Abstract
This article engages with a case study situated in a public social service system in Uganda, Africa. Through case analysis, I highlight the complexities related to professional ethics in social work practice in Africa and argue that efforts to promote ethics, human rights and social justice in this context require creativity, innovation and activism to confront structural conditions that trap people in unjust circumstances. While building ethical capabilities demands grounding practice in the global social work principles, additional infusion of ubuntu ethics and African social work platforms for sharing experiences and actions are needed.
Keywords
Introduction
Human rights and social justice are central principles in social work (IFSW, 2018). In Africa, the magnitude of underdevelopment, disadvantage and limitations in social service systems means that social workers must become innovative, creative and explorative in their efforts to uphold these professional principles. While this is widely acknowledged, many social work practitioners on the continent remain with lingering questions: how do we do this in our daily practice? How do we reconcile these with the numerous obstacles that are ever present in our practice? This article presents a practical case study from Uganda to illustrate the interface between professional ethics, social justice and a human rights-based social work practice in an African context. The purpose is to share practice wisdom, draw lessons and offer recommendations on how to integrate professional ethics, human rights and social justice in a culturally appropriate and locally relevant social work practice.
Methodology and design
This article is both reflective practice and conceptual in nature. It employs a case study analysis to interrogate professional ethics, social justice and social work practice interface in an African context. A case study was mined from a social worker’s practice file. This case was purposively selected since it illustrated the intensity of ethical dilemmas in practice situations. Then, a literature search was conducted from journals, policies and conventions. This literature was also purposively selected for its reference to ethics, social justice, human rights and professional conduct in social work, social welfare, human rights and public service. In addition, literature referencing the African context within the above fields was of primary interest. The ethical scenarios presented in the case study were then compared with the literature to develop the critical commentary, lessons and recommendations for practice.
Case study
Jolly is 37 years old and is 8 months pregnant. She informs the social worker in a public hospital in Kampala, Uganda, that she does not want to keep the baby after birth. The social worker quickly learns that this is her third pregnancy. She has two children, who are living with her ex-husband. In Ugandan culture, children belong to the father and his clan. Jolly originally wanted to abort this pregnancy, although this is illegal in the country. However, the unnamed facility feared to conduct this abortion after learning that her uterus had ruptured in the last two pregnancies. Her foetus is also in a breach position, and birth will be by caesarean section as in the previous deliveries. She also informs the social worker that she got pregnant through a rape by a pastor. She claims that this had occurred at a local church where she had been going for prayers as she is mentally sick and regularly seeks divine healing.
The social worker interviewed Jolly and learnt that she has had a long battle with depression and bipolar personality disorder. Her mother died when she was 5 years old and she stayed with her aunt who died when she was 15 years. She then stayed with her dad and stepmother until 24 years. When her dad died, she was chased out of the house by her stepmother. In the years that followed, she also lost contact with her siblings.
The social worker did not report the alleged rape because the alleged perpetrator is a politically connected pastor. Instead, the social worker focused on the safety and welfare aspects of Jolly, and her unborn child. The social worker ensured that Jolly underwent a mental health examination, and the results indicated high stress, mild depression and bipolar tendencies. The social worker asked Jolly to meet the hospital management to gain support for the management of the caesarean operation and her situation. An appointment was also set up with the medical team in readiness for the operation.
Cases involving children or family are normally reported to the police and probation services for guidance. At both offices, the social worker is told that when the mother is present, they do not have official guidance and policy to guide them and offered no support. The social worker is made aware that they can only be supported when the child has been officially abandoned. The social worker’s insistence leads them to the ministry responsible for social affairs, where it is guided that the child be placed in a baby’s home (alternative childcare facility) while more suitable options are worked out.
When the child is delivered, they are placed in a baby’s home and later into a foster family. Two years later, a sister to Jolly contacts the social worker and asks for the child. Ugandan policy guides that family and close relative are given priority in alternative care interventions. However, the foster care parent works in the probation office and had manipulated the process through forged papers presented in court to obtain the care order. Eventually, however, the baby’s home and the social worker managed to place the child with Jolly’s sister under the customary adoption order.
