Since the pandemic began, I cut back from a lot of things and people. Cut back from conversations that were unproductive, people too. I focused on things that elevated and forced me to keep anything. Last year, I took it to another level. Death has a way of helping you find your purpose and mine was solidified once cervical cancer came to my home. I share this to say I am not a cancer researcher. I can never pretend to be one. But I value what those that call themselves one do.

I am an implementation science researcher and nothing excites me more that trying to figure out how to make research last. I could speak for hours on this. In the next couple of months and weeks, I will embark on writing the grant of my youth. If you see my failure resume, you will see that it is full of failed grants focused on sustainability. I was ahead of the game then, back in 2015, doing what key leaders said to do with naming and framing my grants as sustainability-related from the beginning.

They all failed, with the exception of my R03 grant on sustainability and I sort of moved on to do what reviewers felt were not so ambitious. Why does all this matter today. Well, my journey seems to be coming full circle and I am back to where I started, with me proposing to sustain our ongoing work in Nigeria. I except this one will be tough. I also expect reviewers may not get it or may frame it still as ambitious. But I will dream. This one will truly be the one to really show the why and how sustainability matters. I am writing this here to mentally prepare for what is ahead, knowing that the journey ahead will be raw, also rough. But I look forward to the journey knowing the following too:

Who will believe that grey skies will not be grey forever.

Or daring daunting dreams of our future will not be dreams forever.

Who will believe that some berries may shine in the morning rain and some may not.

Some gifts are profound. So their grace is the Lord.

Other gifts are a release. Freedom, liberating.

The point is to know the difference.

These days and for this next grant I embark on, win or lose, I do. Sustainability will not be vexing soon, not when I lead the way.

If I can stand and smile next to the king of the jungle, may I figure this thing called sustainability then. Leaving this here as inspiration. Watch me roar with this thing called sustainability.

Fela’s anthem ‘water no get enemy,’ has always been a favorite song for me. If you want to wash, you will use water. If you want to cook, you’ll use water too. If your head is hot, water will help you cool it down. And if you want your child to grow, use water. Such a simple description of water’s many uses just resonates with what I love to do with Iife and work. Maybe it’s because swimming camp is on overdrive with the kids, but as you can see, if you want to cool down with this hot summer, you too will use water. Water has no enemy. Nothing also without water. It’s such as essential part of life that should inform all we do to last especially with our public health. interventions. I get tired of people who claim they are looking at sustainability, but their track record says otherwise. Almost few and I mean few interventions are sustained. And I’m taking about all the so-called clinical trials too perpetuating as implementation trials when in reality they are all just recycling the same research and calling it implementation science. My keep for them and others today, ‘be like water.’

Even my son knows to cool down from the sun with water. It truly has no enemy.

Truth is sustainability is hard. The fact there we have very few reliable blueprint for it, also makes this difficult. But what if we approach it like Fela and choose from the beginning to befriend our ideas, diverse ones especially, focused on lasting. Sustaining anything, especially the work we do will require divergent thinking, including from those unafraid to be bold.

I am prepared for it. I long to work with teams dedicated to becoming innovative too with sustainability. In fact, I once used Fela’s song to describe my passion for sustainability. I argued that if you want to last, be like water. If you want to remain in a community, become water too. You won’t have an enemy. To last, no matter who or what you are, is welcomed by all. I want to imagine that we can last when we begin with the end in mind. If we do so, we just might be like water, with no enemies. The opposite needs no discussion.

We were surrounded by trees yesterday at Forest Park. Cherry blossoms trees as majestic as can be. Cherry blossoms signal the return of Spring. Like raindrops on a sunny day, they bring awe, and continuity for life’s many mysteries. They also bring joy. The mere sighting of a tree full of cherry blossoms evokes feelings of silence. Not because words fail me, but because they won’t do. The beauty of a cherry blossom tree is endless so silence is not needless. To see these trees blossom at once is to know the hidden message of trees. Life can be full of joy, full of silence, full of ease, if only we appease our deeper desire for continuity. For as sure as there will be another Spring weather, season after season, there will be cherry blossom trees too, season after season. This certainty, continuity as a certain thing, is why we should keep cherry blossoms in mind. For if we want our research to last, if we want there to be findings, season after season, for as long as the public health issues remain, then we must first begin like cherry blossoms. Keep continuity (i.e sustainability for those of us in implementation science) like cherry blossoms in mind.

