Application of Ethics in the South African Rural Context

Abstract

When conducting research, it is fundamentally important to adhere to universal ethical principles with the intent to minimise harm and maximise benefits. This is not always relevant as these principles are based on the Western way of doing things. In Western culture, the focus of ethics is mainly on individualism and this value undermines the essence of ubuntu. However, in the South African context, the individual is always seen in relation to significant others, meaning that relational philosophies need to inform context-specific ethics in these communities. This paper aims to advocate for the utilisation of contextually relevant ethical principles to embrace diverse South African contexts. The paper is based on the author’s reflexive practice in conducting research in South Africa’s rural areas. The reflection focuses on the researcher’s dilemma in implementing universal ethical principles in a rural South African context. The paper highlights congruent ethical approaches in a diverse African context guided by relational ethics which is grounded in ubuntu principles. The approaches ensure that researchers remain ethical by embracing ubuntu principles.

Introduction

Most ethical principles focus on the Western way of doing things. In Western culture, the focus of ethics is mainly on individualism. Individualism emphasises the individual and his or her individual needs. The main concern is on the rights, safety and dignity of the participants (Parveen & Showkat, 2017). This idea ties well with Kant’s central point that places the individual as a central figure in ethics just because the individual has the capacity to think (Byrd & Hruschka, 2010). This is why the issues of individual respect, privacy, and confidentiality are stressed when dealing with ethical issues. According to the general ethics principle, confidentiality means that participants’ personal information, which may make individuals identifiable, should be protected and not made available to anyone other than the researcher (Wiles et al., 2008). However, in the South African rural context, the individual is always seen from the perspective of the significant others in the community. This paper’s objectives are to provide a brief overview of the South African rural context indicating diversity and to highlight the dilemma the author experienced as a researcher and student supervisor when expected to implement universal ethical principles in a rural context. This paper further presents the proposed approaches for being ethically congruent in a diverse South African rural context guided by relational ethics.

Background

I have started working as a professional nurse in a rural hospital and community clinics in Vhembe District, which is one of the districts in Limpopo Province, South Africa. In the process, I realised how the community members respect their cultural practices and how those practices affect their behavior towards health care services. What I valued most was how communal way of living where the individual is mostly seen in relation to the significant others in the community. For example, when the woman is married, she is controlled by several members of the community including the in-laws, neighbours and even the community elders. That communal way of life had an impact on when to resume sexual activities after the delivery of the child, the issues of family planning, and when to have another child. When I became an academic, I realised how this communal way of life, affects obtaining permission for conducting research in those areas and also how the participants interact and respond to the researchers. Sometimes, researchers end up being so frustrated due to logistical expectations, which seem to be against all the research principles they know. Other researchers end up changing the setting or the study topic.

My experiences inspired me to find ways in which researchers can remain ethically congruent in a diverse cultural African context. To assist researchers in achieving cultural congruency, I want to suggest an approach for implementing ethical principles in such a way that researchers remain ethical while still being respectful of diverse contexts. Respect is a fundamental principle and a basic human right. Quigley (2016) advocated for the need to respect the individual and the community they come from. The emphasis is on respecting the culture and the community.

I have been working as a member of health research ethics committees since 2013. What I have observed is that when reviewing a research proposal, most members of the Research Ethics Committees focus on respecting the research participants by advocating the protection of individuals from harm, how individuals will benefit, and how confidentiality will be maintained for the specific individuals while taking little to no cognisance of protecting the group and the community the person belongs to (Quigley, 2016). A similar concern about the neglect of a community’s right to protection was raised by Shore et al. (2011) who mentioned the Research Review Committees’ lack of understanding regarding the protection of the community and its contextual condition. The protection of a community is important because most of the time, individuals participating in the study represent the common morality of a certain group and society (Quigley, 2016).

