On the importance of uncomfortable questions: Duke Decolonizing Global Health Conference

Odessa Grimard, BSc Psychology and Neuroscience Candidate

Decolonizing Global Health was a student-led conference held at Duke University on January 30th, 2020, and I had the true privilege of attending it. A truly impressive array of global health academics and practitioners presented their viewpoints on the question of decolonization in two panels. Our very own Dr. Madhukar Pai spoke on the first, titled Theories, Methods, Language; the second was titled Case Studies from Haiti, India, USA and beyond. In the audience were over 500 people of a wide range of backgrounds, ranging from first-year undergraduates to NGO practitioners and full professors.  Beyond that, the conference was livestreamed, and the livestream was so well-attended that it momentarily crashed! Thankfully for all viewers, including those at the viewing party organized by our Global Health Programs office, the technical difficulties were quickly resolved. Both panels were also fully recorded and archived on the WHO Center for Global Health Histories’ website.

The conference was a fascinating mix of theory and practice, with speakers ranging from anthropologists to global health journal editors and those working in the field with NGOs. The first panel was opened by Dr. Kearsley Steward with thoughts on anthropology’s historic contributions to colonialism and present methods for working in a decolonial framework. Dr. Walter Mignolo, a professor of literature at Duke University, then explained the theoretical framework of decoloniality to us. Dr. Amy Locklear Hertel, chief of staff to the Chancellor at the University of North Carolina and proud indigenous woman, spoke of how North American universities fit into this conversation, with a particular attention to support for indigenous students on campuses. Dr. Madhukar Pai then showed us data on the imbalance of power in global health between institutions set in high-income countries and their researchers and those set in lower- and middle-income countries. Finally, Dr. Meleckidzedeck Khayesi, a technical officer at the World Health Organization, spoke of the crucial value of tacit knowledge in global health as a way of resisting colonial pressures.

The second panel was moderated by Laura Mkumba, a Masters candidate in Global Health who was on the Decolonizing Global Health Working Group at Duke, and focused more heavily on case studies of decolonial global health practice.  Dr. Eugene Richardson brought together Dr. Mignolo’s theoretical work and the more practical concepts presented in the previous panel to examine work that he had done in partnership with a number of organizations, including the WHO. Dr. Deborah Jenson examined two cases: the more recent case of cholera in Haiti, and the more historic case of early neuroscience’s ties to the eugenics movement and Antenor Firmin’s early critique of it. Dr. Sanjoy Bhattacharya, the director of the WHO Center for Global Health Histories, then situated WHO in its history and examined it through a decolonial lens. Dr. Allysha Maragh-Bass then spoke of the importance of local work in global health, grounding this discussion in her own experience, and of the crucial need to ask hard questions about the power structures, histories and research goals in order to build respectful, collaborative research practices that give back to communities in which research is conducted. Finally, Dr. Seye Abimbola, the current editor in chief for BMJ Global Health, spoke about decolonizing the literature, and how this can be done in practice.

Unpacking all that was said would be truly impossible: the volume of fascinating, important information is simply too great, and I’d invite you to watch the talks if these themes interest you. That said, I’d like to focus on a question that was asked time and time again, implicit in each speech, asked in question periods and breaks: should we be doing global health?  Considering the context of colonization, considering the current imbalances in funding and publications and working groups, considering historical and present inequity, is it my place to be doing the work I dream to be doing? 

Of course, there are as many answers to that question as there are people working or dreaming of working in global health. Dr.Maragh-Bass stated that until she was convinced that she could do more good doing work abroad than doing local work, her work was going to stay very local. Dr. Pai suggested reasons for working in Global Health with an awareness of this context, and conditions to do it well. He talked of how global health research is a valuable mechanism for students from high income countries (HIC) to realize their privilege, and to understand their identity and role as global citizens. He spoke of the importance of appropriate pre-departure training and the less tangible but no less important notion of having the right motivations to do this kind of work. He also spoke about reinforcing the notion of the global being local, and of how HIC students could engage in global health work within their own regions.   

This conversation resonated with me: I am from a high income country with a colonial past and present, studying Psychology in an institution in this same country. Most of my extracurricular work is in global health; my transcript and my CV strongly suggest that I’m aiming to work in psychological trauma in underprivileged communities, both locally and worldwide. That said, I have also been reflecting for some time about whether it’s my place to do such work. Quite frankly, this remains an open question: this conference gave me more new variables to consider than it gave me answers. I have examined my reasons for doing global health, had the chance to hear more of Dr. Pai’s thoughts on this subject, read this article by Dr. Jane Phillpott. I came to the conclusion that I was comfortable enough with my reasoning to apply to international projects within the Global Health Scholars program; what reflections and new directions future events may bring remains to be seen, however.

I had the chance of learning an incredible amount from the event, but also from its organizers, as I was in contact with their working group throughout the weekend and had the chance to hang out with them quite a bit. This dedicated group of Masters candidates in Global Health includes Laura Mkumba, Yadurshini Raveedran, Andrea Koris, Cordelia Kenny and Ali Murad Büyüm. Their passion for global health and willingness to provoke admittedly quite difficult conversations blew me away. Their dedication to holding this conference and providing a space for talking about decolonization is in every way admirable and was for me an important lesson in doing the right thing regardless of high and numerous barriers along the way.  

As I reflect on it all three weeks after the conference, two things stand out: first, I feel that I realize something new every time I think back on the speeches, the question periods, or the time I had the chance to spend with the working group and the speakers outside of the conference. Second, I am filled with gratitude for all of what the working group taught me and so very excited to put that knowledge to good use. Indeed, if you are interested in decolonizing global health, in reimagining its methods and future, stay tuned: a conference along the same lines may well soon be coming to a university near you.

About the author

I am a third year undergraduate studying Psychology and Neuroscience with the aim of working in global mental health. My research interests include trauma-related conditions such as post-traumatic stress syndrome, resilience, and inclusive research practices in Global Health. I served as president of Friends of Médecins Sans Frontières at McGill this year and am part of the working group for McGill's upcoming global health conference.