When running focus groups in Uganda, our partners noticed significant discrepancies in the answers that the community members were giving during the focus groups in comparison to the responses they’d given when baseline surveys had been conducted by the Ugandan team over the past few weeks. They challenged the community to explain why they were saying wood collection took them 7 hours, when previously they’d said it was 3 hours, and why water collection took an hour when they’d previously said only 30 minutes. Part of me wondered whether this was the ‘white person’ effect, where locals change their answers because they expect it is what we want to hear, and will make us more likely to help them. When challenged, in their defence they did have good explanations. It seems that depending on the household’s distance from the tap, water collection can take anything from 5 minutes to 1 hour. Similarly, some people must travel to the far mountains to collect firewood, which takes 7 hours, whereas others own nearby land so they only take 3 hours.
Our partner didn’t seem convinced though, as he said that when he surveyed people both close to, and far from the tap, they’d all said 30 minutes. It is possible that he just didn’t happen to survey the households that had the longer distance to travel, and these are the people that turned up in the focus group. Another community member pointed out that perhaps some people were unable to give accurate estimates of time. Whereas our culture is very time-oriented and regimented, theirs isn’t, and people don’t necessarily time how long tasks take, they just know the tasks that have to occur each day, and do them, at whatever pace necessary.
This definitely correlates to some of our experiences when running a telehealth trial in Tanzania. Due to the limited number of staff available to run the trial we found that some patients were kept waiting for up to an hour before they could see a doctor, and up to 2 hours for medicines to arrive. When asked about the wait time, all but one person said they didn’t mind. I think they were happy with the massive time reduction to reach our telehealth hub, compared to walking to their nearest health centre. When I asked them how long they usually wait at the health centre, I had a strange range of answers, but most people explained that if there were lots of people, they’d have to wait a very long time. When I pushed them for how long this time was, they’d say “maybe 30 minutes”. To me, this seemed extremely short compared to the time they waited at the telehealth trial, which was rather confusing! Our colleague Anna interviewed some patients and asked directly how long they waited at our telehealth trial. Several patients said that they waited for only “5 minutes”, which I know to be completely inaccurate. What I think this shows, it that it is difficult to rely on reported estimations of time, and maybe interviewee’s degree of satisfaction with time taken is a more useful metric. To be fair, how can people possibly keep accurate track of the time, with no watches or mobile phones?!