By contributing author Ijeoma Nnodim Opara, MD
For the masters tools will never dismantle the masters house. They may allow us to temporarily beat him at his own game, but they will never enable us to bring about genuine changeI urge each one of us here to reach down into that deep place of knowledge inside herself and touch that terror and loathing of any difference that lives here. See whose face it wears. Then the personal as the political can begin to illuminate all our choices.
Audre Lorde
These days, one can barely throw a stone in a global health space without hitting something to do with decolonizing global health. The decolonization of global health is the latest topic du jour and everyone is an expert. From blog posts to journal articles and webinars to conferences, the calls to decolonize echo throughout the cybersphere of institutions in the Euro-American region, twirling in and out of social justice conversations and dancing on the edges of diversity, equity, inclusion (DEI) discourse.
Global health must be decolonized! is the growing call to action.
But, how? And do folks understand what the term decolonization actually involves?
Is decolonization even possible especially if the same tools and systems of colonialization are employed in attempts to decolonize? Have global health actors reached down into that deep place of knowledge to touch that terror and loathing of difference?
Whose face does it wear?
Some of us in the global health space who were flying the banner of decolonization long before it became lit to do so, have looked upon the growing decolonization movement with mixed feelings and a lot of discomfort.
On the one hand, we see the need for greater awareness about the lasting damages of colonialism, and the power asymmetries that are pervasive in global health. On the other hand, our unease can be categorized in to three concerns:
How is coloniality showing up in the decolonization movement?
Decolonization is often perceived as a means to uncover the histories of the colonized, those whom Frantz Fanon refers to as the Wretched of the earth, and bring their stories to the awareness of the mainstream. However, it is often confused with any social justice endeavor including diversity, equity, and inclusion and often devoid of a critical analysis of power, history, and sociopolitics. This lack of critical introspective analysis of power, hegemony, and the historical and continuing dynamics of internalized and systemic oppression in contemporary health and higher education structures, results in the reproduction of colonial logics of commodifying human beings, labor, space, and knowledge.
What this looks like is the maintenance of a power hierarchy in global health that is still predominantly white, cis-gendered, heterosexual, male, and European/American. It looks like institutional-community or (neo)colonial-(neo)colonized processes, practices, and policies of funding, partnerships, and program/project development that replicate colonial dynamics of extraction and exploitation. It looks like curricula that re-marginalize, de-prioritize, and minimize the lived experiences, expertise, and epistemologies of indigenous communities. It looks like narratives that obscure the interdependent causative relationship of the development and wealth of Europe and North America and the under-development and poverty of their past and present colonies. It looks like discourse that ignores the role of (neo)colonizer economic and national security decisions and policies that suppress indigenous independence. It looks like co-opting and bending the decolonization discourse to adhere to Eurocentric constraints such as viewing situations in binary terms and, therefore, in tension versus in multifaceted, intersectional, and in harmony. Constraints such as framing approaches as pragmatic vs philosophical as opposed to each informing and depending on the other. It looks like language that reinforces the hegemony of Europe and North America over the rest of the word such as Global North and Global South or defining nations by economic status set to Euro-American indices of prosperity and development. It looks like the absence of a commitment to justice and engagement with community-led justice and liberation movements.
Who is the decolonization movement for?
We have observed a lack of reference and deference to Majority World scholars, thinkers, practitioners, and activists in the rush of Euro-American do-gooders to institutionalize decolonization centers, departments, positions, apply for grants, and create programs, projects, and curricula. This ironic rush to colonize the decolonization movement is done without reflecting on (neo)colonizer intellectual connectivity to indigenous and majority world critical inquiry, often as a result of ongoing epistemological exploitation.
Giants such as Aime Cesaire, Frantz Fanon, George Sefa Dei, Chizoba Imoka, Ngugi Wa ThiongO, Amilcar Cabral, Eskia Mphahlele, and many others are omitted from discourse as institutions mobilize to incorporate decolonization studies into their neo-liberal academic framework. Institutional norms, epistemologies, ontologies, praxes, policies, and processes built on Euro-American neo-liberal values of the hierarchical dualism of the individual over social, human over environment, and industrialized or developed over non-industrialized are expected to embrace what Tshepo Madlingozi and Frantz Fanon describe as a violent and disruptive process, and what Joel Modiri defines as an insatiable reparatory demand, an insurrectionary utteranceIt entails nothing less than an endless fracturing of the world colonialism created.
