Written by Dr Lisa Dikomitis
I landed in September with a sense of energy and enthusiasm, just like every year. As my siblings often joke I keep living in some kind of ‘school pattern’ where the month signifies a new start and exciting things. This year, 2017, I am particularly full of energy, not only by the start of a new academic year, by the prospect of teaching a new cohort of ‘Tomorrow’s Doctors’ at Keele University and enthusing these budding clinicians for my discipline, social anthropology. My buckets of energy this September comes from a field trip to the Philippines and the news that the Global Challenges Research Fund has awarded us funding for an ethnographic study in the Philippines and a partnership which will bring together clinicians, anthropologists, psychologists, public health and humanities scholars from the UK and the Philippines.
Life in Northern Samar, through the lens of Filipino photographer Martin San Diego
But let us start from the very beginning! I am a social anthropologist and have conducted, for many years ethnographic fieldwork among Cypriot refugees. It was when I started an ethnography study about a Flemish psychiatric hospital that I got interested in the social and cultural dimensions of health and illness and I started working in the medical field. By the time I moved to the UK, I knew I wanted to continue working with, about and among those who provide health care and those at the receiving end of health care. Once settled in England, I conducted projects on inequalities in health, on access to health care and on the health care system. In the UK that is of course, the NHS: the National Health Service. One research angle that got me hooked me is that of ‘underdoctored areas’ (also called ‘underserved’ areas): how to attract and retain health care professionals to those areas, often remote, rural and isolated, where doctors and nurses often do not want to work? It is not a coincidence that I am interested in this. Thinking back, already when I was doing fieldwork around refugeehood in a small mountainous village in Cyprus I was confronted with the reality of living in a remote, isolated and underserved area, which had huge implications on the health of local communities. Here is an excerpt from my book, Cyprus and Its Places of Desire (pages 189-190), which serves as an illustration of everyday life in such areas:
One morning, after we had put the köfte (minced meatballs with herbs) in the oven, Sema and Ayşe were looking out the bay window. I was immersed in a novel. Suddenly, Sema jumped from her high stool, took my arm and said ‘gel, gel (come, come)’. I grabbed my camera assuming my two ‘research assistants’ wanted to show me something interesting as they so often did. When we arrived at the bakkal I heard the words ‘hasta’ (sick) and ‘ambülans’ (ambulance). We walked to a house in a small street opposite the bakkal where a large crowd of villagers had gathered outside. Several women were screaming, yelling and crying. The few men present were conversing in loud voices and making telephone calls. A little while later Ayşe explained what happened. An elderly Kozanlı, Osman, had felt sick with a chest pains. When he started sweating and feeling nauseated, someone called an ambulance. It took a long time to arrive, and in the meantime Osman suffered a heart attack. Two men lifted him into a car and tried to meet the ambulance. Someone else called the emergency services again to give the brand, colour and license plate of the car. Orhan died in the car. In the weeks after his death, I heard vehement discussions about the promised road works and the inaccessibility of the village in case of an emergency.
As I explained further in the book, access to the mountainous villages in Cyprus has much improved with fixing potholed roads and asphalting dirt roads (often with funds from the European Union) but the bad roads were, of course, not the only problem with healthcare provision in certain areas. It was precisely around this theme I wrote the SOLACE grant proposal, shifting field sites from Cyprus to the beautiful Philippines.
Catarman and Laoang, our two field sites in the Province of Northern Samar
It is my conviction that developing a geographically balanced and robust health workforce requires strong collaborations between different stakeholders beyond the health care sector, including educational institutions, academics and non-governmental organisations. This is exactly the ethos of SOLACE: partnering researchers from medicine, arts, social sciences and humanities with locals living in these underserved areas, health workers, policy makers and local community partners to co-produce knowledge that unearths both problems and solutions around primary health care in remote, rural and underserved areas.
At the end of July 2017, the Arts and Humanities Research Council and the Medical Research Council announced that they will jointly fund SOLACE as one of only twelve successful applications around global public health challenges. It is precisely this key area of public health—effective, sufficiently dense and geographically balanced primary care workforces—that lies at the heart of our interdisciplinary partnership: SOLACE (Stories Of public health through Local Art-based Community Engagement). SOLACE will run for two years, from November 2017 to October 2019.
Getting off a boat in Laoang, proud to be surrounded by all the fabulour #WeAreSolace team members
So, my energy is high, SOLACE is born, and as in the best families, this baby is so very much loved by its multi-cultural, multi-disciplinary, transatlantic parents, siblings, cousins. In the next blog posts we will bring you the SOLACE adventures, gossips, findings and the kinship stories.