Stigmatized Professions and Ambiguous Subjects: Methodological Reflections from Sanitation Workers and Opioid Consumption in Sierra Leone

Abstract

This paper explores ethical dilemmas in relation to practices of alcohol and drug consumption in the workplace by manual pit emptiers in Freetown, Sierra Leone. Based on observations and interviews with workers, we come to understand the consumption of painkillers and gin as a mechanism to alleviate stigma, rather than an issue of addiction. Indeed, the consumption of psychoactive substances before manual pit emptying appears as a performance to create a symbolic distance between the worker entering half-naked in a tank filled with faecal sludge and the social being, who would never do so in a ‘normal state of mind’. This analysis calls both for a deconstruction of the policies and rules that shape the sanitation sector as shameful and ‘inhuman’ and for proposals to ameliorate those conditions. Furthermore, we explore our positions as researchers on why revealing such practices can make sense in action-oriented research but also must be thought through ethically. Beyond the guidance of institutional ethics boards, the question of short- and long-term engagements with research subjects is central in shaping what ought or ought not to be investigated. We thus contribute to the discussions on how to support better science and practices with and for already stigmatized populations.

what are the ethical implications of investigating controversial practices that might expose research subjects,¹ or partners, to negative consequences? How to proceed when two norms of social anthropology consequences contradict one another: On the one hand, truthfulness and nuanced accounts of social life and on the other, ‘do-no-harm’ and protection? We argue that reconciling these norms implies engaging in research with stigmatized participants in a mutually beneficial manner. This paper discusses these questions in relation to routine practices of alcohol and drug consumption in the workplace by sanitation workers in Freetown, Sierra Leone, which were revealed during a research project on off-grid sanitation in the city. We then go on to explore our position as researchers on why and how it might be ethically important to reveal such practices in the frame of action-oriented research,² where doing so has implications for the design of interventions that are more socially just and relevant for the lived experiences of the sanitation workers in question.

Research background

The ethical dilemmas explored in this paper relate to research conducted for the project ‘OVERDUE: Tackling the sanitation taboo across urban Africa’. This project explored sanitation inequalities in several cities across Africa, with the aim of producing actionable knowledge to inform policy and the design of interventions to promote sanitation justice. The project was conducted by a team drawn from a consortium of universities, research institutes, and non-governmental organization (NGOs), funded by United Kingdom Research and Innovation, and received ethical approval from University College London (no 16739/004). Although the OVERDUE team worked across a number of cities in sub-Saharan Africa, this paper focuses on research with sanitation workers in Freetown, Sierra Leone.

One of the entry points of the OVERDUE project into sanitation inequalities in African cities was the taboos that it sets up—unwritten rules about a subject that, in most contexts, is considered largely unspeakable.³ Our research about women and men’s experiences of sanitation brought up topics such as violence, stigmatization, dirt, menstruation, and excreta. It foregrounded experiences and practices that are hard for people to talk about, but which are nonetheless organized around unspoken, yet widely known rules.

Ironically, topics such as drugs and alcohol use by sanitation workers might represent a similar taboo for us as researchers, as we conform to unwritten rules about what is considered discussable, and what is not, and negotiate uncomfortable relations with research participants. These reveal the asymmetries of the research encounter, with issues of coloniality, openness, and difference in our life comforts floating at the edge of our discussions. These asymmetries were particularly evident in our work with manual pit emptiers in Freetown.

Methodology

The project was conducted through three work packages. Work Package One (WP1) entailed building a picture of the (policy) ‘promises’ made by colonial and post-colonial institutions involved in urban delivering sanitation infrastructures, and what has been delivered in practice at city scale. Work Package Two (WP2) focused on documenting the sanitation experiences, and practices, of sanitation users and workers, prioritizing the documentation of neighbourhoods of the urban poor. Work Package Three (WP3) built on the learnings and relationships developed in WP1 and WP2 to deliver experimentations intended to build pathways towards equitable sanitation in the project cities. This involved pilot interventions (for example, a project for the design and management of inclusive public toilet blocks in Freetown). Also studied were local and international policy advocacy through the Freetown 2021 and 2022 World Toilet Day celebrations⁴ and the ‘We CRAVE’ call for action campaign. The latter was developed at a regional meeting in Nairobi in September 2023 by a collective drawn from the project and a wider network of sanitation practitioners, including, among other actors, collectives of sanitation workers. This call to action was shared at the Sustainable Development Goals Summit in New York later that month.

