A political scientist and two pharmacists discuss their research into prescription and non-prescription drug use the Middle East
Christina Steenkamp, Mayyada Wazaify, and Jenny Scott talk about the supply of prescription medicines for non-prescription use in Jordan, the impact of violent conflict on pharmacy practices in Iran, Libya, Syria, and Yemen, and the use of the amphetamine ‘captagon’ within a refugee population. They also explain how shared research interests and complementary skills benefit their collaboration, and why early career researchers should prioritise ‘friendship and fun’ when pursuing research partnerships.
Dr Christina Steenkamp is a Senior Lecturer in Social and Political Change at Oxford Brookes University, and she is particularly interested in the impact of violence on peacebuilding and the relationship between organised crime, conflict and peace. Professor Mayyada Wazaify is Professor of Pharmacy Practice at The University of Jordan and Adjunct Professor in Social Pharmacy at the University of Helsinki. She has considerable knowledge of the role of the pharmacist in the prevention, identification, and management of prescription and non-prescription substance use problems. Dr Jenny Scott is a Senior Lecturer in Pharmacy Practice at the University of Bath, and has a research interest in using pharmaceutical science and optimising pharmaceutical practice to improve care for people who use drugs.
Christina, Mayyada, and Jenny talked to the SSA at the 2022 Annual Conference about their collaboration in the Middle East, beginning with their research findings about community pharmacy practices.
In the video interview, Jenny describes how pharmacists play “an integral role in Jordan in how people access and obtain medicines for non-medicinal purposes”, due to a combination of individual pharmacists “flexing rules”, and a system where the enforcement of regulations is “not as strong as it could be”. For instance, they found that some pharmacists were supplying medication to patients and then returning the prescription, which meant that the patient would be able to access the medication again somewhere else. One participant called this ‘going soft’ on the rules.
Jenny says, “It’s very easy from our Western, regulated healthcare system to think, ‘Why would a pharmacist do that? They absolutely shouldn’t do that. And if they do that, they should lose their license’”. But, as she explains, that way of thinking wouldn’t help to facilitate an understanding of why certain practices are occurring within the context they are occurring. For example, Christina notes the “enormous obstacles that community pharmacists have to deal with in just doing their job” in Jordan, which would be manifestly different to the kinds of pressures on pharmacists in a country like the UK. Examples include power cuts, no fridges to keep medicines, personal security threats, and the absence of oversight.
On this topic of cross-cultural differences, Christina and Jenny open up about some of the challenges they have experienced in conducting research as ‘outsiders’ – as people who aren’t residents, and who didn’t necessarily start with a deep understanding of the countries and cultures they were doing research in.
“One of the challenges is working in a culture that you don’t understand the nuances of.” – Jenny
They speak about very much needing to rely on Mayyada’s guidance about what to do and what not to do. For example, Christina shares an anecdote about trying to hurry through an interview with a very senior person in the military so as not to waste his time, which Mayyada explained to her was not appropriate. In Jordan, people value hospitality, so sitting and having coffee and taking your time is an important part of the process if you’re interviewing someone.
Mayyada studied in the UK for four years (she did her PhD at Queen’s University Belfast), which gave her a ‘head start’ in understanding some of the key cultural differences between the UK and countries in the Middle East, and some experience with the structural requirements (‘the bureaucracy’) around doing research when based in the UK.
Christina, Mayyada, and Jenny also talk to the SSA about their advice for early career researchers who want to pursue collaborations. They all agree that it is important to find people you get along with, and who understand your personal situation. Christina, Mayyada, and Jenny are all mothers with children roughly the same age, which gave them an instant common ground, and an appreciation for the fact that sometimes the boundaries between work and family life blur.
“Being three mothers of kids of the same age, more or less, we are totally understanding of…for example, not meeting deadlines or being late. This is very important in collaboration. Find someone that you get along with. At the same wavelength.” – Mayyada
The trio were also fortunate to be friends first, and continue to enjoy the work that they do. And, this is the note the interview ends on – ‘friendship and fun’ as the foundation of a great research partnership.
“Mayyada and I met when we were postgraduate students in Belfast – a very long time ago. And we became friends. And then we kept in touch over the years. And I’m a political scientist; she’s a pharmacist. And we always said, ‘oh wouldn’t it be wonderful if we could do some work together’. And then once the children were old enough to look after themselves, we sort of said ‘that’s it, now’s the time’. So, we found some funding opportunities, we put in bids, and we got funding. And we’ve had fun ever since.” – Christina
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