Hello listeners and welcome to the Connecting Citizens to Science podcast. I'm Dr. Kim Ozano and I will be having conversations about how people and communities connect with research and science to co-produce solutions to global health challenges. In this week's episode, we will be hearing from two PhD students who are part of the Arise Consortium. ARISE stands for accountability and responsiveness in informal settlements for equity, and is about promoting social change for improved health and wellbeing with communities and people living and working within urban informal spaces. Enjoy the episode. Welcome to the Connecting Citizens to Science Podcast. We have a very special episode today. We have two PhD students, joining us to talk about their journey into deciding what PhD to do, what it was like choosing methods and how their methods have put communities at the center of the work that they do. So let's meet them. Hello Bachera. Welcome today. Tell us a little bit about yourself, your background.

Hi Kim. Thank you so much for giving me this opportunity I'm Bachera Aktar I'm from Bangladesh I work with, uh, BRAC James P Grant School of Public Health, uh, under BRAC University in Dhaka, Bangladesh. And I'm a part-time PhD student at Liverpool School of Tropical. So my PhD topic is, uh, on informal and formal governance networks in urban informal settlements in Bangladesh and how those network help or facilitate or create barriers in availing health services for the residents.

Before we go on and, and think about why you even chose this PhD, let's hear from Sammy. Sammy, welcome. How are you today? And tell us a bit about yourself

Yeah. Um, good morning, Kim. Um, I am Samuel Saidu uh, and I'm from Serria Leone. Mm-hmm. Um, well, initially I'm, I was a pharmacist and then Master's in Public Health and, uh, now doing PhD, um, at LSTM through the Arise Project, uh, linked with the University of Sierra Leone.

Excellent, and I think for our listeners, what's an interesting dynamic today that I learned is that Bachera was actually your supervisor at one point in Bangladesh, is that correct?

Yeah, absolutely. She taught me and also supervise my, um, Masters dissertation, which is called Summative Learning Project.

So you're from Sierra Leone and you did your Masters in Bangladesh. How did that happen?

Um, I have, um, a senior colleague. Mm-hmm also a pharmacist, uh, who actually, um, had the opportunity to go to Bangladesh, um, and study the Masters of Public Health at BRAC James P Grant School of Public Health and when he went back, um, he was recruited in an organization I was working, eHealth Africa. Then we had to discuss about progress and next steps. Then he introduced me to the website and gave me the link and then I applied. I found it very useful at the end cause um, the teaching and learning in uh, the school actually made me change the rest of my ideas and career path.

Why was that? What, what particularly made you do your experience, change your ideas?

Um, I think as a pharmacist I meet very less people I will not meet more than 100 people physically. But, um, as a public health researcher, um, I think I have the opportunity to meet probably half of the world. Since I had that feeling that I can meet more people through public health, and I can change things through public health innovations. I thought moving towards that aspect can help the world more. Freetown is a tiny town of less than 2 million people, and we have like 78 slums in Freetown. So people call Freetown a big slum mm-hmm. so that situation of where I am able to support the poor, marginalised and people who really may not know what exactly they're doing makes me more interested in public health and what I'm doing now. now When I actually heard that I can do a PhD and I can do a PhD linked with informal settlement which is actually slum, mm-hmm, then I really felt that, I think my dream is coming through where I can use my knowledge to actually change things. So I am really hoping that my PhD will come out to change and bring some kind of innovation and especially among the topic I have chosen, which is actually linked with young people living in slums.

Wonderful. I think that's great. So just before we go any further, tell us the context of the work. So informal settlements, paint us a picture. What are they like?

