Who Knows better?

Who knows better? It’s not only an ethical issue; it is also social, economic, environmental, and cultural issue. The problem that prof Amber raise in his lecture about the sex workers and using condoms raise that issue to my mind, by asking them what they really need and try to understand the socio-economic back ground  for them he improve their risk behavior.

We assume as a health workers that we knows better than the community we are working with, we assume causes, precipitating factors, correlations and decide the best solutions. Since we are the experts in the science, we can decide the best for them. In fact, that is not usually the case. Studies and Science is about probability not certainty, we must know that well. We try our best but at the same time we should take in consideration that we still do not know a lot.

Dose the community knows best? Sometimes yes, but other times no. The communities over time developed their knowledge by try and error, as humans we gain the ability to survive and develop by experience. The natural selection keeps those who had the right choices. Cumulative experiences of the communities are as much important as the science probabilities.

We should consider ourselves as a part of the community not separate. We all know better. When we conduct a study or planning an intervention, we should consider the ethical issue, the cultural back ground, the socio-economic status, the demographic status or whatever, not only from our opinion but also from the opinion side of the community under the study. This will gives us a better chance to discover the salient and hidden factors that contribute in the problem.  Our collective experience can really merge together to produce a better choice. So, the right question is not who knows better? It is how we decide the best interest?

As a global health worker, I think we should not put assumptions or previous judgments on the communities that we are working with.  Previous assumption will hide the real causes and risk factors that may have  high impact on the problem. It also may hinder some simple solution that we can figure it out by just being more open minded and accepting to the community habits and background. People trust those who listen to them and work for their interest and distrust those who are deaf to their concerns.