Celebrating 10 years of Community Engagement Practice

October 2007 will remain a memorable day in my life, it’s a month I joined Malawi Liverpool Wellcome Trust, initially I didn’t have a clear idea about the organization, my eyes centered on earning a living, nothing much.  I was recruited as a Fieldworker (Fw) for a malaria randomized, placebo-controlled, multi-center trial in four hospitals in Malawi testing the efficacy and safety of intermittent preventive therapy post-discharge (IPTpd) (https://www.ncbi.nlm.nih.gov/pubmed/22172305). Being part of a new team operating at Zomba Central hospital, my role as a Fw was to conduct household follow ups, tracing defaulters, consenting, conducting sensitization meetings and collection stool samples from participants in households. Research was a new field to me and I had a lot to learn, especially adhering to ethical standards. Just like other Fw in Malawi, I had partial training about medical research, I had to spend more time studying about research and more importantly learning from colleagues.

Years passed, little by little I developed passion for  my work,  my interest was flamed  as I interacted with study participants inside and outside wards, my team was also a source of inspiration. Some of the team members were Bridget Mangochi (research Nurse), Dzinenani Truwa (Site In charge) and Misho Chibwe (Data Officer), Dr. Kamija Phiri (Study PI). Each one of them had a character that really mattered and contributed to my foundation to be established in Community Engagement. Dr. Kamija sponsored my studies at Kenya Institute of Social Work and Community Development through distance learning and I managed to study Community Development and Community Health.

I formally joined MLW Science Communication Department in October 2011, by this time I had worked in 2 more studies (ADAPT-  http://www.mlw.mw/index.php/malaria-theme-profiles/321-adapt-2-research-profile.html ) and Iron study done by Dr. Michael Essian. 

The department usually called Science Com had one officer Tamara Chipasula (http://www.mlw.medcol.mw/index.php/grants-management.html), her orientation in the made me to pursue community engagement as a career all the more,  October 2017 marks 10 years of my involvement in health research as a community Engagement practitioner. I would like briefly share most important reflections while interacting with communities.

I have learnt many lessons while working in health research, I would like to share some of these lessons. Bear in mind that these are my own observations, so independent from my institution am currently working

Understanding of health research – Community Engagement (CE) is considered as an ongoing process as long as research is conducted, yes this is very true. However we seem to be a long way from achieving our intended CE objectives such as promoting informed participation. There are more factors to this delay, low level of education in areas where research is conducted in low income countries is one of the factors. Health research is science which needs at least a strong foundation to understand its basics, there are other scientific terms which to date have no exact meaning in local languages and this affect a dialogue between researchers and participating communities. Such observations sometimes raise questions, I have been wondering if at all people really participate in our project after they understand, if not then they do for other reasons and thus where some ethical dilemmas arise. We as community engagement practitioners have a lot of work to do to reduce such gaps.  

Researchers’ community perception – often times there’s a gap between researchers and communities, researchers assume people have a low understanding about research, which is not true every time, not all of them don’t understand. In fact there’s more to learn from communities than the messages we take to them. They have their own ways of understanding issues, they have knowledge and experiences to share, and I have noted that sometimes it’s an approach that matters. Researchers and community engagement practioner need learn norms and values of specific communities, later on plan for various activities targeting them, sometimes involving some community members at all levels of the study can help to reduce a wrong perception researchers have.   

Researcher’s priorities– one of the struggles I have always had while working with researchers is for them to engage communities at a right pace with right reasons. I believe in the notions that researchers should consider CE as an obligation not as a tool to achieve recruitment targets only. The visa versa is true for researchers, they consider CE as a tool to boost their recruitment numbers. This is observed in the eyes of researchers when some potential participants say no to participate in studies, very few researchers feel happy and acknowledge that it’s an individual participant’s right to say yes or no. Especially when screening potential participants and most answers are no, researchers think it’s the right time engage areas where potential participants are coming from. Yes its right to engage them however researchers’ motives might be compromised in a way that their main worry is that if participants keep on saying “no” then study given timelines will not match. Perhaps studies should include an extra period of recruitment.

Summary

The past 10 years have been more informing, several lessons have been gained. Am still passionate to share these experiences. Please take note that these are my personal thoughts and experiences n