Seeking exposure: conversions of scientific knowledge in an African city

Abstract

Transnational medical research has become a common feature in many parts of Africa. This paper explores the contribution such activity makes to the social and economic lives of those involved, including both trial subjects and local staff. By considering the value of the ‘exposure’ that involvement brings to staff and research participants, we reflect on the conversion of scientific knowledge into practical knowledge and its value to sustaining precarious livelihoods in an economically fragile city. We consider the interplay between science and sociality and argue for a need to take seriously the circulation of scientific knowledge beyond the confines of expert spaces.

Understanding men, mood, and avoidable deaths from AIDS in Western Kenya

“…Estimates of HIV prevalence ranged from 15% overall to 40% among men aged 30-34 years in one rural location in the province (Amornkul et al 2009). Ethnographic fieldwork involved observation, conversations, individual and group interviews, first focused on the networks emanating from a HIV transnational medical research clinic in Kisumu (2008Kisumu ( -2010 (Aellah and Geissler 2016) and then continuing through doctoral research in Akinda 2 (2010-12), one of the rural field-sites for the transnational medical research organisation which hosted the study. In Akinda, I lived with a host family, following everyday experiences including joining youth and selfhelp groups.…”

“…During my fieldwork, most men in both the city and surrounding rural areas, were not able to access formal employment, following a period of economic and infrastructural decline in the 1980s/1990s. Now, the major sources of employment were offered by the HIV economy: NGO and research activity which limited opportunity to the few (Aellah and Geissler 2016). The rest relied on informal entrepreneurial hustling activities like Atomic's semi-legal telecommunications activities in the city, or combining subsistence farming and fishing with 'squad' motorcycle taxi services (occasional hire of motorbikes from owner-friends for single fares) in rural areas where opportunities for hustling were reduced (Aellah and Geissler 2016).…”

Supporting the role of community members employed as research staff: Perspectives of community researchers working in addiction research

“…CRs bring valuable expertise to the difficult task of identifying and following up with research participants living in precarious or transient circumstances, particularly those who do not access treatment or other services (Griffiths et al, 1993; Madiega et al, 2013). For communities facing discrimination and marginalization, inclusion of CRs as paid research staff can contribute to capacity-building and circulation of scientific knowledge, build collaborations between communities and research organizations, and lead to interventions and policies informed by community expertise (Canadian HIV/AIDS Legal Network, 2005; Aellah & Geissler, 2016; Souleymanov et al, 2016). …”

“…This work required peer researchers to live between two worlds, embracing multiple and fluid identities; some experienced conflicts when their new identity as being ‘in recovery’ and a member of the research team conflicted with their prior identity as an active drug user, but they were required to draw upon that prior identity to achieve success (Broadhead, 1995; Power, 1995; Blanken, 2000). The work of Geissler and Aellah has further explored how research involvement impacts CRs’ identities, as a means to fulfill personal ambitions and associate with scientific gains and knowledge (Geissler, 2011; Aellah & Geissler, 2016). …”

“…In communities impacted by social and health disparities, participants may view study resources as a means for improving their lives (Fisher, 2009; Aellah & Geissler, 2016) and CRs as gatekeepers to medications, therapeutic interventions, and other scarce resources. In these contexts, CRs who serve ‘dual roles’—that is, conduct research activities but also provide material goods as part of an intervention—face additional challenges to ensuring voluntariness of research participation and balancing power relationships between themselves and research participants (True et al, 2011).…”