The research across the three work packages was conducted using qualitative data collection methods. Interviews were transcribed, anonymized, coded, and collectively analysed across the research team. The specific data collection methods relating to the work with sanitation workers discussed in this paper included interviews with ‘sanitation collectives’ (groups and enterprises working on sanitation delivery, advocacy, or governance), community workshops in the neighbourhoods of Dworzack, Colbot, and Abacha Street, where sanitation timelines and governance (through taboos, bylaws, and formal regulation) were discussed and documented, and interviews and work-shadowing of a range of sanitation workers. This coverage of these data collection methods in Freetown is presented in Table 1.

Context: Manual pit emptying in Freetown

Manual pit emptiers play a crucial role in Freetown. With a population of 1.2 million people, Freetown has only a 4-km sewage grid built in the colonial period, and this has remained unchanged despite the city doubling in population over the past 20 years. Consequently, less than 10 percent of the population is connected to the sanitation grid,⁵ and residents predominantly rely on off-grid sanitation solutions, including public and private toilets, which are either emptied directly into rivers during the rainy season or connected to a range of sealed and unsealed septic tanks that need to be periodically emptied. There are a number of private and public enterprises that empty septic tanks using mechanical emptying trucks. However, the hilly terrain and dense nature of Freetown’s informal settlements, which mainly have narrow paths rather than roads (according to Statistics Sierra Leone, 2018, 35 percent of the city’s population live in informal settlements), means that mechanical pit emptying trucks cannot access tanks, and as a result, the city is also heavily reliant on manual pit emptiers, working both as individuals and small collective enterprises.

While there is no law against manual pit emptying in Freetown, pit emptiers are officially required to transport faecal sludge in barrels to the city’s central landfill site. Our research indicates that as many tanks are inaccessible and transporting the sludge would cost more than they charge for their work, manual pit emptiers’ common practice is to dig a pit and re-bury faecal sludge in situ.⁶ Officially, this could result in a fine of up to 500,000 Leones (US$25) or up to 6 months of imprisonment.⁷ In practice, our research found that because of the impracticality of the law and the urgent need for manual pit emptiers’ work, municipal sanitation officers turn a blind eye to this practice. However, this uncertain legal status reinforces the already marginal status of manual pit emptiers.

Manual pit emptiers in Freetown are all men (though women act as commercial agents) and, based on our interviews with pit emptying enterprises, predominantly young men already facing different forms of social stigma and with difficulty in finding alternative sources of income. At the same time, while there have been several interventions, notably by the NGO GOAL, to build the capacity of and equip manual pit emptiers (with improved health and safety equipment and sludge extraction tools such as gulpers), the work remains stigmatized and poorly protected and involves significant contact of workers with untreated faecal sludge. This leads us to explore the coping strategies and aspirations of these sanitation workers.

‘Manual emptiers don’t use gloves… they get by with the help of Mr. Towel’

In this section, we present observations from fieldwork in Freetown in February 2022, as our research team investigated how inhabitants and workers handle pit emptying. The stigma of manual emptying is such that the topic is not disclosed out loud during the day but whispered at night when neighbourhoods are asleep. ‘Could you get a team to empty my pit latrine?’

The workers dig large holes near the pit to re-dump the sludge, break the seal of the concrete slab, and venture their whole bodies into the pit to shovel out buckets of faecal matter. As they perform these tasks around worn out, deficient, or absent infrastructure (Figure 1), manual emptiers are forced to break social norms about distancing with excrement, as well as municipal regulations on nuisance and sludge disposal, as discussed below.

During an interview, a representative of the Sierra Leone Federation of the Urban and Rural Poor (FEDURP) explains that:

• – [FEDURP Representative]: You can’t be in your normal state of mind to do this [manually empty pits]. […] You need to take something to change your mentality. […] Manual emptiers don’t use gloves. They use alcohol. They take Mr. Towel, too.

• – [Leblond]: Mr. Towel?

