Monday 11 June 2018

My experience on the CIRCLE programme

Dr Sandra Ofori, University of Port Harcourt Nigeria
Cohort 3 CIRCLE Visiting Fellow

Dr Sandra Ofori spent her fellowship year at the University of Ghana. After settling back into her home institution, she reflects on her time on the CIRCLE Programme.

How I felt about getting the fellowship
When I got the offer for the fellowship, I was excited. A little apprehensive but still excited. One year away from home to work with and learn from experts in the field of climate change while getting funds to do your own research felt almost too good to be true. Naturally I worried about some things. What the new working environment will be like? What I would do with my small children at home? What I would do about the on-going projects I had at work etc. Anyway, I decided to keep an open mind and soak-in the totality of the experience.

Introductory visit to one of the community chiefs where we went “empty handed” with just our ethical approval letter. From far left- community liaison, Chief, myself, research assistant.

My study
My background is in preventive cardiology. My interest lies in evaluating the underlying risk factors for cardiovascular disease (CVD). One of the factors that influence a person’s risk for developing CVD is the environment and air pollution. The fellowship stipulated that one’s area of research should focus on climate change, so it was interesting for me to formulate a study that would meet that brief. After consultation with my mentor, I came up with a study titled “Indoor air pollution and its relationship to CVD and its risk factors in a rural community in Southern Nigeria”. The rationale behind this was that sometimes when we talk about climate change, the lay person might not be able to relate to it. But if we can show that some human practices such as indiscriminate wood harvesting for domestic purposes not only degrades the environment by contributing to deforestation, but its improper combustion contributes to air pollution and more importantly negatively affects human health, maybe we can get people to sit up and take notice! Therefore, by studying the effects on cardiovascular health, preventive health physicians can work with climate change scientists towards our common goal of protecting health and the climate.

Conducting the study
One important thing I learnt during the induction workshop that was held in Nairobi in February 2017, was the importance of research uptake. The research one does has to translate to actual change in the community therefore, it is vital to identify early on who the relevant stakeholders are and carry them along throughout the study period. 

Me scanning carotid arteries of participants using a portable ultrasound machine.

After the intended study was approved by my supervisor at my host institution, I travelled back to Nigeria to get the relevant equipment, constitute a research team, train them and head into the field. We held sensitization meetings with the various heads of the communities we planned to carry out the research in. We also had to collaborate with the local health authorities and staff of the primary health facilities in the communities. I learnt some valuable lessons during this period one of which was that you do not head into a village to see the chief empty handed! Anyway, we were able to carry out the research as planned with only a few modifications along the way.

Preliminary analysis of the research data showed that the use of biomass fuels compared to cleaner fuel sources was associated with increased levels of air pollutants and markers of increased CVD risk (increased blood pressure and carotid intima media thickness). We organized a research uptake activity in one of the communities where all the stakeholders in all three communities were in attendance. We discussed the implications of our findings. The participants were engaged and asked important questions. For instance, a woman asked me about what I now expected them to do, having come into their community to tell them that an age-old practice (cooking with firewood) is not only harming their environment but also their health. This was even more relevant especially as the cost of cleaner fuels was so high. Before I could answer, another participant responded by saying that at least they could educate their women to cook in better ventilated kitchens or in completely outdoor areas as that would reduce the amounts of pollutants they inhale. That response was met with wide acceptance. In addition, the head of the women’s group asked that the result of the study be shared with government authorities as it may make them more likely to fund the acquisition of more efficient stoves which they can use to more efficiently burn wood for cooking. 

Outdoor kitchen with the logs of wood to be used for cooking

Women and little children most exposed to pollutants released during combustion of biomass

Support from CIRCLE
The support from CIRCLE was fantastic. Not only were emails and queries answered promptly, the funds were released on time and I had the opportunity to attend a workshop organized by CIRCLE at the University of Lagos. That workshop was invaluable especially because some of the talks were given by members of previous cohorts who shared their first-hand experience in all aspects of the fellowship.

A cross-section of the participants (representatives of the three rural communities) during one of the research uptake activities. Sitting in the front row with me are the community chiefs.
Overall feedback
The training and experience I gained during my fellowship year is invaluable. I have taken back positive attributes I observed in my host institution back to my home institution. One of the more notable ones centres around the open-door policy that is practiced by my supervisor Professor Julius Fobil in his department. It made it easier for his research fellows to get guidance and I observed how many mistakes were averted at an early stage and just how overall more pleasant the work environment was. Prof Fobil was amazing during my stay in Ghana and I owe a lot of gratitude to him for helping me complete my work within the stipulated time.

One thing I would advise anyone taking up research would be to take time during the planning stage. Do not rush into the field to collect data. If I could do it all again that is the one thing I would change.

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