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Sahil Warsi from University of Leeds, UK and Iveta Nohavova from Society for Treatment of Tobacco Dependence, Czech Republic paid a week long visit to HERD team to work on a 3 year Randomized Control Trial (RCT) project funded by European Commission titled, ‘Tobacco Cessation within TB Programmes: Real World Solution for Countries with Dual Burden of Disease’. This multi-country project is being implemented in 3 countries – Nepal, Bangladesh and Pakistan. Sahil is helping HERD team in Work Package 1 (Identifying and Understanding the interventions and system modifications required to optimize the delivery of Tobacco Cessation strategies for TB patients in Nepal) while Iveta is working on Work Package 5 (Context Evaluation).

HERD Research Uptake and Communications Unit interviewed Sahil and Iveta to document their experiences of Nepal visit. Excerpts from the interview:

How did you gather your interest in the field of TB-Tobacco Research?

Iveta: I have been involved in tobacco control activities in Czech Republic for quite some time now. I have come for my work visit to Nepal to work on Work Package 5 of the TB-Tobacco project. I have been involved focusing on tracing capacity of nurses in tobacco control and in relation to patient care, see how it is constructed, how they adjust and how patients navigate them through the system and have their opinion about the health system. So, through my involvement in this project I will be interested in coverage. So for me personally being an oncology nurse I believe in better health outcome by helping patients be healthier and recover faster. This is from my personal background. At a broader scale, I definitely see the need of addressing tobacco use all over the world especially the parts of the world where there is higher consumption of tobacco where aggressive tobacco control measures have to be taken. For these reasons, research on TB and Tobacco have been my interest in this area.

Sahil: I am working on Work package 1 which is the first part of the study where we are trying to adopt the behavioural support method. As a social anthropologist what is interesting to me is how we can take different contexts of few different countries but also within each country and understand cultural diversity in different ways of communicating. It is important to consider social context while delivering specific kind of behavioral support in specific setting in the long term taking into account social diversity. This is a matter of interest to me.

Sahil and Iveta sharing their experiences with Research Uptake and Communications team

How do you see the importance of such studies being conducted at multi-country level?

Iveta: For me, given by background, I find the cultural context here in Nepal quite different from Czech Republic.  On the other hand, it is also equally important for me to come here is that it has helped my understanding of the context by experiencing that I would have never understood by reading some papers and explaining about work package 5 in Czech Republic. So for me to the visit is really helpful in terms of understanding the context and setting. There are similarities as well as differences among the three countries in this region which will help me in giving an idea of the context we live in

Sahil: I think what has been interesting is that few countries with similarities of issues. I think even though there is cultural diversity in some ways, there are lots of similarities in terms of cultural reference points but also there are similar issues in health system or within health system and illiteracy and they might represent or present in a country context in a different way. I think the experience has been more of seeing commonality in terms of above the social diversity.

 

HERD team along with Sahil and Iveta in discussion about the TB-Tobacco RCT study

How do you think this short visit to Nepal will help you in relation to this project?

Iveta: I have come here to understand system, organizational system levels and care delivery system. The other part is culture, ethnicity and the actual setting conditions. What’s going to be more interesting and helpful is hopefully we might be able to get opinions from the interviews that is a part of this data collection that will then be collided with what I have been willing to understand.  If I had not been able to come here, it would have been very difficult analyzing just the data from a distance.. It has been very beneficial. This is my first time in South Asia.

Sahil: This visit has not just been to Nepal but also to Bangladesh and Pakistan. I think what is beneficial is that we are finally getting to a stage of the data collection and there were number of things that has to be standardized and worked through the individual teams that are better done face to face rather than over email Skype. Now I have known that everyone has come to the certain level and we have been able to finalize the timeline for data collection and better coordination for rest of the work plan which is just about three months. 

How do you find our team at HERD?

Iveta: It is good to know people face to face and get to know each other, how we work how we think and communicate so it also brings us closer and it’s easier to communicate when we are living apart. Visits such as this also helps us to be effective in our work and achieve or fulfill the objective in best way. I also see huge potential in HERD as an organization with such a nice infrastructure. With such a diverse team, you can rely on each other as you would be having multiple expertise. It shows that if you build the foundation so well, it is likely that the will very likely flourish and bring positive ending.  It’s really nice.

Sahil: A good thing that I noticed in my short stay is the democratic nature of the organization. Although there are positions and hierarchies, still it seems that the people are quite open to engage with each other and maintain high degree of professionalism at the same time.