So the informal settlements are that, uh, commonly known as slum, but we don't use the term slum. Uh, and also in my research, because the communities, it's kind of a, uh, the term itself is, uh, kind of insulting to them. Mm-hmm so they don't like to introduce themselves as slum dwellers, so they want, uh, recognition, legal recognitions, and the use of the term of slum is kind of, uh, create barriers for their development. So that's, that's why they don't like it. And we also, you know, my research, I also don't use the term slum. We use informal settlements. I work in two informal settlements for my PhD, so the one settlement is established in, uh, government land. So it's uh, one of the oldest informal settlements in Dhaka city. Mm-hmm. So haka is the capital of Bangladesh and that informal settlement established around, um, 45 years back. Wow. So it's been long time there. Mm-hmm. So it's more stable and there are many, uh, service providers and many services also available. Mm-hmm. like they have a very good system of water sanitation. They have some legal lines for water sanitation, for electricity. Some part of that settlement also has legal supply for gas and, uh, the opposite scenario is the, another settlement that I'm working with. So the, that the settlement, which is named as shyampur which is kind of a new settlement, uh, it was previously not part of the city corporations. So it's also at the border of Dhaka City. Okay. So because of it's geographical location and history of uh, uh, kind of, it's a new settlement. So there is not many service providers and services available there and that, uh, informal settlement is also very scattered and some part of the settlement is kind of a floating settlement. Okay so it's very close to the industrial area and the industrial waste solid and um, liquid waste are all, all actually where uh, goes to nearby water bodies. So the people who are very poor, very vulnerable in the settlement, they actually live in those floating houses. So they have different level of vulnerabilities. So there are actually two, uh, the characteristics of the two settlements I'm working for my PhD is completely different. Yeah. So I'm trying to understand actually their, their governance system because for this, uh, the established one, even the government system is also established, but for the new one the governance systems is very fluid, very, uh, it's not strong actually. And what I have found, that they also don't have any strong network, Okay, to raise their voice. So this is a scenario,

Two very different contexts there and I think what's really interesting is that, um, we often don't think about informal settlements as being so established. So the, the first one that you mentioned, you know, has this history and has formal services by the sounds of it. And then you have this new one. So it'd be really interesting to, to hear about that. Governance actors. So for our listeners, can you give us some examples?

Oh, sure. So, uh, governance actors are those who have, uh, who made actually make decisions regarding any services that we get and sometimes they're also providing services.

Mm-hmm.

for example, uh, in my case, in, in the informal settlement. So there are two types of governance actors. One is formal, which is like, Public, like government, ministry of health, ministry of local government, city corporations, and also some, um, NGOs like the service providers were providing services, they are also kind of governance, formal governance actors because they are involved in providing those services to the community. And the informal governance actors are the community leaders, and also some, uh, in community influential people; Landlords in, in the specific community and also some local political leaders. And, uh, there are also, uh, another form of formal governance actors in informal settlement is the ward councilors. So they actually have kind of dual role for both formal and informal. So I think I will discuss later about different methods than I'm applying.

Sammy, moving to your PhD and the, the kind of focus there, it's around young people you mentioned earlier. So tell us a bit more about that. Yeah,

my umbrella topic is, um, understanding the health and wellbeing of young people living in informal settlement but, um, uh, at the same time, um, even though I want to understand how they actually um, defined health and wellbeing, their own health and wellbeing. I also want them to give me, um, practical solutions of how these problems can be reasonably solved at community level. So I don't want a solution suggested by policy makers or I don't want the solution suggested by, uh, the community people. but through Like saying we want the government to build this. We want the, the, uh, NGOs to bring this. How can you as community organize yourselves to actually bring solution that can last maybe forever and serve you well within your community? How can you organize your own community and make it a better place for you to live? How will you be able to tell someone? Don't live here and stop anyone from living beyond this point because it is dangerous to live, mm-hmm, tell somebody that this structure should not be built within this community because this is dangerous for us, our children, and the generation after us. So what solutions are they bringing? So I am doing what I call co-production of knowledge, of reasonable solutions that can make the living, health and wellbeing of those residents, especially among young people, reasonable enough. So, um, those are really my objectives and I hopefully, um, be able to have them um, factual to policy makers and tell them these are the problems and these are the solutions we can be able to have, to ensure that this is being resolved like permanently because it's a community based participatory study.

Wonderful. These both sound hugely intriguing. How did you select the methods that you use? What evidence are you collecting and how will you present it to make that change?

