Small is Dutiful

Last month’s column proposed an annual Journalism in Kerala report to monitor the health of the news media industry in the state. The quality and usefulness of such a report would depend most heavily on media researchers, who gather information and present the analysis.

But research does not have to be undertaken always on a big scale, by professional researchers, or by spending lakhs of rupees. It can be useful to society even when conducted in a small way by non-researchers at low cost. The Neighbourhood Network in Palliative Care (NNPC) in Malappuram offers one example.

 

Medical Missionaries of Malappuram

The NNPC is a network of voluntary groups that offers palliative care to tens of thousands of people in the villages and towns of the northern districts of Kerala. At the heart of each group are volunteers—most of them ordinary citizens such as schoolteachers, shopkeepers, and ex-servicemen—who identify people in need of palliative care and raise funds, usually locally itself, to provide medicines, support nursing, and arrange home visits by doctors.

Around November 2011, while attending the periodic meetings and classes in Kondotty region of Malappuram district, Ajmal Rahman K. M., a 25-year old doctor noticed that nurses were repeatedly mentioning catheterisation as an issue. Inspired by his senior colleague Abdulla Manima’s advocacy of an “evidence-based approach,” Dr Rahman decided to study urinary bladder care in three–four clinics in that region. With Dr Manima’s guidance and nurses’ support, information was collected from about 150 patients over six–seven months. Once they identified patterns in the emergency calls to nurses and analysed data on catheter management in patients’ homes, the doctors and nurses came up with solutions to improve catheter care. For example, they observed that in about 30 per cent of the cases, catheters were avoidable. In most cases, once the nurses taught the patients and bystanders about cleanliness, bowel care, and catheter management, the results were remarkable. It not only reduced the number of emergency calls to nurses for catheter change but also boosted the confidence of patients and bystanders to handle emergencies. One of the tools developed for the study—the “catheter-care score”—is a simple scorecard that can be used by other voluntary groups to detect and resolve inefficiencies in palliative care. When contacted, Dr Rahman informed me that a 30-page booklet too has been authored by the nurses to raise awareness and educate families.

Here are bits of information glowing on my desk. Dr Rahman was barely a year out of Kottayam Medical College when he kicked off the study. Middle-aged nurses teamed up with volunteers and doctors to gather information, examine patterns, and raise awareness. The study was done in the course of their workday routines at “negligible cost” and with “teamwork.” All these happened not in any so-called prestigious medical institute in a city, but in less-known places such as Kunnumpuram and Vaazhakkadu. 

Very likely the study was imperfect and did not meet international scholarly standards. But even more likely, thousands of palliative care patients and their families will benefit each year from the efforts of the small study in rural Kerala. 

Instead of simply going about their work in routine fashion or merely crying hoarse over unnecessary catheterisation in medical treatment, the doctors and nurses went a step further and displayed professionalism in their own small sphere. Result? They were able to make a difference.

 

Shoestring Studies on Kerala Media

Ajmal Rahman’s study is just one example from one region in the NNPC. There would be other doctors in other institutions, doing field studies and improving the lives of citizens. If doctors in our state can conduct small studies as part of their professional duty, Kerala’s journalists too should be able to do the same.

Here are a few favourable conditions for journalists to conduct small studies. (1) Newspaper offices in Kerala are not beehives of activity throughout the day. Consequently, subeditors and senior reporters can easily snatch an hour or two each day to critically examine press coverage or newsroom practices. A lot of local coverage seems to be based on press releases, opening up the possibility for even junior, local reporters to get an hour or so each day for kutti research. (2) At the workplace or home, some journalists can review rival newspapers at zero additional cost, and hence undertake even a comparative study. (3) Unlike a few decades ago, there are easy and low-cost tools and platforms for disseminating study findings. Journalists can use e-groups, websites, blogs, or specialised print publications such as Media to draw attention to findings, however small or big.

The soil for kutti research can be made more fertile by newspaper managements. They can, for example, encourage small studies through research competitions among employees. The findings and insights from the studies can be used by the organisation, and after two–three years, released for free, public consumption. A research competition with modest prize-money or other suitable rewards can also motivate staff and boost morale; it can hence be seen as an HR initiative too. Unlike training programmes, which sometimes turn out to be passive exercises for attendees, kutti studies provide scope for active thinking, reflection, and learning; the skills developed in such exercises will also help the media organisation survive in a creative and competitive marketplace.

Journalists in Kerala see the newsroom six days a week from the inside; those out in the field know the terrain of news gathering with equal familiarity. Add the journalist’s innate curiosity and ability to smell a story, and we have all the expertise and qualifications to identify a topic and kick off a study. The next step—collecting data—can be challenging for media practitioners who cannot think beyond the 24-hour news cycle. Yet, a two-week or four-week study may be easier than one presumes. Roping in a colleague as a research partner will come in handy; on a bad day, each can keep the other on track, and help in catching up on data collection. Get cracking, guys!