The attempt to incorporate the disruptive violent process of undoing colonization within colonial frameworks and matrices is itself an act of colonization as it ignores the inherent intent of decolonization and presents as an unwillingness or an inability to change. It is also emblematic of the ego-centrism and lack of self-introspection that often peppers well-intended decolonization actors and their actions. Often, they do not do the work of reaching down into that deep place of knowledge inside oneself to touch that terror and loathing of any difference that lives there, and see whose face it wears, so that the personal as the political can begin to illuminate their choices. Often, they do not submit themselves to the endless personal and political fracturing that is decolonization. The urgency dictated by white guilt leaves little space and time for actual reflection, deconstructing, deconditioning, relationship-building, and structural dismantling. Thus, grassroots indigenous and Majority World leaders are left in the dust, their ideas co-opted in the rush to solutions, while colonial power paradigms and dynamics are left intact, patterns of oppression and structural injustices remaining unfettered and reinforced.
What about intersectionality?
Anchored to the first two concerns, the lack of a critical power analysis rooted in indigenous and Majority World critical inquiry renders the decolonial movement impotent to actualize real fundamental change. This is because a critical analysis of colonialism is fundamentally intersectional and must locate its construction, and thus, deconstruction, at the intersection of white supremacy, global anti-Blackness, patriarchy, capitalism, ableism, classism, homo/transphobia, fatphobia, and xenophobia. It is George Sefa Dei and Chizoba Imoka who state that To colonize one has to equate the purpose of life to material acquisitions, affirm their personhood only through their ability to dominate/bully others, shrink their mental capacity so as not to respect/understand human diversity and rationalize a wide range of unfettered violence. A decolonization movement that is not intersectional and does not contend with these mutually reinforcing interdependent systems of oppression and violence in the structural, interpersonal, and internalized dynamics of global health is doomed to fail. The lack of courage to name these intersectional systems of oppression, the paradigms of structural violence that undergird our global health institutions, and call out their perpetuators and benefactors allow these systems to persist un-checked, in so-called decolonization spaces.
The bottom line is that the decolonization movement itself needs to be decolonized. We cannot decolonize global health using the same logics, dynamics, and paradigms that birthed it in the first place. We cannot dismantle the masters house with the masters tools. Unfortunately, many decolonization scholars and advocates, especially in academia are shackled into inaction, as the only tools at their disposal are the same tools of colonialism, the same system into which we have all been baptized. Which is why many anti-colonial thinkers have expressed that decolonization is impossible, but, in the words of Foluke Ifejola, we must make her possible if we wish to survive this wretched night that this wretched earth has been plunged into by humanity.
This will require an imagination revolution. A liberatory mindset reset. A paradigm cataclysm.
We must de-construct and re-construct global health spaces using transformative tools created by indigenous, grassroots, and majority world communities. The voices of the poorest, darkest-skinned, most disabled, women (cis and trans), and femmes must be centered at decision-making tables in policy, education, health, economy, & Justice. Tables built by them for them.
Nothing about them without them.
We make decolonization possible by:
We will find ourselves liberated.
Global health will not survive its true decolonization. It is not supposed to. Instead, a better, transformed ecocentric world health system should emerge from the ashes of the deconstruction and dismantling of the global health industrial machine. We imagine a compassionate, intersectional, comprehensive, universal healthcare and public health system designed and led by the indigenous and unassimilable Majority people, and representing equity, justice, and liberation benefiting all and sundry.
The author acknowledges with gratitude that the land she lives and works on is the original homelands of the Anishinaabe: the Ojibwe, Odawa, and Botawatomi. She acknowledges the painful history of genocide and ongoing colonialism on this land of Detroit or Waawiyatanong and commits to honoring and respecting the diverse indigenous peoples, while learning how to be a better steward of the land.
Dr. Ijeoma Opara is a double-board certified Assistant Professor of Internal Medicine and Pediatrics at WSUSOM, Associate Program Director of the Internal Medicine-Pediatrics residency, and attending physician with Wayne State University Physician Group. She serves as a Section Editor for the Racism and Health Section of PLOS Global Public Health.
Read this article:
It's Time to Decolonize the Decolonization Movement - Speaking of Medicine and Health - PLoS Blogs
