Health Research in Suriname: Where Science and Indigenous Knowledge Meet

In this article, researchers share a new approach to studying indigenous communities so as to prevent these communities from feeling "study fatigue" caused by being the frequent subjects of health research without benefit. The authors suggest that individuals become frustrated because they are not benefiting adequately from the results of research conducted in their communities and, in some cases, are seeing those results suppressed.

The case of research conducted in mining-affected communities in Suriname shows community discontent. "In Suriname, risk assessment studies estimated the potential impacts of mercury pollution from gold mining on public and environmental health. However, few studies have actually been published and are available for use by indigenous and tribal communities to advocate for change....Findings from public health research on the impacts of gold mining are being suppressed. This further obscures public health risks and leads to insufficient and misguided regulation. Foreign researchers and in-country collaborators are warned by politically and financially motivated officials of 'dire consequences' if they communicate the effects from mercury contamination from gold mining."

Censorship of scientific research is defended in some circles as a government right to policy setting, characterising research as "highly institutionalised and ...an integral part of political structures: funding agencies, universities, development programmes and policies...." In contrast, some research institutions have adopted ethical guidelines that encourage indigenous participation and include full disclosure and written documentation of consent and support from community leaders and participants. However, the ethical reviews are from "mainstream 'Western' perspectives and approved by Institutional Review Boards" from institutions, representing an imbalance of power between researchers and subjects, as stated here. Scientific communities sometimes argue against indigenous involvement in the proposal formulation because "the complexity of the issues is 'not discernible by villagers'." However, "Indigenous communities argue that the unique cosmology of forest people, who do not see a clear-cut distinction between the sphere of nature and the sphere of society, is not discernible to Western scientists."

In seeking a resolution to this division, "a new proposal is for community-based or community participatory research to be taken to a new level; a level which mainstream researchers may consider extreme or untenable. Indigenous communities are calling for support for research projects that are culturally appropriate, community-owned and directed. This means research that combines both scientific and traditional knowledge systems." For example, "Maroon communities (tribal communities descended from African slaves that escaped from plantations in the 15th and 16th Centuries) and indigenous Wayana communities are acting as leaders to create a collaborative environmental health research project....These community-owned studies have one over-arching objective: to support indigenous and tribal communities who want to self-diagnose the effects of development programmes and resource extraction projects on their community and environment. The communities universally identify four objectives:

1. To determine whether they are at risk from contamination of their food and water by waste from mining and siltation;
   
2. To assess the potential health impacts from mercury exposure;
   
3. To address the effects of neo-liberal economic development programmes and land privatisation policies on the health and well-being of their communities, and 
4. To publish their findings, participate in discussion forums and be acknowledged as legitimate stakeholders by national and international government agencies."

The article concludes that "[r]esearch conducted on behalf of indigenous peoples should avoid the biases caused by Western systems for organising, classifying and storing new information, and for creating theories about the meanings of discoveries....The community-owned and community-driven approach being applied in Suriname reframes research, development and the solution to problems. It affirms scientists as experts and indigenous people as equals...."

Click on these three links: Part 1; Part 2; and Part 3 to see a sequential 24-minute community-directed documentary on the stories and perspectives of interior tribes of the Amazon river basin involved in the mining-affected communities in Suriname.