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Ethical Challenges that Arise at the Community Interface of Health R esearch: Village R eporters’ Experiences in Western K enya
Author(s) -
Chantler Tracey,
Otewa Faith,
Onyango Peter,
Okoth Ben,
Odhiambo Frank,
Parker Michael,
Geissler Paul Wenzel
Publication year - 2013
Publication title -
developing world bioethics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.398
H-Index - 27
eISSN - 1471-8847
pISSN - 1471-8731
DOI - 10.1111/dewb.12023
Subject(s) - intermediary , negotiation , accountability , ethnography , public relations , business , psychology , sociology , marketing , social psychology , political science , law , anthropology
Community E ngagement ( CE ) has been presented by bio‐ethicists and scientists as a straightforward and unequivocal good which can minimize the risks of exploitation and ensure a fair distribution of research benefits in developing countries. By means of ethnographic fieldwork undertaken in K enya between 2007 and 2009 we explored how CE is understood and enacted in paediatric vaccine trials conducted by the K enyan M edical R esearch I nstitute and the US C enters for D isease C ontrol ( KEMRI / CDC ). In this paper we focus on the role of paid volunteers who act as an interface between villagers KEMRI / CDC . Village R eporters’ ( VRs ) position of being both with the community and with KEMRI / CDC is advantageous for the conduct of trials. However it is also problematic in terms of exercising trust, balancing allegiances and representing community views. VRs role is shaped by ambiguities related to their employment status and their dual accountability to researchers and their villages. VRs are understandably careful to stress their commitment to self‐less community service since it augments their respectability at community level and opens up opportunities for financial gain and self‐development. Simultaneously VRs association with KEMRI / CDC and proximity to trial participants requires them to negotiate implicit and explicit expectations for material and medical assistance in a cultural setting in which much importance is placed on sharing and mutuality. To ensure continuity of productive interactions between VRs , and similar community intermediaries, and researchers, open discussion is needed about the problematic aspects of relational ethics, issues concerning undue influence, power relations and negotiating expectations.