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Handbook of Community-​Based
Participatory Research
 Handbook of
Community-​Based
Participatory Research

EDITED BY STEVEN S. COUGHLIN

SELINA A. SMITH

and

MARIA E. FERNANDEZ

1
1
Oxford University Press is a department of the University of Oxford. It furthers
the University’s objective of excellence in research, scholarship, and education
by publishing worldwide. Oxford is a registered trade mark of Oxford University
Press in the UK and certain other countries.

Published in the United States of America by Oxford University Press

198 Madison Avenue, New York, NY 10016, United States of America.

© Oxford University Press 2017

All rights reserved. No part of this publication may be reproduced, stored in

a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
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rights organization. Inquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above.

You must not circulate this work in any other form

and you must impose this same condition on any acquirer.

Library of Congress Cataloging-​in-​Publication Data

Names: Coughlin, Steven S. (Steven Scott), 1957–​editor. | Smith,
Selina A., editor. | Fernandez, Maria E. (Maria Eulalia), editor.
Title: Handbook of community-​based participatory research /​edited by
Steven S. Coughlin, Selina A. Smith, Maria E. Fernandez.
Other titles: Community-​based participatory research
Description: Oxford ; New York : Oxford University Press, [2016] | Includes
bibliographical references and index. | Description based on print version
record and CIP data provided by publisher; resource not viewed.
Identifiers: LCCN 2016031904 (print) | LCCN 2016030512 (ebook) |
ISBN 9780190652241 (e-​book) | ISBN 9780190652258 (e-​book) |
ISBN 9780190652234 (paperback : alk. paper)
Subjects: | MESH: Community-​Based Participatory Research
Classification: LCC R850 (print) | LCC R850 (ebook) | NLM W 84.3 |
DDC 610.72/​4—​dc23
LC record available at https://​lccn.loc.gov/​2016031904

This material is not intended to be, and should not be considered, a substitute for medical or other
professional advice. Treatment for the conditions described in this material is highly dependent
on the individual circumstances. And, while this material is designed to offer accurate information
with respect to the subject matter covered and to be current as of the time it was written, research
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loss, or risk that may be claimed or incurred as a consequence of the use and/or application of any of
the contents of this material.

9 8 7 6 5 4 3 2 1
Printed by WebCom, Inc., Canada
 Contents

Preface    ix
Contributors    xiii

1. Overview of Community-​Based Participatory Research    1

S t e v e n S . C o u g h l i n , P h D , S e l i n a A . S m i t h , P h D , M D i v, a n d
Maria E. Fernandez, PhD

2. Community-​Based Participatory Research Study Approaches Along

a Continuum of Community-​Engaged Research    11
S t e v e n S . C o u g h l i n , P h D a n d W o n s u k Y o o, P h D

3. Research Methods and Community-​Based Participatory Research:

Challenges and Opportunities    21
Carl Kendall, PhD, Annie L. Nguyen, PhD, MPH,
J e n n i f e r G l i c k , P h D , M P H , a n d D av i d S e a l , P h D

4. The Use of GIS/​GPS and Spatial Analyses in Community-​Based

Participatory Research    39
T o n n y J . O ya n a , P h D

5. Ethical Issues in Community-​Based Participatory Research Studies    57

Steven S. Coughlin, PhD and Leland K. Ackerson, ScD

6. Community-​Based Participatory Research Studies

in Faith-​Based Settings    71
H e at h e r K i t z m a n - ​U l r i c h , P h D a n d C h e r y l L . H o lt, P h D

v
vi contents

7. Special Issues in Conducting Community-​Based Participatory Research

Studies with Ethnic and Racial Minorities    81
M a r i a E . F e r n a n d e z , P h D , N at a l i a I . H e r e d i a , M P H , L o r n a H .
M c N e i l l , P h D , M P H , M a r i a E u g e n i a F e r n a n d e z - E​ s q u e r , P h D ,
Yen-C ​ h i L . L e , P h D , a n d K e l ly G . M c G a u h e y, B S

8. Community-​Based Participatory Research Studies

Involving Immigrants    115
Lisa M. Vaughn, PhD and Farrah Jacquez, PhD

9. Applying a Community-​Based Participatory Research Approach

to Address Determinants of Cardiovascular Disease and Diabetes
Mellitus in an Urban Setting    131
Tobia Henry Akintobi, PhD, MPH, Kisha B. Holden, PhD, MSCR,
L at r i c e R o l l i n s , P h D , M S W , R o d n e y L y n , P h D , M P H , H a r r y J .
Heiman, MD, MPH, Pamela Daniels, PhD, MBA, Glenda Wrenn,
M D , A l ly s o n S . B e lt o n , M P H , P e t e r B a lt r u s , P h D , S h a n i c e
B at t l e , M P H , a n d L a S h a w n M . H o f f m a n

10. Community-​Based Participatory Research Addressing

Infant Mortality    155
Steven S. Coughlin, PhD and Selina A. Smith, PhD, MDiv

11. Colorectal Cancer Disparities and Community-​Based

Participatory Research    167
S e l i n a A . S m i t h , P h D , M D i v, B e n ja m i n E . A n s a , M D , M S C R , a n d
Daniel S. Blumenthal, MD, MPH

12. Community-​Based Participatory Research Studies on Breast and

Cervical Cancer Screening    185
S t e v e n S . C o u g h l i n , P h D , E m i ly Y o u n g b l o m , M P H , a n d
Deborah J. Bowen, PhD

13. Overview of Community-​Based Participatory Research

in Environmental Health    205
S t e p h a n i S . K i m , M P H a n d E r i n N . H ay n e s , D r P H , M S

14. Community-​Based Participatory Research Studies on Interpersonal

Violence: Ending the Cycle of Poverty and Violence    223
Steven S. Coughlin, PhD
 contents vii

15. Using Community-​Based Participatory Research

Approaches in HIV: Three Case Studies    235
M a r a B i r d, P h D , B r i t t R i o s - ​E l l i s , P h D , J a s o n G l o b e r m a n ,
M S c , D av i d G o g o l i s h v i l i , M P H , A l i c e W e l b o u r n , P h D ,
U l r i k e B r i z ay, P h D , L i n a G o l o b , M S c , S h i r i n H e i d a r i , P h D ,
and Sean B. Rourke, PhD, FCAHS

16. Engaging Communities in Translational Research    251

S t e v e n S . C o u g h l i n , P h D a n d C a r o ly n M . J e n k i n s ,
DrPH, MSN, RN, RD, LD, FAAN

17. Summary and Conclusions    267

Steven S. Coughlin, PhD

Index    277
 Preface

As a collaborative approach to research, community-​based participatory research

(CBPR) equitably includes all partners in the research process and often involves
partnerships between academic and community organizations with the goal of
increasing the value of the research product for all partners. In the past, social
scientists and researchers who focused on disease prevention tended to con-
duct studies of social phenomena and community problems with an “outsider’s
approach” which distanced the research from the participants’ daily lives. This
approach was questioned by theorists such as Kurt Lewin and Paulo Freire, who
proposed more participatory and inclusive methods. As detailed in ­chapter 1 by
Steven Coughlin, Selina Smith, and Maria Fernandez, and in several other chap-
ters in this volume, current perspectives seek to address the complexity of the
human experience and the differential power that sometimes exists between aca-
demic researchers and research participants.
Community-​based participatory research is linked to other social justice–​
informed methodologies to research (e.g., action research, participatory action
research, and participatory learning and action) that attempt to empower com-
munities to address the root causes of inequality and identify their own prob-
lems and appropriate solutions. Community-​based participatory research strives
to acknowledge and implement the participants’ needs, behaviors, and beliefs
concerning their well-​being. Community-​based participatory research takes into
account the strengths and insights that community and academic partners bring
to framing health problems and developing solutions. Not all research that is con-
ducted in communities (community-​placed research) is participatory in nature.
Rather, CBPR and related approaches to community-​engaged research occur
across a continuum, as discussed in ­chapter 2 by Steven Coughlin and Wonsuk
Yoo. In its purest form, CBPR involves true partnerships between academic
researchers and community members.
This book on CBPR is an important addition to Oxford University Press’s
outstanding line of books on public health and related topics because of

