I didn’t think I would cry. But seeing this day come to pass brought tears to my eyes. Finally, we honored the legacy of Dr. Jacob Plange-Rhule with the first ever prize for his contribution to the Global Research in Implementation and Translation Science Consortium. Jacob had this vision to train the next generation of scholars interested in health services research, hypertension research, especially at the community level. He was one of the pioneers of the community based salt reduction interventions for blood pressure control in Africa. He led the first studies in this field. He also led the task-shifting strategies for hypertension control in Ghana. To know him was to know a very gentle man, a very kind man, with a great personality, and a great love for all things Ghana. To think that we will never see his smile, never hear his voice, remains painful to him. But know that he will live on with this prize, fills my heart with great joy. Until we meet again, continue to Rest in the Bosom of the Lord.

This week is salt awareness week. It’s one of my personal weakness. It’s also a silent killer. Last year I worked with a group of fabulous researchers led by Dr. Oyebode to make sense of the impact of salt in Africa, Nigeria in particular. The love for salt in the region is a silent epidemic. Not only do most people add salt to their meal preparations, myself included, we also add bouillon cubes known as Maggi. In fact, I am certain that most Nigerian households would agree that a food isn’t delicious until you add more than one of these cubes to your meal preparation. I have tried to prepare meals myself with and without them. My family knew the difference.

Image from Tahir. Maggi Bouillon cubes.

One study in Sierra Leone, led by one of Dr. Oyebode’s students Tahir Bockarie noted that 91% added salt in cooking, another 40% added salt at the table, while 30% ate salty snacks. Our own pilot study highlights the same with most Nigerian men for example consuming 3.31grams of sodium per day. But how do we begin to curb this love for salt including our obsessions with cooking with these bouillon cubes. Enter hypertension. One in three Nigerian adults is hypertensive. While the World Health Organization recommends a daily sodium intake of 2 grams, Nigerians consume up to 5 times this amount at 10 grams. I had this grand idea with Dr. Oyebode that a community-driven intervention led by and for communities themselves may make a difference. We haven’t tested it out yet but we are hopeful. Hopeful that when like minds come together, we can curb our love for salt. Hopeful that when we create a sustainable platform for research with communities themselves leading the way, even our love for bouillon cubes such as Maggi can be reduced. Hopefully that with insights from the community, not only would we achieve a salt-free lifestyle, but a no high blood pressure lifestyle too. We have miles to go to test our ideas out but with Dr. Oyebode as my partner, we are well positioned to work to reduce excess salt intake globally and through a sustainable program of research. Until then and for this salt awareness week, keep eating less salt. It can literally save your life.

I have been thinking lately about good questions. What are they and why do we need to nurture and teach good questioning skills? By day, I am a global health researcher passionate and committed to asking questions, enduring ones focused on creating sustainable health interventions. I often begin with a grant. For to conduct research in a setting already limited with resources, access to funding is crucial. So to are questions, not just any questions, but good ones that lead to funding.

Good questions have helped to test the limits of my grant writing abilities. They pushed me to try everything, all the way, until I get the outcome I want, including the grants that allow me to address pressing public health issues. And when you find a good question to ask, questions that are enduring, it just so tremendous. And so I do feel a responsibility to ask these good questions. I have always felt and continue to feel that no one is really asking those tough but good questions. I remember after collecting my data for my dissertation on child malaria diagnosis, I told my participants, some mothers of children under 5, that my research has ended. Some asked why? It’s not like their child’s malaria has ended. They were right.

I am aware of the fact that it was rare and still rare to ask good questions overtime. Aware that though some may state they are interested in asking these questions, such as how might they last, they are never really prepared to go the distance. So I assumed two things: 1) good questions focused on lasting, focused on sustaining my global health work matters; and 2) if I ask these good questions, if I continue to hone in on what they entail, planning for it from the beginning, with the right people, learning what it takes, adapting where necessary but nurturing the questions overtime, then it will become universal. Good questions focused on lasting will become the norm.

I am hoping to train the next generation of scholars committed from the beginning to plan to ask good questions. My goal is to help them become prepared to roar if they choose to, with asking more enduring lasting questions. I call this PLAN or how people learn to adapt or nurture whatever good questions they may have. I finally wrote a research paper on it that I intend to submit this year. My goal with the paper is to a start the dialogue necessary to train a generation of scholars committed to making the necessary plan to become enduring questionologists.

The choice in the end is always up to us. We may choose to ask the typical questions that allow us to get by for the next 1-5 years, or we may go the distance and plan to become comfortable even with questioning the questions asked. When your goal is to remain, when your mission is to last, then asking all sorts of good questions becomes a necessity. We all have the power to think long and deep about how our questions can and should be good. We should all be willing to explore limits of the questions we ask for as long as the issues remain. For to be good, to hone in and polish the questions, to a gleaming finish is illuminating, exceptionally powerful to me. Keep asking good questions. Plan for them too as the world desperately needs them.