backlog: Batey hopping.

My work in the DR is structured in a rather circuitous way – as both a program evaluation and a needs analysis concerning access and utilization of health services – making things kind of hectic, much like many endeavors in my life. It’s been a long running start, building up to a rapid finish.

Following weeks of reviewing literature, struggling through meetings (en español, por su puesto) with stakeholders, and participating observantly, the madness of surveys began. I developed a rather extensive, 100-question, quantitative-data collection instrument and trained two Haitian medical students (able to translate Spanish into Creole when needed) in collection methods. After testing and revising the survey, we collected information from multiple field sites in individual Batey communities.

As a background I ought to explain that the organizations with which I’m working provide healthcare through mobile ambulances to communities without access to any other types of health services. This includes preventative medicine, treatment, prenatal care, health-education, and so on. Accordingly, there are huge varieties of unmet needs. At the same time, these Batey communities live on the fringe of society and suffer in need of many other types of services, like education and sanitation infrastructure.

In the name of ethics I won’t reveal too much about the project here or now, but I will say that it has been challenging to segue between the areas of inquiry and practice – between the acts of research versus organizational assessment. The dependency of patients upon these health services limits the accuracy of the reach of a general evaluation survey – these patients lack the typical “rights” of choice, access, and time that other users are afforded in routinized healthcare services. At the same time, as a development and public health practitioner, it’s hard for me to adapt my motivations to fit solely within the “curiosity” realm of the researcher who seeks definitive “conclusions.” Neither my professors nor supervisors were able to guide my thinking in order to pigeon hole the work in one way or the other and I suppose it isn’t necessary.

For the mean time, I’m considering the most appropriate categorization of this project (which will likely inform the thesis I will begin preparing next month) as a practice of applied research to make things work better and more efficiently while meeting the basic needs of individuals who deserve and need critical health services.