For me, uh, I'm, uh, using, completely participatory methods. So this is also kind of pilot testing for me as well because I have never done this, the way I'm doing currently participating method, I have never done before. So for me, uh, I am doing, uh, it called governance mapping where I try to understand the whole governance network system, both formal and informal system in the settlements, how those work, what the actors, what are the facilitator factors? What are the barriers in those networks? How those two networks collaborate with each other or may create barriers with each other or conflict, have, have conflicts with each other. So that's one method. And in that method, I, uh, have a group discussions with, uh, community people, different types of community people, like person with disabilities, like women who are single or who are the female headed household head of households. I also have, uh, group discussions with informal workers who are living there, and also with the, uh, community leaders. So with the discussions with multiple types of, uh, participants, I try to understand their point of view about what is accountability to them? What is governance to them? What are the networks, how they, uh, are linked with that networks? What are the factors that help them to be part of that network? Mm-hmm. and, and their decision making, uh, power in that network. So that is one of the method. And another method is, oh, it's called governance diaries. So in that method, I will select some households in, in the two settlements and I will have a kind of a follow up with them for certain period of time. And that method is more about individual level. So I will try to understand that what are the factors that actually help them to be part of that network and if they're part of that network, how that help them to avail some service. Or maybe if there is any other factors that actually create barriers for them to be, to participate in that network. And if that's so then, then how that, uh, impact in their daily lives, especially for their access to health services. Mm-hmm, so, uh, these are the two very interesting methods. Uh, and um, yeah, I have completed one method, the governance network mapping and I have found very interesting findings and also some challenges with the application of participatory methods with this very sensitive topic, because in our context discussing governance issues with the community leaders and also the people in a group setting, that is also kind of a challenging because there are some, uh, governance issues that people actually don't want to share, but that's a very important for their access to services and availability of the services in their community. Those are the things I'm doing and I also will do, it's called organograph method, so that is also another participated method where I will involve policy makers. So that will be kind of a discussion with them to know their perspectives, how they think about governance issues and how they actually link up with the informal sector, uh, governance actors and also what is their planning for urban health. So these are the participated methods I will be applying in my research and in addition to that, I will also do policy analysis and also interview some of the policy makers to understand their perspective and their, their plan for the future urban health for Bangladesh. And, uh, these are my methods. And, uh, I have actually come up with these methods. I did lots of, uh, search mm-hmm. to look at that, what can be the best method to talk about this governance issues. And I did lots of literature review and I found this, these two methods, especially the governance diaries is and governance, uh, network mapping, these two, uh, best fit for my research question. Mm-hmm. And then, uh, I did pilot of with the governance network mapping and that was very successful. And that actually, uh, helped me to more be more confident about the method, but when I actually applied the method, uh, in the real world, real field, uh, I actually faced lots of challenges. But that's also learning for me, each method actually helped me to improve my facilitation skill, improve my method, and also my tools. So that's also very good learning experience for me. I'm now more mature, I should say, about the method and also more confident about how to talk, how to interact with different types of participants.

Yeah. On this podcast, we've heard a lot about the importance of embedding yourself within the, the context where you want to work Sammy, did you have the same experience of working with young people, tell us about the methods and how you found applying them.

I looked at the fact that I have to bring in maybe two methods to ensure that I am able to actually have, uh, the data I will need, rich enough to have my output and, um, what is needed for young people living in slums. So one of my method that I always start with is social mapping. So I try to map the communities and understand what do they have within the community. So the young people themselves will map their community and tell me what they have within the community, especially things that relate to their health and wellbeing. Mm-hmm. So we map the communities and we on all of us understand what exactly they have within this community. So I get my participant like 11 to 15 participants from one community. Men and 11 to 15 women, or boys and girls, but we try to draw them from different sections. So ARISE initially had already mapped these communities, uh, geographically.

Mm-hmm.

