DR. HERRY MAPESI is a young physician researcher based in Ifakara, some 450km from the Tanzanian economic capital of Dar es Salaam. He has the loudest laughter in town, and apart from being occasionally perceived as snobbish, he is a beautiful mind and an extraordinarily likable character.
Herry and his colleagues run an 11,000 patient HIV clinic serving nearly 50 villages in the vast Kilombero Valley. About half of their patients are on regular follow up, receiving the best possible treatment for HIV and related illnesses such as tuberculosis, meningitis, diabetes and chronic kidney diseases. When I last visited them, 94% of their patients no longer had any detectable HIV virus in their blood, meaning they no longer transmit the virus to their partners. Herry and team had also created a one-stop clinic providing comprehensive treatment and nutritional services for whole families affected by HIV. Today, HIV-infected mothers who attend the clinic no longer transmit HIV to their children even if they breastfeed regularly. All this for just pennies, and of course very large doses of laughter.
Several times a year, the team also works closely with the Tanzanian health agencies to support development and evaluation of improved care and treatment regimens for chronic Illnesses.
For the record, Herry and colleagues are research scientists at Ifakara Health Institute. They write papers, attend research conferences, study for PhDs and apply for grants. Yet their primary mission remains unchallenged - improving people’s health and wellbeing. In many ways, theirs is a research program with a difference. Their work – both clinical and research –profoundly impacts people’s lives each day.
So, what makes these millennials so motivated and so successful?
As Director of Science in a major research organization in Africa, I have a vested interest in understanding how we can best support young researchers like Herry. Over the past three years, I have systematically examined management practices commonly used by organizations and businesses around the world to improve staff performance and creativity. This included multiple surveys and in-depth interviews with innovators and researchers in and outside Africa.
In this article, I share some of the key lessons I learned about challenges facing early-career researchers, and certain essential practices that our institutions can prioritize to help them succeed.
There are still only a handful of opportunities for high-quality training, and unacceptably low levels of supervision and mentorship for our young people aspiring for a life in research and academia. Equally minimal are role models for the guppies to swim along. Instead, science is still widely perceived as a club of bearded introverts and bookworms strongly averse to fun and fiercely unwelcoming to women, a situation keeping many talented young people away.
Limited financial investments by governments have also limited necessary growth of critical scientific mass, as well as exploratory but potentially high-impact research.
Another challenge is the traditional glorification of individual success over team success. This is driven in part by the archaic evaluation criteria of ranking scientists based on publication counts, citations and research grants. If unchecked, researchers easily adopt insalubrious ethos such as “competing against” rather than “competing with.” At Ifakara Health Institute, Herry and colleagues have curtailed these toxic egos by embracing the African humanness philosophy of Ubuntu - I am because you are. Perhaps this is easier for young people than it is for their more established, Nobel-chasing godfathers.
While inter-disciplinary work is proven to create greater impact, many universities still run geographically segregated departments. Engineering schools can be tens of kilometers from biological sciences or medical schools, effectively limiting opportunities to co-create solutions. Architectural and organizational innovations such as shared coffee lounges, subsidized cafeterias, open plan offices or glass walls may help in certain circumstances, but are not enough to bridge these gaps.
Other equally important challenges include excessive administrative and teaching loads for young faculty, and poor management practices in many institutions. Language gaps too can prevent non-native speakers from taking full advantage of the English-dominated global research ecosystem. This is not a uniquely African concern, but must be especially considered in countries where, French, Swahili, Portuguese or Spanish are the main languages of instruction.
So, what must we do to help our young researchers succeed?
Not surprisingly, the most important is providing effective supervision and mentorship. This may include long-term commitments to guide early-career researchers on both work-related matters and vital extras, such as engagement with communities or regulatory agencies, and family resettlement. Institutions should create environments where supervision or mentorship arrangements are mutually agreed, rather than being institutionally-enforced.
Training programs should preferably mix hard and easy tasks, so young people experience incrementally difficult challenges for optimal learning. Prof. Alex Ezeh, former CEO of the trailblazing African Population and Health Research Centre once told me, “you must occasionally throw your young researchers into the deep waters, but always be ready to dive in, if they are drowning”.
The second is to maximize interactions between researchers and their target populations, communities or patients, so they may identify priority questions firsthand. This way, we are more likely to create or adapt solutions to fit local context. At Ifakara Health Institute, community members are our most important stakeholders, so we take great pains to protect our partnerships with them. This is also the reason that colleagues like Herry and team have remained impactful despite being so far from the tarmac, and so limited by financing.
Communities can also be great sources of new knowledge for researchers, making these partnerships perfect for “mutual learning”. In one example, after expert mosquito biologists had tried fruitlessly for more than 30 years, it was the young village boys who showed us the exact locations where malaria mosquitoes congregate each evening for their ritualistic sex games, a discovery which could allow scientists to target these mosquitoes for community-wide control.
By extension, institutions should deliberately and actively create interdisciplinary programs. At Ifakara, young researchers now regularly combine math, chemistry and biology to create new diagnostics for infectious diseases like malaria, something only possible because of the active desegregation of disciplines. Others are using portable ultrasound devices to limit potentially toxic treatments for people falsely diagnosed with Tuberculosis.
With increasing financial constraints and economic vigilance, research and academic institutions may be tempted to operate on a traditional profit & loss basis, as if they were typical business corporations. However, investments in science are mostly long-term, and returns hardly come until after several years. Leaders must therefore focus on building sustainable research ecosystems and careers, even as they track year-to-year performance indicators. Equally important are semi-autonomous and flexible leadership structures. These should embrace efficient administrative and financial systems, which meet international standards without ignoring research priorities. Sadly, bottlenecks like delayed contracts or slow procurement procedures are still common in many universities, enormously demotivating of scientists.
Aspiring researchers should be forgiven for believing that science is a preserve of certain demographics. To the contrary, gender and cultural diversities are both associated with higher performance in workplaces. Institutions should therefore identify barriers to engagement for women or other under-represented groups, then endeavor to overcome the barriers using different means.
A common question that arises in many institutions is whether direct incentives should be promoted. For example, should we pay scientists for each research paper? Well! It turns out nothing works better than Dale Carnegie’s principle of honestly and sincerely appreciating people. Emotional intelligence among leaders will go a long way, but financial or material incentives beyond regular institutional pay grades are unsustainable and can backfire with serious cobra effects.
These are only a few examples of what institutions in Africa can do to catalyze effective ecosystems for their early-career researchers. A careful mix of these practices and other emergent themes, will allow youngstars like Herry and friends to bloom brighter, while staying true to improving people’s health and wellbeing.
Dr. Fredros Okumu is Director of Science at Ifakara Health Institute in Tanzania, and an Associate Professor at University of the Witwatersrand. He is a mosquito biologist and public health expert working on new ways to improve control and prevention of vector-borne diseases. https://twitter.com/Fredros_Inc