ix
x preface

widespread interest in CBPR; health disparities; public health research involv-

ing racial and ethnic minority communities; the health of immigrants; women’s
health; maternal and child health; infant mortality; cancer screening; preven-
tion of cardiovascular disease, hypertension, obesity, and diabetes; cigarette
smoking, physical activity, and diet; HIV/​AIDS prevention; faith-​based health
interventions; gay, lesbian, bisexual, and transgender health; mental health;
substance abuse; sexual assault and violence; urban health; rural health; envi-
ronmental health and environmental justice; global health; research ethics; and
public health ethics. This volume complements and explicates closely related
developments such as community-​ based evaluative research, community-​
engaged research, and the National Institutes of Health (NIH) Clinical and
Translational Science Awards.
This book is likely to be a useful resource for public health researchers, practitio-
ners, and members of communities who are challenged by health disparities. This
book will be of interest to practicing public health professionals from various pub-
lic health disciplines (epidemiology, behavioral science, health communications,
community engagement, nutrition, environmental health, health disparities, and
global health) and to members of nonprofit organizations, community-​based
organizations, and members of community coalitions and health advocacy orga-
nizations. Many contributors to this book are nationally and internationally rec-
ognized for their work. The chapters were contributed by experts from a variety of
backgrounds and disciplines. Notably, several of the authors who contributed to
this volume are members of community-​based organizations, community coali-
tions, and nonprofit organizations in the United States, Canada, Great Britain,
and Switzerland. While editing this book with his coeditors, Steven Coughlin
served as a member of both the Connect-​to-​Protect community coalition on HIV/​
AIDS among young people in Memphis, Tennessee, and the Mayor’s Health Task
Force Healthy Active Living Working Group in Lawrence, Massachusetts. Maria
Fernandez was founder of Latinos in a Network for Cancer Control (LINCC)
in Texas.
We are grateful to our families and close friends who supported us in this
multiple-​year effort. We would thank Chad Zimmerman, our editor with Oxford
University Press, and his assistant Chloe Layman. In addition, we are grateful to
our professional colleagues and students at the Rollins School of Public Health
at Emory University (S.S.C.); the University of Tennessee College of Medicine
Department of Preventive Medicine (S.S.C.); the University of Massachusetts
Lowell Division of Public Health (S.S.C.); the University of Massachusetts Center
for Clinical and Translational Sciences (S.S.C.); the Augusta University College
of Health Sciences (S.S.C.); the Institute for Public and Preventive Health at the
University of Augusta (S.A.S.); the Department of Family Medicine at the Medical
College of Augusta (S.A.S.); and the University of Texas at Houston School of
 preface xi

Public Health (M.E.F.). Selina Smith was supported by a grant awarded to the
Augusta University Institute of Public and Preventive Health by the National
Cancer Institute (R01CA166785).
S.S.C.
Augusta, Georgia
S.A.S.
Augusta, Georgia
M.E.F.
Houston, Texas

Leland K. Ackerson, ScD, MPH
Graduate Public Health Program
Coordinator
Associate Professor
Department of Community Health
and Sustainability
University of Massachusetts, Lowell
Lowell, Massachusetts
Tobia Henry Akintobi, PhD, MPH
Associate Professor and Associate
Dean, Community Engagement
Director, Prevention Research Center
Director, Evaluation and Institutional
Assessment
Associate Professor
Department of Community Health
and Preventive Medicine
Morehouse School of Medicine
Atlanta, Georgia
Benjamin E. Ansa, MD, MSCR
Senior Research Associate
Institute of Public and
Preventive Health
Augusta University
Augusta, Georgia
Contributors
Peter Baltrus, PhD
Associate Professor of Community
Health and Preventive Medicine
National Center for Primary Care
Morehouse School of Medicine
Atlanta, Georgia
Shanice Battle, MPH
Department of Psychiatry
Center for Maternal Substance Abuse
and Child Development
Emory University School of Medicine
Atlanta, Georgia
Allyson S. Belton, MPH
Associate Project Director
Satcher Health Leadership Institute
Morehouse School of Medicine
Atlanta, Georgia
Mara Bird, PhD
Director
Center for Latino Community
Health, Evaluation and Leadership
Training
California State University,
Long Beach
Long Beach, California
xiii
xiv c o n t r i b u to r s

Daniel Blumenthal, MD, MPH Maria Eugenia

President, American College of Fernandez-​Esquer, PhD
Preventive Medicine Associate Professor of Health
Professor Emeritus Promotion and Behavioral
Department of Community Health Sciences
and Preventive Medicine University of Texas Health Science
Morehouse School of Medicine Center at Houston, School of
Atlanta, Georgia Public Health
Houston, Texas
Deborah Bowen, PhD
Professor Jennifer Glick, PhD, MPH
Department of Bioethics and Department of Global Community
Humanities Health and Behavioral Sciences
School of Medicine School of Public Health and Tropical
University of Washington Medicine
Seattle, Washington Tulane University
New Orleans, Louisiana
Ulrike Brizay, PhD
University of Applied Science, FH Jason Globerman, MSc
Erfurt, Germany Ontario HIV Treatment Network
Toronto, Canada
Steven S. Coughlin, PhD
Associate Professor David Gogolishvili, MPH
Department of Clinical and Digital Ontario HIV Treatment Network
Health Sciences Toronto, Canada
College of Allied Health Sciences
Lina Golob, MSc
Augusta University
International AIDS Society
Augusta, Georgia
Geneva, Switzerland
Adjunct Professor
of Epidemiology Erin N. Haynes, DrPH, MS
Rollins School of Public Health Associate Professor
Emory University Director, Clinical and Translational
Atlanta, Georgia Research Training Program
Director, Community Outreach and
Pamela Daniels, MBA, MPH, PhD
Engagement Core, Center for
Epidemiologist
Environmental Genetics
Morehouse School of Medicine
Division of Epidemiology
Atlanta, Georgia
Department of Environmental Health
Maria E. Fernandez, PhD University of Cincinnati, College of
Director, Center for Health Promotion Medicine
and Prevention Research Cincinnati, Ohio
University of Texas at Houston, School
Shirin Heidari, PhD
of Public Health
Director
Professor, Health Promotion and
Reproductive Health Matters
Behavioral Sciences
London, United Kingdom
Houston, Texas

Harry J. Heiman, MD, MPH
Director, Division of Health Policy
Satcher Health Leadership Institute
Morehouse School of Medicine
Atlanta, Georgia
Natalia I. Heredia, MPH
Predoctoral fellow, PhD candidate
University of Texas Health Science
Center at Houston, School of
Public Health
Houston, Texas
LaShawn M. Hoffman
Chair, Community Coalition Board
Prevention Research Center
Morehouse School of Medicine
Atlanta, Georgia
Kisha B. Holden, PhD, MSCR
Associate Professor, Department of
Psychiatry and Behavioral Sciences
Department of Community Health
and Preventive Medicine
Interim Director, Satcher Health
Leadership Institute
Morehouse School of Medicine
Atlanta, Georgia
Cheryl L. Holt, PhD
Associate Professor, Behavioral and
Community Health
Director, CHAMP (Community
Health Awareness, Messages, and
Prevention) Lab
Codirector, Center for Health Behavior
Research
Coleader for Population Science Program
in the Greenebaum Cancer Center
University of Maryland
College Park, Maryland
Farrah Jacquez, PhD
Associate Professor
Department of Psychology
University of Cincinnati
Cincinnati, Ohio
c o n t r i b u to r s xv
Carolyn M. Jenkins, DrPH, MSN,
RN, RD, LD, FAAN
Professor and Ann Darlington
Edwards Endowed Chair in
Nursing
Director for Center for Community
Health Partnerships
Codirector, SCTR Community
Engagement
Medical University of South Carolina
Charleston, South Carolina
Carl Kendall, PhD
Director, Center for Global
Health Equity
Professor, Department of Global
Community Health and Behavioral
Sciences
School of Public Health and Tropical
Medicine
Tulane University
New Orleans, Louisiana
Stephani S. Kim, MPH
Doctoral Student
Division of Epidemiology
Department of Environmental
Health
University of Cincinnati, College of
Medicine
Cincinnati, Ohio
Heather Kitzman-​U lrich, PhD
Director, Research and Development
Diabetes Health & Wellness Institute
Baylor Scott and White Health
Dallas, Texas
Adjunct Assistant Professor
Department of Behavioral and
Community Health
School of Public Health
University of North Texas Health
Science Center
Fort Worth, Texas
xvi c o n t r i b u to r s
Yen-​Chi L. Le, PhD
Project Manager II, Adjunct Faculty
Healthcare Transformation Initiatives
Department
University of Texas Health Science
Center at Houston, McGovern
Medical School
Houston, Texas
Rodney Lyn, PhD, MS
Associate Professor and Associate
Dean for Academic Affairs
School of Public Health
Georgia State University
Atlanta, Georgia
Kelly G. McGauhey
Center for Health Promotion and
Prevention Research
University of Texas Health Science
Center at Houston, School of
Public Health
Houston, Texas
Annie L. Nguyen, PhD, MPH
Assistant Professor
Department of Family Medicine
Keck School of Medicine
University of Southern California
Los Angeles, California
Tonny J. Oyana, PhD
Director of Spatial Analytics and
Informatics Core,
Research Center for Health
Disparities, Equity, and the
Exposome
Professor, Department of Preventive
Medicine
University of Tennessee Health
Science Center
Memphis, Tennessee
Britt Riot-​Ellis, PhD
Founding Dean
College of Health Science and Human
Services
California State University,
Monterey Bay
Seaside, California
Latrice Rollins, PhD, MSW
Assistant Director of Evaluation and
Institutional Assessment
Prevention Research Center
Department of Community Health
and Preventive Medicine
Morehouse College of Medicine
Atlanta, Georgia
Sean B. Rourke, PhD, FCAHS
Scientific and Executive Director
Ontario HIV Treatment Network
Professor of Psychiatry
University of Toronto
Scientist, Li Ka Shing Knowledge
Institute of St. Michael’s Hospital
Toronto, Canada
David Seal, PhD
Professor and Vice-​Chair
Doctoral Programs Director
Department of Global Community
Health and Behavioral Sciences
School of Public Health and Tropical
Medicine
Tulane University
New Orleans, Louisiana
Selina A. Smith, PhD, MDiv
Director, Institute of Public and
Preventive Health
Professor and Curtis G. Hames, MD,
Distinguished Chair
Department of Family Medicine,
Medical College of Georgia
Augusta, Georgia