The importance of protecting and respecting the community and society is to avoid exploitation and exacerbation of the stigma and discrimination of vulnerable and poorly resourced communities. It is helpful to consider the community’s rights as well as those of the group from which participants are sampled when developing contextual and culturally relevant interventions. The development of a relevant intervention for the community will contribute to the community benefits while minimising the risk (Guta, et al., 2010); thus, integrating the principles of beneficence and non-maleficence for the entire community. It is therefore important for the research ethics committees in rural South African contexts where communal life is valued, to ensure that, when reviewing the applications, aspects of avoiding harm to the community are taken into consideration.

However, the blame for individualism should not be on the research ethics committees and reviewers since they are guided by the existing research ethics guidelines. Most of the time these principles are applied to all contexts globally, regardless of diverse cultural practices (Parker & Crabtree, 2014). Examples of such guidelines are: Australian National Statement on Ethical Conduct in Human Research (2007); the Canadian Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (2018); the Council of Europe Steering Committee on Bioethics: Guide for Research Ethics Committee Members (2011); the Council for International Organizations of Medical Sciences (CIOMS) (2002); the ICH Guidelines; the Nuffield Council on Bioethics: the Ethics of Research Related to Healthcare in Developing Countries (1999); the World Medical Association: Declaration of Helsinki (2013); the World Health Organization Operational Guidelines for Ethics Committees that review Biomedical Research TDR/PRD/ETHICS/2000; the World Health Organization Standards and Operational Guidance for Ethics Review of Health-Related Research with Human Participants (2011); the Montreal Statement (2013); Singapore Statement (2010); (Department of Health: Republic of South Africa Ethics in Research Ethics in Health Research Principles, Processes and Structures (2015); Federal Democratic Republic of Ethiopia Ministry of Science and Technology National Research Ethics Guideline (2014); Indian Council of Medical Research, and National Ethical Guidelines for Biomedical and Health Research involving Human Participants (2017).

Most of the time these principles are applied to all contexts globally, regardless of diverse cultural practices (Parker & Crabtree, 2014). These guidelines are generally focused on those communities where individualism and independence are very important. The guidelines pay little to no attention to research focusing on minority groups and vulnerable groups where there is a great deal of interdependence. Several authors have started to challenge such universal guidelines by developing guidelines that promote research among indigenous people in minority groups. Examples of guidelines targeting indigenous people in the Te Ara Tika were developed for conducting Aboriginal and Torres Strait Islander health research in Australia (National Health and Medical Research Council, 2018). A similar initiative was undertaken in Canada in the form of a Tri-Council Policy Statement to protect the First Nations, Inuit and Métis peoples of Canada (Burns et al., 2019). Schroeder et al. (2018) mention that there should be equitable and respectful relationships between countries and research and innovation partners when conducting research. The authors further emphasised the need for performing research that is legally and ethically acceptable in a specific country (Schroeder et al., 2018).

Regardless of these transformative guidelines which also emphasise the community focus rather than just individual research participants, there is minimal evidence showing the adherence to the guidelines. The consistent adherence to the research ethics guidelines which emphasises individualism, regardless of alternative guidelines and policies which recommend the consideration of an individual as part of a larger community challenged me to write this paper. In this paper, the argument is that Africa cannot be dependent on universal principles since these principles comprise people and communities from diverse cultural backgrounds.

The South African context

South Africa is one of the 54 countries in Africa. Like most African countries, South Africa with diverse race and ethnic groups, has four race groups: Africans (sometimes referred to as blacks), whites, Indians and coloureds. Although there are four race groups, the groups are not homogeneous. For example, among black South Africans, there are four major ethnic groups, namely Sotho, Shangaan-Tsonga, Venda, and Nguni. The ethnic groups still have subgroups. For example, under the Nguni group are the Zulu, Xhosa, Ndebele and Swazi people (South African History Online, 2019). All diverse race groups and ethnic groups have their own unique cultural practices, beliefs, and values. Although people belong to similar cultural groups they are not homogenous because they also differ according to marital status, sexual orientation, gender identities, age, employment, occupation, residential areas, educational status, and other mannerisms which are used to further classify people with some even boiling down to medical diagnosis.

