What has COVID done to the research field work in Pakistan: Nearly a year has passed since the COVID Pandemic started in Pakistan. It has claimed nearly 11300 deaths so far while around half a million cases tested positive. It was the end of Feb 2020, last year, when the first few cases of COVID Pandemic in Pakistan were reported. However, by the end of March 2020, when the daily reported cases touched around 1500, the Government of Pakistan, announced a national lock-down. This national lock down was lifted completely by early May 2020. Subsequently Pakistan did see a surge in cases, placing it among the top twelve pandemic-affected countries globally.
Due to the rise in cases, the Government set up a National Command Operation Center (NCOC) for the COVID related services and guidelines. After the national lockdown lifted, the strategy of smart lockdown has been deployed by the Government. Smart lockdown just means, closing off circumscribed areas within a city. This has been somewhat effective in addressing the surge, but not completely and weekly the situation is updated by the NCOC for Pakistan.
How COVID affected our field research work: Like all activities be it social, economic, educational or field research have massively been affected by COVID in Pakistan. All our field research projects had to be halted during the national lock-down period and even post May 2020, when the national lock-down was lifted, general activities and life was not fully functional with smart lockdowns in place, everyone was tentative in resuming activities. More so, the Government messaging was also vague in terms of returning to full pre-lock down status or to wait and watch. However, like many institutions and organizations of Pakistan, we also irked on the cautionary side and did not resume full face to face meetings or field work and moved into a virtual online mode of working for meetings.
Coping with COVID and nudging our way ahead to resume field work: Unfortunately, our rural community-based research activities suffered the most. One of our projects called Bachpan Cohort Study (Read more here) which is based in a rural subdistrict of Punjab province of Pakistan had to conduct household based assessments of mothers and their 5 ½ year old children in May 2020. The Bachpan (local language word meaning Childhood) study is in fact a birth cohort of 1154 participants that was established in 2014 and is being followed up regularly since then. The household community based assessments entail a long battery of instruments capturing a number of constructs that cover maternal psychosocial wellbeing, maternal mental health, her social support and her child’s socio-emotional, cognitive and physical development. All these assessments need a face-to-face interaction and can compromise the quality and reliability if done otherwise. Within the lock down phase all our research staff and senior investigator meetings were shifted to Zoom and/or TEAMS. Alas, our household community based assessments could not be shifted to such a platform. All field work was withheld.
From March until end of August 2020, we did all the background paperwork, eg securing ethics approvals, getting the district health authority permissions, developing/designing study protocols, finalizing the study questionnaires and identifying potential field research teams to eventually recruit and induct at the opportune time, once the conditions permitted to resume field work.
In between August and November 2020, with Government’s policy of smart-lock downs and general guidelines in place we observed that the COVID numbers plummeted and seemingly the first wave of COVID was over. This indeed was a welcome sign and opened the window of getting our field work up and running – of course with all COVID safety precautions in place. For the Bachpan Cohort Study and its continued follow ups, a field research team was inducted and their training (which included both classroom and field practice began).
What it means to do field work in COVID days? To state in four words …..”it is not easy”. Field research and its procedures are complex and includes many steps; adding to those the COVID related precautions and SoPs do get in the way and add to the complex operations of field research.
Wearing Masks Hinders Face to Face Interactions: Consider an interview which uses a diagnostic approach to record if there is current major depression or not. This requires that the interviewer is able to see the facial expressions of the interviewee to be able to judge what the prevailing affect/mood is. This part of the interaction gets obscured with masks. Similarly, there are so many other nuances that get added due to the COVID safety procedures to be kept in place by the field researchers during the interviews that it does become a bit intrusive and disturbs the flow of interview and the quality of interaction. It is tedious to do this and run the interviews simultaneously. Not to mention, if your field research also involves interacting with kids, it becomes even more tedious! Interacting with kids in the field a very different ball game to manage with COVID safety procedures in place. Kids need to be constantly checked to ensure they adhere to the COVID safety procedures – thus interrupting their flow of thought and the flow of the interactions. Well, many adults too need to be checked as well for adherence to COVID safety procedures.
Like many other aspects of our lives that have adapted to COVID situation, field research too is fast adapting to COVID.
Future of field research in the wake of COVID: COVID or no COVID, we cannot stop field research - that is for certain! Despite the second surge of COVID in Pakistan field work will have to carry one, unless the NCOC decides upon a full second national lockdown. Until our population gets vaccinated, COVID safety procedures will take precedence (as they currently are). This will continue to interfere with the face-to-face interactions and interviews. Not to mention the fear of contracting COVID will lead to poorer response rates, hyping up anxiety levels among participants that may get picked up spuriously by some mental health screening instruments. This has the potential of adding noise to the data since many screening tools are not sensitive in differentiating between the sources of anxiety. Lastly it will continue to challenge the field research teams – especially adding to their stress levels and impacting their overall motivation levels.
Like many other aspects of our lives that have adapted to COVID situation, field research too is fast adapting to COVID. For example, where possible and acceptable, telephonic interviews are conducted. This is challenging since in many rural settings, women do not have access to telephones (despite the mobile phone network coverage being exceptionally widespread in Pakistan).
One could borrow from the experience of tele-medicine & tele-psychiatry to conduct field interviews using a video link. This carries massive logistical issues especially for rural areas. Not to mention that this will still not address field assessments where children need to perform on certain instruments like the Weschler Intelligence Scale or Bayley’s Development Scale for their cognitive assessments. Perhaps the future could bring digital applications for children to use and have assessments carried out for their cognitive and socio-emotional development – but even if this were available now, it too would carry many logistical issues to successfully implement in the field. We continue to be hopeful and optimistic about resumption of full field activities minus the overlay of COVID safety procedures which clearly meddle with our field-based interactions.
Siham Sikander is an Associate Professor at the Health Services Academy, Islamabad and a Principal Scientist & Mental Health Advisor at the Human Development Research Foundation, Pakistan. Follow him on Twitter @sihamsikander