Lesotho is a small developing country contained within South Africa. You and your team of academic researchers (10 in all) are spending the next two weeks travelling to different communities throughout Lesotho to test water sources for disease-causing pathogens. The testing you need to do is simple but requires significant assistance from the community – showing your team all the different locations where individuals get their water from, and places/methods for storing the water. You do not see the need to pay the community members, considering if someone asked you about your water source, you would not mind driving them up to the lake! The ultimate goal of the project is to understand the life cycle and characteristics of a specific pathogen, which is found only in this region of Lesotho. Several publications are expected from this research study. A comprehensive profile of this pathogen can help in many ways including development of chemical additives to make the water safe to drink. Is it ethical to conduct this research study? What will you do next? 

Step 1: Determine the facts in the situation and clearly state the ethical issue.

• The research team (10 people, including you) is going to Lesotho for two weeks to conduct research on the pathogen in their water source
• The goal of the research is to investigate the life cycle and chemical/biological features of disease-causing pathogen
• There are no stated benefits to the locals in their research proposal
• The results from this research could be used to develop chemical additives to make the water safe to drink.
• There is limited knowledge on the culture in Lesotho and what the indigenous knowledge is relative to the water
• The researchers will release publications on their findings of the pathogen
• The researchers will need the help of the local people to locate where the people obtain and store their water.
• Assume we have all necessary approvals needed for research
• The researchers are unaware of other researchers already working on a similar study
• Ethical issue: As of right now, the locals are not benefiting from the research in any way, and the academic researchers have no intentions to pay the community members.

Step 2 & 3: Define the Stakeholders and assess their motivations 

• Academic researchers:
  • Test the water in Lesotho for disease-causing pathogens
  • Understand the life cycle and characteristics of the pathogen
  • Write several publications from the research study and further your professional career
  • Possibly develop chemical additives to make the water safe to drink
  • Patent discover to possibly profit from findings 
  • Driven by social impact or fame in helping the local community
• Locals 
  • Provide location of water sources 
  • By providing access to the water sources, they contribute to the development of chemical additives in hopes of getting access to them for safe consumption of water
  • Vulnerability that stems from working with them may motivate them to stretch the truth and tell you what you want to hear, not what you need to hear.
• Your research university/institution:
  • The findings could add to their reputation, making them highly regarded
  • Disseminate the research found to make findings available for companies, open source research journals, and local community leaders
  • Strengthen new/existing partnership with other funding agencies
  • Open rooms for future collaborations within the area/country (e.g., new ventures)
  • Create opportunities for students to gain experience on social impact projects (and make impact) 
• Sponsors of the research:
  • Want to gain the benefit of discovering a new pathogen
  • Gain the opportunity to develop chemical additives against any harmful chemicals that are found in the water
  • Can potentially earn monetary benefit from the chemical additives that will be developed
  • Gain a better reputation and have their name attached in the breakthrough of helping treat water issues in another country
  • Publicity that will potentially aid in gaining funding for other projects or investigations
• Local government: 
  • Make sure the research team is not exploitative and does not cause any harm (mentally or physically) to its own citizens (for example, poison the water sources, etc)
  • Validates whether or not the water source in the area is safe to drink for the community
  • Ensure that the citizens have accessibility to the research
  • Ensure the area have some sort of benefit to the chemical additives that is developed if pathogens are found in the water
  • Building/expanding relationships with other funding agencies/countries 

Step 4: Formulate three alternative solutions 

Step 4:

1. Provide education from our team and any trusted local leaders and/or researchers to make sure locals are aware of the dangers. 

• Ethical Principle or code: Informed consent. This helps establish a relationship with the community and provides the awareness necessary for us to work respectfully. 
• Pros: 
  1. It would allow locals to make an informed decision
  2. We would be ethically correct
  3. It could save us from lawsuits in case something went wrong. 
  4. Locals are more likely to listen to a trusted local than outsiders

• Cons
  • Locals might decide to not participate in the case study.
  • Locals might change their behavior.
  • Worst case scenario: locals might not want the research done in their community.

