Dismantling Colonialism in Global Health: Emerging practitioners are in it to win it!

by Shubha Nagesh and Ifeanyi Nsofor, GHMe Mentors, 2019 - 20

COVID-19 is the most significant pandemic experienced by our generation. Contrary to expectations, Asia and Africa have fared better, with strong adherence to timely public health measures including lockdowns, robust communication, activation of well-established vaccine delivery mechanisms, and leaders seeking the advice of scientists.

Even in 2021, as we continue to navigate this pandemic and learn new lessons, the glaring chasm that opened up in global health is the asymmetry between the Global North and Global South. If ever there was a time when the Global North could learn lessons from the Global South, this was it. However, the chance has been squandered, with the notion that continues to persist — the Global North knows it all, does it best, and has it all. This applies to power, practice, resources, funding, research, teaching and opportunities in global health - no space is safe anymore.

COLONISATION AND GLOBAL HEALTH

We need to consider both the direct legacy of the colonial era on health systems and the way that patterns from that era are reproduced. The very concept of global health is inherently colonial or neo-colonial. What was colonial health became tropical health, international health and finally Global Health. This is where we stand today. Since the very early days, the primary focus of colonial health has remained to serve the primary interests and well-being of the colonisers and their kin; never the wellbeing of the populations with whom they were living and supposedly benefiting. A long, deep and dark history of slavery, racism and oppression underlie the present-day concept of global health; to aim to dismantle it would take a new mindset, a shift in perspective, use privilege in a measured way and develop strong networks with the Global South.

"We need to consider both the direct legacy of the colonial era on health systems and the way that patterns from that era are reproduced."

DECOLONISING GLOBAL HEALTH

Global health is about creating and sustaining a fair, equitable world where each person has access to health, education, employment and well-being irrespective of their personal circumstances. The reality is far from it. In recent years, particularly in 2020, the concept of "decolonising global health" has emerged strongly and gained prominence globally. The goal is to replace the hierarchical, colonial, foundations and remove the domination of experts from the Global North with a fairer process and system that have equal, if not more representation from the Global South.

To decolonise global health, many forms of power-inequities need to be addressed, both the Global North and the Global South need to take action, within countries, between countries; in global health research, practice, authorship, education and global health careers. However, is this pace enough, or do we need to do more, and do it faster?

Source: Dr Shubha Nagesh

HOW CAN I HELP?

As students of global health, and global health practitioners, it is vital to understand the history, acknowledge the lessons learned, and apply them today. As we struggle to make sense of our largest challenge yet, every global health professional has a role to play in dismantling this inequitable system.

Here are some ways to dismantle global health colonialism:

1. Empower experts in the Global South to establish themselves as key expert voices for their countries and regions and to collaborate more with their own communities and people to lay down policies and programs.

2. Strive to make global health education available in the Global South. Help establish educational institutions, build faculty capacity and encourage more students to learn locally.

3. While choosing electives in Africa or Asia, determine well in advance how the host country will benefit from the visit.

4. Build research capacity and shift the imbalance with more southern authorship.

5. Bilateral exchanges should benefit the southern partners too, if not more, with those communities being researched experiencing positive shifts.

6. Promote diversity and inclusion in panels, committee's, cohorts, fellowships, conversations and all else- more diverse voices at the table make the table strong, representative and powerful.

7. Mentor more people from the Global South, to help them become agents of change. Let your ceiling become their floor.

Scholars and practitioners from the Global South have to amplify their voices, rewrite narratives and emerge collectively to change the landscape for the better by changing power imbalances. There is a need to shift analyses, institutions, and processes in funding, initiatives, and access to services towards a fair and equitable system that benefits all, equally.

Source: Dr Shubha Nagesh

Experts agree there can be no single solution to addressing the colonial influence on health systems — the way forward is still under discussion. The process has only begun, needs momentum and needs the voices of more young global health practitioners who will emerge as the next global health force.

We are keen to understand the perspectives of young, emerging, and established practitioners in global health around this topic."

WE WANT TO HEAR FROM YOU

In this context, we are keen to understand the perspectives of young, emerging, and established practitioners in global health around this topic and request you to share your responses in a brief survey. Can you please take 5 minutes to complete the survey here. If you have any questions, please reach out to Dr Shubha Nagesh (s.nagesh@atlanticfellows.org) and Dr Ifeanyi M. Nsofor (i.nsofor@atlanticfellows.org).

Suggested Additional Readings:

• Decolonial conversations about our HPSR praxis: How do we resist? https://www.youtube.com/watch?v=QEPkj_lkGvI&t=157s

• CREATING A COALITION OF THE WILLING TO DECOLONISE THE GLOBAL HEALTH SECTOR https://developmentreimagined.com/portfolio-posts/creating-a-coalition-of-the-willing-to-decolonise-the-global-health-sector/

• Decolonising global health: if not now, when? https://gh.bmj.com/content/5/8/e003394

• The activists trying to 'decolonize' global health https://www.devex.com/news/the-activists-trying-to-decolonize-global-health-94904

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Thank you to Shubha Nagesh and Ifeanyi Nsofor for your valuable perspective. For any inquiries related to the GHMe Blog, please contact our team at globalhealthmentorships@gmail.com

Disclaimer: This blog was prepared by the author, in his/her/their personal capacity. The opinions, views, and thoughts expressed in the blog belong solely to the author and do not reflect the views of Global Health Mentorships.