akmal stops me, and takes the gun from my hand. He stretches his arm as much as possible so that he can blow the hot air being at the furthest possible distance from Lina. However, it is difficult for a person to target the air at the right location from that distance. Lina tries a couple of times, but fails to melt her end of wire. Then she takes the hot gun in her one hand, holds the wire with the other, and tries to solder all by herself. Although she succeeds to solder the wire, it is not positioned exactly at the right place. Akmal checks both the ends and thinks for a while. He says to Lina, “Your end is not done well, but I guess you now know how to do this task, right? That is enough.” Lina nods her head, but does not say anything.

As the class ends and the students start leaving, Lina calls me softly and requests me to stay back in the class for 10 more minutes so she can try jumpering again. I agree. I can see Akmal sitting now at the front desk of the training center. He is talking loudly with one of his friends about how new the current mobile market is for him and how helpless he feels about it. I observe that Lina is not looking at him at all. Akmal looks at us once and then ignores. Maybe, like the new mobile market, he also does not know what to do with this burgeoning growth of woman participation in the informal tech markets of Bangladesh.

Syed Ishtiaque Ahmed is currently a PhD candidate in the Department of Information Science at Cornell University.

(y)our stories

As we found ourselves immersed in discussing, debating, and planning ahead for our workshop in May, one thought we had was to create a space for our growing community to share stories with one another. These would be the stories that form the sub-text of our papers – occasionally acknowledged but always there, influencing inevitably the projects we take on, the lenses we use for writing, the perspectives we read from, the conversations we have with each other, and more: a piece of ourselves, a piece of our lives, and a way to connect.

We invite stories from all those among you who have some to share – stories of people, projects, tussles, victories, realizations, goodbyes. One is too small a number, no doubt, because you probably have hundreds coming to mind right now, but let’s start with one and see where we land. Some of us are familiar with undertakings in the field that aim for participation and content-generation of, for, and by the communities we work with. Here, that community will be us.