2) Ask the government to assign some local leaders and supervisors to assist the research team to find the locations of the disease-causing pathogenic water 

• Pros:
  • Local leaders might also help facilitate the communication between the researchers and the locals 
  • Local government permission makes the research less intrusive 
  • Locals may trust us more if their government is helping us
  • Researchers will obtain guides or a map of the locations of the water source and storage location
  • Research team is still able to effectively conduct research
• Cons:
  • Might be more work to set up beforehand
  • Might cost a lot of money to train locals to properly extract the water sample (assuming locals do not have the education to do so)
  • Local government may not welcome the research team to conduct investigation on their water
• Ethical Principle: 
  • Respect for others: we would be communicating with local leaders to get their insight and expertise on the community, respecting them and their culture.

 3) Recruit and train locals to do help with research

• Ethical Principle or code: Invading communities that do not want outsiders
• Pros:
  • Locals are more likely to trust locals
  • Researchers wouldn’t be contaminating the environment
  • It would allow researchers to see if locals already have methods to clean the water.
  • Helps validate our intentions 
• Cons:
  • It would take longer to train the locals
  • Unsure if researchers can trust the locals to do the work correctly
  • Researchers would have less control over the case study

 

Step 5: Seek additional assistance, as appropriate

• As a researcher, we have our own agenda, but if we are planning to release several publications, a true protective researcher will look for a more in-depth connection with the community and its people. For research to be successful, it needs to be supported by different parties, and in this case with the people that actually know where the water sources are. In addition, for the research to become successful in the long-term, we must establish some type of connection with them so the communities will become more open to other related research or partnerships like these in the future. They are crucial in communicating our findings, intentions, and recommendations on reducing exposure to the pathogen. Chemical additives are an innovation that we can only speculate about developing, however we can create a mutually beneficial relationship if we work with local leaders and relevant stakeholders such as water agencies. This can be formed by building a relationship with village elders / local community leaders / past Lesotho researchers so that we have the trust of respected people to ease our transition into Lesotho.

 

Step 6: Select the best course of action

• Because Lesotho is a small developing country, their people and communities may not understand how pathogens/diseases work or even not believe they exist. Therefore, educating the people is critical, because allowing them to know what is going to happen may allow them to be more accepting of research, and if they could benefit from the research, in this case, better quality of water and sanitation. In addition, it is important to involve any current leaders and/or researchers who have the trust of their communities, likely have indigenous knowledge, or can help facilitate our experience working with the community. For example, if there are any local water agencies, we can collaborate and exchange information on our work and intentions. They can 

 

Step 7:

• Economic: 
  • Although constantly testing the water may become expensive, possibly installing a pH, bacteria reader or some type of low cost purification method that consistently runs, could help cut down the costs for testing multiple times. 
  • In Lesotho, the research findings may lead to clean water which means less deaths caused by water, which in turn leads to more people alive to give work and contribute to the economy 
  • If increasing tourism is something the local government chooses to pursue, they can learn how to communicate dangers of this pathogen as well as the work that is being the traffic of new people coming in would increase the country’s economy since they would be spending money in country 
• Social: 
  • The community would have common ethical requirements that does not involve someone getting hurt from participating in the research and having the choice to understand what the research is about
  • Lesotho’s government and locals will have a mutually beneficial relationship with the researchers, research institution, and sponsors; trust between them will be created, possibly leading to future endeavors together
  • People of Lesotho who are curious about the research will have access to the findings, and can conduct research of their own using ours as a starting point. This could also spark intellectual curiosity in the locals, maybe causing them to pursue more education or working to change the way they source their water.. 
• Environmental: 
  • Testing which water sources are much more cleaner, can prevent the possible spread of diseases. If certain water sources are identified as contaminated, we can learn how this can be communicated to the community to inform them of our findings and recommendations until chemical additives are developed. Certain regions have a specific area where they mainly get their water from, so it may be likely that their food that they eat (crop) and their livestock would be using the same water source. 
• Technology: 
  • Irrigation systems can be constructed for locals to source their water from uncontaminated sources; one example of this are ram pumps that use the air pressure and water flow from river streams to pump water. This eliminates the need for power and could help substitute where people source their water until chemical additives are developed. Building irrigation systems could also benefit from low cost filtration.