"If you can't laugh, you'll discover nothing"

05/Dec/2016

Marcel Tanner has more than 35 years of experience in research collaborations with countries in the Global South. He is in no doubt that flexibility, mutual respect and contextual knowledge are essential to his work. By Marcel Hänggi

(From "Horizons" no. 111 December 2016)​​​

​Marcel Tanner's pencil-holder is a component from the gearbox of a Land Rover – it's a memento of the biggest-ever repair job he had to undertake during his field trips. It was in Tanzania in April 1982, he recalls. He retired at the beginning of this year – in theory, at least. He has moved from the Director's office in the Swiss Tropical and Public Health Institute in Basel into a smaller office. Art objects testify to his working visits to Africa, Asia and Latin America. But Tanner isn't content with just babysitting grandchildren. He's got too much still to do. And he doesn't wait for our prepared questions to start talking about his research collaborations.

MARCEL TANNER: The founder of our Institute, Rudolf Geigy, began working in Tanzania in 1944. He was busy with ethnological topics, not medicine. But when you see how people live, you soon enough come up against the topic of health. Our approach has always been that we wouldn't fly in with a research question ready to be answered. Instead, we develop our research questions together with the people on the spot. You need good local knowledge for that. 'No roots, no fruit'.

Didn't you have your research questions finalised when you first went to Africa in 1979?

That was a formative experience. We were in Cameroon, looking for a new diagnostic tool for river blindness, which is a parasitic worm disease. We went into the villages where affected people lived, and treated them. Then we realised that these people had very different problems and concerns besides these worms, and that it wasn't meaningful to deal with just one disease in isolation. After this experience I switched from immunology, which acquires its material in Africa, to epidemiology and public health, which is concerned with system contexts and investigates fundamental principles and solutions through partnerships. It's about engaging in mutual learning to promote change.

Are many researchers open to changing their research questions?

Whenever possible, I send my postgraduate and doctoral students into the field. It doesn't have to be Africa. If there are parasites in the tap water in the Lützeltal here in the canton of Basel, you still have to work together with all those who are affected. If you send people out and have them work in the field, they will be able to adjust their research questions accordingly. But that's not always easy when it comes to those giving the money. The people who provide funds usually never get their hands dirty, so they don't really understand the context.

But Africa isn't the Lützeltal!

Intercultural collaboration occurs whenever you work together. You don't need any seminars on interculturalism or any touchy-feely workshops. They just kill off all pleasure in your work. And the pleasure of it is what really counts. If you want to do research, you have to be curious. You have to enjoy sharing your findings with others, and you have to want to achieve something. If you're in a region with a million inhabitants and you manage to lower child mortality by a third, then you know you've achieved something. If you take no joy in things, if you only see the problems and can't laugh, then you'll not discover anything. And the joy of it is also what helps you when things don't go well and you spend a whole day running round to find diesel for the generator in your lab, for example. You learn a lot in such situations.

But learning to find diesel out in the bush isn't going to help you here in Switzerland.

Oh but it does, because you've learnt to help yourself and to deal with operational crises. Today, a lot of Swiss people want to clarify all possible eventualities before they travel to Africa. They even want to know who will provide nappies for their kids – instead of just going there and organising things themselves on the spot.

That all sounds well and good. But there are also cultural difficulties.

How right you are – small ones and big ones! African culture functions by word of mouth, and they don't always answer straightaway. It's annoying if I don't get an answer to my e-mails and I can't communicate properly. Sometimes you flounder because of the political realities. In Chad, we had a comprehensive programme with the nomads. We were well on the way to setting up an institutional structure. We expected the government to participate, also in financial terms. But then nothing came. Despite eight years of planning with everyone involved, the programme failed to produce results – at least to the extent that had been intended.

Are there enough well-educated people in poor countries?

Education is the biggest problem. We often have students from poor countries who are good in their own subject, but they don't possess any broad knowledge. You can put this right, but their doctorate will take longer, and the donors have to be prepared to pay the extra. But it's worth it. Training people well is the biggest impact that you can make – far more important than any journal citation reports or any H index, which are purely for self-glorification purposes.

Science, its methods and cultural codes, emerged in our cultural area. So isn't any scientific collaboration asymmetrical from the outset?

Sure. But it depends how you deal with this. Our holy scientific standards are not beyond all doubt either. Just think of the problems we have with peer reviews and our useless publication impact factors... But if you listen to each other, then common codes can emerge. In certain circumstances that can take several generations, which is why a long-term commitment is so important. And it needs respect. If there is no respect, there is no trust. The worst people are the Western consultants who have no local knowledge but always assume they already know everything.

Why does Switzerland need a Tropical Institute?

Can't the people affected help themselves? You have to forget the word 'help' straight off. When the official Federal Message on Education, Research and Innovation for 2008-2011 first included research collaboration with developing countries, the critics said: You shouldn't finance development aid through the research budget. But that's not what it's about. If you see that a country has a health budget of CHF 15 per person per year, then you can learn something valuable about our own health system that spends CHF 7,000 per head. It's not about providing 'help', it's about learning together by comparing and sharing.

Is your message getting through?

Yes. For example, I recently accompanied a group of members of parliament to Tanzania, from political parties ranging from the Greens to the Conservative Democratic Party (BDP). We visited the projects themselves, we weren't just in high-level meetings. Even the sceptics were convinced by the purpose of our work and by the value of our partnership approach.

Marcel Hänggi is a freelance science journalist in Zurich.

A charismatic scientist

Marcel Tanner, a professor for epidemiology and medical parasitology at the University of Basel, was the Director of the Swiss Tropical and Public Health Institute (Swiss TPH) in Basel from 1997 to 2015. From 1981 to 1984 he ran the outside facility of the Swiss TPH in Ifakara in Tanzania (today the Ifakara Health Institute). He has been awarded honorary doctorates by the University of Neuchâtel and the University of Brisbane. Since 2016 he has presided over the Swiss Academy of Sciences.