So we have already a GIS map of the community, and these communities have been divided into sub sections. So I draw them from different sections and bring them together, draw the map of their community, get everything that affect their health and wellbeing, then I do Venn diagraming. So how are these issues you have done already? You have drawn from the social map. How are they link to each other? Mm-hmm. So I want to have a vendor diagram where you link them together. So with the support of co-researchers, they help me get these Venn diagram, link, these issues they have already listed on the maps, I mean social map, together. Then I will do wellbeing ranking. So when I was doing wellbeing ranking, we tried to state the issues that affect their wellbeing, and then we rank them. What do you prioritize most? Then? Then, then, so try to list them. Then we ask why, and if you say this, why is this and why is this not coming before this? And what are the issues that are really affecting this? So we try to make sure we rank them very well. I try to also understand a bit from key informants. So key informants are people who really interact with these young people, so they can be within the community. They can also be outside the community. So within the community, like the community chiefs, community elders, people who have organizations within the community are providing service for young people within that community and also outside the community there are organizations, NGOs, INGOs who work with these young people within the community. Like for example, CODOHSAPA Center of Dialogue on Human Settlement and Poverty Allevation, which is linked to it, SDI, they actually provide a lot of services. They call them FEDURP in Sierra Leone, Federation of Urban and Rural Poor. So they work with these young people, so I talk to them as key informant. I talk to the Ministry of Health and Sanitation personnel who actually work with young people, wings within the ministry. I also talk to Ministry of Youth Affairs, especially the National Youth Commission, Youth Coordinator. So these are people who really I talk to, the Freetown city council work a lot with the young people within the informal settlement especially on garbage collections, sanitation, et cetera. So I also brought them in as key informants to let me understand how really this problem the youth stated affect, um, the general health and wellbeing of them and other people around them within the information settlement and how will that affect the health or wellbeing of the country as a whole of Freetown. Then narrative interview is also included young people who are really disadvantaged, vulnerable, they are extremely sick, they are extremely poor, they are commercial sex workers, et cetera. So I try to try to let them narrate their own story and how are these issues really affecting their health and wellbeing. Then I did a photo voice specifically for young people between 15 and 17 years. Why was this age selected? I felt that they can express themselves more when they see things and not really when talking. So, and when, uh, I trained them how to take pictures, which pictures they should take, why they should not take some pictures, et cetera. So they took very, very nice pictures of things that affect their health and wellbeing, they brought them and individually we talk those pictures through mm-hmm depending, uh, based on what satisfied them to be discussed in group. Then I now bring them in group and project the pictures that they selected that, Okay. Yes. This picture, I can talk about it anywhere but this one. No. So the one they say no. I don't discuss in group, but the one they say yes, I put them together and we all sit down and look at the pictures, one after the other. So for example, you can see that you have a hanging toilet. Somebody might be talking about, it's not hygienic, but some other people they do not concern about hygiene, they are concerned about security. Mm-hmm. you know, some people are not concerned about both, they are concerned about falling down. So you can see that everyone has their own dynamics and interpretation of one photo, which probably all of them took, but I just had to post one of them so that we can discuss those issues. But what I have not done at all yet is the co-production. So I really want to understand the data properly at this point before I bring this data to them. Like bring something live. This is what you how can we have a solution so that co-production will be hopefully done in two to three months from now? Yeah, when I shall have understood my data really very well. But these are like the methods I use to get my information, which I really want to have, um, and present them to the world, to authorities, to people in Sierra Leone, actors to see if they can really help support to change those young people's views, their health and their wellbeing as they live within those settlements. Excellent. So, so many methods there, and I understand it'll be a triangulation process where you'll put your different, uh, kind of evidence pieces together to, to create a thesis. From thesis point, once you write up, what do you think is next in terms of making sure that your data creates the change that you aspire to, and also what's next for yourselves?

Uh, well, okay. So, uh, for me, uh, I think it's the privilege of being part of a larger research project because there are lots of ongoing activities in the project where you can also link your and incorporate your PhD findings. So for me, uh, I have, I am planning to also share some of my findings with the stakeholder meetings, which the ARISE project is planning in Bangladesh so that my PhD also will supplement some ARISE data that we have in Bangladesh. So that is one way of contribution of my PhD. Mm-hmm to the project and also to the larger urban landscape in Bangladesh. From my PhD, uh, I will write some papers and also I'm planning to do some kind of, uh, policy brief, produce some policy briefs, especially for the urban policy makers in our context. So that will, will another, uh, type of contribution of my PhD for the improvement of urban health in, um, in, in Bangladesh. And, uh, in future, I actually want to also do some kind of implementation research where we can test some of the urban health models based on the. PhD findings and also based on the findings of ARISE project. So that is my broader goal and aim. So I hope that will actually, that will benefit it for our cities also because, uh, we still don't know that what will be the next urban primary healthcare for us. Mm-hmm, so, uh, if we can, and if we have that funding, um, support from the donor agencies, that will be really important for us to also test out multiple models to look at that, what actually work. And not only just testing the models, but also the solutions which actually the community produce. Because from my research, I have found, there are some local level solutions, they're implementing in their daily lives for accessing services. So maybe we can, uh, institutionalize those, uh, solutions to think about more broader solutions for the urban force in my Bangladesh context. So that is my future goal to at least try and test out some of the models which work for them. Mm-hmm, and produce and, and, uh, produce evidence for the go to think more about the different approaches for providing services and uh, yeah, and I also would like to do my postdoc on urban health system and, and especially the policy and governance. So that is my plan for the next coming years.

So for you, the PhD is almost the start of a journey and your passion. This is the beginning of collecting evidence, but it's not the end. It's, you know, it will get you your PhD, but it's start of a longer journey, um, in this field, which is really interesting and, and it's great that you want the models that you, uh, kind of find through your PhD to be tested and piloted and, and to see if that can make change. So that's great. Sammy, same question to you. Um, what do you think will happen to your PhD data? How will it benefit communities and what will be next for you?