Apart from the factors related to diversity in South Africa mentioned above, the country also has a constitution which advocates that everyone living in the country must be respected. However, reality indicates that what is written in the Constitution is not what is practiced at grassroot level (Muray, 2013). This is shown through the different ways of caring and status among the different groups and citizens in the country. The difference also involves socioeconomic status. The socioeconomic difference is partly the result of the post-apartheid state where the resources were capitalised (Howell & Shearing, 2017). While other people are very rich and able to claim/enjoy all the rights as specified in the Constitution of South Africa, some people live in severe poverty and their rights to freedom and human dignity are being compromised (Alloggio & Thomas, 2013). To most of these individuals, even their freedom to information and the right to life and health are compromised. These groups of individuals become vulnerable to all kinds of abuse due to their poor socioeconomic status. Most of these individuals live in overcrowded, poorly serviced townships, rural areas, or slums in urban areas (Oduro et al., 2012). These groups of individuals also become the target of abuse by researchers.

Why am I mentioning all these aspects? What relevance do they have for ethics in Africa? This is very relevant to culture in the diverse African context. Having a blanket application of universal principles of ethics in a country with so much diversity is not helpful, as it might only be relevant to a few individuals, while other communities and ethnic groups are being exploited and disrespected. To elaborate on this claim, I will share my experiences as a researcher in a rural area among the Venda ethnic group. The experiences placed me in a dilemma between being ethically correct, based on universal ethical principles and being morally correct and culturally congruent.

The Dilemma I Faced as a Researcher and Student Supervisor in Implementing Ethics Principles in the South African Rural Context

In this section, I will highlight two ethics scenarios where I was torn between doing what is ethically correct, according to the universal ethical principles and morally correct, according to social norms and standards in the rural community where I conducted the study. The scenarios can assist in elucidating ethical issues relevant to recent real-life research and innovation activities among one of the ethnic groups and vulnerable populations in South Africa. The findings may assist in preventing the violation of ethical principles and rights of participants and communities in the name of adhering to universal ethical principles which might not always be morally correct in the African context. The frequently used ethics principles are based on the Declaration of Helsinki, which include:

• Respect for autonomy – leading to freedom to make decisions to participate and withdraw enshrined in the (contested) concept of informed consent.

• Non-maleficence which requires researchers to be mindful of the potential of harm as well as known harms.

• Beneficence – concerning the use of research to promote good things.

• Justice and fairness.

These are the principles that I was expected to follow as a researcher, since in my proposal to conduct research, I promised that I would adhere to those principles. All those principles are generally focused on an individual as an autonomous and independent human being. I will present how I got stuck in trying to implement these principles by presenting the following two scenarios.

Scenario 1

As a researcher at one of the universities in South Africa, I visited a rural village to conduct a study. On my arrival, I met ‘vhakoma’ who was expected to usher me to the chief. Vhakoma according to vhavenda tradition and practices is a community elder, responsible for ushering guests or reporting matters to the Chief. Vhakoma is mainly an elderly person who is either a relative or a trusted person who acts as mediator between the community and the chief (Matloga, 2002). He is more or less a chief’s representative and can even take decisions on behalf of the chief. Vhakoma mentioned that I should give him a goat before he would usher me to the chief. I was shocked and told vhakoma that nobody said anything about a goat. I also told vhakoma that even if I had been told in advance about the goat, I would not have brought it since it was wrong, according to the ethics principle of voluntary participation. Giving him a goat would be like bribing him to coerce people to participate in the study. Vhakoma looked at me and said: This is a royal kraal; you do not just enter barehanded. He further emphasised using the following Venda idiom: “Phanda ha ndau a hu iwi u sina tshikuni,” literally meaning that “One cannot go in front of a lion without firewood.” Which means that you cannot meet the king without a gift. I thought: What should I do? The research proposal was approved and having to go back to rewrite the proposal to change the research site and research population, meant another 6 months of waiting. It was also impossible to give vhakoma a goat. Where would I buy a goat? And if I did that, my study would be discredited, because it would mean that I acted in an unethical manner. I reviewed the principle of respect in research. Who do I respect? Do I go back? What came to my mind was cultural congruent nursing which I learnt while doing my honours in nursing. Based on that, I decided to negotiate further with vhakoma. The conversation went as follows:

