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Scientific research and local health services

January 18, 2013 - 04:41 -- Ricardo Ataide

In malaria endemic areas, researchers and basic health workers need to and often do find ways to join forces and complement each others work. Nevertheless, the prevalent idea among a few who are higher up in the health services is that researchers, like myself, are only there for the "kill". Some of the complaints are that we have a limited time-span in the area, we take joy in seeing a patient who provides us with some parasites and we ultimately take without giving in return. I think that these are usually the things we hear most (and mostly through the grapevine...). Like I said, the basic health worker, who is there with us everyday, knows the reality... but as in many other scenarios, those who are below have little access or are rarely heard by those who are on top (and more often than not also have very distinct agendas). So, on behalf of a few of my friends that I know have heard and continue to hear these things, here it goes:

1) We have a limited life-span in the area. It is a fact that, being an outside researcher (and foreign on top of all) more often than not implies that we are working on a limited budget provided by a grant. This entails not having the means to stay in the region forever. I'm sorry... It is what it is and I do not foresee a change. I do, however, encourage the formation of qualified local researchers that can themselves apply to and execute those grants!

2) We love it when a patient gets malaria. Wrong. We do love our work, yes. But all of us who have seen a child in a hospital bed, or worse, subjected to an autopsy due to malaria or seen the suffering and the emotional pain of a would-be mother after losing her baby due to malaria have only one desire: to defeat the parasite. We may choose different weapons (less meetings and discussions over dinner, less commissions and task-forces and think-tanking and paper-signing, and less visits with the senators, ministers and presidents), but we aim to fulfill the same goal. We do need the parasite to know it better. We do need the patient's bio-samples to understand our responses. We do enjoy when we find an odd case. It is intellectually stimulating. But most of all we enjoy the common goal. Fighting malaria.

3) We take without giving. Ahh... my favorite! Where can I start? A research program (a good one, at least) is always a true partner of the local health services. I can say this: how many malaria diagnosis have researchers made, where the health services could not or would not go? How many local services have received some much needed drugs or medical supplies only because research programs have provided for them(sometimes bending the rules of the grant funding scheme they are under to be able to do so)? How many local students and health workers have gained valuable experience working with research groups on local projects and then went on to continue applying that knowledge and making a career out of it? Are lives saved and improved not proof we are "giving enough"? How about helping to build and set-up a research lab in the local University so that every student of the university and every teacher that wishes to do so can experience what working in a molecular biology lab actually is? How about leaving your loved ones behind for weeks, months and even years and diving head-first into areas of a country that 90% of that country's nationals don't know and strongly advise you not not visit? How about having to be the liaison between Federal and state government, or between health workers and health authorities because everyone has their backs to each other? How about paying out of your own pocket to provide a transport for a patient, some food or vitamin or iron supplements, or simply to equip a local health center? How about providing some counseling and guidance for pregnant women that due to not having any documents (a not so rare occurrence in the humblest areas) cannot go to the Maternity? We take without giving... like I tell you, it's my favorite!

Any of you field-researchers out there has a story to share that exemplifies how you were able to help/complement/replace what should have been the local health services' duty?