Another hot and steamy morning in Hanoi. I鈥檓 sitting by the city鈥檚 central lake trying out my clumsy Vietnamese on Hiep, a street child I鈥檝e known for a few weeks. The heat is making us tired. Sweat is glistening on our foreheads and I鈥檓 about to suggest we go and get some ice cream. Then, without warning, children are running in all directions, shouting to each other at the top of their voices. Policemen on motorbikes are everywhere, roaring around in pursuit of the children and throwing the ones they catch into their sidecars.
Hiep is by my side, shoe-cleaning equipment in his lap, all the more visible because he is sitting next to me, a foreigner. I whisk up his work materials, throw them into the basket of my bicycle and cover them with my jacket. Then I make as if we are deep in conversation. In reality I am whispering soothing words to Hiep, who is immobilised by fear. The police pass by, shaking their heads, sizing me up as one of those do-good foreigners meddling in their work.
I am an anthropologist and that two-minute experience in 1997 changed the direction of my research. For one thing it was the first time I had intervened to alter the fate of one of my subjects 鈥� something anthropologists are traditionally not supposed to do. For another, if I had not been with Hiep that day, I might not have discovered that street children were being placed in police-run 鈥渞eform schools鈥� after their arrest for illegal street trading.
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I originally went to Vietnam to look at healthcare initiatives, but I subsequently focused my research on one of these reform schools. While working there I found myself confronted by the biggest dilemma that anthropologists face: if their human subjects鈥� lives are at risk, should they intervene or carry on observing dispassionately? I decided not to ignore the dangers that the school鈥檚 inmates faced, and as a result some of my peers have publicly questioned my professional ethics. My experience goes to the heart of an unresolved dilemma in anthropology. In the end, what is the point of what we do?
Within four months of witnessing the arrests I had managed to get permission to carry out fieldwork in the reform school. In some ways it was a progressive institution. The principal was deeply suspicious of outsiders coming in and enforcing their own beliefs about how children should be treated, but the school was a new and very positive alternative to the more common practice of locking children up alongside adults.
I spent the next two years carrying out fieldwork in the school, observing and interacting with the boys. One of my aims was to study their strategies for coping with institutional life, and perhaps the most interesting of these was their practice of tattooing each other. They formed into groups with the unity of each cemented by the members鈥� identical tattoos. One mark shaped like a 鈥淭鈥�, for example, symbolised a reserve of strength and optimism. Another, a lone dot on the web of skin between the forefinger and thumb, made a point of their isolation. Boys with this tattoo referred to themselves as 鈥渁lone in the universe鈥�.
鈥淧erhaps the most interesting of their strategies for coping with institutional life was the practice of tattooing each other鈥�
Tattooing was prohibited by the school authorities and so the boys had to improvise with whatever was available. They used a mix of blood, ink and dirt, introduced under the skin using shared, dirty needles. It was immediately obvious to me that this carried numerous health risks, the biggest of which, of course, was HIV infection.
鈥淭he boys improvised. They used a mix of blood, ink and dirt, introduced under the skin using shared, dirty needles鈥�
At that time in Vietnam, the virus was only recognised as a threat to a very small segment of the population: adult drug addicts and prostitutes. Children were viewed as innocent of sexual and drug-related practices, so the boys鈥� tattooing each other with shared needles was not thought to carry any risk of spreading the virus. How could they have become infected in the first place?
Here was my first dilemma: should I warn the boys of the dangers associated with their behaviour? Plenty of anthropologists would say, 鈥淣o, getting involved with your subjects 鈥榙amages the data鈥�.鈥�
I didn鈥檛 fret about that for long. I simply could not stand by and say nothing. I told some of the boys about the risks of tattooing. They dismissed my concerns immediately. The tattoos allowed them to express themselves in an otherwise conformist environment and also gave them a sense of belonging to a group. As with any pre-teens and teenagers, these immediate gains outweighed any long-term concerns. Why should they worry about what might or might not happen to them months or years into the future when, from their perspective, they had so little future anyway?
I was not the only westerner in the school. An American aid worker called Jack (not his real name) taught some English and mechanics classes. We were both concerned about the effects of the tattooing on the boys鈥� health, so we went to the Vietnamese staff to ask if they could be tested for HIV as a precautionary measure. Our request was refused. That was that: as members of the police force, the staff鈥檚 decision overruled any concerns that we had.
