Turning the gaze: challenges of involving biomedical researchers in community engagement with research in Patan, Nepal

Global health funding bodies are increasingly promoting and offering specific funding support for public and community engagement activities, in addition to research and programme funding. In the context of this growing commitment to engagement work, we need to find ways to better support contextually appropriate and meaningful exchanges between researchers and community members. I argue that, rather than focusing solely on how to involve communities in engagement with global health research, we should also pay attention to the quality and depth of the involvement of researchers themselves. This is an often overlooked dimension of community engagement in both practice and the literature. In this paper, I present three contextual factors, which created logistical and attitudinal obstacles for researchers’ involvement in meaningful engagement in a global health research unit in Nepal. These comprised implicit and explicit messages from funders, institutional and disciplinary hierarchies and educational experiences. Lessons were drawn from an exploration of the successes and failures of two participatory arts projects connected to the research unit in 2015 and 2016. Both projects intended to foster mutual understanding between researchers and members of their research population. As an engagement practitioner and ethnographic researcher, I documented the processes. Enteric fever is a major public health problem in the Kathmandu valley, Nepal (Karkey et al., 2016). During preliminary conversations about a study designed to trial a water filter intervention, researchers from the Oxford University Clinical Research Programme in Nepal (OUCRU-NP), based at Patan Hospital, experienced resistance to participation in the study from residents within the area. So as to understand community concerns, two participatory arts projects – Sacred Water1 and Jeewan Jal2 – were initiated and were led by an artist from Vietnam and myself, respectively. The projects aimed to use conversations and collaborative art-making to generate opportunities for meaningful dialogue between researchers and community members, and to foster appreciation and understanding between the actors involved (Kester, 2004; Phillips, 2011). This aim was achieved with varying degrees of success. I show here, the projects followed the logic (and funder imperatives) of community engagement, but the researchers themselves were difficult to bring into the project activities. Below, I describe these projects and explore the challenges encountered in involving medical research staff. I found three contextual factors that created obstacles for researcher involvement in engagement activities: implicit and explicit messages from funders that create ambiguity around the ARTICLE HISTORY received 22 June 2017 accepted 12 February 2018