Working in Uncertain Times: Studying COVID-19 Health Seeking Behaviour in Marginalised Settings Using Ethnography as Research Method

Abstract

COVID-19 pandemic was new for everyone; fear and uncertainties created a unique opportunity to study health seeking behaviour in marginalised settlements in Bangalore. Ethnography as a choice of methodology for a community-based research study on health seeking behavior for COVID-19 during the pandemic was a realistic decision both academically as well as operationally. This work was based on stories of fear, pain and loss which needed slower pace of enquiry, an organic flow with developing trust and rapport with the research team and the community. Slow pace of ethnography helped navigating lockdown and positive cases in the community. Like a tight rope walk adopting a slow, organically developing method helped us achieve research rigour as well as rapport within the community. All the elements of moving from general topics to specific topics worked well as we collected COVID stories of faith, perception for health seeking vis-à-vis social cultural practices. Smaller sample size helped us to delve deeper into individual stories and create interconnections with stories from health systems personnel, faith-based healers, local traditional healers in the community. Restricting fieldwork to localised geography helped in understanding layers of heterogeneity within homogeneity. In the uncertain time, sharing stories, listening to people who are in distress also created a sense of connection between research team and the community. Fragmented belief systems, the dilemmas of seeking care at the public institutions during the pandemic at the backdrop of communal unrest was palpable and created an opportunity for analysing different ‘truths’ that existed within the community. Health care seeking is not an abstract pathway but a dynamic one, laden with contexts which are complex and needed to be observed, understood, and not contested. In nutshell, a qualitative enquiry based on ethnographic methodology worked beautifully for this research in an unprecedented time of the pandemic.