One of my favorite aspects of the novel Anthills of the Savannah’s by Chinua Achebe is the focus on the power of the story and the storyteller. In it Achebe reminds us of ‘stories being our escorts, and our guides’ through life. Some people, the novel notes, have been given the gift of leadership, summoning their fellow citizens to rise to the sounding and timing of battles. Others have been given the gift of fighting, the gift of putting on war-time garbs and going to engage in the battle. But still others have been given the gift of waiting for the battle to end. Waiting to take over to tell the story of the battle. Achebe shared that the sounding of the battle is important, the fierce waging of the war too. But of all this, it’s the telling of the story that is most critical. The story as Achebe pointed out, ‘boldly takes the eagle feather.’ Stories are indeed connected to all aspects of our lives. Our being and becoming, our penetration and preservation, even our silence and survival or ability to enlighten and empower depend on the stories we tell. It is only the story that continues noted Achebe, beyond the war and the warrior. It’s is the ‘story that also saves us, so much so that without it, we are blind.’ Sustainability or the ‘continued use of program components and activities for the continued achievement of desirable program and population outcomes,’ are like stories.

Sustainability is connected to all the life cycles of research from initial conceptualization to implementation. Sustainability draws attention to the struggles, the values, even the quest for efficacy or effectiveness that binds a research team and how all these intersect to enable their intervention to ultimately remain. It is also where the collective memory of an intervention resides. Not the memories as with steps delineated in a protocol, but in the minds of all people influenced by the intervention. It informs the process through which an intervention defines itself from its beginning to the end. It raises awareness and builds consciousness of key values or adaptations that can take evidence-based interventions forward. It highlights the role of key people and resources necessary for any attempt to sustain an intervention, capturing key processes and outcomes that future researchers and implementers can rely on. Finally, sustainability helps implementer to re-imagine and reframe their own stories on what it means to last. It’s their for the telling and they have the capacity and ability to affect and inform the outcome, if only they know their power.

Of course sustainability cannot be separated from the social, ecological, historical or political forces in which evidence-based interventions are implemented. In a seminal review by Pan-African Studies Professor, Tavengwa Gwekwerere on the Anthills of the Savanah, like stories, sustainability ‘binds the past, the present and the future together, making inroads into the past to inspire the present, narrating the realities of the present to imagine the future, all while preparing the future for potential struggles and aspirations with attempts to last.’ Sustainability’s connections to the past, present and future, prepares researchers and implementers to make sense of ‘where they have been, where they are, and where they must go.’ It’s for this reason that having a plan becomes critical. By plan, I mean working with the right people to learn how to adapt and nurture aspects of an evidence-based research so that it lasts. It’s no surprise then that sustainability remains a threat to all statue quo form of research, so much so that those who seek to make this a career are actually called ambitious. But why even bother implementing any research if it never lasts? Keep sustainably in mind and have a plan while you are at it. That and keep remaining ambitious. Sustainability requires, no demands that you remain ambitious. So keep it as well.

I gave a talk this week, my first for the year to a small group of Masters in Public Health students. It was on sustainability and why we need more public health interventions that last. I started by asking them to suspend all they know about the topic and go with me on a journey to Sesame Street. Yea, I took them there and let’s just say it was one of the best lectures I have ever given in a while. It came from my soul and helped me articulate for the first time to a public audience what I mean by the how to do it literature on sustainability. Of course the ideas are still evolving and in due time I will share, but if you can, keep Sesame Street in mind. They have a lot to teach on how to make programs last.

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.