• – [FEDURP Representative] A pain killer. Strong one. Tramadol. They take 250 milligrams. In the market we call it Mister Towel.⁸

At first, we took this interview and other similar references to the use of alcohol, drug consumption, and intoxication of sanitation workers as the usual clichés and degrading speech held against emptiers. Sanitation workers had indeed been denouncing accusations of ‘madness’ in other African countries, including during the OVERDUE ‘Voicing just sanitation’ campaign.⁹

Three days after our FEDURP discussion, however, as we shadow a team of emptiers in an unrelated location of the city, we notice sachets of gin and packets of drugs littering the floor. In the house whose pit is being emptied, Bangura, Walker, and colleagues from our partners in the project, the Sierra Leone Urban Research Centre (SLURC), the Center of Dialogue on Human Settlement and Poverty Alleviation (CODOHSAPA), and FEDURP, interview the leader of the sanitation team about his work and the transformations of the profession. Outside, Leblond observes three workers getting ready to empty the pit after excavating a shallow hole to re-dispose of the sludge. The worker who has had the most gin is designated to enter the pit first. He hops in. We now only see the back of his neck and his hands raising buckets of faecal sludge that the others quickly remove and empty in the nearby excavated area (Figure 2).

Beyond anecdotal mentions encountered during interviews, Tramadol consumption was declared a ‘public health emergency’ by Sierra Leone’s pharmaceutical regulators in 2016.¹⁰ Over the past 10 years, addiction, non-medical, and recreational consumption have skyrocketed and been framed as an African ‘opioid crisis’, plaguing Nigeria, Guinea, Ghana, Sierra Leone, and Cameroon.¹¹ Studies especially track consumption among manual professions, commercial drivers,¹² and self-employed workers.¹³ Faced with observations of workers drinking and this growing public health concern, we begin to wonder: Should we explore drug and alcohol consumption amongst the already stigmatized population of sanitation workers?

The ethics of advocacy, silence, and silencing

When our research team encountered the use of alcohol and painkillers at work by manual pit emptiers, we needed to confront three ethical considerations about how we represented (or not) these practices in our findings. First, we had to consider whether to draw attention to an illegal/unsafe activity conducted by an already stigmatized group of workers, which could result in social and legal sanctions for them. Secondly, and in contrast, as the research was representing the lived experience of sanitation workers in Freetown, there was an ethical imperative to reflect what we were told and could see in a way that was coherent with how respondents had represented their working practices to us. Third, with an action-research orientation, we were concerned with negotiating a position and work relations conducive to long-term work and shared interests, not a simple ‘mediatize and run’. This meant building trust and respectful work relations and avoiding shallow activist/developmentalist tropes, which tend either to glorify sanitation workers or victimize and reinforce stigma.

It appears that the common approach in research across the sanitation sector to these ethical quandaries is to push the uncomfortable practices out of sight, in favour of validating sanitation workers as ‘unsung heroes’. Most of the scientific literature is silent on opioids and alcohol consumption in the sanitation sector. Only one out of 65 studies on the occupational health of sanitation workers in India mentions alcohol addiction.¹⁴ In Freetown, an NGO report mentions cannabis use by manual pit emptiers to ‘feel stronger’ and alcohol consumption to ‘motivate hard work’, ‘reduce shame’, ‘reduce nausea and burning sensation’, and ‘help the body tolerate exposure to faecal sludge’,¹⁵ but these themes are not explored in depth.

In parallel, the international movement that soared over the past 10 years to destigmatize, rehabilitate, and support sanitation workers has focused on appalling work conditions and abuses faced by workers, from sewer deaths to exploitation and caste-based discrimination, physical harm, as well as social stigma.¹⁶ It says little about controversial practices and harm that workers might be inflicting on themselves. For example, the international assessment of sanitation workers produced by the World Bank, the International Labour Organization, WaterAid, and the World Health Organization¹⁷ states that among sanitation workers, ‘alcoholism and drug addiction to evade the working conditions are common’, but it is neither clear if this makes it to the ‘areas for future studies’ nor on what evidence these assertions lie. The only African reference, from Burkina Faso, elusively reads: ‘The consumption of drugs and alcohol by sanitation workers is not uncommon.’¹⁸

Looking away from potentially incriminating practices makes a lot of sense from an advocacy perspective. Openly discussing these practices could reinforce stigma and discrimination, fuelling behavioural stances that link addiction to attributes of the workforce. In this vein, the president of Sierra Leone’s pharmacy board links Tramadol to a ‘general attitude and disposition’ towards illegal practices and ‘youth gang activity’.¹⁹ This can render sanitation workers less worthy of sympathy and support.

