Ethnography

Evaluation Practice Around the World

Ethiopia

The Evaluator as Ethnographer

Within an ethnographic study, the ethnographer is not just evaluating the “field” of “other” but also her or his role in what is going on. In so doing, the ethnographer becomes what Ruth Behar refers to as the “vulnerable observer.” For me, the experience of being the vulnerable observer meant challenging all my taken-for-granted assumptions about being white, Irish, middle class, and a nurse, in a situation of oppression in a Third World country where a breakdown in caring had occurred. My experience is contextualized within a culture of Western aid to the Third World and as such problematizes the notion of a neat understanding of specifics when debating national or cultural context in relation to evaluation. I was engaged in a project in Ethiopia from March 1996 to March 1997 that was working to improve nursing and patient care in a hospital there.

I provide three vignettes to illustrate the complexity of evaluation practice when judging both self and “other.” The first relates to an early occasion on a ward when, due to the absence of both human and material resources, it was not possible to provide minimum, adequate care for patients.

I am desperate and I feel very angry. I ask the health assistant: “What can I do?” He suggests that I “go home.” I then say to the intern and later to the surgeon (who came to visit a woman returned from the operating room) that “the situation is inhuman and desperate and people should not be at risk because they come into hospital.” I suggest to them: “It is your responsibility to speak out.” The surgeon replies, “I have, but nobody listens.” He also states: “We can't [speak out].” He goes on to say: “Surgery is easy; it is the pre-op preparation and the post-op nursing care that makes a difference.” I agree, and I add: “You need to keep saying that the situation is unacceptable until people hear you.” The surgeon talks about “people's attitudes” and I say: “You must first start with your own attitude.” He speaks of the energy he had when he came one year ago and of how he has lost some of it. I say: “Please don't lose your energy, you need to use it.” The second vignette was recorded 6 months later: When leaving the School of Nursing I see two men carry a boy of about 10 years on a plastic bag. There are flies on the boy's face. I wonder if he is dead or very sick. If the latter, why is he on his way out of the hospital? They stop to get a better grasp of the “stretcher.” People look, I do too. Desperately I want to do something, [but] I have no language and they are on their way from the hospital. I walk on and once again I feel the ache of it all, the inhumanity, poverty, struggle of so many here. Later I learn that the boy was taken from an outlying area and died when he got here. As I record this I feel the pain. Tears come to my eyes; I am aware that such responses drain me. If I lived here permanently would I survive this level of emotional pain? Perhaps I too would learn to ignore it; that is to appear to be indifferent to it, to act inhumanly. We in the West live very privileged lives and all by accident of birth.

The third vignette situates the historical context with which those wishing to engage in patient or nursing care, and the evaluation practices that are inherent within such activities, had to contend. It contains the words of an Ethiopian man working for the donor aid agency.

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