Ethical tensions and critical commentary
Whether the social worker should have reported the legal violations in this case
The client reported a probable rape and attempting to procure an illegal abortion while there was a forgery of documents in the probation office. The social worker should have reported these to the authorities but chose not to. In the alleged rape, they could have considered that significant time had passed, and successful prosecution of the perpetrator was no longer possible. The power and political connectedness of the alleged perpetrator could also have swayed the decision for the social worker to instead prioritize the safety of Jolly and the unborn child. Safety of client’s has been promoted as an ethical consideration (IFSW, 2018). The social worker also did not report Jolly for attempting to procure an illegal abortion. This decision could have been guided by her mental illness as indicated in her mental health assessment. Failing to report the forgery of documents however raises greater risks and potential consequences for the social worker (National Association of Social Workers of Uganda [NASWU], 2012: 11). In not reporting these legal breaches, the social worker could have carefully weighed the facts on the ground, the risks to their practice and concluded that the options they had taken were the most productive in the circumstances. This resonates with the application of ethical considerations as guided by field actions (Benson and Siciliano, 2021: 190).
Tension in seeking to protect Jolly’s rights and seeking justice
The IFSW (2018: 3–5) puts emphasis on human rights and social justice as ethical principles. These have roots in the Universal Declaration of Human Rights (United Nations, 1948). In this regard, this case presents ethical tension for the social worker in seeking to protect Jolly’s rights and seeking justice. By not reporting the case, the social worker allowed an injustice to go unpunished and if the allegations are true, then an abuser has remained a threat to other women in the society. The social worker could have considered the client’s mental state as well as the power of the alleged abuser as a strong obstacle in building a credible accusation. The social worker managed to uphold the client’s right to self-determination as the child was taken into alternative care. This decision could also have been influenced by the harm the child was likely to suffer if left with a mother who did not want them. Also, the client was included in deciding to meet hospital management to seek cost exemptions and management of her medical condition. This decision appears to have been guided by placing access to medical services as critical for the well-being of the client and the unborn child above the right to privacy and confidentiality. The social worker could have been guided by prioritizing client interest and well-being (NASWU, 2012: 6). The social worker also could have considered that the client’s privacy is not absolute. In inter-professional working, information can be shared to inform joint action and secure services for the client.
Tensions in professional boundaries, duties and responsibilities
Another ethical dilemma in this case regards the professional boundaries and the duties and responsibilities of the social worker. There are questions as to how far and how long a social worker should handle a case. This is an in-house social worker who is stretched by the case to search for solutions across many external actors. It appears they had great awareness of the welfare processes surrounding this case. Even when they obtained no support from the first points of call at police and probation, the social worker expanded the horizons of services to reach the ministry responsible for social affairs. This could be that they were guided by the care and ubuntu ethics, in which the responsibility of helping those in need is a journey not an event. It is a demonstration of stepping up to action and lending support to those who need social work services (Becker, 2021; Gabel and Mapp, 2021). The social worker was simply demonstrating servant leadership for public good as envisaged by the country’s code of conduct of public servants (Ministry of Public Service [MOPS], 2021: 97). It appears from the case study that the social worker did not step out of their professional boundaries but used inter-agency collaborations and remained the coordinating point in services for Jolly and the child. This could have been guided by the organizational procedures and national policies in handling such cases. Social work is not regulated in Uganda. Therefore, the social worker could have been guided by their professional judgement within professional ethics without the limitations inherent in the codes of conduct (Sewpaul and Henrickson, 2019: 1474).
Tensions between culture and social worker’s actions
This case also raises serious concerns regarding cultural influences on the social worker’s decisions. There have been calls for practice ethics rooted in cultures, ubuntu and local contexts (Reamer and Mimmagadda, 2017; Thomspon and Wadley, 2019). The social worker enabled the placement of the child with blood relatives, Jolly’s sister. This followed government policy that is rooted in ubuntu care. The social worker could have considered that the emotional harm to the child by removing them from their foster care family was less compared with the benefits of their placement with biological relatives. This decision could also have been informed by the social worker’s knowledge of childhood psychology indicating that this child will not recall these childhood events in later life stages (Peterson, 2020). The social worker also did not include Jolly’s other children in their interventions. This was influenced by the social worker’s understanding that their father’s care was sufficient within this cultural context, and as guided by official policy that supports children being in the care of their biological father or his relatives. This decision is validated by the fact that both Jolly and later her sister seemed not to need to have custody of the other children.