Vhakoma: Vho Makhadzi, (referring to me as an aunt – which is a prestige status among VhaVenda ethnic group) for me to lead you to the chief, I will need a goat.

Me: Nobody told me about the goat. Giving you a goat is unethical, as it will be like I am paying you a bribe.

Vhakoma: Do you want to meet the chief or not? If you do not have a goat, just go back.

Me: What is the goat for?

Vhakoma: It is the “Gate-opener.” Nobody is allowed to the chief’s kraal without the gate-opener.

Me: Where will I get the goat?

Vhakoma: If you do not have a live goat, pay R200. R200 is a goat. (This amount is very little compared to the real price of a goat which is about R1 000 to R2 500).

Me: (Handing over the R200 note): I think this will be fine.

Vhakoma: (Taking the money and then escorting me to the chief).

On arrival at the chief’s kraal, vhakoma left me outside and entered the kraal. After a few minutes, he returned and mentioned that the chief wanted a cow before granting me approval to meet his people. While I was still reeling in my astonishment, vhakoma said that I must just give him R500 which is equivalent to a calf. Upon receipt of the R500, I was told that I should come back the following morning to communicate with the community elders about my research. The purpose of the research was to assess the attitudes of young women toward breastfeeding. The following day, when I arrived to start with the discussion in the form of khoro, which is a group of community elders, I was requested to buy a 25 L bucket of mahafhe mutomboti (African beer) and a case of cold drinks (12 1,25-litre cold drinks) for the participants. After buying the required drinks, I wanted to start the conversation, but I was told to change my attire as I was wearing a suit (trousers and a jacket) and they do not want a female who dressed like a male. I felt so frustrated thinking that this would be another wasted day. On my way back to my car, one of the female community elders called me back and gave me a shawl (tshalana) to wrap around my trousers. After I explained the purpose and objectives of my study and all the ethical aspects, including confidentiality, vhakoma mentioned that I should be accompanied by an elderly woman when interviewing the young women to make sure that I am only asking women what I said I would because most researchers used to come and instead of focusing on their research, they influenced the women to revolt against their husbands and start using pills and injections so that they would not to be able to conceive, which is the main purpose of being married. On arrival, instead of me explaining the research to get informed consent, the elderly woman accompanying me was the one who asked the women to participate and that they should freely tell the researcher everything. During the interview, the older woman encouraged the woman to talk and not to be ashamed. Sometimes the elderly women even reminded the women about other incidents. After the interview, vhakoma wanted a report on what the young women had said. After providing the report, I was given a live chicken as a token of appreciation from the chief’s kraal.

Scenario 2

One of my students conducted an ethnographic study on VhaVenda cultural practices which may have an impact on HIV/AIDS management. Her key informants were traditional healers, traditional leaders, and community elders who are knowledgeable of VhaVenda cultural practices and traditions. On the day she visited one of the traditional healers, she was instructed to take off her shoes on her arrival. After removing her shoes, she was shown an animal skin on which to sit. After sitting down, the traditional healer requested a “Mvula mulomo”, literally meaning a “mouth opener”. She was amazed and asked what a “mouth opener” was. She was told that she had to put money on the mat before the traditional healer could speak to her. She requested to be excused for a moment so that she could go to her car to fetch the money. The reason was just for her to make a call asking me what to do as the traditional healer wanted money before communicating with her. The amount requested was R100. I told her that she should do it as it is part of their culture, which needs to be respected. I also advised her that she should do whatever the healer told her unless it means putting herself at risk; or unless the demands were unreasonable (according to her judgment). She returned, put R100 on the floor and the traditional healer then requested “phuthulula thevhele” which is literary translated as “medical instrument opener”. She mentioned that she did not come for traditional healing but for an interview, as communicated telephonically.