Lisa M. Vaughn, PhD
Professor, Pediatrics
Cincinnati Children’s Hospital
Medical Center
University of Cincinnati College of
Medicine
Cincinnati, Ohio
Alice Welbourn, PhD
Founding Director
Salamander Trust
London, United Kingdom
Glenda Wrenn, MD, MSHP
Assistant Professor
Department of Psychiatry and
Behavioral Sciences
Morehouse School of Medicine
Atlanta, Georgia
c o n t r i b u to r s xvii
Wonsuk Yoo, PhD
Associate Director, Data
Coordinating Center
Institute of Public and
Preventive Health
Associate Professor
College of Dental Medicine
Augusta University
Augusta, Georgia
Emily Youngblom, MPH
Institute of Public Health
Genetics
University of Washington
Seattle, Washington
1
Overview of Community-​Based
Participatory Research
S T E V E N S . C O U G H L I N , P H D , S E L I N A A . S M I T H , P H D , M D I V,

AND MARIA E. FERNANDEZ, PHD

This chapter provides an introduction to community-​based participatory research

(CBPR), a collaborative approach to research that equitably involves all partners,
including community members affected by the health topic being addressed,
organizational representatives, and academic researchers, in the research pro-
cess. This approach includes partnerships between academic and community
organizations with the goal of increasing the value of the research product for
all partners and sustaining its impact on population health. Community-​based
participatory research addresses health disparities and inequities in diverse
communities including groups that are socially disadvantaged, marginalized,
stigmatized, or that have suffered historical injustices. It takes into account the
strengths and insights that community and academic partners bring to framing
health problems and developing solutions. As illustrated throughout this vol-
ume, CBPR approaches have been used to address a wide variety of health topics,
including environmental hazards, HIV/​AIDS, maternal and child health, cancer,
cardiovascular disease, diabetes, obesity, cigarette smoking, substance abuse,
and mental health. The combination of experiences of community members
with public health science provides a deeper understanding of complex social
phenomena, thereby providing more relevant interventions and increasing the
likelihood that the interventions will be effective and that they will be adopted,
implemented, and sustained in real-​world settings. The CBPR research paradigm
represents a fundamental shift in academic researchers’ views of community
residents, from patients and research subjects who may benefit from medical
advances to essential partners who can energize their communities to develop
and implement effective, sustainable interventions to improve health and elimi-
nate health disparities.

1
2 Handbook of CB PR

What Is Community-​Based Participatory

Research?
Community-​based participatory research is a collaborative approach to research
in which the research process is driven by an equitable partnership that is formed
between relevant community members, organizational representatives, and aca-
demic researchers; the CBPR framework uses this partnership with the aim of
increasing the value of the research product for all partners. Community-​based
participatory research takes advantage of the unique strengths and insights that
community and academic partners each bring to framing health problems and
developing solutions. Community members, organizational representatives,
and academic researchers participate in and share control over all phases of the
research process from assessment—​discovering the community’s health needs—​
to dissemination—​developing strategies to increase the adoption, implementa-
tion, and maintenance of evidence-​based interventions (EBIs) in communities
and healthcare settings. Community-​based participatory research approaches
facilitate and accelerate research translation so that research produces pragmatic
results capable of leading to positive and sustainable community change.
In the past, social scientists and researchers who focused on disease preven-
tion tended to engage in studies of social phenomena and community problems
with an “outsider’s approach,” which distanced the research from the participants’
daily lives. Lewin1 and Freire2 questioned the “outsider’s approach” and proposed
more participatory and inclusive approaches to research. Current perspectives
seek to address the complexity of the human experience and the differential
power that sometimes exists between academic researchers, representatives of
community groups, and research participants.
“The CBPR research paradigm represents a fundamental shift in academic
researcher’s views of community residents, from patients and research subjects
who may benefit from medical advances to essential partners who can energize
their communities to develop effective, sustainable interventions to improve
health and eliminate health disparities.”3
Rather than focusing solely on health problems or other concerns, the CBPR
framework highlights community resilience, resources, and opportunities for
positive growth.4 It places emphasis on shared decision-​making, co-​learning, recip-
rocal transfer of expertise between partners, and mutual ownership of research
products.5 Partners also strive to acknowledge and act on participants’ needs,
behaviors, and beliefs concerning their own well-​being. Community-​based partic-
ipatory research is linked to other social-​justice-​informed approaches to research,
such as action research and participatory action research, that empower commu-
nities to address the root causes of inequity and identify their own problems and
appropriate solutions; thus CBPR efforts typically do not focus on the individual
only. Instead, CBPR fits within an ecological perspective about the determinants
 Ov e rv ie w 3

of adverse health outcomes and includes consideration of individual-​level risk

factors, multiple social determinants of health, and structural problems such as
poverty, unemployment, homophobia/​transphobia, racism, and lack of access to
primary healthcare.

PROCESS
The starting point for a CBPR project typically includes a health needs assess-
ment, a focused literature review, and a review of published and unpublished data
to identify priority health concerns. Epidemiologic data about the geographic and
social distribution and determinants of health concerns in a community are also
useful for planning purposes. For example, such data may include age-​adjusted
morbidity and mortality rates at the zip code or county level broken down by race,
ethnicity, or other factors, or geospatial information about educational attain-
ment, household income, or the availability of primary healthcare and public
transportation. The needs assessment process should be carried out using the
same principles of CBPR as all other phases of the research effort. Gathering
community member feedback can be done through a variety of methods, such as
obtaining information through in-​depth interviews of key informants or solicit-
ing feedback during community advisory board meetings. Including community
representatives as integral members of the planning group, however, helps ensure
participation throughout the planning process. Planning groups including com-
munity partners should explore existing sources of data and the need for new
data collection and should participate collaboratively in the interpretation of find-
ings.6 The CBPR approach requires academic researchers to listen to the voices of
community residents before a shared decision is made about which health topics
to address first. Thus, although seat belt use may be an important public health
concern in a community, and an academic researcher may wish to compete for
funding for a study of the effectiveness of an intervention to increase seat belt
use, community residents and representatives of community organizations may
give priority to projects that address breast cancer screening and survival among
African American women or disparities in infant mortality by race, ethnicity, or
socioeconomic status.
The importance of addressing community priorities is emphasized in a defini-
tion of CBPR provided by the Kellogg Foundation Community Health Scholars
Program. According to this definition, CBPR “equitably involves all partners with
a research topic of importance to the community with the aim of contributing
knowledge and action for social change to improve community health and elimi-
nate health disparities.”
Several principles of CBPR have been identified: the need to ensure openness,
trust, and power sharing among partners; the need for a genuine partnership
approach; capacity-​building of community partners; and the importance of shared
decision-​making, colearning, shared ownership of research products, applying
4 Handbook of CB PR

findings to benefit all partners, and including community partners in all phases
of the research from the identification of health priorities to evidence translation
and the dissemination of research findings.7 Another principle of CBPR is having
an ecological perspective about the determinants of adverse health outcomes and
considering individual-​level risk factors; multiple social determinants of illness;
and structural problems such as poverty, unemployment, homophobia/​transpho-
bia, racism, and lack of access to primary healthcare.
Previous authors have noted that CBPR should move toward action through
the translation of findings and their application in the community.5,8–​10 This
may include changes in practice or policies through policy advocacy, additional
research, or evaluation to understand how to intervene effectively.

U S E O F C O M M U N I T Y - ​B A S E D PA R T I C I PATO R Y R E S E A R C H
The CBPR approach to public health research and evaluation has grown in popu-
larity in recent years. This is evidenced by an increase in peer-​reviewed journal
articles on CBPR and major funding initiatives from leading and private founda-
tions.3,7,11,12 Contributing to the popularity of CBPR is that it addresses health
disparities and inequities in diverse communities including groups that are
socially disadvantaged, marginalized, stigmatized, or have suffered historical
injustices.5
In the United States and other countries, CBPR approaches have been used
to address a wide variety of health topics. Many CBPR projects have been con-
ducted in mid-​and low-​income countries where public health concerns include
infant mortality, infectious diseases such as malaria, and food insecurity. The
development and implementation of effective interventions for complex health
problems, such as HIV/​AIDS in socially disadvantaged or marginalized commu-
nities, are strengthened from the perspectives of community members and aca-
demic researchers.10 The combination of experiences from community members
and public health scientists provides a deeper understanding of complex social
phenomena, thereby providing more relevant interventions and increasing the
likelihood that the interventions will be successful.10
The discussions that follow cover several CBPR principles and provide an
account of how innovation and creativity are hallmarks of CBPR research and
evaluation. The first is an account of the importance of CBPR to addressing health
disparities in diverse communities.

