[Music]
you
hello good evening everyone what is the
purpose of research how can research
really make a difference I should be
able to give you some clever answers to
these questions I’ve spent the majority
of my career so far in or around
research and I’m currently the
spokesperson for a unit specializing for
research in humanitarian programs and
yet I can tell you from experience it
can be quite tricky to grasp the essence
of a single study let alone the purpose
of research in general research is the
realm where true and unconditional
critical thinking is possible and
encouraged when everything or everyone
can be questioned any standard any
tradition any routine can be contested
and where new ideas and innovation
emerge and can be tried on how could one
sentence do all of that I really really
and truly believe in the critical power
of research and I still do today to
remediate problems of course with this
notion of critical research for one if
you like me worked in the humanities or
in the arts you do eventually have to
ask yourself how applicable or how
practical is your research really my
subject was the power and politics of
digital media social networks mobile
communication devices interactive media
and I was trying to analyze all of these
technologies using critical theory
discourse analysis deconstruction and
other philosophical approaches it wasn’t
not to worry as philosophical as you may
think
there was a practical side to it this
was 2011 when there were high hopes for
these new media technologies to have an
almost mythical Democratic revolutionary
power you both remember that discussion
around the Arab Spring or the Occupy
movements so the scandals we’re facing
today around the complete loss of data
you see were more on the horizon but my
work outside of the immediate circle of
my own critical reflection and beyond a
group of academic received their
researches with granted a strong passion
of critical theory had very little to no
concrete impact not for the governments
who were regulating these technologies
not for the companies who were selling
them not for digital media users like
you or me and certainly not for the
people who were trying to break out of
oppressive regimes using technologies
like social networks my second problem
had to do with the university itself as
an institutions five universities are a
great and by all means important place
for independent research the only place
where critical reflection and scientific
methods can be taught developed and
evaluated they are not necessarily the
greatest when it comes to deciding what
to put on the research agenda and
they’re also not that strong with acting
on the evidence that they may find in
their studies university research
science and academia have their own
priorities and their own rhythms and
sometimes working in the system you
can’t help but ask yourself that these
priorities really only are who publishes
the most papers and who learns the
biggest next research grant both of
these problems a lack of impact and the
issue of a university as an institution
were part of the reason why I decided to
leave University and do something more
practical luckily I can say today I was
to return to research today full
disclosure I work for the biggest
independent humanitarian medical
organization in the world medicines on
frontier or Doctors Without Borders we
call it short
MSF I’m part of a team of amazing
specialists that do research to improve
the way we provide humanitarian
assistance my job is to take research
evidence and move it into tangible
concrete policy changes improve draft
practices and communication the research
we do is the
Applied Research field research it’s
what we call operational research all of
our projects and studies are initiated
and inspired by challenges my colleagues
face in their daily work in the field in
over 70 countries MSF works in that also
makes our research particularly
difficult and challenging we work in
areas where war hunger poverty and
famine strike where scientific methods
or research methodologies are often
honestly of the very least concern and
where studies need to have a more
concrete a more actionable result than
just a published paper and yet and I
find that amazing this operational
research in humanitarian programs seems
to be able to bridge some of the best
qualities and greatest challenges of
conducting critical research that makes
a real difference I would like to show
you a few examples on why I think that
is the case and how that works
first research should by all means be
inspired by and targeted at real
problems in the democratic republic of
the congo for example MSF is regularly
fighting outbreaks of infectious
diseases such as measles measles are or
would be a vaccine preventable disease
in fact this week is the world
immunization week so it’s very fitting
to speak about this example on the
occasion all of you shouldn’t have
received at some point so called MMR
shot immunizing us against measles mumps
and rubella DRC the Democratic Republic
of the Congo like all countries in
Africa has committed to try and
eradicate missiles using regular
immunization by 2020 but vaccinating
against measles in DRC is a fairly
challenging task the country is
two-thirds of the size of Western Europe
that is bigger than Germany France and
Spain taken together in size w-h-o the
World Health Organization estimates that
70% of the Congolese population live in
areas with little or no access to health
care that means especially young
children whom are at the highest risk of
measles infections live in particular
danger of not getting vaccinated last
year alone 45,000 cases of measles were
reported by the government a number that
is quite likely to be on the reported in
an outbreak the standard approach to