Focusing on opioids could also be called out as sensationalism, showcasing sordid details while diverting the focus away from colonial and post-colonial legacies, such as the disinvestment from sanitation infrastructure and services that affixed growing amounts of faeces to African residences, and to pit emptiers down the line.²⁰ Indeed, structural legacies are at play in shaping pit emptiers’ work conditions and their status. Manual emptying started during the colonial period, as colonial administrations failed to deliver necessary sanitation infrastructure and services and justified ‘civilizing’ practices of domination.²¹ The forceful introduction of bucket latrines and night-soil work (often tapping into prisoners and forced labour), paralleled by limited investments in collective sanitation infrastructure for the privileged, made manual pit and pail emptying both necessary and stigmatized.²²

In the 2020s, these political and infrastructural legacies are still vivid: 75 million urban inhabitants in sub-Saharan Africa are served by sewers versus 123 million relying on septic tanks and 191 million on pit latrines.²³ As a result, 80 percent of human excreta in African cities remain in the subsoil, are directly discharged in the environment, or are removed mechanically or manually by sanitation workers. Although several ethnographic and historical investigations of ‘night-soil men’ exist,²⁴ this is far from a systematic engagement with the breadth of the workforce and the question. As international institutions put it, that workforce is ‘far too often invisible, unquantified, and ostracized’.²⁵ However, as Desvaux²⁶ demonstrates with the case of Zabbaleen waste pickers in Egypt, the accumulation of research and media coverage does not necessarily yield better descriptions but can trap researchers in pre-constructed narratives that need to be critically examined.

Romanticizing research participants

Given the sensitivity of sanitation as a sector and a profession, it might seem safer to produce iconic and romantic characters—heroes, saints, villains, and victims—and brush away elements that might tarnish the picture. After all, the packets of Tramadol pills confuse the picture of an exploited labour force. Drugs can be relegated to the background, and the narrative refocused ‘from the worker’s point of view’ on protective equipment and improved trucks (Figure 3). The sacrifice of ethnographic depth and analysis is an effective move and is a well-worn method of pragmatic activism.

But romanticized visions of unduly stigmatized populations can be harmful too, as they remain shallow and partial. They overlook the trade-offs, messy identities, and compromised and criminalized agencies that sanitation workers sometimes must put up with to operate above and below ground. They could contribute to the sort of epistemic disarticulations that render the lives of Africans illegible.²⁷ Furthermore, they also risk discrediting accounts of professional hazards, dismissed as personal behavioural issues. If indeed there are ‘widespread substance abuse’²⁸ and common ‘alcoholism and drug addiction’ (see Footnote 16) among African pit emptiers, then silencing comes at a high cost too. How are these practices accounted for in occupational hazard assessments? Are morbidity and mortality rates dismissed because of addiction or is addiction being acknowledged as a coping mechanism? These ambiguities and tangles will be familiar to many researchers, ethnographers, geographers, and health practitioners alike as they directly relate to their/our positionality in the field and the relations they/we establish with their/our research subjects and partners.

Dealing with ambiguity: Precedents and pitfalls

In considering how to address these ethical issues in our research, we were able to refer to accumulated experiences of addressing such ambiguous topics in social research. Stigmatized communities, criminalized behaviours, and illegal practices, and how to document them, are not unprecedented terrains or encounters for sociology and ethnography. Since the 1950s, the Chicago School of Sociology has worked precisely on these questions. Authors such as Howard Becker²⁹ have documented how marijuana consumption is not the result of a state of mind or intrinsic weakness, as health/psychology experts framed it then, but a social practice learned by consumers and reinforced by social norms regulating the consumption.

Examining practices labelled as ‘toxic’, ‘deviant’, or ‘harmful’ as interactions that are part of wider social relations and constraints has also been taken up in ethnographies of health and work. These have tackled a broad range of cases, from obesity—drawing attention to structural, spatial, and social mechanisms favouring the accumulation of fat beyond personal eating patterns³⁰—to electronic waste processing in Ghana that trace exclusion processes to make sense of e-waste burning practices in Agbogbloshie.³¹