Addressing Health Disparities

As an orientation to research, CBPR is useful for addressing health disparities
and inequities in diverse communities, including groups that are disadvantaged,
marginalized, or stigmatized. In many countries, including the United States,
 Ov e rv ie w 5

pronounced health disparities exist across population groups defined by a vari-

ety of demographic factors.13 Efforts to reduce and eliminate disparities among
racial and ethnic minorities in the United States include a seminal report by
the Institute of Medicine and the landmark 1985 US Department of Health and
Human Services Heckler Report on variations in health status among non-​W hite
populations.14–​15 Over the past three decades, health professionals have made
increasing efforts to define the causes of health disparities and to identify effec-
tive ways to promote greater equity in healthcare access and outcomes.13 Recently,
national goals to reduce and eliminate health disparities and achieve health equity
were set through the Healthy People initiative.16 Racial minorities in the United
States are more likely than Whites to die from many common diseases includ-
ing breast cancer, cardiovascular disease, and HIV/​AIDS, and have higher rates of
infant mortality.13 While overall health status continues to improve for all popula-
tions in the United States, there is little improvement in racial disparities.
The CBPR approach to health research offers advantages to addressing health
disparities in diverse populations. For example, many health disparities and ineq-
uities are best addressed at multiple—​individual, group, neighborhood, commu-
nity, society, and policy—​levels.10 Structural problems and social determinants
of disease, such as poverty, unemployment, inadequate or substandard housing,
the stigmatization of persons living with HIV/​AIDS, and lack of primary health-
care, can be addressed through CBPR approaches.17 Community-​based participa-
tory research offers promise for addressing health disparities because this process
combines insights of community members with scientific knowledge to provide a
deeper understanding of complex phenomena, thereby providing more relevant
health interventions and increasing the likelihood that the interventions will be
effective and sustainable.10

Shared Decision-​Making
The strength the CBPR approach has in addressing health disparities comes from
its principle of shared decision-​making between partners so that community
members, organizational representatives, and academic researchers participate in
and share control over all phases of the research process: assessment, definition
of the problem, selection of research methods, data collection, data analysis, and
the interpretation and dissemination of findings.5 Power sharing helps to ensure
that all those with a stake in the research or evaluation effort can have their voices
heard.10 For example, when Native American communities are fully involved in
developing and implementing health promotion programs, a common result is
culturally relevant and potentially sustainable approaches for improving com-
munity health.4 As in-​group members, Native American residents are in a posi-
tion to know whether the research methods are culturally appropriate and how to
best recruit participants.18 Because of shared decision-​making and its partnership
6 Handbook of CB PR

approach to research, the CBPR process is able to use the strengths and insights
that community and academic partners bring to framing health problems and
developing solutions.
Building and sustaining trust is essential in all aspects of CBPR. Community
members may distrust researchers from outside organizations because of a his-
tory of prejudice, discrimination, or marginalization of minority communities by
healthcare systems, or earlier experiences of helicopter research, when research-
ers enter a community, collect data, and leave without providing any informa-
tion or direct benefits to the community.18 Community participation and shared
decision-​making help to ensure that the study objectives are relevant to the
community, that the methods of accomplishing the objectives are practical and
acceptable to residents, and that the study findings are shared and provide direct
benefits to the community.

Community Advisory Boards

In order for CBPR projects to successfully use shared decision-​making, a com-
munity advisory board composed of CBPR partners should be established if one
does not exist. Many community advisory boards include community members,
patients, representatives from local nonprofit organizations and faith-​ based
institutions, teachers, business owners, primary care providers, and representa-
tives from local hospitals or clinics. In projects undertaken in collaboration with
Native American tribes, tribal elders generally serve as valued members of the
community advisory board.19 Community advisory board members and academic
researchers work together to plan and monitor CBPR studies. For a given project,
some members of the community advisory board may be more involved than oth-
ers depending on their interests and time commitments. In addition, the commu-
nity residents and organizational representatives who are part of the community
advisory board may change over time.
Academic researchers who engage a community advisory board in order to plan
and conduct CBPR projects must foster communication and seek to develop trust
within the partnership. The focus should be on encouraging equitable participa-
tion and establishing norms for working together.19 To build a partnership, aca-
demic researchers can confer with people in their institution who have existing
community partnerships for guidance on approaching community gatekeepers.
Local public health departments, agencies, nonprofit organizations, and coali-
tions may also be helpful in establishing partnerships.6
Potential partners may differ in priorities, such as the extent to which they
focus on research versus delivery of health services, acquiring new scientific
knowledge versus building infrastructure, or publishing versus informing policy
change. Communication styles and approaches to decision-​making are also likely
to vary across partnership organizations, which is why establishing norms for
 Ov e rv ie w 7

working order is important.18–​19 Building and sustaining a CBPR partnership

requires a long-​term commitment of time and effort by the partners.10

Reciprocal Transfer of Expertise

One of the benefits of CBPR partnerships is that they create space for colearning,
the reciprocal transfer of expertise, and mutual ownership of research products
between community and academic partners.5 The process of colearning brings
academic researchers and community members together and helps community
participants to increase control and self-​ownership of their health lives.4 For this
to be successful, academic researchers must respect nonacademic knowledge and
expertise and support an egalitarian relationship with community members.
Community partners can help develop new hypotheses, provide new ideas for
intervention and delivery, and contribute to research and evaluation activities by
advising and participating in recruitment and retention of study participants.18
The expertise provided by community partners takes into account the social,
cultural, and economic realities of community residents who are potential par-
ticipants. Academic partners provide knowledge about the extent of the health or
social problems in the community from an epidemiologic perspective, potential
study designs and implementation approaches, and how to test hypotheses about
evidence-​based health interventions with scientific rigor.18

Sustainability, Evidence Translation,

and Dissemination of Research Findings
A core principle of CBPR is increasing community capacity,7 yet challenges in
increasing capacity to implement and maintain effective interventions in com-
munities persist. Rhodes et al.10 noted, “By working in partnership, individual
and community-​level capacities are developed. These capacities may include an
increased understanding of how to affect change among individuals and within
communities, and the development of community mobilization, problem-​solving,
and even public speaking skills.” Community-​based participatory research can help
ensure that programs are developed with dissemination and sustainability in mind
and can improve community capacity and increase the potential that the inter-
ventions will be adopted, implemented, and sustained. For example, community
engagement can facilitate integration of programs into existing health systems 20
by employing CBPR processes during the development of interventions, or adapta-
tion of existing evidence-​based interventions. Collaboration between partners in
data analysis and dissemination of research findings can also contribute to the use
and usefulness of data for improving community programs and health systems.
8 Handbook of CB PR

The translation of CBPR findings to address public health concerns helps to

ensure that the research has pragmatic results that lead to the greatest possible
benefit. The CBPR approach increases the potential of the translational sciences
to develop, implement, and disseminate effective public health interventions in
diverse communities. Implementation and dissemination are defined as strate-
gies to adopt evidence-​based health interventions in order to effect change within
specific community settings.20 Relative to nonparticipatory research studies that
do not involve partnerships with community residents or organizations, findings
from CBPR studies are more likely to be disseminated to diverse audiences and to
be translated into useful outcomes, such as improvements in policy. For exam-
ple, CBPR partners may wish to adapt an EBI for increasing physical activity and
healthy eating, previously shown to be effective in a randomized trial conducted
in an urban population, to a rural population that includes more seniors, persons
with chronic illnesses such as obesity and diabetes, and persons with low health
literacy. The CBPR approach is helpful for translating specific findings from con-
trolled trials to real-​world settings in diverse communities.20 The input received
from community partners who understand the community’s culture, language,
and other contextual factors helps to maximize the external validity of the health
intervention. In attempting to translate evidence from one setting to another,
researchers and their community partners must consider variability in culture,
resources, and community acceptance of research.