vaccinate against measles is to start
vaccinating in the most densely
populated and easiest to reach area
first
aiming to reach the highest possible
vaccination coverage as fast as possible
to contain the outbreak since 2012
MSF has been testing a different
approach instead of vaccinating around
the outbreak we try and get to the heart
of it to the epicenter as fast as
possible vaccinating where the outbreak
started this is to tell you the truth
often much more difficult logistically
as it might sound here because reaching
these areas makes Mexico to communities
that are so remote and hard to reach
that you can only go by boats
motorcycles and often the last
kilometers on foot in a research study
my colleagues compared this novel
approach to vaccinate against measles
against the standard approach and found
some very promising interesting evidence
less people are infected an outbreak
with measles using our approach lets
people die in an outbreak and the same
vaccination rate is reached per
intubation in a health so overall we are
currently discussing these promising
findings with policy makers advisory
groups and implementing partners both in
DRC and on an international level
suggesting this approach has possibly
better
rapid response mechanism against
infectious diseases like measles it is
also as I believe a great example that
research that is inspired by a concrete
– the power to be critical and to
question results this is of course
something that is inherent to academic
research as well but in operational
research it is less about getting
critically acclaimed about being quoted
by some famous person or by reaching a
highest or highest possible rate of
publication and more about finding
concrete solutions another colleague of
mine back in 2011 supported a
malnutrition program in Bangladesh in
the car in an urban slum setting
malnutrition is a major issue in
Bangladesh back in 2011 46% of children
were reported to be too short for the
age and 15% on the weight the program in
myself was running was using a product
called Plumpy’nut plunky not is a
ready-to-use meal as you can see here
that is based on peanuts and enriched
with milk powder sugar vitamins and
minerals it’s originally being developed
for African countries but is very
successfully used all over the world
also in Bangladesh and also with some
positive results but the community-based
nutrition program my colleagues were
analyzing did not have satisfactory
results so my colleagues went and run a
survey in the community speaking to
mothers family members and to caregivers
asking how they used the product and
where the challenges may be what they
found was a bit problematic there was a
relatively low acceptance of the program
of the product amongst children over 60%
of them did not like the taste of Pompey
not found they too sweet or the
consistency of the food weird a majority
of caregivers and family members could
either not read or understand the
packaging instructions and in some
households Plumpy’nut was simply
stacking up on shelves unused my
colleagues countered this finding these
findings immediately by organising
better information sessions and some
commune
the cooking lessons showing people how
to correctly use the product but in
their study they also called for the
need to look into a different ready to
use meal as a peanut based product
Plumpy’nut is very suitable for Africa
the African diet not so much for a
Southeast Asian one where a product
using seasoned me soy or chickpeas may
be much better it’s for the same reason
at a different level scientific
community level that we systematically
publish all our research in
peer-reviewed journals
always open access and always free of
charge we do this because publishing our
research provides us with a quality
control mechanism we get an ethics
review at the beginning of our studies
and we get a critical review of our
methods our results and our findings
before publishing it and sharing it with
the broader community being critical
questioning your results and question
what they mean for your programs is of
number three research with impact
requires good communication I just said
how important publications for us our
but publishing a paper in operational
research is usually not the end of our
work but merely the beginning we spend a
great deal of time and energy to produce
policy briefs issue briefs we share our
study our stories both the successful
ones and those with challenges that we
face as widely as we can we even have a
format that is very short basically a
postcard that manages to summarize some
of our key findings of a study each we
do all of this because scientific
evidence as convincing as it may be
there’s almost never directly to change
what it takes is active communication
translating the findings towards the
right stakeholders and decision-makers
so that they actually change policies
and improve practices a great example of
this is a study we did in 2015 and
Tamara north of Pakistan in a hospital
where MSF supports
let’s click the study was looking at the
health risks of misused oxytocin
oxytocin is a hormone very successfully
and safely used all over the world
either to treat women with heavy
bleeding after birth or to induce labor
in cases of obstructive prolonged or
complicated labor if oxytocin is used
for labor induction however it should by
all means and always be used in a
hospital so patients can be monitored
closely in Pakistan despite health
regulations that actually would forbid
that oxytocin is known to be available
in local pharmacies over-the-counter
very cheap and it is known to be asked
by family members in-laws and members of
the community to be administered to
patients even if they they have
absolutely normal labor our study
basically very simple and
straightforward delivered the evidence