However, descriptive accounts of ambiguity and blameworthy practices have backfired and been criticized as colonial (degrading, lacking accountability, and extractive) and as ‘white sociology’,³² enabling a number of white sociologists to make a career on degrading observations while putting themselves in secure positions. Criticism has come from researched populations, indigenous researchers, and advocacy groups alike. Already in the 1940s, South African Zulus opposed the continuation of ethnographic fieldwork by Max Gluckman after he exposed the complicity of Zulu officials with the white colonial administration.³³ Advocacy groups and decolonial/anticolonial scholars have argued that descriptions of poverty, violence, and harm could reinforce othering stereotypes.³⁴ Scholars such as Alice Goffman, first acclaimed for her work on the justice system’s impacts on black communities of West Philadelphia,³⁵ faced backlash, for example, for focusing on the lives of black criminalized men while not engaging with her positionality.³⁶

Ethical challenges in research practice

In this context as a team, we needed to agree on how to address the ethical implications of representing manual pit emptiers’ uses of alcohol and painkillers. Should we erase the pictures? Should we follow up on alcohol and Tramadol consumption? Should we look at our navels and reflect on why we were shocked by drug consumption among sanitation workers in the first place when opioids and alcoholism also flourish within our own white-collar communities? Should hidden dimensions of sanitation work remain hidden to protect the integrity of workers? These questions are textbook ethical questions. Answers, however, are neither clear-cut nor intrinsic but, rather, context-dependent.

Indeed, the overarching contribution of the authors cited above³⁷ is to demonstrate that stigmatized or ‘deviant’ behaviours are often not the result of the individual agency of those engaged in such practices but are rather choices that are highly influenced if not constrained by wider structural power relations, such as social norms, and access to resources and infrastructure. This more ‘structural’ analysis has in some (rare) cases been applied to substance consumption by pit emptiers. For example, manual pit emptiers in Haiti, known as ‘bayakous’, are described as ‘extremely intoxicated with homemade alcohol in order to bear the smell’,³⁸ an observation weaved into a broader analysis of the structural violence embodied in health hazards and inadequate sanitation.

Using this structural analysis, there need not be a dichotomy and clash between our ethical concerns (how to represent a ‘true’ account while not further stigmatizing pit-emptiers, accounting for ambiguity while maintaining trust). This is because the stigma of drug and alcohol use by sanitation workers is linked to the idea that these workers are making poor and reckless choices and/or unable to control addictions. In contrast, if drug and alcohol use is the consequence of problematic social norms and the unequal legacy of (post-colonial) sanitation institutions, the responsibility and stigma attach not to the individual workers but to structural power dynamics. In this vein, we turn to the political underpinnings of researching sanitation work in urban Africa and how it has tended to elide the structural and colonial legacy of sanitation injustices shifting blame and stigma to sanitation users and workers.

Drug and alcohol consumption: Individual behaviour and addiction, or a collective means to manage social norms?

As Bangura shadowed pit emptiers, research participants’ accounts began to reveal that, rather than being triggered by individual choices or substance addictions, inadequate infrastructure requiring physical context with excreta, and social stigma around sanitation work, were the drivers behind psychotropic consumption. ‘How can I play with someone’s waste when I am in my normal state? I need to be in a second state of mind’ explained a worker justifying alcohol consumption to Bangura. The open display of gin and Tramadol in the workplace was thus legitimated by social norms surrounding faecal matter and its handling.

Although our research in Freetown found that pit emptiers have shifted from a hidden trade performed at night to an important service conducted during the day, their work is still stigmatized as ‘dirty’ business, and one that no one in their normal state of mind should do. A norm has therefore emerged that workers must perform their work under the influence of substances to overcome their senses. This narrative, shared by workers and customers alike, frames alcohol and opioids as a paradoxical protection—one that workers should take to protect their mental integrity by indeed giving up on their full consciousness when working: To be considered human while performing a task perceived as ‘inhuman’, one had to visibly take drugs and enter a ‘mad world’, which could be left and closed off afterwards.

In short, for manual pit emptiers, placing one’s body and mind under influence turned out to be what sociologist Erwing Goffman³⁹ would call their ‘demeanor’, a ‘ceremonial behaviour typically conveyed through deportment, dress and bearing’, both a social obligation and expectation, just as policemen wear uniforms and undertakers discipline their bodies and the corpse during mortuary rituals.⁴⁰

As workers described their ‘need to be drunk [in order] to work’, it became clear that in the context of manual pit emptying, alcohol and Tramadol were not about addiction. Rather, they served a double function, enabling workers to distance mentally from faecal matter while handling excreta on the one hand, and ritualizing shifts between normal and abnormal to preserve social relations and status on the other hand. As we further investigated formal and informal ‘by-laws’ regulating sanitation work (which is how the sanitation worker teams describe their workplace rules), the ostensible consumption of psychoactive substances appeared very regulated indeed.

