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Abstract
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As part of the call to decolonise global health, there has been an emphasis on shifting different aspects of the global health system, including the role of donors and journals, addressing racism, decolonising the mind, and ensuring adequate working conditions for staff in low-income and middle-income countries. Historically, decolonisation has always been a violent process and global health might experience the same. Disrupting and calling out neo-colonial practices requires courage to bear the cost that comes with doing so.
I write this piece specifically in the context of academic research partnerships between high-income and low-income countries and what can be anticipated. In response to the movement, when researchers in low-income countries challenge the current systems to fight power asymmetries on their terms, the process of power transfer is going to be violent, taking different forms. Little has been written about how to deal with the complexity of the process, particularly the violence that comes with it, and how this violence manifests itself in research collaborations between high-income and low-income countries.
Violent, marginalising behaviours can include continual questioning of the ability and technical skills of the staff from low-income countries. Other behaviours that undermine equitable collaboration include critical decisions being made about the study by high-income country researchers or travelling to the site without prior communication with the low-income country's principal investigator; publishing papers or deciding authorship without the knowledge of the low-income country's principal investigator; directly communicating with the field staff undermining the site principal investigator, and communicating unsubstantiated allegations against the principal investigator to the low-income country's university leadership as a means of coercive influence. I have come to understand the power dynamics that influence decision making from my position as a marginalised player in the system. Although the literature often situates power as a consequence of an inherent superiority of high-income countries universities, I argue that those power asymmetries are primarily influenced by the weaknesses of institutions in low-income countries. Global health research institutions in low-income countries give away power in exchange for resources, funding, recognition, and the chance to be published in high impact journals by affiliation. That situation is often perceived as more comfortable and risk aversive than addressing local systemic issues. Decolonisation can succeed only if the colonised are willing to move out of their comfort zone and seize the opportunity to take responsibility for their own destiny.
Language: en |