‘Inspiring Stories’ with Lucy Gates
Senior Research Fellow, Musculoskeletal Global Health Team
This is part of the Engaged Medicine āInspiring Storiesā blog series. The blogs explore the stories behind outreach and patient-public engagement activities of staff and students from the University of Southamptonās Faculty of Medicine.
Public engagement in low resource settings ā The importance of in-country partners
How it all began
Before working in low-middle income countries (LMICs) I had no idea about the real importance of public engagement. Working across continents, in resource poor settings has totally changed the way I think about conducting research and has also re-ignited my passion (which I once lost) for working in academia. I always wanted to conduct research that is truly impactful, and not just for the sake of keeping my job (I am an eternal fixed termer- not by choice), but I never quite felt I was getting there. During the pandemic my career-long mentor Professor Cheryl Metcalf recognised this, and put me in touch with Demographer Professor Amos Channon, who is now one of my closest collaborators. We talked about how to combine our expertise in Social science, epidemiology and health for the greater good of people in low resource settings. We recognised we were missing a superpower, in the form of an engineer, and so gave Prof Alex Dickinson little choice but to join us in our planning. Together, with our Nepali partners CREHPA, we designed and successfully ran a study to understand the scale and impact of lower limb conditions in Nepal. After this we spent a period of time disseminating our results in Nepal and engaging with local stakeholders, which confirmed our ongoing research agenda; the need to improve access to mobility devices in rural Nepal. The next step was a series of public engagement events. These look a little different in Nepal and there is a more formal process to follow. Thankfully our in-country partners were able to guide us on this processā¦
The events
We began our public engagement activities, where we held an initial stakeholder event with policy influencers and health professionals to understand the acceptability of designing and developing an āappropriate, cost effective and acceptableā mobility device (e.g., stick, crutch or frame), that can be engineered and maintained by Nepali trades using local materials.
In Kathmandu we presented our work so far, along with our planned activities in a rural region. Itās a big deal to pitch your ideas to local experts, especially when you are not a local yourself. Thankfully our Nepali audience were as welcoming as ever, and appreciated the expertise we could offer in order to undertake this work. Essentially we got the green light and our journey to the rural mountains of Dolakha began.
In Dolakha we held a rural event with local traders, people with disabilities, local NGOs, local health professionals etc to determine the key elements required to develop such a device. This event looked somewhat different from that in Kathmandu. I had grand ideas of interactive activities involving storytelling, crafting and modelling in order to encourage discussion among our members and provide an environment that all could engage in. These ideas were somewhat different to normal ways of engaging with the public in Nepal, however our partners rose to the challenge, and together we planned the event with a mixture of formal talks and discussions and more interactive activities. People worked in groups to think about what mobility devices meant to them and how these could be improved. There was a wonderful buzz around the room as people worked in groups and discussion (and play dough!) flowed. At the end an individual from each group even stood up and presented their groups’ thoughts and ideas.
Success (thanks to the commitment of our in-country partner)
Throughout, we were guided by our partners on the more formal methods of engagement within Nepal. CREHPA, a non-profit consultancy and research organization, supported us in everything from getting all the right people to the table, to ensuring we chose the right setting and location, especially for those with disabilities. There is a common format to use to respectfully engage stakeholders in Nepal; this includes invitation from a distinguished professional or institution (in our case our CREHPA), a formal event hosted by an external chair which involves welcome, introductions, presentations, event activities, chairs summary and discussion from the floor, all followed by high tea. There are also other cultural norms I had to consider to show respect, those such as clothing, greetings, and hand gestures. These methods were somewhat different from the plans I had for more informal and less hierarchical engagement activities, however we designed these with our partners in the comfort that their experience in public engagement would provide the best outcomes. It paid off!
The events were hugely successful and we got more from them than we anticipated. Through this engagement we realised that local device users did not want new mobility devices, instead they wanted to improve local methods of repairing the devices they already use. Local traders, in particular bike mechanics were keen to be involved and to add skills to their trade so they could be a part of this repair process. Iāll be honest, had we not considered public engagement at this time, our onward research plans may not have worked. Because we spent time involving the public we now feel confident that our research will truly benefit the people of rural Nepal.
What next
We continue working with CREHPA and members from our public engagement work to date. Together we are building a larger grant. Based on the output from these engagement events we plan to take this research forward to begin developing sustainable methods for the repair of mobility devices in rural Nepal.
Stay Connected! To find out more about the āInspiring Storiesā series, Faculty of Medicine educational programmes and research, or to get involved use the links below or contactĀ Prof Lucy Green.Ā
University staff or students click here for the Engaged Medicine SharePoint.