A controlled loss of control in the workplace

Two informal by-laws widely enforced in Freetown in relation to the use of psychoactive substances were brought forward by sanitation workers in interviews and workshops:

1. For mechanical workers: ‘No team member should come to work drunk.’

2. For manual pit emptiers: ‘All team members are provided with a packet of cigarettes and sachets of alcohol’, but their ingestion should be controlled. As a manual emptying team leader explained, ‘All team members must take 3 packets of gin before the work starts, 3 during operation, and then 4 once the work is completed.’

Stemming from these by-laws, it thus appeared that in both cases, workers were to remain in control of vehicles, equipment, and sludge. If manual emptiers were expected to have drunk, this was in limited quantities, enabling them to perform their work successfully.

It also appeared that consumption was stratified along the sanitation ladder and the amount and visibility of alcohol and drug consumption diminished from manual to mechanical work. Supply practices went in this direction too: If customers were expected to provide manual emptiers with pills and sachets, mechanical emptiers were not supposed to be given alcohol by customers or co-workers. If they had a drinking habit, this was to be outside of the workplace and invisible, like any other worker that we could see buying gin sachets from sellers near public toilets but that nobody mentioned in the interviews.

Furthermore, addiction did not stand out as an issue specific to the sanitation sector and was never described as a problem. Rather, the consumption of psychoactive substances appeared as a ritual that would change if stigma was lifted, and work conditions improved. Given the expectations of sanitation workers described below, we decided not to investigate this topic further, but instead to reflect on ground rules to handle controversial practices, to which we now turn.

Practical implications for research ethics?

Given our research findings, in the context of the reflections above, as a research team, we needed to consider how we could practically manage the ethical implications of writing up the contentious practices of manual pit emptiers. As a research project funded by a national research council, based at a university, we had undergone an ethical approval process designed to ensure that our research participants were protected and would not face negative impacts because of engaging with us, including being exposed to social stigma or legal sanctions. Central principles of this institutional ethics approach are, first, the securing of ‘informed consent’ by participants and, secondly, the use of data protection protocols and anonymization to avoid individual research participants being identifiable in research outputs and subject to social and legal sanctions.

However, while these ethical protocols protect the individual sanitation workers that we interviewed from having some of their stigmatized working practices made public without their consent, the focus is on protecting individuals and does not address the ethical implications of making public the taboos of sanitation workers as a category. Yet, this could have profound consequences for this collective, both in terms of reinforcing social stigma and in terms of informing public policies about how the sanitation workforce is managed and policed.

The ethical relations of our research were very much understood by our research participants in practical terms—they were explicitly concerned with how our research might affect their working conditions. Accessing sanitation workers in Freetown proved uneasy (Figure 4). Bangura was turned down by a mechanical vacuum truck operator accusing him of ‘making money from his head’, being ‘always at [their] doorstep asking information’ but ‘not doing anything [for pit emptiers]’. The worker continued, ‘We channelled our concerns to [an NGO] and the government for help with the vacuum trucks but no one helped. We are now using our own money to buy our trucks and do our businesses…. And you are behind us to ask for information, but you were not the ones helping us, so why should you ask about our business?’ The mechanical truck operator then denied our request to shadow his workers, limiting our possibility to document the lived experiences of his team.

Beyond the specific afterlives of development projects considered ‘unhelpful’ by sanitation workers, this refusal sheds light on power dynamics in Freetown’s sanitation sector. Desludging businesses are both in critical material conditions and in powerful positions by which they can turn down seemingly useless interviews and participatory processes. To operate, researchers must demonstrate the added value of their approach and perform benefits right from the start.

