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Health Anthropology Forum

COVID-19
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Dear Debbi, thanks for opening the discussion…

I’ll share a bit about what I’ve been up to this year - in mid-February I was setting up a field site office in Jakarta (for an ARC project concerning experiences of cervical cancer and the health system response to cervical cancer control in Indonesia), fast forward 1 month later I was back in Australia for what we initially thought would be no less than 6 months.

Having just moved to the second field site we were on the brink of interviewing informants from some of the stakeholder organisations that we’d been engaging with for 2 years prior.

We quickly amended ethics to transition to Zoom and phone-based interviewing with health and NGO workers – its actually meant out research team haven’t needed to negotiate the notorious traffic jams and wait for hours in hospital waiting rooms, and we could do interviews on the weekends rather than business hours, so participants were less rushed. I then have a lengthy debrief with the research team members after each interview, just like we would have done if I was still in Indonesia, except we’re doing it over WhatsApp call (how amazing is technology?!).

What has been disconcerting is that the efforts of health workers and activists working in the cervical cancer prevention and screening space are seeing their collective efforts of the last 5-10+ years sliding backwards, for others the pause button has been struck, indefinitely.

The lobbying efforts for the HPV vaccine to be included into the national immunisation schedule is on hold as the key concern is around cutting expenditure, reducing health care costs and reallocating resources to the COVID-19 effort. The Jakarta branch of Indonesian Cancer Foundation has lost a big chunk of its annual budget from the government, and the 2021 allocation is uncertain, so clinic hours have reduced from 5 days to 3, and the staff has been halved. And another concern is because there's less screening (visual inspection with acetic acid and pap smears) occurring at present,  cervical cancer related deaths will increase.


I’m supposed to be in the thick of interviewing our core informants – women who have been affected by cervical cancer. These interviews are quite different to the health worker and NGO interviews and would ideally be done in person, but we cannot compromise the health of our participants or interview team. So we will be navigating this transition in the coming month, training the team to carry out these interviews via phone or Zoom.

Just this week I came across this resource from Uganda on phone interviews on sensitive topics with participants who have been through or are experiencing trauma, and what to look out for in terms of communication cues.

Another helpful resource is the Devex, Facebook and World Food Programme’s Gender Data Series on Mitigating the impact of COVID-19 on women and girls.

Hi All,

I'm curious as to what people are coming across in terms of COVID-19 in their fieldsites/networks. What websites are we using to keep track of info? Is anyone looking into uptake of the COVID-19 app? For people working in hospitals and clinics - how has COVID-19 impacted the work of your host communities?

I've found the success of the Indigenous Community Controlled Health Orgs response particularly interesting. While the impact of COVID-19 on many indigenous communities round the world has been devastating, Australia's done really well so far (keeping fingers and everything else crossed). The strength of NACCHO (National Aboriginal Community Controlled Health Organisation) and the relationships the peak body has with its member health services meant they were able to hit the ground running with public health strategies and communications. Thanks to decades of work from organisations like NACCHO and the various state ACCHOs, The Lowitje Institute, LIME (Leaders in Indigenous Medial Education) and CATSINaM (Congress of Aboriginal and Torres Strait Islander Nurses and Midwives), Australia has hit population parity with Indigenous doctors and near parity with nurses. The COVID-19 response shows just how important Indigenous health workers are to health governance, and the importance of community control of health services is for Indigenous communities.

The Australia Institute held a really interesting webinar on this, The Success of the Aboriginal-led Health Response.
Speakers: Lesley Nelson, CEO of South West Aboriginal Medical Service; Professor Sandra Eades, Dean of Curtin Medical School; Assoc Professor Dan McAullay, Director of the Centre for Improving Health Services for Aboriginal Children at Edith Cowan University; and Francine Eades, Chair of Derbarl Yerrigan Health Service. In conversation with Australian of the Year (2003) Professor Fiona Stanley, Patron of the Telethon Kids Institute and chief economist at the Australia Institute Richard Denniss.
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