on how dangerous this practice is women
that have reached the hospital having
received unregulated oxytocin are at the
3 times higher risk of suffering uterine
rupture their babies are at a
significantly higher risk of birth
asphyxia and stillbirth we shared these
findings both with partners on the
ground and with the government we
published this paper available online
for everybody to see yet that alone did
not really bring any change so what
we’re doing since last year is running a
multi point strategy and action plan
including
training activities explaining the
correct use of oxytocin to health
workers community community health
promotion activities in the communities
to all people about the risk of oxytocin
a communication campaign informing about
their activities and various
partnerships on the ground looking
inferred to further understand why
people are so interested in using
oxytocin all elements of these
strategies have at their heart a little
communication strategy if you will that
allows you to communicate research
active communication key
research with impact fourth and final
point bear to act on the evidence in the
2015 unprecedented refugee crisis that
hit Europe MSF was amongst other
projects in Serbia supporting refugees
with mental health care and medical care
in a study we were looking at what kind
of problems patients were presenting
with in both our mobile and our
stationary clinic found some alarming
evidence to say the least
57% of refugees that were stranded in
Serbia had witnessed violent events
along their journey 43 percent were
presenting with physical injuries there
were also severe mental health issues
such as anxiety or depression but the
most shocking finding most appalling
result wasn’t so much that it was who
the perpetrators of this violence were
in 93% of physical injuries these
injuries were caused by police and
border forces of new member states right
on our doorstep
together with a number of eyewitness
stories MSF called upon the EU to
respect human rights and to provide safe
passage to refugees seeking protection
as a humanitarian organization and
epidemic University I think MSF has the
opportunity and the obligation to act
upon its evidence to speak up to learn
of violence and of suffering that we
witness in our projects to condemn
attacks on hospitals and federal
humanitarians and to advocate for those
forgotten or those vulnerable I believe
that I would hope that these four short
stories may give you a good idea on why
I think operational research in
humanitarian programs is important and
most valuable I will have ever tried I
feel out of units and I feel I went to
my publisher to conclude in one single
sentence here it goes look into real
problems question and criticize
share your findings and act on the
evidence and research will make all the difference thank you very much
you
hello good evening everyone what is the
purpose of research how can research
really make a difference I should be
able to give you some clever answers to
these questions I’ve spent the majority
of my career so far in or around
research and I’m currently the
spokesperson for a unit specializing for
research in humanitarian programs and
yet I can tell you from experience it
can be quite tricky to grasp the essence
of a single study let alone the purpose
of research in general research is the
realm where true and unconditional
critical thinking is possible and
encouraged when everything or everyone
can be questioned any standard any
tradition any routine can be contested
and where new ideas and innovation
emerge and can be tried on how could one
sentence do all of that I really really
and truly believe in the critical power
of research and I still do today to
remediate problems of course with this
notion of critical research for one if
you like me worked in the humanities or
in the arts you do eventually have to
ask yourself how applicable or how
practical is your research really my
subject was the power and politics of
digital media social networks mobile
communication devices interactive media
and I was trying to analyze all of these
technologies using critical theory
discourse analysis deconstruction and
other philosophical approaches it wasn’t
not to worry as philosophical as you may
think
there was a practical side to it this
was 2011 when there were high hopes for
these new media technologies to have an
almost mythical Democratic revolutionary
power you both remember that discussion
around the Arab Spring or the Occupy
movements so the scandals we’re facing
today around the complete loss of data
you see were more on the horizon but my
work outside of the immediate circle of
my own critical reflection and beyond a
group of academic received their
researches with granted a strong passion
of critical theory had very little to no
concrete impact not for the governments
who were regulating these technologies
not for the companies who were selling
them not for digital media users like
you or me and certainly not for the
people who were trying to break out of
oppressive regimes using technologies
like social networks my second problem
had to do with the university itself as
an institutions five universities are a
great and by all means important place
for independent research the only place
where critical reflection and scientific
methods can be taught developed and
evaluated they are not necessarily the
greatest when it comes to deciding what
to put on the research agenda and
they’re also not that strong with acting
on the evidence that they may find in
their studies university research
science and academia have their own
priorities and their own rhythms and
sometimes working in the system you
can’t help but ask yourself that these
priorities really only are who publishes