In light of this, it became apparent that the individualizing ethical mechanisms of consent and anonymity can be argued to derive from the ethical norms of a Global North university research ethics committee, rather than from ethical norms in the research context.⁴¹ This runs the risk of basing ethical principles on a ‘Western-propagated universalism’ rather than fostering ‘… proactivity in the adoption of deeper levels of self-scrutiny among researchers through an intersectional lens that places the researcher and the researcher’s work within the frames of historical and present-day contexts’.⁴² In this light, in the context of our research, we felt it would be preferable to go beyond a ‘procedural’ to a ‘practical’ approach to ethics⁴³ and to adopt what has been framed as a ‘situated ethics’.⁴⁴

The first aspect of our aim to deliver situated ethics relates to participants’ concerns about our research’s relation to their livelihoods, as discussed above. Our formal consent forms—and the matching audio–video versions—explained that interviewees would not be remunerated and that the project would not bring direct intervention but long-term benefits (for example, through policy advocacy). However, we soon needed to revisit this stance. Interviewees’ expectations forced Bangura to build in ‘tokens of gratitude’—based on humanity rather than formal ethical guidelines:

It is based on our human feeling. You ask that person to move away or use her time – How can you use someone else’s time during which she has to look for her livelihood? How can you take the livelihood of a half day for your own business without compensating?⁴⁵

Our team, comprising Sierra Leonean and foreign researchers, was especially concerned with engaging with research participants in a way that would be productive and respectful in both the short term and the long term. As in other African urban settings, we ended up adapting our approaches and guidelines to produce ‘dirty yet ethical’ methods.⁴⁶

The pit emptying observations described above are the result of such an adaptation: The interviewee and leader of the emptying team performed his work on our demand and on our project’s budget, as we covered the cost of the sludge removal process. This was not simply an artefact of our research approach (generating desludging timing convenient for our ‘parachuted’ foreign members to observe) but also the fruit of a skilful negotiation by the leader of the pit emptying team, who set the price and the place—offering his desludging service to a family member. In that context, as we shall illustrate below, extraction and benefits were very much mutual.

The second focus of our situated ethics concerned our mode of reflecting on the ethical implications of psychotropic consumption for the social status and official treatment of sanitation workers, which implied trying to work ethically ‘within’ the context of sanitation work in Freetown. In this vein, the following principles of conduct came to the fore:

1. As a team, engage, do not elude: We included ambiguous and potentially illegal practices in our collective debriefings and discussions rather than overlooking them. Placing them as observations that could further be backed by data collection or kept untouched helped us to discuss methodological challenges and strategic choices. This is especially important to locate and counter orientalist tropes by which a foreign (Western) perspective can end up emphasizing exoticness and otherness.⁴⁷ It is also critical to question the stereotypical descriptions that stem from over-researched objects/subjects or trendy paradigms that can erase and simplify attachments and complexities of grounded importance.⁴⁸ Having the Freetown team contextualize drinking, drugs, and addiction within the sanitation sector and beyond and highlighting how pit emptiers’ practices differed were critical for us to understand as a team what was at stake and how to handle it, that is, contextualizing the research question and methodology.⁴⁹

2. Make sure the subjects/participants are aware of the topics of interest to you, as they emerge: Research interviews can sometimes be understood as ‘warm, caring, and empowering dialogues’, but they are de facto moments of data collection crafted to ‘efficiently obtain a disclosure of the interview subjects’ world’ and they are riddled with power asymmetries.⁵⁰ Consent forms do not inform on what exactly will be recorded, as they are signed beforehand, and discussions and observations can go beyond what was expected.⁵¹ Furthermore, analysis and interpretation are out of the hands of interviewees, and cherry-picking can yield profoundly distorted interpretations. We did not presume that some topics could not be discussed a priori but rather sought the rules ordering a given practice, moving them from mere anecdotes to topics of conscious discussion. This way we ensured that the interviewees knew of our interest and recording of things and were not caught by surprise or feel instrumentalized on points that they would have liked to keep secret.

3. Think twice and collectively about outwards communication and outputs: We discussed collectively, sometimes going back to research participants, what should be publicly shared and how. Blurring, anonymizing, dubbing, as well as last-minute editing when interviewees changed their minds were some of the practices we adopted to reconcile documentation and protection. There is no doubt that ‘Stories of trash and the people who deal with it must be made visible in a way that ensures those who work with our most intimate discarded things are safe from ridicule or retribution.’⁵² However, the boundaries of safety, ridicule, respect, and anonymity are situated and subjective, hence here again these decisions must entail discussions and sometimes concessions to those who live in the researched place and bear the immediate consequences and long-term responsibility of the research produced.