Innovations in Health Promotion and

Community-​Based Participatory Research
Community-​based participatory research is not a specific qualitative or quanti-
tative research method but rather an orientation to research; there is no single
approach to CBPR. Rather, this orientation to research encompasses an array
of diverse approaches to community-​based research that have been refined and
improved over time. Innovation in community-​based research and the develop-
ment of creative approaches for engaging and empowering community members
are hallmarks of CBPR, as they have been over the past decade or two.4
The incorporation of photovoice, a method of telling personal community sto-
ries through photographs, into CBPR studies highlights the creativity of the CBPR
approach.4,21–​23 Photovoice is especially useful as a method of health needs assess-
ment and fits well with CBPR principle of equitable partnership. When Casteden
et al.24 used photovoice in a CBPR project conducted with an indigenous commu-
nity in Canada, the researchers found that the process was culturally relevant, fos-
tered trust between researchers and community members, and created a sense of
ownership regarding the information that was collected.24 Other researchers have
incorporated community arts events into CBPR projects. Chung et al.25 collected
 Ov e rv ie w 9

survey data at art events in an African American community in Los Angeles as

part of a CBPR project on depression care. The researchers used photography
exhibits, group discussions, and story readings as catalysts for responses that
were obtained through the survey.25

Summary
The CBPR research paradigm discussed in this chapter and throughout this book
represents a fundamental shift in academic researcher’s views of community
residents from subjects who may benefit from medical advances to essential
partners who can add value and efficacy to research processes and products.18
Academic researchers and community members who are engaged in CBPR seek
to democratize the production of knowledge in ways that transform research
from a top-​down process driven by scientific experts into one of colearning and
coproduction.26 The benefits of CBPR for community partners include learning
new skills and becoming members of engaged communities that are taking charge
of their own health.26 A key principle of CBPR is increasing the capacity of com-
munity members in research and program implementation.7,10 By increasing com-
munity and researcher capacities, all partners gain an enhanced understanding
of effective community mobilization and how to incite change among individuals
within their unique community setting.

References
1. Neill, S.J. “Developing Children’s Nursing Through Action Research.” Journal of Child Health
Care 2 (1998): 11–​15.
2. Freire, P. “Creating Alternative Research Methods: Learning to Do It by Doing It.” In Creating
Knowledge: A Monopoly, ed. B. Hall, A. Gillette and R. Tandon. New Delhi: Society for
Participatory Research in Asia, 1982; pp. 29–​37.
3. Wallerstein, N. and Duran, B. “The Conceptual, Historical, and Practice Roots of Community-​
Based Participatory Research and Related Participatory Traditions.” In Community-​
Based Participatory Research for Health, ed. M. Minkler and N. Wallerstein. San Francisco,
CA: Jossey-​Bass, 2003; pp. 27–​52.
4. Gray, N., Ore de Boehm, C., Farnsworth, A. and Wolf, D. “Integration of Creative Expression
into Community Based Participatory Research and Health Promotion with Native
Americans.” Family and Community Health 33 (2010): 186–​92.
5. Viswanathan, M., Eng, E., Ammerman, A., et al. Community-​Based Participatory Research:
Assessing the Evidence (Evidence Report/​Technology Assessment no. 99). Rockville, MD:
Agency for Healthcare Research and Quality, 2004.
6. Bartholomew Eldredge, L.K., Markham, C.M., Ruiter, R.A.C., Fernández, M.E., Kok, G.,
Parcel, G.S., eds. Planning Health Promotion Programs: An Intervention Mapping Approach
(4th ed.). San Francisco, CA: Jossey-​Bass, 2016.
7. Israel, B.A., Schulz, A.J., Parker E.A., et al. “Review of Community-​Based Research: Assessing
Partnership Approaches to Improve Public Health.” Annual Review of Public Health (1998):
173–​202.
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8. Cornwall, A. and Jewkes, R. “What Is Participatory Research?” Social Science and Medicine 41
(1995): 1667–​76.
9. Minkler, M. “Community-​ Based Research Partnerships: Challenges and Opportunities.
Journal of Urban Health 82 (2005): ii3–​ii12.
10. Rhodes, S.D, Malow, R.M. and Jolly, C. “Community-​ Based Participatory Research
(CBPR): A New and Not-​so-​New Approach to HIV/​AIDS Prevention, Care, and Treatment.”
AIDS Education and Prevention 22 (2010): 173–​83.
11. Centers for Disease Control and Prevention, and Agency for Toxic Substances and Disease
Registry Committee on Community Engagement. Principles of Community Engagement.
Atlanta, GA: US Department of Health and Human Services, 1997.
12. Institute of Medicine. Promoting Health: Intervention Strategies from Social and Behavioral
Research. Washington, DC: National Academy Press, 2000.
13. Adler, N.E. and Rehkopf, D.H. “U.S. Disparities in Health: Descriptions, Causes, and
Mechanisms.” Annual Review of Public Health 29 (2009): 235–​52.
14. Heckler, M. Report of the Secretary’s Task Force on Black and Minority Health. Washington,
DC: US Department of Health and Human Services, 1985.
15. Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health
Care. Washington, DC: National Academy Press, 2002.
16. Braveman, P.A., Kumanyika, S., Fielding, J., et al. “Health Disparities and Health Equity: The
Issue Is Justice.” American Journal of Public Health 101 (2011): S149–​55.
17. Eriksen, M. and Rothenberg, R. “Editorial.” Health Education Research 27 (2012): 553–​4.
18. Horowitz, C.R., Robinson, M. and Seifer, S. “Community-​Based Participatory Research from
the Margin to the Mainstream: Are Researchers Prepared?” Circulation 19 (2009): 2633–​42.
19. Baldwin, J.A., Johnson, J.L. and Benally, C.C. “Building Partnerships Between Indigenous
Communities and Universities: Lessons Learned in HIV/​ AIDS and Substance Abuse
Prevention Research.” American Journal of Public Health 99 Suppl 1 (2009): S77–​82.
20. Wallerstein, N. and Duran, B. “Community-​Based Participatory Research Contributions to
Intervention Research: The Intersection of Science and Practice to Improve Health Equity.”
American Journal of Public Health 100 Suppl 1 (2010): S40–​6.
21. Wang, C., Yuan, Y.L. and Feng, M.L. “Photovoice as a Tool for Participatory Evaluation: The
Community’s View of Process and Impact.” Journal of Contemporary Health 4 (1996): 47–​9.
22. Wang, C. and Pies, C. “Family, Maternal, and Child Health Through Photovoice.” Maternal
and Child Health Journal 8 (2004): 95–​102.
23. Moffitt, P. and Vollman, A. “Photovoice: Picturing the Health of Aboriginal Women in a
Remote Northern Community.” Canadian Journal of Nursing Research 36 (2004): 189–​201.
24. Castleden, H., Garvin, T. and Huu-​ ay-​
aht First Nation. “Modifying Photovoice for
Community-​ Based Participatory Indigenous Research.” Social Sciences and Medicine 66
(2008): 1393–​405.
25. Chung, B., Jones, L., Jones, A., et al. “Using Community Arts Events to Enhance Collective
Efficacy and Community Engagement to Address Depression in an African American
Community.” American Journal of Public Health 99 (2009): 237–​44.
26. Balazs, C.L. and Morello-​Frosch, R. “The Three R’s: How Community Based Participatory
Research Strengthens the Rigor, Relevance and Reach of Science.” Environmental Justice 6
2013. doi: 10.1089/​env.2012.0017.
Another random document with
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AN AMRI SHEPHERD.
 CHAPTER V