The traditional healer said, “Young lady, do you want help or not? If you do not want help, please go back as I have to assist a lot of people. I cannot speak to you unless my ancestor gives me the go-ahead to give you information.” When she asked about the amount of “phuthulula thevhele”, she was told about the other R100. After paying another R100, the traditional healer took out her animal skin purse, threw the bones and requested the researcher to blow over the bones before throwing the bones down and analysing them. Thereafter the traditional healer said, “Yes, you are ‘not heavy’. The ancestor has permitted me to talk to you”. The interview continued after the ritual and the student gathered adequate information.

If we judge the above scenarios from a Western point of view, it would be as if all the ethical principles have been violated.

• the issue of incentives

• aspects of respect

• confidentiality

• informed consent

• voluntary participation

• justice

However, from the African cultural perspective where “a person is a being because of other beings”, all the ethical aspects have been considered. Following that incident, I informed the student to go to all other participants prepared for the unknown. The two scenarios challenged me to advocate for ways of being ethically congruent in a diverse cultural African context.

Following these actions, which could be considered a violation of the ethics clearance certificates offered, I reported the actions to the University Research Ethics and Integrity Committee which fortunately I was also a member. I emphasise the need for flexibility in the research ethics policy in order to allow the different contexts in which the researchers find themselves as long as it indicates respect to the community. The issue was highly contested and debated until the committee finally agreed to provide provision for cultural diversity when amending the research ethics policy while also curbing the amount which could be accepted to avoid the abuse of funds or engaging in corrupt practices.

3 Approaches of being ethically congruent in a diverse cultural South African Context

This section aims to raise awareness of how to be ethically congruent in a diverse African cultural context. In order to be ethically congruent in a South African cultural context, there is a need to advocate for ethical principles which take the context of the research participants into account, not only as individuals but also as interactive women whose existence is interdependent with the significant others. My assumption is that the information provided below would guide research ethics reviewers, researchers, and even examiners of students’ research works to consider the uniqueness and diversity of the contexts under which the studies are conducted.

In an African context, the individual is always regarded in the context of the significant others in the community (Azenabor, 2008). The point of departure for Africans is that individuals are born into a culture which imparts certain rules which all members of the community are bound by duty to observe. These rules foster responsibility towards members of a given community. Thus, the individual is subjected to the rules of the majority; which does not imply that individual rights, privacy, respect, and confidentiality are disregarded. In fact, these aspects are protected in the very observance of the rules whereby one exists by bearing in mind that harmony and peace can be achieved by observing the rules that make one to see in another the reflection of oneself. That is, I am because we are – and this forms the basis of ubuntu, which means a person is a person through other persons (Haselau et al., 2015).

Hence, Kant’s imperative as a universality principle has little place in communities where the community is a group of significant others. This may further be explained by an example of research behaviour towards participants. If, for instance, a research participant is a woman, it is not just a woman participating, but the consent to participate is familial/communal and includes the consideration of a spouse or partner, a mother, a sister, a community member, and all other role players. For example, in the first scenario, where I just need to communicate with the women and end up communicating with Vhakoma, the chief, community members and finally accompanied by an elderly women, it showed that it is not about the women alone, but the entire community. This also means that the intervention should not be focusing only on women, but should address interlinks of society. After all, the issue of breastfeeding, if I want to bring it to the basics, healthy children, leads to the reduction of infant mortality, which in turn saves the community from preparing and attending the funerals, thus spending time that would have been utilised in other activities which would benefit the community in general. Therefore, the findings when communicated with the entire community members via the formal processes, may produce a communal support for the intended change.

