6

Ana Clemmer
IR 2/10-GT
Period 2
Second Interview

Interviewee: Janet Robinson F.I.B.S.

Director, Laboratory Sciences, Program Sciences and Technical Support
Global Health Population and Nutrition
Interview Conducted on November 30, 2018 at 2:30 pm

AC: Hi, I’m Ana. My father recently spoke to you about my research project.

JJ: Hello Ana, I’m Janet!

AC: I greatly appreciate your time here today! I’d first like to introduce my independent research
class. After that, could you tell me a little bit about your job in general and how you’ve
been involved with antimicrobial resistance?

JJ: That sounds good. When I suggested this time, remember I have another call at 3:00, so if we
don’t get done in time, we can always speak next week.

AC: Thank you so much! I appreciate that. Thank you for being available.

JJ: No worries!

AC: So, the independent research class is a class in which students can pick their own research topic
and then follow the typical research process throughout the school year. I believe that it is in the
third quarter when we collect data. Finally, we disseminate our findings to a target audience. I’m
currently looking at antibiotic resistance as a result of animal waste management systems,
however I’m afraid it might be taken as an attack on the agriculture community, which I am a part
of.

JJ: Okay. So, I started out as a researcher, many decades ago. So you know, I’ve done a lot of
research over my career. More recently within FHI 360, I’ve been leading our diagnostics
division, supporting a lot of human health laboratories and their diagnostic systems. This has led
to the recent work that I’ve been working on and we’ve been able to win some wars surrounding
antimicrobial resistance. We’ve got a large USAID grant now to try and tackle antimicrobial
resistance globally. FHI is responsible for the diagnostic strengthening component of that. I am
leading our work to look at expanding into AMR because WHO has regarded it as the potential
next HIV if the world doesn’t step up and do something about it. So for you, it’s a really hot
topic, and we’re starting to see millions if not billions of dollars being put into it. Most countries
now are trying to take a one health approach, looking at the human and the animal sector, and the
 environment, and how antibiotic use in one area can lead to misuse or disease in another. I can
understand your concern about your potential idea, because people are not going to want to hear
things that are going to harm them. I also think it’s a difficult research topic to do since its
antibiotic resistance in waste, not that it’s come from a specific source, because we know that
there are some antibiotics that are used that can get into the water. You know, rainwater can get
into the soil, and the cows eat it and there’s antibiotics in the waste simply because they
accidentally ingested it since it was in rain water. Or, it could be given as feedstuff or growth
promotion. I think it would be hard to say that since there’s antibiotics in waste it’s because of a
bad practice, and it would be really difficult to prove where it happened. If you’re interested in
agriculture, do you perhaps want to do a survey among farmers, in order to understand how they
use antibiotics in their farms. I mean, do they know whether it’s in the foodstuff that they buy, do
they use it for growth promotion, and so doing a survey around antimicrobial use would generate
information to help others understand what is the pattern of antibiotic use in livestock in this
particular area. So, you’re just documenting what is used and why it’s used. You could document
some perceptions around why they feel it’s necessary, and that can lead to a positive intervention.
In terms of handwashing, there’s been a lot of research done already on handwashing. Johnson
and Johnson have commissioned quite a bit of research on the antibiotics and the AMR in
healthcare settings, and what handwashing practices have led to reduced acquired resistance
infections. So, perhaps that idea is less novel. They might be willing to donate some soap though,
10 minutes washing with this soap vs 10 minutes washing with that soap, and you reduce the
incidence of some of the more resistant infections. One of the greatest concerns at the moment is
a bug called Campylobacter which is causing a lot of ICU critical infections and deaths. One
thing you could think about, if you’ve got access to some lab testing, is going around a hospital
and swabbing different surfaces and finding out what type of bugs are on what type of surfaces.
Which would then lead to interventions to improve cleanliness and less picking up resistant
infections. There’s been some work done in that area, but not a great deal. If you wanted to do
some sort of survey, I think it would be interesting to speak with healthcare workers, both in
hospitals and community care settings, and understand what do they understand about AMR. Do
they know what causes it? Do they know how to prevent it? Do they think it’s a big issue? And
that might again lead to something like only X percent of healthcare workers think that AMR is a
big issue and X percent don’t know how to prevent it. That could lead to a recommendation for a
behavior change intervention, or an education campaign. And you could to the same with
consumers as well, like in a shopping mall.

AC: Or do you think I could do a combination of healthcare workers and the public?

JJ: Yeah, definitely!

AC: Also, I was thinking that in a survey, if healthcare workers don’t mention handwashing as a way
to prevent antibiotic resistance then it tells you that information in almost a better way than
asking questions about antibiotic resistance.
JJ: Yeah, I mean sort of an open ended short survey, where no answer is right or wrong. This could
yield good quality data from which conclusions can be made in terms of the overarching
misperceptions in the healthcare community versus in the public arena. And that would be really
good informations stating you just really need to do a better job of educating you healthcare
workers. Now, as states are taking on the challenge, it would be really important information to
get additional knowledge about attitudes toward AMR. Like, when you go to the doctor, do you
expect to walk out with a prescription? You know, I’d be happy to help you frame a discussion
guide.

AC: Thank you so much! I know you have to go soon, so I just wanted to thank you for being
available!

JJ: Yeah, I’m happy to help. If you need help in the future just contact me. Have a good weekend!

AC: You too, bye!

JJ: Bye!
Reflection:

There are many key things that I will take away from this interview for my research, including the

possibility of a new narrower topic. Janet helped me to think of how to incorporate handwashing into my

research. The interview went very well. I was able to stay focused on what we were talking about, and I

gained another person to help me with my research. She was very excited to offer new ways for me to

gain sources and for me to research. In my next interview, I will try not to plan so rigidly. For each

question, I am going to try to create follow up questions for each question. These follow up questions will

allow me to continue the conversation in either direction it goes. Also, I will determine how exactly to

describe the independent research class to the interviewee, since it seems that is a vital piece of

information for them to understand where I am coming from. Additionally, I am working on my pattern of

speech. I tend to end statements as questions, causing confusion. Also, I say “um” a lot, so I am aiming to

eliminate that. To prepare for this interview, I created a list of questions. However, we were short on time,

so I changed the flow of the interview to be more to the point. This was so that I could gain as much

information as I could in the short amount of time we had. I’ve found more success in interviews when I

do not abide so strictly to the questions. However, I have only done phone interviews so far, so this may

change when I conduct my first in person interview.