Finding the art of public health research in the Gambia

Everyone has their favourite sayings. One of my previous bosses loved to keep telling me that healthcare was both a science and an art. He loved to emphasise the “art” part of the statement by demonstrating different ways to phrase a question, or how he read between the lines, or how he persuaded somebody to do something.

Here in the Gambia, I’ve discovered that the “art” component of the equation can be much more literal. As a researcher, I’ve benefitted from many doors being opened simply as a result of showing some creative skills. Apparently, they’re not just useless hobbies, after all.

I’ve been working on a qualitative research project on infertility here, representing the University of Sheffield at the Medical Research Council Unit. My supervisor is none other than the ever-encouraging and energetic Julie Balen, who provides me with all the guidance that I need, remotely from Sheffield. She gives me the freedom to follow any leads that I think could be useful to the project. Some of these have been fascinating.

The first unexpected connection through art had occurred at the end of a tiring week. I needed to recharge, and I knew that the best way to do this would be through feeding my creative side. The Gambia, unfortunately, does not have a national art gallery. And so I made the long and arduous journey, via five shared taxis, to the home and private art gallery of one of the local artists here.

The trip gave me everything that I needed, and more. Not only did I feel replenished afterwards, but I was able to meet and chat with the artist herself. It turns out that she runs several other projects from her art gallery space. One of these was an infertility awareness project. Another was to engage local traditional herbalists who provided treatments for infertility. Suddenly, the dots started connecting between my research work and creative pastimes. I was able to form some new connections for our research.

In the end, though, I’m much more of a musician than a painter. The art gallery was a great start, but I needed music in my life. This need became so persistent that it drove me to search social media on a daily basis, until I finally tracked down a music teacher.

I started taking lessons in playing the ‘Balafon’, a traditional Gambian instrument that was one of the precursors to the orchestral xylophone (more details on my personal blog). My classes take place at my teacher’s home, a typical Gambian compound with multiple dwellings belonging to the same family. Many of his family members sit in the central courtyard listening while I play. They’ve started to teach me Mandinka, one of the local languages, and invited me over to attend a ceremony.

The most satisfying experience so far has been on a field visit to a village called Janneh Kunda, about three hours away by road. I was there to observe a women’s group, in order to help with planning a similar event for our own project.

Out of the 20 women in the group, there were 5 kanyalengs, who are a special group of women in the Gambia and Senegal. They are essentially women who have struggled with infertility, repeated miscarriages or neonatal deaths, and they form a local support group for each other. What is culturally unique about these support groups throughout the country is that the members learn to be performers, and they are often invited to ceremonies to sing, dance and entertain the audience with their jokes and antics.

These antics are meant to be a little bit ridiculous, and at times subvert social norms. This is so that they can attract the attention of God, who might then see their self-shaming actions and pity them enough to give them a child who survives. And so while the kanyalengs were, for the most part, attentive and engaged members of the women’s group, at various times they started crowing like roosters, or danced around, much to the amusement of everyone else in attendance.

This particular women’s group was structured around a two-day workshop. On the first day, the participants were given homework. I was not quite sure how this was going to go. After all, these women were busy farmers with families to look after. The homework was to come up with a short play to illustrate one of the concepts that had been discussed. These plays were then to be performed on the second day.

I had not prepared myself to be so pleasantly surprised. The women came to the second day armed with props and costumes. The kanyalengs, who were the seasoned performers, led each performance, but the other women joined in as well. Enthusiastically, in fact. The final group to present had a play that was in two parts. The first part was a story about a man learning how important it was for his teenage daughter to stay in school. Then, to transition to the second part, one of the kanyalengs started singing a song that they had composed especially for this play, and another woman started drumming on a plastic chair. The rest of the performing group started clapping along with a particular rhythmic pattern.

Standing in the corner of the room, I started clapping along too. One of the kanyalengs saw that I understood the rhythm, and pulled me out into the middle of the room to dance. And so I became part of this performance, as a random dancing foreigner who happened to be passing by and crash the apartment of this man, his wife, and their teenage daughter. Seeing that I was dancing was enough for everyone else to get up and join in as well, and so there ended up being an unscripted apartment party. The “off-script” aspect of my participation probably applied to my research objectives as well, but I am sure that this will be one of the indelible memories of this stint in the Gambia that I will take home.