CWWeekly presents this feature as a spotlight on issues faced by executives in clinical research. This week, writer Karyn Korieth spoke with Dr. Mohammed Siddique Tayob, CEO of the Mzansi Ethical Research Centre in Middelburg, South Africa, the winner of the Society for Clinical Research Sites’ 2015 Site Patient Recruitment Innovation Award (SPRIA), which recognizes sites that employ innovative patient recruitment strategies.
Q: Tell us about your research center’s innovative efforts to engage traditional healers in referring patients for clinical studies.
A: In South Africa, traditional healers are people who heal with herbs, fruits and other medicinal potions. They evoke the ancestral spirit of people, so it’s not really a scientific treatment modality. My wife, Dr. Ayesha Bassa, with whom I started a medical practice 25 years ago, did some research and found that up to 80% of the population would consult a traditional healer before consulting a Western or allopathic medical practitioner. [The World Health Organization also has published this statistic.] It’s a traditional, cultural belief system that has been around for hundreds of years.
In rural, third-world places, people are skeptical or suspicious of what we do. We thought if we could get buy-in from the traditional healers and if they would recommend patients to participate in clinical research or a study, it would make it much easier for the patient to consent or participate in such a program. So we went out and tried to develop relationships with traditional healers. Obviously, they were suspicious at first because traditionally we operate on opposite sides of the fence. It took us about three or four years to gain their confidence. We showed them … that we didn’t want to steal their patients or condemn them in front of their patients. Over time, they understood the benefits of clinical research for patients and it was a great benefit for us to recruit from their patient base.
Today, we give the traditional healers regular updates about our clinical studies. We do luncheon programs with them and from time to time they just pop in, have a cup of tea and discuss what we are doing. Our recruiters also meet with them and inform them about our studies and give them the basic inclusion/exclusion criteria so that they have a rough idea of the type of patients we are looking for.
Traditional healers have become like other types of health practitioners referring patients. We give them feedback, as well, and educate them about the disease process. It has become a comprehensive, holistic approach. Everyone gets a bit more empowered and knowledgeable. The element of treating the traditional healers as professionals, with the respect that they deserve, also helps. They are interested in learning and being part of a process.
Q: What other types of community engagement and clinical trial awareness programs have you conducted in your large farming and industrial town in South Africa?
A: For us, innovative recruitment is not just about newspaper ads or convincing the patient that they need to come and participate in a study. One of the key goals is access. A lot of times we have patients who would be willing to participate in studies, but access to our facility is an issue. We developed our own transportation infrastructure. We have our own vehicles, drivers and pick-up points. We had to implement processes and infrastructure that other sites may not need when they are based in cities or first-world countries.
We were involved in community projects long before we started the clinical research center in 2000. You need to earn the trust of your community. If you look at it from their perspective, they are putting their lives in your hands. You have to develop your site into a place that is very welcoming and address their transportation needs.
We also arranged a cooking class for diabetic patients and invited the whole town. We contacted Wayne Kaminsky, who is the CEO of FitChef Food in South Africa, and convinced him that it was an empowerment project for our community. He was kind enough to conduct a hands-on cooking class for diabetic patients that taught them about real, affordable food that used local ingredients. After the class, we informed the participants about research, what we do and how it benefits people.
Q: What lessons can other investigative sites learn from your initiatives?
A: For us, a key component is that we were prepared to re-invest our earnings over the years to improve the site. Most sites are not taking their clinical research dollars and investing in their sites, transportation or in the community. They don’t see the long-term benefits. You are not always going to see the returns immediately.
The culture of the site also is key. It needs to be patient-centric and welcoming. You need to be constantly aware that you are talking about sensitive issues. We have study coordinators and recruiters that speak the 11 official languages that we have in this country, plus Swahili and French. Being able to speak to people in their language, understand nuances and their cultural sensitivities, helps us understand the patient.
This article was reprinted from Volume 20, Issue 15, of CWWeekly, a leading clinical research industry newsletter providing expanded analysis on breaking news, study leads, trial results and more. Subscribe »