Bloodletting in Africa.

• Author: Halnon, Emily
• Position: WORLD WATCHER

MELISSA GRABOYES worries that history is repeating itself with medical research in East Africa. Through her research, the assistant professor of African & Medical History at the University of Oregon has identified many ethical questions concerning consent, participation, and exploitation that have remained unanswered for decades, as she has examined historical case studies of researchers collecting blood samples in the middle of the night without any explanation, officials promoting experimental programs as "therapeutic," and medical researchers who started referring to East Africans as a "pathological museum" in the 1950s.

These case studies highlight questions that remain at the forefront of contemporary global health conversations, but date back to at least the 1940s: Does the human subject understand what the researcher is doing? Have the risks of participation been adequately conveyed and agreed to? What types of conditions could be considered coercive? Why is the medical research being conducted and are its benefits worth the associated risks?

"The fact that we don't have answers to these questions is impossible and unacceptable," Graboyes says. "My hope is that a careful history of medical research in East Africa will provide useful information to contextualize debates and create more-sensitive policy and research programs in the future."

Graboyes published The Experiment Must Continue: Medical Research and Ethics in East Africa, 1940-2014 to compare a number of historical and modern case studies that demonstrate the parallels between the past and present. An interview she conducted with a Tanzanian woman highlights some lingering ethical questions and demonstrates how historical context could be useful for current research efforts.

When Graboyes first heard Mama Nzito describe "blood getting stolen" from her village in Tanzania, she assumed something was getting lost in translation. Graboyes was conducting interviews for her research--in Swahili--and Nzito was explaining how white "experts" came to her school in the 1960s to "steal blood," an act that she claimed killed several of her classmates.

Though Graboyes initially was skeptical, she found it difficult to dismiss Nzito's claims completely and turned to the local archives to investigate, as her methodology relies on overlaying oral narratives with careful analysis of historical records. She soon uncovered information that supported elements of the Tanzanian's story.

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