Um, it, it's almost similar, uh, but I believe in action rather than research. I believe in research, but I believe in action more. Uh, what I mean by that is, um, um, when I was in my study site collecting data, I had a lot of voices, comments, concerns about 'you guys only come and interview us and go away. We don't see anything. We don't do anything'. So it means the participant are getting tired of being talked to, being asked questions, all the time, but if you make some actions, then they will feel better. Um, what I mean by that, if, um, my goal is really not to end at just publication, which I plan to do, um, or making my research findings known, which of course there's a platform in Sierra Leone called City Learning Platform, where you can share this information and, uh, maybe orally or in any form. Um, I also plan to maybe give data, I mean, in any form that they like to the co-researchers so that they can be able to like, make request on their own and also tell people, No, we have already this, we don't want it anymore. Mm-hmm you know, so I also want to empower my co-researchers maybe with that kind of information, not very much, but some basic information, but my aim really is to ensure that I have an action on my co-production. So if the young people are able to maybe prefer solutions that are reasonable enough, practical to be implemented, I want to have a grant that can really support that. So I prefer writing grants supporting these young people and moving them from one step to another rather than continuing to collect data and publish. So, um, based on that, I already submitted a proposal to, um, I, I just completed Mandela Washington Fellowship in the US uh, which is a 10 weeks fellowship, uh, with six weeks in university. I did four weeks internship with the task force for global health. So at the end of your, um, fellowship, you have to submit a proposal of something that you are really interested in and want to do and want to change in your home country. So I submitted a proposal against the end of my PhD so that I will have some grant to help start training some young people based on any solution that we have in my co-production, which I don't have yet, and that is fine. So, that is really what I am aiming at. I will want to teach, I will want to continue to do research, but I will also want to see how that change can be made among young people living in these slum settlement. Otherwise, Um, for us in Africa, more than 50% of our population is young. Mm-hmm, and for Sierra Leone, more than 60% of our population is below 35. So if we are not able to take care of them and by 2030, according to UN half of the urban population will be living in slums in low and middle income countries. So Sierra Leone is low income, not even middle income. So we might have more than half of the population living in slum and these are mostly young people. So it means we are losing the generation from time to time. So if I am able to support them, then uplift them from that low poverty level among very poor people, then I think I will be happy that I am making some change in my community.

Thank you very much. It's again, the passion comes through from both of you. How this is not just a PhD at all. It really is instigated and situated within your heart to to make change long term, and I can see that the selection of your PhDs has been, um, really very particular to your interests and your passion as well. I think that's important when you're deciding your PhD. I know I felt the same, that it's, you live with your PhD for so many years, you have to love it and feel passionate or it's difficult. So just as a, a final comment, what piece of advice would you give to others that are just starting their PhD planning process? Uh, Sammy, let's start with you.

You don't need to see it as like an achievement only, but you have to really like it like, you have to be passionate about it because, um, like ours is even more lonely than maybe being on campus? We are doing offsite PhD and, um, doing offsite PhD. You talk to your supervisors online all the time. This is my first time or our first time meeting our supervisors face to face. We have been talking to them online. We don't know them. Mm-hmm we have not met them before. And, uh, they are expecting that, um, you are not taking any lecture. You don't have any traditional teaching where you will say, Okay, I want to do qualitative research. This is what exactly, um, you should do as a qualitative researcher. So like when I was doing my Master's, you are taught first in class, then you are sent to the field to implement what you have been taught. But for this PhD, though the expectation is that you should do it. So if you don't really like it, then you will definitelybe in a very big trouble.

Thank you for that. Um, so Bachera, one piece of advice.

Oh, okay. So, uh, for me, like Sammy already told, so, uh, I'm a part-time PhD student and offsite. So for me, uh, if anyone wants to do a part-time, offsite PhD, so my piece of advice for that person or that upcoming students will be that it's very important to know the balance between the study and the work because the part-time PhD students usually do work in addition to their PhD or do PhD in addition to their good work, I should say, this way actually, because that is the thing which happened. So it's very important to also have that discussion with, uh work, that this is the time you need to focus more on your PhD. So this is what I have learned over the last two and a half years of my PhD journey that, uh, it's very important to have dedicated time for, for, especially for the offsite PhD students and another piece of advice, I should say that it's also very important to know myself, Okay, what I can do, what is my passion? Because it's kind of investment. Yeah. So if I'm not very clear about that, what I want to do with my PhD, it's very difficult to actually continue the PhD. So this is very important to, at the beginning, even also before the beginning, to know that what I really want.

Well, wonderful pieces advice there and, uh, it's great that you're here in Liverpool for these few weeks where you do have some company so I hope that goes really well. Thank you for joining the Connecting Citizens to Science podcast. It's been wonderful to have our first recording live in a studio. So thank you once again and good luck moving forward. We will look out for your publications and your change that you're clearly gonna make in the world moving forward.