the most papers and who learns the
biggest next research grant both of
these problems a lack of impact and the
issue of a university as an institution
were part of the reason why I decided to
leave University and do something more
practical luckily I can say today I was
to return to research today full
disclosure I work for the biggest
independent humanitarian medical
organization in the world medicines on
frontier or Doctors Without Borders we
call it short
MSF I’m part of a team of amazing
specialists that do research to improve
the way we provide humanitarian
assistance my job is to take research
evidence and move it into tangible
concrete policy changes improve draft
practices and communication the research
we do is the
Applied Research field research it’s
what we call operational research all of
our projects and studies are initiated
and inspired by challenges my colleagues
face in their daily work in the field in
over 70 countries MSF works in that also
makes our research particularly
difficult and challenging we work in
areas where war hunger poverty and
famine strike where scientific methods
or research methodologies are often
honestly of the very least concern and
where studies need to have a more
concrete a more actionable result than
just a published paper and yet and I
find that amazing this operational
research in humanitarian programs seems
to be able to bridge some of the best
qualities and greatest challenges of
conducting critical research that makes
a real difference I would like to show
you a few examples on why I think that
is the case and how that works
first research should by all means be
inspired by and targeted at real
problems in the democratic republic of
the congo for example MSF is regularly
fighting outbreaks of infectious
diseases such as measles measles are or
would be a vaccine preventable disease
in fact this week is the world
immunization week so it’s very fitting
to speak about this example on the
occasion all of you shouldn’t have
received at some point so called MMR
shot immunizing us against measles mumps
and rubella DRC the Democratic Republic
of the Congo like all countries in
Africa has committed to try and
eradicate missiles using regular
immunization by 2020 but vaccinating
against measles in DRC is a fairly
challenging task the country is
two-thirds of the size of Western Europe
that is bigger than Germany France and
Spain taken together in size w-h-o the
World Health Organization estimates that
70% of the Congolese population live in
areas with little or no access to health
care that means especially young
children whom are at the highest risk of
measles infections live in particular
danger of not getting vaccinated last
year alone 45,000 cases of measles were
reported by the government a number that
is quite likely to be on the reported in
an outbreak the standard approach to
vaccinate against measles is to start
vaccinating in the most densely
populated and easiest to reach area
first
aiming to reach the highest possible
vaccination coverage as fast as possible
to contain the outbreak since 2012
MSF has been testing a different
approach instead of vaccinating around
the outbreak we try and get to the heart
of it to the epicenter as fast as
possible vaccinating where the outbreak
started this is to tell you the truth
often much more difficult logistically
as it might sound here because reaching
these areas makes Mexico to communities
that are so remote and hard to reach
that you can only go by boats
motorcycles and often the last
kilometers on foot in a research study
my colleagues compared this novel
approach to vaccinate against measles
against the standard approach and found
some very promising interesting evidence
less people are infected an outbreak
with measles using our approach lets
people die in an outbreak and the same
vaccination rate is reached per
intubation in a health so overall we are
currently discussing these promising
findings with policy makers advisory
groups and implementing partners both in
DRC and on an international level
suggesting this approach has possibly
better
rapid response mechanism against
infectious diseases like measles it is
also as I believe a great example that
research that is inspired by a concrete
– the power to be critical and to
question results this is of course
something that is inherent to academic
research as well but in operational
research it is less about getting
critically acclaimed about being quoted
by some famous person or by reaching a
highest or highest possible rate of
publication and more about finding
concrete solutions another colleague of
mine back in 2011 supported a
malnutrition program in Bangladesh in
the car in an urban slum setting
malnutrition is a major issue in
Bangladesh back in 2011 46% of children
were reported to be too short for the
age and 15% on the weight the program in
myself was running was using a product
called Plumpy’nut plunky not is a
ready-to-use meal as you can see here
that is based on peanuts and enriched
with milk powder sugar vitamins and
minerals it’s originally being developed
for African countries but is very
successfully used all over the world
also in Bangladesh and also with some
positive results but the community-based
nutrition program my colleagues were
analyzing did not have satisfactory
results so my colleagues went and run a
survey in the community speaking to
mothers family members and to caregivers
asking how they used the product and
where the challenges may be what they
found was a bit problematic there was a
relatively low acceptance of the program
of the product amongst children over 60%
of them did not like the taste of Pompey
not found they too sweet or the
consistency of the food weird a majority
of caregivers and family members could
either not read or understand the