We could have threatened to stop attending the school, but this was unlikely to lead to a change of heart. Instead it would have jeopardised our positions in the school, and therefore the support services Jack was offering to the boys. At the time, no other NGOs had been permitted to work there, so our protest would have isolated the children still further from the outside world.
I had three options. I could stay and help the children as and when the opportunity arose. I could go and do my fieldwork elsewhere in Vietnam, somewhere where the work would not disturb my conscience. Or I could simply 鈥渂e a good anthropologist鈥�, record what I saw and write it up 鈥� after all, that鈥檚 what I was being funded to do. In the end I stayed, continued my observations, and helped out where I could.
Jack and I regularly appealed to the staff to allow HIV testing, but they always refused. They were adamant that children did not get AIDS. The boys were finally tested three years later, a year after I left Vietnam. Out of the 180 boys I had studied, 162 tested positive for the virus.
鈥淭hey were finally tested a year after I left Vietnam. Out of the 180 boys I had studied, 162 tested positive for HIV鈥�
Like the school鈥檚 staff I was devastated by this news, which left me with a host of unanswered questions. What had my responsibilities been as an anthropologist, and did they conflict with my responsibilities as a human being? What worth did my research have after I had tried to stop the practice and get the boys tested? Some would say I damaged the data while achieving almost nothing to improve the well-being of my research subjects.
Standing by while the boys infected each other with HIV is an extreme example of observational fieldwork encompassing tragic outcomes, but is there a lesson to be learned for anthropology as a whole? Since my return, at conferences and seminars I have taken to asking whether as anthropologists we should spend more time exploring the ethical dilemmas of our work. This has not won me plaudits 鈥� quite the contrary. At a recent seminar, a senior academic observed that I was becoming an activist. As an anthropologist, he said, that in itself bordered on the unethical.
I am learning to live with that label. After all, I鈥檓 not the first. People such as Nancy Scheper-Hughes at the University of California, Berkeley, and Paul Farmer at Harvard University have involved themselves deeply with their research subjects in Brazil and Haiti, respectively, and have already blazed a controversial trail for 鈥渁pplied anthropology鈥�. This now seems to me the only responsible way forward for our subject.
Some have accused anthropologists who become involved with communities that inform their work of neocolonialism, forcing their values on the people they study. It is ironic that becoming involved in controversial social issues in different cultural settings, particularly those in the developing world, leaves one open to the accusation of being a neocolonialist. I would argue that the opposite is true: not engaging with social issues is the true mark of colonialism.
鈥淪ome have accused anthropologists who become involved with the communities who inform their work of neocolonialism鈥�
There are distinct advantages to carrying out fieldwork in 鈥渆xotic鈥� locations, whether for anthropology or some other discipline such as pharmaceutical research. First, the results are often more interesting to western academics (the lure of the 鈥渆xotic other鈥�), so they win the researcher more kudos. Second, there are fewer ethical constraints. If I had been carrying out my fieldwork in a UK institution, I would have had to submit proposals for scrutiny by ethics committees before even starting. Anthropologists and other researchers face fewer such hurdles in most developing countries. So to go to such places and use their populations and situations for the sole purpose of writing research papers, in whatever discipline, seems like the truly unethical position.
After my experiences, I wonder how some of my colleagues can continue to write papers that are only distributed within the academic arena, rather than attempting to disseminate their findings more widely. We bring our findings back from the field to inform academic debate and prove our abilities as researchers. Shouldn鈥檛 the first priority be to explore what we have discovered with the communities whose practices have provoked our interest and concern, with a view to influencing social policy?
Some anthropologists still subscribe to the myth that their subject is ethically neutral. But in doing so I believe they are taking advantage of the people they study 鈥� often already disadvantaged people 鈥� to fulfil their own ambitions.
I am racked with guilt over the boys who infected each other with HIV while I watched. This is irrational, I know. I believe I did all anyone could have done to prevent this happening. But whether some of my colleagues like it or not, I am proud of the stance I took. Yes, I damaged the data 鈥� and I鈥檇 do it again.