4. Think about further engagements: Accountability in research has been criticized as shallow, too often leaving research participants in the same situation if not worse off. As Toyin Falola phrases it, ‘Front-ended Eurocentric methodology is supposedly designed to envisage in advance field-specific details and knowledge extraction but lacks design on how to monitor the return of the refined knowledge back into their contexts.’⁵³ As a response, decolonial researchers invite us to think about engagements and returns with participants, in the long term and from the start. The central ethical and political question here is ‘who’ exactly should be embedded and seen as the beneficiary of the knowledge produced. The push by UK funding agencies for research ‘impact’ has sometimes led to producing knowledge for Western donors rather than African institutions, which has been interpreted by some as a continuation of colonial research and a tool for indirect rule.⁵⁴ In our case, sanitation workers and municipal institutions were at the core of the engagements envisioned, and bringing questions of expectations, as we detail below, put a halt to our line of enquiry.

5. Frame the findings to reveal the structural underlying causes and associated responsibilities: As the project has an action research component through WP3, we intended to use our findings to inform policy and sanitation interventions. Given this, what became crucial in this case was to emphasize the structural dynamics that led to the practices of substance use. In our analysis, these structural dynamics leading to substance use by sanitation workers include inadequate infrastructure for sludge storage, transport, and treatment, and social stigma around sanitation work, which required the ritual of substance consumption to maintain manual worker’s dignity. Such analytical framing leads to a different set of policy implications—shifting from behaviour change and policing of sanitation workers to revisiting off-grid sanitation investments and addressing social norms that stigmatize sanitation work.

Conclusion: Practical ethics and ambiguous subjects

Our research with sanitation workers in Freetown led us to confront the ethical implications of how to treat ambiguous and poorly regarded practices of an already highly stigmatized group of workers. It also led us to consider how to address this in the context of an already problematic set of power relations between our development research institutions and the research subjects—workers in a marginalized and legally liminal space.

Given this background of power hierarchy, the material benefits of research were an important determinant of our relationship with research participants and the ethics that underpinned these. This question was very much at the forefront of interviews, focus groups, and shadowing of workers alike. In some cases, such as the pit-emptying process described above, reciprocal interests could be encountered. However, that mutualist relationship was not systematic and other waste workers, especially mechanical emptiers, were less enthusiastic about another study/project on their work practices. Especially, the question of alcohol and drug consumption was a difficult starting point as it is not a desired site of intervention and cannot be easily converted into beneficial returns.

On reflection, given our analysis that routinized consumption of alcohol and painkillers by sanitation workers was a collective response to structural norms and inequalities, we felt that it was a topic that should be reported as a basis to negotiate for policy interventions that challenge these structural determinants of behaviour. Workers mentioned precisely such structural and material constraints hindering their work as topics of interest: The need for broader recognition and better work conditions.

Therefore, we decided that the need for discussing substance consumption by sanitation workers was to challenge the dominant water, sanitation, and hygiene policies—behaviour change and technological fixes⁵⁵—and to focus instead on policy advocacy to address the structural dynamics that leads to such practices, that is, approaches to urban sanitation that stigmatize off-grid sanitation workers at the same time as relying on their work, and fail to provide the infrastructure and services required for their work to be dignified.

In another context, discussions around substance use might have quite different ethical implications. Bangura’s field observations in Freetown raised the concern for more serious forms of addiction among unemployed youth and poor residents, especially to ‘Kush’, a new widely used substance, which is overtaking tramadol as it is cheaper and creating major health concerns due to its uncontrolled chemical composition.⁵⁶ Occurring in a much less ritualized and socially controlled setting, this constitutes a greater preoccupation than the intoxication of sanitation workers. It will nonetheless require just as much caution and anticipation to not further marginalize those put in less favourable situations.

In summary, our ethical decision to report and analyse substance use by workers in an action research project focused on sanitation justice has been based on our observation that this practice informs debates on the underlying structural drivers of undignified and hazardous work in the sector. Analysing this practice may also be a route towards collective responses. As argued by Allen,‘[A]s those stigmatised become individualised, isolated, and undermined, they also are deprived of being part of a collective experience and are deeply challenged to reclaim their agency as entitled citizens.’⁵⁷

As researchers, we can play an active role in counteracting stigma, by openly talking about unspoken practices and challenging discrimination. While silence might feel a most comfortable, risk-free, and ‘politically-correct’ option, it also helps to reproduce stigmatization mechanisms by overlooking the conditions of their emergence and the consequences for those routinely stigmatized. Instead, we call for embracing a sensitive but more political approach to research that does not shy away from our engagement with the contradictions and choices that plague our encounters in the field.

Footnotes

Author notes