packaging instructions and in some
households Plumpy’nut was simply
stacking up on shelves unused my
colleagues countered this finding these
findings immediately by organising
better information sessions and some
commune
the cooking lessons showing people how
to correctly use the product but in
their study they also called for the
need to look into a different ready to
use meal as a peanut based product
Plumpy’nut is very suitable for Africa
the African diet not so much for a
Southeast Asian one where a product
using seasoned me soy or chickpeas may
be much better it’s for the same reason
at a different level scientific
community level that we systematically
publish all our research in
peer-reviewed journals
always open access and always free of
charge we do this because publishing our
research provides us with a quality
control mechanism we get an ethics
review at the beginning of our studies
and we get a critical review of our
methods our results and our findings
before publishing it and sharing it with
the broader community being critical
questioning your results and question
what they mean for your programs is of
number three research with impact
requires good communication I just said
how important publications for us our
but publishing a paper in operational
research is usually not the end of our
work but merely the beginning we spend a
great deal of time and energy to produce
policy briefs issue briefs we share our
study our stories both the successful
ones and those with challenges that we
face as widely as we can we even have a
format that is very short basically a
postcard that manages to summarize some
of our key findings of a study each we
do all of this because scientific
evidence as convincing as it may be
there’s almost never directly to change
what it takes is active communication
translating the findings towards the
right stakeholders and decision-makers
so that they actually change policies
and improve practices a great example of
this is a study we did in 2015 and
Tamara north of Pakistan in a hospital
where MSF supports
let’s click the study was looking at the
health risks of misused oxytocin
oxytocin is a hormone very successfully
and safely used all over the world
either to treat women with heavy
bleeding after birth or to induce labor
in cases of obstructive prolonged or
complicated labor if oxytocin is used
for labor induction however it should by
all means and always be used in a
hospital so patients can be monitored
closely in Pakistan despite health
regulations that actually would forbid
that oxytocin is known to be available
in local pharmacies over-the-counter
very cheap and it is known to be asked
by family members in-laws and members of
the community to be administered to
patients even if they they have
absolutely normal labor our study
basically very simple and
straightforward delivered the evidence
on how dangerous this practice is women
that have reached the hospital having
received unregulated oxytocin are at the
3 times higher risk of suffering uterine
rupture their babies are at a
significantly higher risk of birth
asphyxia and stillbirth we shared these
findings both with partners on the
ground and with the government we
published this paper available online
for everybody to see yet that alone did
not really bring any change so what
we’re doing since last year is running a
multi point strategy and action plan
including
training activities explaining the
correct use of oxytocin to health
workers community community health
promotion activities in the communities
to all people about the risk of oxytocin
a communication campaign informing about
their activities and various
partnerships on the ground looking
inferred to further understand why
people are so interested in using
oxytocin all elements of these
strategies have at their heart a little
communication strategy if you will that
allows you to communicate research
active communication key
research with impact fourth and final
point bear to act on the evidence in the
2015 unprecedented refugee crisis that
hit Europe MSF was amongst other
projects in Serbia supporting refugees
with mental health care and medical care
in a study we were looking at what kind
of problems patients were presenting
with in both our mobile and our
stationary clinic found some alarming
evidence to say the least
57% of refugees that were stranded in
Serbia had witnessed violent events
along their journey 43 percent were
presenting with physical injuries there
were also severe mental health issues
such as anxiety or depression but the
most shocking finding most appalling
result wasn’t so much that it was who
the perpetrators of this violence were
in 93% of physical injuries these
injuries were caused by police and
border forces of new member states right
on our doorstep
together with a number of eyewitness
stories MSF called upon the EU to
respect human rights and to provide safe
passage to refugees seeking protection
as a humanitarian organization and
epidemic University I think MSF has the
opportunity and the obligation to act
upon its evidence to speak up to learn
of violence and of suffering that we
witness in our projects to condemn
attacks on hospitals and federal
humanitarians and to advocate for those
forgotten or those vulnerable I believe
that I would hope that these four short
stories may give you a good idea on why
I think operational research in
humanitarian programs is important and
most valuable I will have ever tried I
feel out of units and I feel I went to
my publisher to conclude in one single
sentence here it goes look into real
problems question and criticize
share your findings and act on the
evidence and research will make all the difference thank you very much
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