This is evident in Malunga (2006) who mentions that most indigenous African societies practice the principles of ubuntu where the societies believe in taking collective responsibility and that when one marries someone, one does not marry only the individual, but the whole clan.

Sometimes, the gatekeepers, especially in the rural African context, might need to be involved or even be present to ensure that what is being said is not violating their cultural practices. There are some researched aspects that can be considered sacred, which the participants may not even be allowed to talk about; only designated people in the community are allowed to do that. This should be considered as researchers may sometimes find themselves interviewing more than one participant depending on the power roles and communication patterns in the community (Hepworth et al., 2006). Generally, when talking about privacy, we focus on the privacy of the participants, whereas in a cultural context, privacy may refer to safeguarding sacred practices in a specific community. So, there is a need for researchers to observe dual privacy – that of the participants and that of the sacred/protected community information.

In Western practice, the issue of justice mainly considers the fair treatment of direct participants. The concern is only for the few from whom information is sought. However, in communal settings, such as in other countries, and specifically in the African context, fair treatment consists of consideration of the entire community. For example, if you are conducting a study where the participants are provided with food parcels while others are excluded, you will be considered unfair to the rest of the community who may be starving. Because such communities believe in sharing, exclusion may be viewed as a destabilising ploy, as the excluded members did not choose to be excluded from the study in the first place. Thus, researchers should always be wary of unfair discrimination when they go to these parts, as justice is only viewed from the community’s point of view to guarantee the community’s wellbeing and interest. Also, under the beneficence principle, great care must be taken where funds are disbursed that the communities should be left better off after the research; otherwise, it is unjust to leave them in a similar situation or even worse off.

The same principle applies to providing incentives to the gatekeepers. In African culture, it is a sign of disrespect to approach the gatekeepers but leave a community elder or a community leader, chief or king without a gift. Whereas from the Western point of view this practice may be considered a bribe, in the African context, it is considered a “gate opener.” After providing a “gate opener”, the researcher might still be expected to pay more money or provide any form of gift, depending on the community practice to a person who has higher authority than an initial contact person, which is usually considered a “mouth opener”. If those customs are not followed, it might be difficult to access the participants.

Sometimes, instead of getting permission to conduct the study, especially if it is in some rural village where the community leader/chief wants to inform the people in a gathering formally, the researcher might still be expected to discuss the study with a group of community members. At times it is the community leaders who will identify relevant people; thus, the participants will be known to the researchers and the community members. That is why it is important to take the aspect of shared confidentiality and shared privacy into consideration.

This means that to provide contextually relevant ethics education, the ethics facilitators/educators should be knowledgeable about the cultural practices of a certain community. Indeed, it is not advisable for researchers to impose their ethical principles since communities have their own rules, which they expect everyone to observe. As African culture is diverse, research ethics principles should just be offered as a guide but should allow flexibility to cover diverse cultural practices concerning ethics.

Instead of following the deontological research paradigm, which emphasises strict adherence to the codes and guidelines as prescribed (Parker & Crabtree 2014), we must focus on flexible research paradigm relational ethics. The relational ethics focuses on the individuals in relationships between the family, the entire community, populations, countries, governments, and institutions (Aellah et al., 2016). This type of relational ethics is not static but complex and situational depending on the individual’s interactions with significant others. Relational ethics is mostly not guided by strict ethical rules but by an individual and social conscience in relation to a specific situation (Aellah et al., 2016). The aspect of relational ethics is based on humanity, where a conscious researcher could not interview the mother and leave the family whose child is starving without providing assistance. Besides collecting data, the researcher following relational or situational ethics, may need to find a solution for additional problems. For example, in one of my community engagement projects, where the focus was on the prevention of HIV through educating life orientation educators to offer contextually relevant HIV education, I noticed during my visit to the schools that the learners were living in a poverty-stricken community Figure 1 (See the pictures below).

