London School of Hygiene & Tropical Medicine

An email from the Dean of Students and Taught Programmes, titled “Farewell and good luck to our Intensive MSc students” just landed in my inbox. It still feels surreal that my MSc journey at LSHTM & MSc Public Health for Developemnt (now titled Public Health for Global Practice) has come to an end. It is a bittersweet feeling: a mixture of pride and relief for completing my studies – what an intense year it has been but sad to say goodbye to my friends whom I have come to see as an extension of my family in London.

Currently other than working on my part-time job as an Independent Researcher for La Trobe University on a respectful maternity care study, I am continuing to search for more stable jobs and start working with my supervisors on a manuscript to publish my summer project study.

My summer project

I conducted a primary data collection, using a qualitative method to examine the influence of cultural and religious values on service providers’ responses to intimate partner violence in Timor-Leste. I chose to focus my summer project research on intimate partner violence (IPV) because IPV has affected many people whom I love. I have sat down with those I love and listened as they recount the abuse that they have experienced and how it has impacted their health and wellbeing.

I come from Timor-Leste, the youngest nation in Asia, which is predominantly Catholic. Whenever I read studies and grey literature about IPV in low and middle-income settings, I notice that those studies state that rigid gender norms, attributed to cultural and religious values contribute to IPV. Given the settings of my country, I became curious to understand to what extent service providers, the first point of contact for survivors when seeking formal help, are influenced by their personal and cultural values in their interaction and response to survivors of IPV. These service providers were the police, shelter staff, health workers, staff who conducted forensic examinations, and legal staff who worked on IPV cases.

How discussions with my Personal Tutor helped

At first, I thought of doing my summer project on something infectious disease-related. I was conducting a literature review on tuberculosis (TB). I discussed this with my tutor who was fully supportive of my idea and even tried to connect me with some LSHTM professors who are experts in this area. I managed to meet a couple of them. But I have never worked in TB before. I chose it because Timor-Leste despite its small size is considered to have a high incidence of TB, though there is a lot of underreporting. As I was finalizing my proposal outline to be submitted to my tutor and programme directors, in the back of my head, I kept thinking about IPV because it is an area that is close to my heart. I brainstormed some questions about IPV that I had with one of my programme directors, Simon Cohn, who is a medical anthropologist. He asked me to write down my ideas in one paragraph. Once I was set with the topic, I contacted LSHTM Gender Violence and Health Centre (GVHC) to find some professors who might be interested in supervising my research. That was how I got my primary and secondary supervisors.

LSHTM & local ethics proposal

Looking back at the process for the LSHTM ethics proposal, known as the CARE/Leo form at LSHTM, it feels that the process was quite straightforward. However, I remember it was quite an intense process because it was in early March, and we were also getting ready with summative examinations for the second term modules. Given that I was conducting primary data collection, we also had an earlier deadline to submit our CARE form. Both my supervisors were significantly helpful in reviewing and providing detailed feedback on my proposal. However, there was a bit of back and forth with LSHTM Travel and Offsite as participating in a mandatory workshop about travelling was a prerequisite for obtaining approval from ethics. Once I got everyone to sign my proposal and submit it, my attention shifted to focus on preparing for the summative exams. The whole approval process from the LSHTM MSc Ethics took approximately eight weeks.

I travelled to my home country, Timor-Leste in early June for my summer project research. Before my travel, I had submitted my research proposal to the local ethics committee. Once I arrived in Dili, the capital city, I followed up on my application. There was someone else in my cohort who was also doing primary data collection in Timor-Leste. So, it was very nice to have someone else who completely understood what you were going through. Back to the local ethics- I had to print all the required documents and submit seven copies of all the documents. These included: the LSHTM CARE form, the research proposal for the local ethics, the consent form, participant information sheet, etc. I remember checking every document to make sure no missing pages or documents and stapling every copy. The photocopy shop had to tell other customers that they were not able to accept other orders as they had to focus on my order alone.

The interviews

Once I obtained the local ethics and shared the copy of approval with LSHTM, I began my data collection. I conducted my research in two municipalities: Dili and Baucau. I was already in Dili, so for the first two days, I interviewed service providers in Dili. While I was not interviewing providers, I was following up on my letter for interviews. There was quite a lot of bureaucracy involved. For instance, for me to interview the police in Dili and Baucau, I had to write a letter addressed to the Commander General of the National Police. I had to follow up with his office to check whether he had authorized the interviews to be conducted. The same process was for every service provider, the coordination had to be with the higher level. Some approval took longer than others. But I had to be proactive meaning I could not just follow up with a phone call (government officials in Timor-Leste rarely use emails for official purposes), so I had to go to every office in person. This was not possible with Baucau, which is about 123 kilometres from Dili. I tried to call the Director of Health Municipality and the Director of referral hospitals to coordinate the interviews, but I was asked to deliver the hard-copy letters. In the end, I was able to interview 18 service providers in total. I sincerely thank those service providers who gave their time to speak with me. 

Looking back...

I truly enjoyed the whole experience of conducting research in my home country, Timor-Leste. I am committed to addressing health inequity. In global health, we see the publication of research in peer-reviewed journals continue to be dominated by researchers from the Global North due to reasons such as financial resources, access to information, and racism. Timor-Leste is not unique to this problem. I hope to change that. I believe that research about us, should not be done without us. Our contribution should not be merely reduced to translating survey tools into the local language or coordinating with the local stakeholders. We should be included in the analysis and writing of the results. Our contribution needs to be acknowledged. This is why I would like to continue this process so I can get my research published in peer-reviewed journals. I want to contribute to the knowledge production of my country. As an Indigenous Timorese woman, I see this process to be very important.

My advice

The advice I would share with future MSc students on summer projects - for me there are two:

1. Choose a topic that you feel curious about in a way that you want to learn more about or are passionate about. I have recently read this same advice given to anyone who is considering a research area for a PhD. At first, I wanted to do TB because everyone at LSHTM seemed to be doing something related to infectious diseases, but it is important to listen to yourself and I guess I did that and it helped me a lot with the whole process.
2. Ten weeks is very short. For those who choose to do primary data collection, start your CARE form early enough (I submitted mine in mid-March). 

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