Collaboration: It’s the African way!

Africa is a very beautiful continent with vast possibilities, especially when it comes to research. This is because of our natural resources, something in which we can take great pride. Unfortunately, as I’ve mentioned before, we run the risk of over-exploiting our own resources as we’re slow in taking up research to address environmental degradation and climate change. I think, however, there is a solution.

Collaboration. The classical definition of the word is working with someone to produce some shared end result. But how can this benefit Africa and its researchers? Let me firstly reflect on the “great” (and rather pervasive) idea of a solitary scientist.

One of the most momentous discoveries of the modern era was the discovery of penicillin. History has it that penicillin was discovered in 1928 by Alexander Fleming,

Sir Alexander Fleming at work.jpg
Sir Alexander Fleming at work

who was a professor of Bacteriology at St. Mary’s Hospital in London. After realizing that many soldiers were dying from festering wounds during the 2nd World War, Prof Fleming decided to go to the lab and try to find a remedy. As history now tells us, he was able to isolate a rare strain of Penicillium notatum which was able to inhibit the growth of bacteria. This was the greatest discovery that  paved way for further development of antibiotics. Today, Prof Fleming is celebrated as one of the greatest scientists to have ever lived. But was Prof Fleming really alone in the lab? Formal history rarely acknowledges that it was his assistants, Stuart Craddock and Frederick Ridley, who successfully isolated pure penicillin from the mould juice that Fleming had observed.

My argument here is not that these people should be credited but rather that even the greatest discoveries were a team effort – a collaboration between two or more people. Today, this is what Africa needs. Internationally, collaboration is increasing at an incredible rate. These consortia between multiple institutions and even countries ensure maximum access to resources and further advancement of all team members’ work.

In Africa, I get the impression that we believe in making the name for ourselves, as individuals. It is almost as if not being known as a solitary researcher discredits one’s work. Sure, you can protect your ideas and discoveries if you’re working in isolation, but there are major drawbacks to keeping to yourself. Limited funds, resources and slow processes are just the beginning. We often forget that science, in its nature, is collaborative.

Let us look at what will happen if Africans were to collaborate more, instead of working in isolation.

African scientists will have access to cutting-edge technology which will open up vast possibilities for research. The networks and consortia will help with access to bigger grants that are tailored for improving the African research.

Capacity building in terms of retaining skills, more knowledge and tools will also be born from these collaborations. This directly leads to the last important element of collaboration – critique.

Much of science works better if it is critiqued. You may have two people from the same field with the same set of skills but I can bet that their opinions will not be the same. This is the reason why collaboration works. The scientist whose ideas are critiqued and pass through some amounts of fire comes out golden on the other side.

It is high time that we get these collaborations going as Africans, otherwise we are doomed to stay where we are in research. As with the true spirit of Ubuntu, we become better by working together and helping others. I do not believe that the developed countries have the intellectual capacity that we don’t. For us it just takesgoing back to our African way of being – collective action – to ensure that we see a better tomorrow.

 

Ubuntu-The true African way of being.jpg
Ubuntu-The true African way of being

Ideal research in un-ideal environments

I’ve been following the tragedy happening in the North West province, regarding the collapse of the health services due to the community and trade union protests. Health systems are the stage where the impact of corruption and bad leadership plays out very dramatically, because they cost people’s lives. What was a trade union-led slow-down of health services in the province has escalated to full-on community strikes that shut down roads and health facilities.

Mahikeng service delivery protest
Welcome to the hospital. Source Bhekisisa.org (Photo by Oupa Nkosi).

 

North West hits close to home because it is the focus of my research. I am investigating how we can measure all the elements that come together to improve maternal health outcomes, including community factors. Although I love evidence and metrics, they always show you the picture in retrospect. They show you something that has already happened. They can help model future trajectories for sure, but those depend on certain conditions that in turn depend on the whims of individuals in positions of power. And they can tell you what needs to be done but can’t make people do it. And they are not empowering to the person they are supposed to benefit, the patient. Because measurements don’t equip a patient for dealing with the unexpected challenges that spring up in the public health system.

Mahikeng protest
The worst affected are those who need health services the most. Source Bhekisisa.org (Photo by Oupa Nkosi)

In this case I use the word “unexpected” very generously. As the reports state, the trouble in the North West has been brewing for years.  And it now manifests in a health system where the budget was overspent but few of its targets met. Where prices of medicines are inflated. Where money is divested from hiring more nurses and doctors to fraudulent projects. Where the frustrated reaction of health workers that feel powerless leaves patients without medicines and being discharged prematurely from hospital. Clinics closed. Patients stranded. So I may research the effect of lack of services on health trajectories all I want, and sure enough contribute to the “evidence vault”. But I can’t make people not award contracts to their friends, and that makes me angry.

I became a public health researcher to make a difference, but instances like these make you think hard about how to do that. We are all pieces of a puzzle, I understand. But nothing makes you feel more powerless than the self-interested actions of powerful individuals who can adopt or not adopt whatever guideline you come up with. It’s a reminder of just how embedded health systems are in society – and how a researcher therefore has to be embedded in society-wide action in order to make a difference.

So I’ve been looking for the links between my academic research and those people and organisations that play a more active role. I’ve learned about organizations that track stock-outs, that advocate for rural health, that are on the ground now as we speak, monitoring the situation. They are active behind the scenes, working to entrench real change in the health system. Maybe in the next few weeks I will figure out how to align myself with these actors, beyond just a Twitter follow. Maybe the hopelessness will subside.