The anthropologist will see you now
Kevin Bardosh isn’t like a lot of his co-workers at the University of Florida’s Emerging Pathogens Institute. Not only is he a qualitative social scientist in a sea of quantitative types, he’s also a long way from his home institution, the University of Edinburgh.
An applied anthropologist with a background in development studies, Bardosh is embedded at UF as part of a unique international exchange sharing expertise between the two institutions. In September, he began a year-long project in Haiti, working on a grant to improve disease-elimination efforts there. The grant is part of Grand Challenges Explorations, an initiative funded by the Bill & Melinda Gates Foundation. We asked him what brought him to UF and what his hopes are for his work in Haiti.
What’s an anthropologist doing at the Emerging Pathogens Institute?
Social scientists bring a different perspective to fighting disease, especially when it comes to implementation. Once we know how to treat or prevent a disease, the problem is doing it. The process of implementation is really one of social transformation, and that’s something the social sciences are quick to understand and foster. I would challenge more social scientists working in academia to apply their knowledge. There’s great room for positive change.
How do the quantitative and qualitative sides come together to fight disease?
We need to understand the political, economic and ecological issues around these diseases. In global health, there’s a lot of emphasis on metrics, and that needs to be tempered with a more qualitative understanding of the people and context you’re working in. Large-scale disease programs often don’t have a large amount of community participation, but you need community ownership to make it effective and sustainable. If a vector control person came to your house in the US and wanted to spray chemicals around, would you say yes? You’d have questions. So you’ve got to get to terms with what people in the area think is feasible and what they’re willing to do.
The level of interdisciplinary work here is quite high. When I presented my plan for Haiti, 10 or 15 people all from different disciplines and backgrounds took time to provide input. There were people from epidemiology, clinical medicine, vet med, geography, environmental health; there was a biostatistician, an economist. There’s a great sense of teamwork here. I think that will become more and more the case as we try to address problems in global health.
You’re looking at ways to combine efforts that combat elephantiasis, malaria and cholera in Haiti. What do you hope to accomplish?
First, we’re going to look at the political economy of global health in Haiti, from policy and implementation issues to donor priorities. Then we’ll look at community priorities and perspectives so we can design policy interventions that are locally acceptable. We’ll implement pilot studies and assess their impact, then model those at a larger scale. This will tells us about acceptability, cost, sustainability and epidemiological impact. Our goal is to help build on existing efforts, and to see where greater coordination and collaboration can help improve elimination efforts as well as other public health issues. The hope is that, after a year, we’ll have a compelling model to show what can work in a country like Haiti.