I took an amazing course on the ethics of global health practice that I have found myself thinking a lot about during my time at Population Council. Several ethical considerations have been needed to be made surrounding one of the AGI-K project implementation sites, Wajir County.
This project site is dramatically different from the other in the urban slums of Kibera in Nairobi. In Wajir County, many adolescent girls have already dropped out of school or have never been taken to school; in part, for some, because of early marriage and childbearing. Baseline results showed that 99% of adolescents had experienced FGM. Much of this is cultural and religious in nature. These cultural and religious factors must be considered throughout the entire project lifespan; you don’t want to let any cultural challenges stop you from implementing your project altogether, but at the same time, as I learned in that ethics course, you have an ethical obligation to consider these factors carefully and respect the cultural norms of the community you are trying to work in.
If it is considered by some to be religiously unacceptable to send the girl child to school, taking them out of their home, how do you work with the community to implement your project which sends the girl child to school? The AGI-K project has done a lot of work in sensitizing the community to the project, getting not only community buy-in, but getting the buy-in from religious leaders and other community gatekeepers. This is an important step in the project lifespan, and one that the project continues to do as it still faces challenges with program acceptance in Wajir. Much of this is a result of misunderstanding and concern over the motives of the project; however, by listening to and involving the community from the get-go, you give them a real voice in how the project is to be implemented. Without this, the project would have little chance of succeeding.
This has been an important lesson and one that I’ll remember in my future work as a global health practitioner. I am so fortunate to have had the chance to see some of those lessons learned in that ethics course be put to use in a real life global health setting.