Before we left, the GROW team approached Columbia global health professor Alastair Ager for some research advice that would help us develop our projects. Being already familiar with Gulu and public health initiatives, he suggested an exercise we could conduct in a short time and without extensive research experience. The result was the prioritization activity that we did with members of Loyobo Village.
The point of the activity is to get a sense of what people find most important and why. While it’s obvious that access to clean water, medical care, nutritious food, and education are vital, the ranking of these resources varies greatly along with the justification for the order. Instead of assuming that we know which issues are most important to northern Ugandans, the exercise allowed members of a GWED-G beneficiary community to voice their own opinions. And instead of simply talking about these issues in a formal interview setting, we used physical objects to represent priorities. This made it fun and interactive but also extremely informative. In our case, a jerry-can symbolized water, a rock symbolized land, a notebook symbolized education, a cassava symbolized food, and pills symbolized healthcare.
After arriving in Loyobo and introducing ourselves to the community, we drew a line in the dirt and the numbers 1-5, explaining that each number represented spots for the five items. We divided the community members into groups of five, and varied the groups by age and gender to see if these factors affected responses.
The first group consisted of five middle-aged women who seemed to be vocal members of the group. Laying the objects on the ground in front of them, we explained that we were most interested in the reasoning behind their ordering and that each participant was entitled to her own opinion. Each woman put the five objects in a different order and each had an equally convincing justification for her decisions. For instance, one woman who placed the rock first argued that with land comes both food and money associated with crops. Another defended her decision of prioritizing water by explaining that without safe and reliable water, children are not healthy enough to attend school or able to take medications properly.
It quickly became clear to us that the five resources we focused on were parts of a complex cause-and-effect web where everything is related. The diversity of responses within and across the groups revealed that it is impossible to isolate any single issue as the most important since nearly all aspects of welfare are related. The conversations among the participants also showed that everything was relative, and several people rearranged their priorities after hearing the explanations of others.
Although responses differed from person to person, we noticed some trends in priorities based on age. One of the groups of five consisted of primary school-aged children, fresh out of class and still in their uniforms. During their exercise, land was consistently ranked as least important, while resources like education and food were generally ranked higher. We inferred that while land ownership and harvesting directly affect adults who farm, children are much more removed from these issues and find day-to-day food and school needs most vital.
On the other end of the age spectrum, there was a group of four women and an eighty-year-old man (see below). After each of the women made their rankings, he would move the cassava up to the first position and push the pills to the end of the line. The women finally became annoyed and, after a good laugh, reasoned that he was preoccupied with food because he was so old and only wanted to enjoy himself before he died. Curious, we then asked him to prioritize based on community instead of personal needs. Just as the women predicted, he then ranked medical access higher than food, recognizing that healthcare was a significant need for the rest of his village. It was a humorous display showing the effect of age on priorities as well as considerations of individual needs versus larger community ones.
The exercise was a great opportunity for us to observe how people view their needs and the relations between various resources. We left with a much better understanding of the ways different development initiatives can indirectly affect each other and the old man got to keep the cassava. Win-win situation.