THE TUAREGS

After I got back to France I often came in contact with people

who, as the expression goes, were interested in geographical and
colonial questions, and sometimes I was subjected to a most
extraordinary cross-examination. The following is a true account of a
conversation I once had:—
“So you have really been amongst the Tuaregs? They are
savages, are they not? Are they cannibals?”
I protested that even during the worst famines they had never
tasted a scrap of the flesh of a fellow creature.
“But at least they are cruel? They thieve and plunder, do they not?
They have neither religion nor laws?”
I really do not feel sure of having convinced a single person that
even if the Tuaregs have their faults, that they are not wanting in
good qualities, and that their social condition, different though it may
be from ours, is nevertheless an established one, that it would be
alike humane and politic to turn to account the undoubtedly good
qualities of the race, and to endeavour to develop those qualities. It
would surely be better to extenuate their faults, and if possible
correct them, than to propose—which, by the way, is of course
impossible—the extermination en masse of a great branch of the
human race, occupying a district peculiarly suitable to it, and where,
as a matter of fact, the Tuaregs alone can live.
So-called truisms and ready-made opinions are of course very
convenient. By adopting them one is saved the trouble of thinking
about, still more of going to see, a place for oneself. It is far less
fatiguing, and within the power of everybody. It would certainly be
perfectly safe to wager ten to one that the habit of taking things for
granted is not likely to go out in France in a hurry, or indeed for that
matter anywhere else.
Maybe I shall only in my turn be lifting up my voice in the desert.
But I should like first to try and make those who are willing to eschew
foregone conclusions better acquainted with the truth.
I will avoid exaggeration, and also too much generalization from
isolated experiences. On the one hand, as I have already said, the
Tuaregs have very serious faults—serious for us, because they are
such as to make it difficult for them to accommodate themselves to
European civilization, and as a result we in our turn find influencing
them a very hard task.
Moreover, when I have proved that the Tuaregs have noble
qualities, when I have shown them actuated by elevated motives,
those who read what I say must beware of thinking that all members
of the race are cut on the same pattern.
My idea is, that to begin with we have only to inquire whether in
their natural condition the Tuaregs are or are not inferior in morality
to the other native races, such as the Ammanites of Cochin-China
and the Kabyles of Algeria, with whom by hook or by crook the
French have managed to find a modus vivendi?
To a question of that kind I can reply at once, “No, no, the Tuaregs
are certainly not more barbarous than other native races!” and as
proof I can quote our own journey. My readers will have seen how
the Tuaregs behaved to us. I have described how they were won
over from hostility to friendship; and the chapter succeeding this I
shall tell how they protected—even saved us. And what happened to
us might, it seems to me, very well happen to others.
Am I alone in my opinion? Did not Barth owe his very existence to
the active protection of the Tademeket at Timbuktu and the
Awellimiden at Tosaye?
Then, again, Duveyrier travelled for more than a year in the
Tuareg districts, guided and protected by Ikhenuakhen, chief of the
Azgueurs. Not only had he nothing to fear from them, but he was
actually saved from insult even from the Senussis and the tribes
which had risen against the French under the leadership of
Mohammed ben Abdallah.
Our case was therefore no isolated one, and our experience
would no doubt be repeated if it were decided to enter into more
intimate relations with the Tuaregs. We should avoid the
unreasonable fear of finding ourselves amongst traitors and
assassins, but at the same time take such precautions as are
needed in the Sudan, where there is at yet no police force.
There are indeed few if any races who can pride themselves on a
more ancient lineage than the Tuaregs.
Speaking in their own dialect they say, “We are Imochar, Imuhar,
Imazighen,” all which words come from the same Tamschenk root—
ahar meaning free, independent, he who can take, who can pillage.
(We shall see later what the Tuaregs mean by pillage.) In the
Tamschenk dialect the word ahar also signifies lion.
If we go back to the days of antiquity, and read our Herodotus, we
shall find that he speaks of the Mazique tribe as dwelling in Libya.
There are Numidians of Jugurtha and of Maussinissa, and the last
word is translated almost literally into the dialect now employed,
mess n’esen meaning their master, or the master of the people,
whilst the word Mazique is evidently the Greek form, from which is
derived the present name of Imazighen.
If this etymological proof is not sufficient, there exists another, this
one absolutely irrefragable, viz. the Tuareg writing.
Here, there, and everywhere in their country, now cut with a knife
on the trunks of trees, now engraved on the rocks, we meet with
inscriptions in peculiar characters known as the tifinar; and at this
very day every Tuareg who has to wait, or who suffers from ennui for
any reason, always wiles away the time, whether on the banks of the
Niger, on the tablelands of Air, or on the summits of the volcanic
Atakor n’Ahaggar, by writing according to the best of his skill his
name and that of his sweetheart on a rock or on the trunk of some
tree, now and then adding a sentence or two, or in rarer cases a
complete poem.
Now the letters employed in these tifinar, ancient or modern, are
the same, or very nearly the same, and are therefore identical with
those used in the celebrated Tugga inscription, dating from the time
when Carthage was still a thriving city.
Imochar, of which the singular form is Amacher, is the name by
which the Tuaregs of the Niger districts generally speak of
themselves. They are, say the Arabs, Tuaregs (singular Targui);
Surgu, say the Songhay; Burdane, say the Fulahs.
Now not one of these various appellations comes from a root
signifying anything evil, and a Tuareg would be sure to use one or
the other according to the dialect he speaks in referring to his
people. Some have pretended that Tuareg means abandoned by
God, for Arabs are very fond of explaining everything by puns and
plays upon words. Yet another Arab root from which the word might
possibly be derived is one signifying nomads or wanderers.

TUAREGS.
 Without attempting to throw fresh light, or perhaps to add further
obscurity to the question, I may remark here, that a certain Berber
tribe (we shall see that the Tuaregs are Berbers) calls itself Tarka,
whilst a small section of the Awellimiden is known as Tarkai-Tamut,
whilst the great Berber conqueror of Spain was named Tarik.
It seems most reasonable to suppose that the Arabs gave to the
whole race the name of one of its tribes, probably that with which
they were brought into close contact. Does not the very name of
Berber, characterizing the whole great race, including not only the
Tuaregs, but the Kabyles, the Chambas, and others, itself come from
that of but one fraction—the Berbers or Barbers of Morocco?
During the Roman decadence the Berbers, including the Tuaregs,
joined the flocks of Saint Augustine and his successors as converts,
very half-hearted ones probably, and then after a time of
considerable obscurity in their history came the Mohammedan
conquest. Rebellious at first, the Berbers ended by accepting the
religion of Islam, without feeling any more enthusiasm for the new
faith than they had done for the old. As for the Tuaregs, it is said it
was not necessary to convert them more than fourteen times!
Now it was these tribes who so loathed a foreign yoke, and fled
further and further into the desert before the invaders of their
country, who were the forefathers of the present Imochars.
With regard to the Awellimiden, their very name indicates their
origin; they are the descendants (uld lemta) of the Lemta or
Lemtuma, a Sahara tribe which conquered and finally absorbed all
its neighbours of the same stock.
All this may perhaps be called actual history. Now for some of the
legends of which the Awellimiden Tuaregs are so fond. Great lovers
of the marvellous, they account for their origin thus. I will translate as
literally as possible what one of them actually told me:
“I say the ancestors of the Imochars were no other than genii.
“The women of a village called Alkori went one night to dance in
the bush, and there they fell asleep.
 “Presently they were surprised by some genii, who, surrounding
them before they were fully awake, embraced them.
“In the morning the women returned to the village.
“When a few moons had risen and died (that is to say, when a few
months had passed), the men of the village saw that the women
were about to become mothers.
“The chief of the village therefore cried, ‘Seize them and put them
to death!’
“But the cadi replied, ‘No, let us wait until the children are born.’
“So they waited until nine moons had risen and died, when each
woman gave birth to a boy.
“Some men said, ‘Now let us kill the mothers and the children.’
“The cadi replied, ‘No, let us wait till they are older, none but God
can create a soul.’
“So they waited.
“The boys grew, and as time went on fought with the other
children of the village; and they made for themselves weapons of
iron, swords and daggers, such as had hitherto been unknown in the
country.
“The chiefs then said, ‘If we do not put them to death these boys
will become our masters. Let us kill them at once, before they come
to their full strength.’
“To which every one replied, ‘Yes, yes! you are right!’
“They then sent a messenger to call the uncles of the young
fellows, and said to them, ‘What we wish is that you should kill your
nephews, and if you do not we will kill you.’
“To this the uncles answered, ‘We have no wish but to comply
with your demand, but we do not know how to put to death our
nearest relations. You take our weapons and do with them what you
will.’
 “‘Very well,’ said the chief. ‘You had better leave the village now
and return here to-morrow evening.’
“So they left; but one of them managed to warn his sister of what
was in the wind, so that the sons of the genii knew what to expect.
“They therefore ran away, walking all night until the dawn, when
they climbed a mountain.
“In the morning the chief of the village beat the war-drum, and the
horses were saddled.
“The people followed the boys till they came to the mountain they
had climbed, when they lost all traces of them.
“Meanwhile one of the children had said, ‘Shall we have to fight
here?’
“‘Of course we shall,’ replied another; and they were just about to
defy the enemy with shouts, inviting them to the combat, when a
second boy said, ‘It would be better to go first to the village and fight
those that are left behind there.’
“They therefore descended the mountain by the other slope, and
returned to the village. When those who had remained there saw
them coming they were afraid, and cried, ‘Alas! here are the boys
coming back again. They have evidently defeated the party we sent
out against them.’
“One man went out to parley with the children. They took him
prisoner, obtained from him all the information they wanted, and then
they drew their swords and killed him.
“They next advanced upon the village, entered it, and even went
up to the hut of the chief, who was a very old man. He got up and
came to meet them. They shouted, ‘Thou didst mean to kill us and
our mothers with us, but now it is thou who art to die; thy children
and thy children’s children, and all thy nephews are dead. It is all
over.’
“They flung their spears at him, and one of them pierced his heart,
coming out at the other side. Then the boys shouted, ‘Death to thee,
and to thy mother, thou son of a harlot!’ Next they burnt the village,
and killed all the women and children. Only one man escaped. He
ran out to the army and told the troops all that had happened, asking
them, ‘Did you not meet the children?’ ‘No!’ ‘Did you not find any
trace of them?’ ‘We did; but we lost their track!’
“‘Well,’ he went on; ‘go to the village, there is not a man left alive,
not even a woman, not even a child. All, all are slain!’
“They put spurs to their horses and galloped back; they reached
the village. The children of the genii came out and began the battle.
They fought from ten o’clock in the morning till sunset. The boys
were victorious, slew all their enemies, and took possession of the
war-drum.
“Of the sons of the genii sixty were dead, but sixty survived, and
became the fathers of the Tuaregs.”
In the fifteenth century they founded a great city, about 281 miles
to the north of Gao, which they called Es Suk, or Tadamekka (now
Tademeket), where they probably led a half-nomad, half-sedentary
life, as do certain tribes or fractions of tribes at the present day at
Rhat, Tintellust, and Sinder, or Gober. At the same period the Askia
Empire of the Songhay negroes was at the zenith of its prosperity,
with Gao, or Garo, as its capital.
An Askia went to attack Es-Suk, and destroyed it. Rather than
submit to the yoke of the conqueror, the Tuaregs abandoned their
capital, and fled to the Ahaggar heights or the plateaux of Air.
According to a legend only one Es Suk escaped, a man named
Mohamed ben Eddain, who founded a new tribe, that of the present
Kel es Suk, by giving his daughters in marriage to Arabs, sheriffs of
the tribe of El Abaker, descendants of the Ansars, or first
companions of the Prophet.
This was how it came about that the Kel es Suk supplied the so-
called Tuareg marabouts, and explains the fact that these marabouts
have abandoned many of the characteristic customs of the true
Tuaregs in favour of the strict observance of the Mussulman law.
 A GROUP OF TUAREGS.

