Smoke, donkeys & peanuts

Reflections on research in a rural community - BRENDON BARNES of the Health and Development Research Group in Johannesburg writes about his experiences of a research project in the rural North West province.

As an outsider, the natural beauty of the rural setting is striking. Dwellings made from mud and thatch blend effortlessly with the flat landscape, loaded with brown, yellow and ochre hues.

This beauty forms a sharp contrast with the poverty the people here experience. Over 40 percent of households (with an average of nine people in each house) earn less than R500 a month. This amounts to no more than R1.80 per person per day!

People are forced to rely on naturally occurring fuels such as wood and dung to provide a cheap and effective means for cooking and warmth, particularly during the cold winter months.

The problem is that when burned indoors, the smoke produced by these fires can severely impact on children's respiratory health, and the project I have been involved with aims to design an intervention to reduce young children's exposure to this smoke.

The project plans to encourage people to open windows and doors during burning and move children just a little further away from fires. It will then quantitatively determine how much of an effect this has on indoor air pollution and children's respiratory health over a 12-month period.

When we started, however, we first needed to qualitatively understand rural families' relationship with fires and smoke. To do this, the team and I spent long periods of time (up to 13 hours each day) watching how people made fires, where they collected their fuels, when they opened windows, and how much time their children spent close to fires.

We asked questions, listened and learned. We tried to get a sense of how much of what we saw was driven by culture, and how much was driven by the basics of survival in conditions of extreme poverty and extremes of weather. Smoke became a part of our clothes, our equipment, our lungs and, symbolically, our lives. We, in turn, were drawn into the complex layers of rural village life.

The rural silence is broken occasionally by the sounds of donkeys wandering through the village. In a small way, the donkey represents a means of mitigating the effects of extreme poverty that forms part of the hardships of rural life. They play a pivotal role and, together with other livestock, provide a means of transport, are used to work and plough the land, are a source of food and importantly, their dung is used as a fuel to keep essential fires going.

With hardly any money for food, it is not uncommon for families to go without eating for two days or longer. Villagers have to walk an average of four kilometers a day to fetch water from a well, are without flush toilets or electricity. Sadly, in the space of two months, three of our study children had died due to factors associated with malnutrition and exposure to environmental hazards. When we return in winter this year I expect to hear even more sad news.

With this in mind, one would expect that families would be somewhat averse to the idea of us, as outsiders, telling them to open their windows and doors in winter to improve their children's health. In fact, we are aware that what they really need is running water, flush toilets, electricity and jobs so that they will be able to afford to use those services.

On the contrary, we have been received with nothing short of warmth in peoples' homes. I'm reminded of one particular family in whose house we were to do indoor air quality monitoring for a week. When we arrived, the family had not eaten since the morning of the previous day as they had run out of

food. The only subsistence they had was a small bag of peanuts, which is considered to be somewhat of a treat in rural villages. In our 'honor', they roasted the peanuts over a fire and offered them to us.

When one considers how meager a place peanuts hold in western society ("I'm paid peanuts") and how valuable they are in the context of poor rural life, one is forced to reflect on the significance of this gesture. My colleague and I uncomfortably (but gratefully) accepted the offer. Thankfully, neighbors chipped in to help the family with food and they were able to eat again. I will never view peanuts in the same way again!

My symbolic experiences of smoke, donkeys and peanuts in this project allowed me to reflect on a number of aspects, not only about the way we approach research with human beings, but also about the values I hold true as a person. I am eternally grateful for this.