Ethics of Research

ICDDRB, the International Center for Diarrheal Disease Research Bangladesh, is one of our key partners in this trip, and probably one of the best known International NGOs from Bangladesh exhibiting excellence in research.  What began as a study on the effects of Cholera (which originated in the Bay of Bengal 6,000 years ago) in 1960, ICDDRB has grown into a multi-faceted organization of both research and service, particularly noted for the longest standing ongoing health study in the world.  We traversed the winding, one-lane roads of the peri-urban ‘countryside’ for four hours, finally reaching Matlab, a city only 50 km outside of Dhaka, where ICDDRB has focused its Maternal Child Health – Fertility Program since 1977.

With partners like the UNDP and Johns Hopkins School of Public Health providing millions, the funding available is anything but inconspicuous.  Yet, as a humanist and perhaps naive student of sustainable development in a program that lauds the importance of bottom-up, community-based approaches to development, the use of ICDDRB’s funding presents ethical dilemmas of which I haven’t deciphered yet.  Of the 250,000 people in the Matlab surveillance area, half are provided free services in the health and fertility program (including birth control, hospital services, checkups, physicals), while the other half are left as the “control” group as for comparison purposes.  Although the other inhabitants of the Matlab area can receive some emergency healthcare from the government, literally 125,000 people have been ostracized from a donated service for purposes of research.

The demographic and health research that has come out of the Matlab study is breaking barriers.   30 years of ongoing observations afford the analysis of the effects of a particular health program and fertility promotion: Life expectancy has raised to 69 from 55 in 1966; the infant mortality rate has decreased to 41 from 120 in 1966; total fertility rate in women is down to 2.6 in the variable group while the control group still lingers around 4; and keratosis, diarrhea and other communicable diseases are significantly lower in the variable group than the control group.   With valuable statistical information like this, ICDDRB has powerful policy-changing ability, like no other NGO we have seen in this country yet.

But at what cost?  Utilitarian arguments of sacrifice of one for the better of the whole orbit my mind.  Faces, hands, wrinkles, and smiles dance in my memory as I drive away from beneficiary villages, through the villages of exception.

There are many forms to development, and ICDDRB is one that is receiving accolades the world over for their work; how do I categorize this experience in my education?