Figure 1.

Example of learners and their situation including their uniform. The two females in the pictures are also pregnant at the ages of 10 and 12 years.

Apart from empowering educators, I also had to find means of assisting the learners. As learners are not independent, I took a step further to find out where they come from. What I found was even worse than the uniforms they were wearing Figure 2 (see the picture below).

Figure 2.

Some of the houses where learners stay.

Thus, supporting the relational link of participants (teachers), their immediate community (schools and learners), and the extended community (which is where learners come from) is very crucial. Based on the findings, I started an advocacy campaign to support learners, including their parents. This was done through providing not only information to assist them in HIV prevention, but also distributing clothes and uniforms (collected from colleagues and church members) to learners as some of them mentioned that they are sexually active at a young age because they need money to buy uniforms and clothes. On the other hand, I had a meeting with the school governing bodies, the local farmers, learners’ guardians and parents, to find ways in which the community could be assisted to sustain themselves without predisposing their children to the risk of being infected with HIV. The core message was, prevention of one HIV infection benefits the entire community, which is very true because a sick child will not be at class, the parent of a sick child will not go to work, farmers will lose profit, the absent child will also affect the school enrolment target, which may intern affect the budget allocation, thus leading to retrenchment of some teachers. To bring this back to ethics, focusing only on learners, may not bring the required change. That is why most of the time we see minimum impact of humanities and social sciences based on the individualistic focus of research ethics.

Conclusion

Following the incidents sketched in the two scenarios and the participatory action research above, I am convinced that ethics principles should not be prescriptive, but should be used flexibly to embrace the diverse context of Africa. I will provide an example of how the ethics principles were implemented in this paper without being boxed by the individualistic approach, which is more relevant to the Western way of life (Ali et al., 2012).

However, to be ethically congruent in the diverse African context, the principles can still be applied, but with broader flexibility. To be culturally congruent, not only the participant should be respected but also the cultural practices and customs of the community. As researchers, there is a need to follow community protocols. If it means payment should be made (mouth openers) in the community to access leadership and participants, this needs to be adhered to. These practices should also be provided for institutional research policies. The researcher should study the context and contextual practices before going to the field to avoid practices which may be assumed as disrespectful to the community. This include issues like dress code and sitting positions.

Confidentiality should be contextually relevant. In the first scenario, I have realised that confidentiality is shared among the community members. The presence of an elderly woman during the interview and the feedback that is provided to the community is part of confidentiality. What they need is the protection of community confidentiality, even by their community members; in this case, the presence of elderly women.

In the participatory action research shared, the confidentiality and assent of learners and their parents was overshadowed by the principle of beneficence. It was more urgent to ensure that learners’ needs for uniform and clothing were met. Same was rolled out to their homes to ensure that their need for shelter was dealt with; thus, unintentionally exposing learners. But, the risk of possible harm that may come to them and extreme poverty, was higher than the risk of undermining their privacy when ensuring that they get the help they need. In this instance, the principle of beneficence supersedes privacy and informed consent from parents. The same situation where some principles supersede others based on a situation was documented by Aellah et al. (2016), who raised the issues of the emotional struggle researchers sometimes deal with when faced with the conditions of abject poverty experienced by some participants. If the action will not cause harm to any person, the principles of consent and privacy may be infringed to the best benefit of the participants and community (Hardwick & Worsely, 2011; Parker & Crabtree 2014).

When faced with a situation of dire need, a researcher needs to decide whether to be a researcher or an aider. We are first human beings and then we are researchers. This means that we should not relegate our responsibility to care. Parker and Crabtree (2014) recommend that social care researchers construct an ethic for research that adds to their accountability as researchers and should not be restricted by rigid ethical rules. Azenabor (2008) advocated that ethics in an African sense should be humanistic, focusing on the welfare of people. To be ethical, the researcher has a moral and social duty to show empathy (Azenabor, 2008).