Then came the invasion from Morocco, when the Armas, or

Romas, as the soldiers of the Sultan of Fez were called, thanks to
their firearms, destroyed the armies and broke the power of the
Songhay; but these Armas were not numerous enough to hold what
they had taken, and in the course of a few generations they became
merged in the negro race, and completely lost all their warlike
qualities.
Protected against invasion by the arid and poverty-stricken nature
of the districts they inhabit, the Tuaregs, on the other hand, inured to
hardship, gradually became stronger, nobler, and more able to hold
their own, developing all the virtues of the true warrior. They now in
their turn conquered their old enemies the Songhay, who, though
aided by the Armas, descended from the old invaders from Morocco,
were powerless to resist them. The negroes were defeated and
reduced to slavery. Since then the Tuaregs have been the dominant
race on the banks of the Niger, from Timbuktu almost as far south as
Say.
 The history of the Tuaregs has been that of one long series of
struggles between the various tribes, in which the Awellimiden finally
gained the ascendency they still maintain. I have already related how
they resisted the Fulah invasion, and later that of the Toucouleurs.
The taking of Timbuktu by the French resulted in the crushing of
the semi-independent fraction of the Tuareg race known as the
Tenguereguif, or the Kel Temulai, and what I have said about the
Igwadaren, will be remembered. As for the Awellimiden, their power
remained undisturbed, and I do not think I am far wrong in saying,
that should they be threatened they could put 20,000 men, one-
quarter of them mounted, in the field at once.
When we remember the courage of the Tuaregs, and take into
account the immense difficulty French troops would have to contend
with in crossing the districts belonging to the enemy, it is impossible
to help realizing that these warriors are far from being a negligible
quantity, and that the conquest of their land would cost the invader
dear.
And would it be to the interest of France to possess the districts
now inhabited by the Tuaregs? To this query I reply emphatically and
without hesitation, No!
There are in the Sudan two totally different kinds of territory, which
I shall characterize as those fitted for the occupation of sedentary
settlers, and those suitable only to nomadic tribes.
The former are the banks of streams and rivers, such as the
French Sudan between Kayes and Bamako, with the whole reach of
the Niger district up to Timbuktu. In these lands gutta-percha and
cotton can be readily grown. They are inhabited by negroes, and it is
indispensable if we are to trade in security that we should have a
preponderate if not exclusive territorial influence.
In what I call the nomad lands, on the other hand, on the right of
the Senegal, on the Niger beyond Timbuktu (if we except the actual
banks of the river), we shall find that the chief articles of export are
gum and the products of flocks of sheep, which are indeed the only
things the nomad tribes have to offer to our traders.
 It is absolutely useless to attempt to impose on these people a
yoke against which they would never cease to rebel, and which,
moreover, they would have the power as well as the will to throw off.
It is much better to give them what are called enclaves, or reserves,
such as the Americans assign to the Redskins. Of course we should
always have to guard against pillaging raids from these enclaves; but
I am quite convinced, that when the Tuaregs once realize that their
liberty and their customs will be respected, they will willingly accept
the modus vivendi suggested, especially if they find that they can sell
their produce to our traders to advantage, thus gaining means for the
amelioration of their present condition.
How much better would it be then, instead of condemning the
Tuareg race as a whole, because of certain preconceived prejudices,
if we were to set to work to study them, to gauge their real moral
worth, and to make the best arrangement possible with them for the
benefit of all concerned. Faults, many faults, of course they all have.
They are proud, they are fierce, they rob, and they beg. One of their
peculiarities makes it very difficult to deal with them—they are very
ready to take offence. They are, moreover, in constant dread of
being subjected to servitude, and fear invasion above all things. All
this of course leads them to listen eagerly to the calumnies our
enemies especially the marabouts, are always ready to circulate.
 TUAREGS.

