Why didn’t you write this in your diary? Or how nurses (mis)used clinic diaries to (re)claim shared reflexive spaces in Senegal

Abstract

Between 2015 and 2017, we implemented the clinic diaries project as part of the qualitative component of an evaluation of a supply chain intervention for family planning in Senegal. This project combined different tools including the diaries and participatory workshops with nurses. At the intersection between writings and silences, this paper explores the role played by the clinic diaries to mediate ethnographic encounters, and the iterative nature of ‘doing fieldwork’ to produce knowledge in hierarchical health systems. This paper also reflects on the processes through which the diaries created a space where accounts of lived experiences routinely unfolding in health facilities could be shared, in the context of a health system increasingly dominated by metrics, performances and vertical reporting mechanisms. The clinic diaries research process therefore sheds light on the limits of approaching bureaucratic norms and practices as coming from the top, an approach reinforced by data reporting and coordination mechanisms in the Senegalese pyramidal health system. In contrast, the diaries suggest a role for participative ethnography to identify collegial spaces to reflect on shared experiences in and of bureaucratic spaces.

Exquisite Corpses and backward glances: European social anthropology 2019

“…Who writes what down, who makes the record and how, are key ethical portals. Shared participation in diaries and mapping chart the limits of the ethnographer’s neutrality, objectivity and responsibility (Duclos et al 2019; Anthia 2019). Malinowski’s principles are also invoked by Bierschenk and de Sardan (2019), who urge awareness and caution in respect of what they call ‘ideological populism’, the ethnographer’s instinctive antihegemonic stance which inclines to deny the bureaucrat the same status and rights as a subject that are granted to so‐called ‘clients’ or what Malinowski might have termed ‘natives’.…”