A New Look at an Old Method: Ethnography as Essential to Good Work, or How Doing Should Start with Being

The inaugural meeting of the University of Alabama Department of Anthropology Journal Club was held Friday January 18th at 2:00 p.m. Attendees were grad students Tina Thomas, Becky Read-Wahidi, Anjelica Callery, Achsah Dorsey, and Greg Batchelder; undergrads Brittany Brooks, Samantha Sloan, and professors Kathryn Oths, Dick Diehl, and Ian Brown.

With me (Kathy Oths) moderating, a lively discussion ensued regarding a recent piece in Social Science and Medicine (SSM), On sitting and doing: Ethnography as action in global health by Stacy Pigg [99:27-134(2013)], the previous editor of Medical Anthropology. She relates scenes from her fieldwork among International Health (now Global Health) and NGO personnel who were attempting to introduce HIV/AIDS prevention education in Nepal in the late 1990s. As she sat and listened ‘between the cracks’, it emerged that a word-play exercise that encouraged participants to shout out ‘sex’ words was antithetical to a Nepalese aversion to discussing sex (much less with strangers!). While the health workers realized this, they felt obligated to carry out the mandates of the program’s international funders. A classic case of vertical programming. Or, since it ‘worked’ (really?) in Uganda, it should work everywhere. By means of much listening and many intense discussions with perceptive nationals, Pigg adroitly led her colleagues in developing a slightly altered exercise that used word about sexual relations instead of sex. Aid workers were thrilled, and across several months met and pre-tested the new exercise. It was a smashing success with the intended audience, and they self-published educational brochures using the concept, yet the higher up administrators were too wedded to the received wisdom of the international programs to pay any heed. While the revised exercise failed to be implemented, it succeeded in identifying a better way to reach a population. Many years later, Nepalese health workers were still talking about the wisdom of their strategy.

Somewhat surprisingly, SSM devoted an entire issue to ethnography, a topic that seldom receives attention anymore—especially in the medical social sciences literature—perhaps because it seems the method is uncomplicated and all that needs to be said about it has already been. I chose the Pigg article for its reminder that all good scientific work starts with reflection, observation, listening, being, mindfulness–the lesson being, “just sit there, don’t do anything (at least to start with).” The insight and hypothesis-generation that sitting and listening can engender is qualitative, and at one and the same time the crucial first stage of any systematic, scientific endeavor. I am concerned that mixed-method training in biocultural medical anthropology, while the best and most comprehensive approach (IOHO here at UA), can tend to focus on the clearly essential ‘hard stuff’—statistics, computer programs (such as SPSS, Anthropac, GIS, ATLAS.ti, UCINET…), lab analysis, measurement tools (anthropometry, cortisol, blood pressure….) and sometimes slight the ‘soft stuff’ like participant-observation, leaving it to chance. This emphasis is entirely understandable, as most of the complex tools are best learned in a classroom setting, whereas the art of fieldwork seems more idiosyncratic. This division in training is not at all unlike the case with medical education, where technological competence wins out over the art of care, even though both are vital to effective therapy (see Good and Good “Learning Medicine” in Knowledge, Power, and Practice, 1993).

I also noted that Pigg’s zen-like approach generalizes to all the anthropological work we do, such as data collection and writing (and as Dr. B noted, to everything we do in life, really). It is essential when doing ethnography to drop one’s expectations of what is the ‘right’ answer. We can unconsciously convince ourselves beforehand what it is we will ‘hear’ from an attachment to our hypothesis, e.g., we could subtly be thinking “because a girl is rural, has a single mom, goes to a poor high school, therefore…” and be expectant of a response before it emerges, thus causing us to filter what the girl really is saying. The article resonated with Tina’s dissertation fieldwork experiences. She noted that the African-American girls she is studying in Tuscaloosa regarding their perception of HIV risk “take me to places with their comments” and bring up unexpected connections, such as the 2011 tornado. Tina cautioned that “we can lose context if we focus too narrowly.” Becky notes that we should be keenly aware of “what are our goals versus those of our informants.” From Achsah’s reading of the text, she perceived that “aid workers accept that the answers will be different from one culture group to another, but maybe not that the way to ask needs to be different also,” that one needs to re-do the whole process. Dr. B, an archaeologist, could easily generalize the article’s lesson to his cemeteries class in which on the first day he has his students “just walk around and observe” to soak it all in and generate ideas. Invariably, the student who immediately starts writing does not do well and becomes frustrated, as they focus too intently on the details to see the larger patterns. Greg was impressed and grateful that the author had written about the importance of ethnography. “By doing ethnography, we can focus on ‘insider meanings’ instead of imposing our agendas and ‘mining’ for data which supports our hypotheses. Through ethnography, we allow ourselves to be open and attend to aspects of culture which we may not have been prepared for or looking for.” For further reading Greg recommended Writing Ethnographic Fieldnotes, by Robert M. Emerson et al., to which Kathy added Learning How to Ask, by Charles Briggs

A special thanks to Tina Thomas for organizing the series, and to Sarah Szurek (PhD Alabama), Post-Doc at the University of Florida, for providing us a model of how the UF journal club functions. We’re looking forward to the next meeting!