Side by side with all this, however, many noble virtues must also
be placed to the credit of the Tuaregs. Their courage is proverbial,
the defence of a guest is with them as with the Arabs a positive
religion, whilst their steadfastness of character is well known, and
their powers of endurance are absolutely indispensable to their very
existence. Lastly,—and here I know what I say is quite contrary to
the generally-received opinion,—the Tuareg is faithful to his
promises and hates petty theft.
“Never promise more than half what you can perform,” says a
Tuareg proverb, and even in the opinion of their enemies this is no
idle boast. Our own adventures are a striking proof of this.
As for what I have said about thieving, I can testify that all the time
we were amongst the Tuaregs not the very smallest larceny was
committed by them, although all manner of very tempting articles,
such as various stuffs, beads, looking-glasses, knives, etc., were
lying about in our boats, on deck, and in our cabins. Nothing could
have been easier than for our Tuareg visitors to run off with a few
odds and ends, and if I had seen any one take anything I should
probably have said nothing, for fear of a dispute leading to a rupture.
At the sight of these riches of ours, which surpassed anything
they had ever seen before, the eyes of our guests would gleam with
desire for their possession, and they would ask for things, keep on
begging for them without ceasing, but they would not take anything
without leave. I often had hard work to resist their importunity, but,
for all that, not one of them ever appropriated a single object
however small.
I said, it is true, a few pages back that the Tuaregs were pillagers,
and the reader may very well ask how they could be pillagers yet not
thieves. We must, however, judge people by their own consciences,
not by the ideas current amongst ourselves. Now to pillage and to
thieve are two essentially different things amongst the Tuaregs.
All nomads are pillagers, and as a matter of fact war with them is
generally simply a pillaging expedition. Migrations are constantly
taking place as a very necessity of their mode of life, and as a result
casus belli as constantly arise. We must, however, even in such
cases as these, do the Tuaregs the justice to add that they generally
first make an appeal to diplomacy. In meetings known amongst them
as myiad, the question at issue is discussed, chiefly by the most
influential marabouts, and they have recourse to arms only if
conciliation does not answer.
Even then it is all fair and open warfare. The warriors even
challenge each other as in a tournament to single combat. There are
razzi too, no doubt, when the Tuaregs make a descent on the
enemy’s camp and pillage it, carrying off the flocks and herds if
possible, and by thus depriving them of the means of subsistence,
compelling them to sue for peace.
There is little foundation for the charge brought against the
Tuaregs of pillaging caravans, they respect them when the right of
passage has been paid for. This payment is a very just one,
guaranteeing the protection of the tribe against the gentlemen of the
road, for in the Sudan, as in Italy, there are brigands, but they are not
Tuaregs.
 On the other hand, if traders, thinking themselves strong enough
to force a passage, refuse to pay the tribute demanded, the caravan
becomes the lawful prize of any one who chooses to attack it.
Is this very different to what happens amongst Europeans?
Suppose, for instance, that we refuse to pay custom and octroi dues,
the officials will seize the contraband goods without hesitation, and
we shall have to pay the legal fine, or even, perhaps, go to prison,
and who will think us unfairly treated? Although they have no officers
in uniform in their service, the Tuaregs are quite within their rights in
demanding payment for right of way. But pillage merchandise when
that payment has been made they never do. Did they do so, all trade
would be simply impossible in the Sudan, and when they are
reproached on the subject they reply—“Our irezz aodem akus wa
der’itett (we do not break the bowl from which we eat).”
When he has to do with Christians, infidels, or, as he calls them,
Kaffirs, the Tuareg is perhaps not quite so jealous of his promises
and of keeping faith exactly; but this is really chiefly the fault of the
marabouts, who tell them that they are not bound where infidels are
concerned, and quote passages taken, or said to be taken, from the
Koran to prove it.
Then, again, there is something spirited and noble about pillaging,
for it often means to expose oneself to danger, and real courage is
needed for that. It is not so very long since our ancestors went to do
much the same thing in Sicily and in Palestine, and there was not
much more excuse for them than for the Tuaregs.
Thieving and petty larceny are very different from pillaging, and of
them the Tuareg has perhaps a greater horror than we Europeans.
A careful study of Tuareg society will reveal a very strong
resemblance between it and that of Europe in the Middle Ages. Truth
to tell, except that he has no strong isolated castles, a Tuareg
surrounded by his tribe, or a fraction of that tribe, engaged in one
long struggle to defend himself, or absorbed in attacking some chief,
brutal and violent, but chivalrous, respecting the honour of women,
and curbing his wild passions where they are concerned, his
reverence for them inspiring his most courageous efforts, pillaging
the traders who will not submit to the prescribed tribute, but
protecting those who have paid their toll, has a soul not so very
different, after all, from that of the Castellan de Coucy of the twelfth
century, or of the heroes he celebrates in his poems.
As was the population in Europe in mediæval times, the Tuaregs
are divided into two very distinct classes, the Ihaggaren and the
imrads, corresponding to the old feudal chiefs and vassals.
What originally caused this broad line of demarcation between the
two? Many different things, no doubt. Certain conquered tribes
became the imrads of those who had defeated them. Or again, some
tribes may have submitted for the sake of being allowed to settle
peacefully down on lands belonging to Ihaggaren. Whatever may
have been the reason, however, as time went on the Ihaggaren[6]
became the owners of flocks and herds, whilst the imrads never
possessed any property of their own, but looked after that of their
masters.
The former had to fight and to protect their imrads, ownership of
property giving them the right to demand tribute; the latter could
originally only hold their fiefs at the will of their suzerains, but after
many generations had passed away their tenure became so
established a thing that rent was all which could be demanded. At
the present day it sometimes happens that the imrads are richer,
better dressed, and even more influential than the Ihaggarens.
When a whole tribe is seriously threatened, and the nobles are
not sufficiently strong to defend themselves, the tenants are armed
just as they used to be in olden times in Europe, and these tenants
fight marvellously well. At the same time, except in such
emergencies, it is the business of the Ihaggarens to defend the
imrads.
In the service of the imrads are a class of negro slaves known as
the Belle or Bellates, who have as a rule been attached to the same
family for many generations. The attachment these slaves have for
their Tuareg masters is really wonderful, and a positive proof that
they are well treated by them. In the struggle which took place round
about Timbuktu between the French and the various tribes who
resisted the foreign occupation, Bellates were often taken prisoners,
but however kind our treatment of them, in spite of promises of
complete liberty on the one condition that they would remain with us,
we were not able to keep a single one. They all ran away to rejoin
their old masters. In warlike expeditions they form a very useful
supplement to the Tuareg infantry, and they are quite as brave as
are the free soldiers.
One peculiar fact which speaks well for the Tuareg character is,
that though these warriors own hereditary slaves they never sell or
buy them. Before the French arrived at Timbuktu that town was the
centre of the slave trade, whence captives were sent to Tripoli on the
one hand and to Morocco on the other. The convoys with the
melancholy processions of slaves were generally under the
leadership of traders from Mosi, who brought the unhappy captives
to the town and sold them to merchants from Morocco or Tuat.
We have already seen, and we shall have again occasion to
remark, that the whole negro population of the Niger districts is in a
similar state of servitude with regard to the Tuaregs, a fact which will
explain how it is that no Songhay or Arma would dream of disputing
the orders of the chiefs, or offering the very slightest resistance to
their demands.
There would therefore be absolutely nothing to prevent a Tuareg
who should chance to be in want of money or of clothes to go and
seize one or more of the Gabibi, as the negroes of the villages are
called, and sell him or them for slaves at Timbuktu. In fact, it would
be quite as simple a matter as to choose an ox out of his own herds
and send it to market. Yet never has a Tuareg been known to do
such a thing. I have made sure of this by cross-questioning many
negroes, and their answers have always been the same.
At the very bottom rung of the social ladder we find the negroes of
the riverside districts, the Songhay and the Armas. They cultivate
millet, rice, and tobacco. When their masters are at daggers drawn
with each other, as was the case when we were amongst the
Igwadaren, they have a good deal to complain of, for they are, as it
were, between two fires, and their position is anything but enviable.
Amongst the Awellimiden, however, their condition seems to be
much happier, and when they have once paid their dues they are left
in peace, great chiefs such as Madidu protecting them against the
exactions of the less powerful Tuaregs.
I confess I do not feel any very special pity for them. They are
quite as numerous as the Tuaregs, quite as well armed, and all they
need to recover their independence is a little courage. If, moreover,
they cared to study the history of the past, they would not fail to
remark that their Songhay ancestors brought their doom upon them
when they destroyed Es Suk, and forced the Tuaregs to lead their
present wandering life.
As for the project of pressing the negroes into the service for the
suppression of the Tuaregs, it is but a Utopian idea, and that a very
dangerous one, for the Songhay race is too debased by its three
centuries of servitude to have any real stamina left.
I need scarcely point out the great mistake implied in the
suggestion: We ought to favour the black at the expense of the
Tuaregs, because the former are producers as tillers of the soil, and
the latter are useless idlers, for the Tuareg is as hard a worker as the
negro; he works in a different direction, that is all—breeding flocks
and herds instead of growing cereals. When the means of transport
are sufficient for it to be easy to get to and from Timbuktu, it will be
the Tuareg, whose camels will carry the gum harvest into the town, it
will be he who will sell skins and wool; in fact, he will turn out to be
the greater producer of the two races after all.
The Tuaregs have been accused of being cruel, but this is another
grave error. They alone perhaps of all African races do not kill their
prisoners after a battle. One must have been present at the taking of
a village by negroes to realize the awful butchery with which the
victory ends. Everybody not fit to be sold as a slave is put to the
sword. The throats of the old men are cut, and little children too
young to walk have their heads smashed against stones. Tuaregs,
on the other hand, are quite incapable of such atrocities. When we
passed Sinder, Boker Wandieïdu, chief of the Logamaten, had more
than two hundred Toucouleur prisoners in his camp, who had been
taken in war two years before, and he was feeding and looking after
them all. After the fatal battle with the Tacubaos, in which Colonel
Bonnier was killed, the two officers who alone escaped from the
scene of the combat, Captains Regard and Nigotte, fled in different
directions. Nigotte reached Timbuktu, and was saved, but Regard
went westwards, and was taken prisoner by the negroes of the
Dongoi villages, who took him to the Tenguereguif Tuaregs. In spite,
however, of the fact that the excitement of the battle had scarcely
subsided, these Tuaregs would not themselves slay the unfortunate
Frenchman. “Do with him what you will,” they said; and the negroes
killed him.
Moreover, it has been said that the Tuaregs are fanatics, but I
have never seen them prostrate themselves or fast. It is, however,
unfortunately quite true that the marabouts exercise a great influence
over them; but it is the kind of ascendency that clever people always
obtain over big children, such as the Tuaregs are, and such as
sorcerers get over the superstitious. “You are Christians, and we
ought not to have anything to do with infidels,” Yunes said to us at
Tosaye. A good excuse, and one that he could not help laughing at
himself. Yunes, I am glad to say, never really followed the precepts
of Islam any more than did any of his fellow-countrymen.
How does it come about that, left to themselves, with scarcely any
contact with more advanced civilizations, constantly exposed to the
malevolent influence of Mahommedanism, and by their very nature
peculiarly susceptible to the temptations which appeal to the violently
disposed, the Tuaregs have yet managed to keep their high moral
character. Once more we find a parallel for their position in the
Middle Ages. It is the reverence they feel for women, to whose
gentler influence they yield, which has been their salvation. Just as
the lady of the feudal chief, brutal and hot-tempered, coarse and
savage though he often was, knew how to soothe his worst
passions, and to inspire him with an ambition to excel in those noble
tasks of which she herself was to be the reward, so does the Tuareg
woman in her tent, chanting praises of the mighty deeds of the lord
of her heart, rouse in that lord all chivalrous instincts, and inspire him
with a love for all that is best and highest in life on earth.
 The Tuareg—and here he differs essentially from all
Mahommedans—takes only one wife, but she is literally his better
half. Moreover, a woman is free to choose her own husband. During
our stay at Say, we were told that Reichala, daughter of Madidu, was
about to marry the son of El-Yacin, one of the chiefs of the most
powerful tribe of the Confederation. I sent some presents on this
joyful occasion. A month later an envoy from the chief of the
Awellimiden told us that the young lady, in spite of all her parents
could do, had refused her fiance. Her will was respected, and even
the Amenokal himself would not have forced her to comply.
Her future husband once chosen, a Tuareg girl has perfect liberty
to see him when she likes, and will sometimes travel on her camel
more than fifty miles to pay him a visit. The Tuaregs themselves say
that no bad results ensue; but there are three words for bastard in
the Tamschek language, and if it be true that the abundance of
expressions for a thing in any tongue proves the prevalence of that
thing, we shall know what to think. However, when a Tuareg woman
is married, however free and easy she may have been beforehand,
she is a model of discreet behaviour. The Tuaregs do not brook any
tampering with their honour, and a deceived husband will never
hesitate to wash out his shame in blood.