Ethical actions in semi-regulated or unregulated environments
Another ethical dilemma regards how the social worker should act in an unregulated environment. While the provision for social workers’ positions in Uganda’s public service structures are a recognition of the social work profession, the lack of an Act and therefore the lack of a professional regulating body means that there are no codes of conduct for social work practitioners. However, the social worker in this case appears to have been guided by the code of ethics of the national association of social workers (NASWU, 2012) and the public service standing orders that guide the conduct of all civil servants in the country (MOPS, 2021). The social worker also rooted their decision making in the policy context of the country as much as possible. By so doing, they adeptly filled the vacuum left by the lack of a code of conduct for social workers with available ethical guidelines, general standards of conduct and social welfare policies. The social worker could have very easily made different decisions or taken different courses of action if they did not have this awareness and knowledge. In an unregulated environment, which is common in the African context, extensive knowledge of the welfare policy and constant reference to national or international ethical standards guided the social worker’s actions to navigate the ethical challenges.
Lessons for social work practice
First, it is critical for social work practitioners in Africa to become creative and innovative in addressing ethical dilemmas. This should be strengthened through more advocacy and door-knocking strategies (Gabel and Mapp, 2021). It, therefore, implies that social workers should collaborate more with other institutions and actors in managing ethical tensions and seeking justice for their clients. Second, through action and activism (Becker, 2021), social workers should be able to raise awareness around such broader social injustices without compromising personal and clients’ safety. Such actions could focus on addressing structural challenges that perpetuate injustice, promoting access to social services, raising consciousness on issues of injustice, name-shaming abuse hotspots and building mass support for a just society. Third, the support of well-intentioned knowledge of contextual cultures could help in such cases, as pointed out by Mungai et al. (2014). This will also require social workers to work more closely with community and informal systems to strengthen their practice and domesticate social work ethical and human rights principles to local conditions for pragmatic solutions.
Fourth, it is very important to document cases pointing to potential ethical tensions. These could be shared with supervisors and other social workers for guidance. This will help to build the recognition that cultural, political and structural conditions in many African contexts may present challenges to ethical and socially just practice. The resultant analyses from such documented cases will support working collaboratively and focusing on the possibilities of maximizing non-politically sensitive rights that could better serve clients. Finally, practitioner’s ‘tenacious determination’ is important. This case has illustrated how determined the social worker was in seeking services for their clients. They pursued all potential channels for possibilities to secure service for their client. Social workers should therefore be courageous, determined and use sheer will to serve their clients and yet still be ethically bound.
Recommendations
I therefore recommend that social workers seek continued professional support in dealing with ethical dilemmas in a culturally sensitive way as articulated by Mungai et al. (2014). Second, practitioners should seek, accept and use ethically appropriate services offered by informal systems within their local contexts through working with elders, communities and self-help groups. Finally, practitioners should obtain knowledge of human rights to promote social justice in practice (Huang and Zheng, 2019) through self-education, formal training and from invited human rights guest speakers.
Conclusion
In this article, I have presented a practical case study illustrating a client’s situation, the ethical dilemmas encountered and the actions undertaken by the social worker. I have then presented a critical commentary on the actions taken based on literature on social work ethics, human rights and social justice. From the lessons presented, I conclude that social workers can use innovation, exploration, reasoned action and advocacy to overcome constraints to socially just practice such as resource inadequacies, harmful cultural impositions and workplace bureaucracies. In addition, sharing potential ethical dilemmas with colleagues and supervisors offers a brainstorming space in which options for action are generated, discussed and shared. As learned from ubuntu ethics, building ethical capabilities for social work practice in Africa will be a journey comprising successive progressive steps.
Footnotes
Acknowledgements
The author acknowledges the support of Katerina Nolan and Janet Walker at the School of Health and Social Care, University of Lincoln, UK. Their comments and feedback during the preparatory framing of the case/commentary and the assessment feedback were incorporated in the text of this article.
Author’s note
The case study was extracted from a practitioner’s case file. Real names were not used. This article is an edited and expanded text of an assignment essay originally submitted to the University of Lincoln, UK, as part of the ERASMUS Mundus master’s in Advanced Development in Social Work (ADVANCES).
Declaration of conflicting interests
The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author received no financial support for the research, authorship, and/or publication of this article.
