I’m Just a Gear: Reflections on a Research Strategy

    Over the first few weeks of research, I quickly learn that heat protection, refugees, and Munich are three keywords that seem to overlap as much as my language skills and German. It’s like one of those three-circled Venn diagrams, except the space in the middle where all three magically come together is blank and sad. Materials on heat protection and refugees exist, but they usually focus on much hotter regions such as refugee camps in Syria. Materials on heat protection and Munich exist—the municipality is very keen on making this information available to the public; whole databases on climate change, heatwaves, and heat protection are publicly available. And finally, data on Munich and refugees exist, consisting of reports that detail their overall numbers, accommodation choices, home countries—even down to gender breakdown. But try to put all three together? Good luck.

    This gap is precisely what our research aims to reduce, but I wanted to first understand the implications of reducing such a gap. At my first research meeting with MSCL, we defined our goals for this project. Aside from being especially useful when people stare at me blankly and ask, “What is heat protection,” they have been helpful for me when thinking about how to approach my time at MSCL. One such goal is to come out of our time here knowing how a generic heat protection workshop could be adapted to the refugee community. Essentially, we hope to produce something like a manual saying, “Change X, add Y, and keep Z in mind with this demographic.”

    To me, this inherently singles out the refugee community as a distinct group, one which exists apart from other Munich neighborhoods and one which is vulnerable enough to necessitate isolated treatment. As I reflect, sometimes this action gives me pause. At least in the context of heat protection, there seems to be very little precedent for it in Germany. German heat protection resources that target demographics defined as “vulnerable” very rarely mention the terms “refugee” or “migrant.” Perhaps part of why this is is because “refugee” is a social and political designation, not a medical one. It pertains more to the legal status of a person rather than to their health history, which could make it hard to formulate specific health advice. Not only that, but it is a blanket term that spans a wide array of backgrounds, cultures, and narratives, meaning drawing a broad health assumption around this entire demographic might risk homogenizing them.

    Furthermore, the biggest risk factor to me is further alienating a demographic that is already alienated by virtue of their migration status. Many refugees already live in separate housing from the rest of Munich, making them physically unintegrated with the rest of the city. During the initial months of their stay, many of their living costs are paid with vouchers or government-issued money, and they have less access to jobs due to language shortcomings. In many ways, “refugee” is a designation that otherizes and stigmatizes. To me, I could see how tailoring heat interventions to this demographic might play into existing structures of alienation.

    But the flip side is also very convincing. Even at the risk of making generalizations and drawing distinctions, shouldn’t health interventions take into account the social context of a demographic, since that context matters very strongly in the determination of health outcomes? Every refugee’s experience does not have to be exactly the same, indeed they very rarely are, in order for patterns in health outcomes to be drawn. Around 80% of the refugee population in Munich are spread out over eight different countries, a rather diverse mix,1 but we know that in general, this population has very little control over their housing,2 undergo the same asylum application processes, and most face a language barrier that impacts job opportunity and social health. These structural forces give rise to similar risk factors, and it’s not unfounded to suggest that these shared characteristics contribute to a relative lack of readiness when it comes to heat protection. A municipal pamphlet on heat protection emphasizes that socioeconomic elements such as poverty, lack of access to healthcare, and insufficient accommodations increase the likelihood that someone will be less prepared against heat waves.3 If more often than not refugees check most of these boxes, might it be helpful to define them as a vulnerable demographic even if it means making “refugee” a unique category?

    A few weeks ago, I have this conversation with Dr. Goodwin, city council member Barbara Likus, and my program colleague Eva McDonnell, trying to decide if singling out refugees as a vulnerable group for heat protection would be constructive. Dr. Goodwin offered a comparison that helped tip the scales for me in favor of this argument: Many vulnerable groups exist when it comes to heat protection, such as the elderly or people with chronic illnesses. However, not every elderly person or person with chronic illness has to be more at risk of heat-related stress than the general population for this to be a helpful designation. If an elderly person lives in a more rural area that averages 80 degree summers, they might experience less heat-related health consequences than a city dweller, where the average summer temperature is above 100 degrees. In the same vein, if a person with diabetes has dependable housing with effective cooling mechanisms, they may be less susceptible to overheating than someone with no history of chronic illness living on the top of a stuffy, non-air conditioned building, even though diabetes can hinder the body’s natural cooling capabilities.4 In this way, someone’s vulnerability to heat is of course in each case distinct and unique, but nevertheless, healthcare providers still find it insightful to categorize demographics into different vulnerable groups as a helpful indicator or predictor of heat-related risk.

    Ultimately, this was my conclusion: making the claim that refugees are a unique demographic that can experience heightened risk when it comes to heat protection is both carefully specific and tolerantly general. It is specific in that it acknowledges this group has unique needs that others may not necessarily face, but it is general enough to allow for breathing room to say that each person is different and will experience different levels of risk. In application, this means that when going into a worksop, it is helpful to keep in mind what we might expect to see, and why, but we should never initially assume these variables to be true.

    Reflecting on all the pre-workshop research we have done over this past month, I realize that filling in the gap, making the aforementioned three-circle Venn diagram light up and be happy, requires some level of boundary drawing. This is true simply by virtue of when you bring something into existence, you must turn a blank, amorphous void into tangible information with a shape. If we try to connect Munich, refugees, and heat protection, then patterns naturally crop up. And if we try to tailor heat protection communication to this demographic, as we know that is helpful given the social risk factors they generally experience, then we must inform this tailoring with the patterns that emerge.

    And yet, the ability to retain individuality within a generalization gives me hope that it is not the categorization itself that is inherently destructive, but rather an over-reliance on the generalization that leads to stereotyping and alienation. A single approach is rarely 100% Right (with a capital R). To tap into my inner bike fanatic, it is like adding one more gear to a bike that can only run well by using all its different gears. The paradoxical thing about research, however, is that it necessitates we only investigate one approach at a time, and more than that, it encourages us to investigate each approach all the way to the end. So in any given moment, we must concentrate solely on the building of one gear, making it the best possible gear for its model. We smooth down the sharp edges and shine the rough patches. We oil it to make sure it runs smooth. And finally, when it’s all perfect and ready, we must add it to the collection of other gears that were built with just as much care, with the recognition that though it will not always be used, it will kick into action when it’s most needed.

Footnotes

1. “Daten zu in München untergebrachten Geflüchteten.” Muenchen Stadt, stadt.muenchen.de/dam/jcr:e355f5d5-8d04-4006-bbae-5314ace441ec/31.pdf. Accessed 5 Aug. 2024.

2. Fachinger, Teresa et al. “Types of Accommodation - Asylum Information Database: European Council on Refugees and Exiles.” Asylum Information Database | European Council on Refugees and Exiles, 6 June 2024, asylumineurope.org/reports/country/germany/reception-conditions/housing/types-accommodation/.

3. World Health Organization Regional Office of Europe. Gesundheitshinweise, 2021, iris.who.int/bitstream/handle/10665/341625/WHO-EURO-2021-2510-42266-58732-ger.pdf.

4. “Managing Diabetes in the Heat.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 15 May 2024, www.cdc.gov/diabetes/articles/managing-diabetes-in-the-heat.html#:~:text=Heat.