Challenging Colonial Ways of “Knowing” in Global Health Research
Editor’s Note: As the world faces the once-in-a-century pandemic of COVID-19, it’s more important than ever that we challenge colonial ways of approaching global health. As Sarah Dalglish wrote in an op-ed in The Lancet, “The global health model is based in large part on technical assistance and capacity building by the US, the UK, and other rich countries, whose response has been sclerotic and delayed at best…The pandemic has given the lie to the notion that expertise is concentrated in, or at least best channelled by, legacy powers and historically rich states.” The below piece is part of our ongoing decolonizing global health series.
An uncountable number of today’s global health inequities are a direct result of the unequal power dynamics created through the infiltration of colonial projects into the Global South. Modern global health movements are no exception. As a white, American male researcher working alongside women’s rights organizations in the Global South to end the pandemic of violence against women (VAW), I am fully aware that I am a part of this very system.
Colonialism, as a historical construct, was marked by centuries of economic exploitation of lands, natural resources and human labor. We often view the colonial period as a bygone era of history created by imposed boundaries, divisions and hierarchies between Global North and Global South. This manifested through the imposition of capitalist, imperialist and patriarchal worldviews on Southern populations and communities favoring not only ‘colonizer’ over ‘colonized’ and white over non-white, but also male over female. Colonially-imposed gender power structures persist to this day and exacerbate struggles for equity fought by Southern women’s movements.
As a modern reality, coloniality continues to take on new forms and perpetuates power imbalances. While we cannot speak of either North or South as monolithic, we must consider the distribution of power across the world stage, particularly when contemplating accountability in global health movements. The international development and global health sectors created and maintain structural power imbalances through language like donor vs. grantee, coordinating agency vs. local organization, program manager vs. program staff, or foreign “expert” vs. national project officers. Similar to the imposed power structures of colonial periods, development assistance from the Global North continues to dominate funding — and decisions on how to spend those funds — for development initiatives across the Global South. This perpetuates a cycle of dependency wherein local actors are hard-pressed to mobilize necessary funding for local interventions without outside assistance.
Development initiatives designed to help countries achieve what the Global North has conceptualized as “modernity” may thus be viewed as an extension of colonial “civilizing missions” and power relations between “developed” (upper-income) and “developing” (lower/middle-income) countries, particularly when importing political, economic and social systems from foreign contexts.
Colonialism was marked by extraction — not only of natural resources and human labor, but of knowledge. Quantitative and qualitative methods are commonly rooted in Northern/Western epistemological perspectives and ways of understanding the world. Modern development research acts as an extension of colonial ways of knowing, with “rigorous” methodologies developed to extract learning from the “other” to understand their norms and behaviors. Development research continues to extract and appropriate the knowledge and experiences of populations throughout the Global South through research led predominantly by Global North researchers…like me.
I built my career in large part thanks to the immense privilege that comes with my advanced Western degrees and my “international experience” in Uganda, Tanzania, and Myanmar, all made possible by my access to visas and foreigner-friendly hiring policies of the international organizations for whom I consult. Previously I worked as a 2014–2015 Uganda fellow with Global Health Corps, which pairs American citizens with African nationals through its fellowship program. This academic and organizational name recognition throughout my CV appeals to donors and contributes to the added privilege that being male affords me while working in more rigid patriarchal contexts.
Decolonizing global health and development work means we must recognize and address our own power over others, including patriarchal structures that continue to value the contributions, ideas and decisions of men (particularly, white men), over those of women (particularly, women of color).
Therefore, I believe that my role as a white, American male working in global health and VAW prevention research in the Global South is first and foremost to regularly reflect on my privilege. This requires being open to input on how I can responsibly use this privilege, while not exacerbating power hierarchies I find myself to be a part of. It means reflecting on accountability, taking on supportive roles wherever possible, and actively avoiding the use of dominating tones in conversations that I cannot speak to from my direct experiences. I can then combine humility and accountability with my unique position within collaborative efforts to highlight the immeasurable value of local and indigenous knowledge over my own.
As a member of The Prevention Collaborative, I support an advocacy agenda to address colonialism within VAW research and elevate the value of Practice-Based Knowledge — the knowledge and experience of local, frontline practitioners and responders. We aim to inspire donors to focus less exclusively on hard evaluation data and more on the voices and experiences of those most intimately involved with prevention work. I work alongside a brilliant team of practitioners and researchers from Sri Lanka, South Africa, England, India, Uganda, Kenya and the United States to push this agenda forward and develop key resources on documenting and using Practice-Based Knowledge, which has helped to inform a growing discussion on decolonizing knowledge in the violence prevention field.
The legacy of colonialism continues to affect the way we learn and construct knowledge, and the way we conceptualize and “other” certain groups — whether via race, gender, class, (dis)ability, ethnic group, religion, geographic location, or the intersectionality of human beings’ varying identities. Women’s health, violence prevention, and feminist movements are paying increased attention to these dynamics. In order to responsibly learn from and address complex global health issues, we must all take stock of the knowledge that informs our work and critically interrogate how we are collecting, documenting, and sharing diverse knowledge and learning tools from various contexts.
The European colonial project thrived by dividing humankind. Health equity and social justice movements through organizations like Global Health Corps and The Prevention Collaborative have vast potential to challenge these divisions and promote collaboration and a united front against the injustices and inequities that continue to drive interpersonal and structural violence and poor access to healthcare around the world. This must start with ceasing the self-congratulatory backbone of development work and seriously reflecting on the role we all play in the manifestations colonialism continues to take.
Devin Faris was a 2014–2015 Global Health Corps fellow with S.O.U.L. Foundation in Uganda.
Global Health Corps (GHC) is a leadership development organization building the next generation of health equity leaders around the world. All GHC fellows, partners, and supporters are united in a common belief: health is a human right. There is a role for everyone in the movement for health equity. To learn more, visit our website and connect with us on Twitter/Instagram/Facebook.
