Last week I gave a short presentation at our weekly staff meeting about bribery. Since the major funding for this project comes from the Novartis Foundation, we have to follow their rules and regulations and they recently developed an official stance on bribery. The main point is: bribery is illegal and you shouldn’t give or receive bribes. This sounded pretty straight forward to me and I wasn’t expecting many questions or much discussion around this point, but I was completely taken aback when the staff bombarded Kate and me with questions. One person asked if giving a piece of candy to a child who just had a finger prick to draw blood for the malaria testing was considered a bribe. I had never thought about this, but she argued that to the child a treat like that is huge and could be coercive. Some staff were very reluctant to sign anything saying that they received the training and agreed to follow the rules (something required of them by the Novartis Foundation). I talked to Kate about this afterward and she says that the University of Namibia, the employer of all of the local staff, has an unofficial policy that disagrees with the Novartis Foundation policy and that no one wants to be held to a different standard than what is typical in this context. Basically, if you want to get something done here, it’s fairly common to give a small bribe to fast-track paperwork or cut a line. Ultimately, we decided that when the local PI comes up here in a few weeks, we’ll have him go over the rules with the staff because he has more authority than either of us.
According to Kate there are very strict labor laws in Namibia and everyone knows the rules very well. If someone things they are being treated unfairly or are asked to do something that’s not in their contract, they will threaten to quit. That seems like a pretty poor strategy for someone in an area with 50% unemployment, but well-trained people who are qualified for mid- or high-level jobs are in high demand and they feel like they have control of the bargaining. This does not always work out in their favor though: just in this study Kate cited two examples of people demanding double the salary offered or they would quit and they their contracts were not renewed.
The work culture here is different than in the US in other ways as well. Here there is no sense of urgency, ever. No one ever rushes anywhere to get something done. For example, if someone here forgot something in the office and the rest of the team was waiting in the vehicle to depart, that person would not rush to retrieve their forgotten object; they would amble along at their usual pace. In fact, everyone walks very slowly. Part of the reason is that it’s hot and the faster you walk the more you sweat, but it’s more than that. I have trouble walking as slowly as people here; even when I am shuffling along I often outpace the locals.
I’m not really sure what motivates people in their work here. Certainly everyone I know wants the project to succeed and to streamline data collection, but there’s some sort of disconnect in the thought process about how to make that happen. I can’t quite explain it, but it’s sort of like people don’t have a good understanding of how their actions can lead to consequences for themselves or other people.
And when something goes wrong, no one likes to own up to it and take the blame. This is not so different as from the US; no one wants to be called out for doing things incorrectly of course, but somehow it seems different. I don’t know.
I went out to the field with one of the teams on Wednesday and we had an amazing day! The team was ready to go at 8:20 am (a new record). The place we were looking for was only 50 km away so we got to the area in less than 45 min. The first person we talked to knew the index case we were looking for and was able to direct us to the house immediately. We found the case and his mother within moments and she let us set up our interview and testing area in a covered building that serves as her kitchen so we were out of the sun. Most people had their health passports with them and they had the GR IDs we assigned. Nearly everyone in the closest houses were home and we were able to interview and test over 25 people that day as they came home from school or work. We only missed a few people who were away at a funeral. And we got back to the office before 5 pm!
It was the ideal data collection situation and I tried to talk to the team on the way back about what went right and how we can continue this trend in the future. They had some good suggestions and we will see if they can implement them in the future. Here’s hoping! Obviously some things are out of our control: if the index case as moved since we assigned them a GR ID, then it can take a lot of time to track them down and determine if they still live in our study area, but there are things, like having the bins packed with enough supplies for the week, that are in their control that I would like them to improve on.
On Friday, Kate flew back to Windhoek for a week, where she is based. Since January she has been home for one week and has struggled to keep up with the staff there and all of her other job responsibilities. She’ll be back at the end of the month, but until then I am in charge here! Yikes! She left me with what feels like an overwhelming list of things to do, but there’s no expectation to get them all done this week.
Luckily, Monday, March 21 is a holiday. It’s Namibia’s Independence Day and they are celebrating 26 years of self-rule. Can you imagine remembering when your country became independent? It boggles my mind.
Then, Friday, March 25 is Good Friday which is also a national holiday, as is Easter Monday, March 28! That means I have a three day weekend followed by a four day weekend ahead of me! There will probably be some work involved, but I am looking forward to getting out of town.