Was becoming an Emerging voice for Global Health supposed to be life-changing? It is a rhetorical question! Emerging Voices for Global Health (EV4GH) is an ambitious program for talented multi-national emerging and influential actors in their respective fields in global health, with some focus on health policy & systems research. The program includes online distance e-coaching and face-to-face learning. This year, participants from 25 countries joined the network for the ten-day face-to-face training in Medellin, Colombia. The network promises to shape global health narratives and debates, as seen during the conversations at the 7th Global Health Systems Research symposium 2022  (HSR2022), which took place in Bogota, the capital. During the symposium, I had the opportunity to reflect on a few lessons or takeaways.

One critically questions the origin of trending buzzwords or phrases. For example, decolonizing global health is becoming a common phrase, but it means different things to people on closer scrutiny. For example, Abimbola et al argued that decolonizing refers to the systematic destructuring of power, privilege, and systems that systematically discriminate or exclude people on ethnicity, gender, race, religion, and economic background. Recent examples of visa apartheid, Black Lives Matter, and Me-Too movements have galvanized the narratives around decolonizing. Scholars argue that this stems from the colonial education that shapes the mindset. Therefore, it is crucial that a researcher carefully assesses and communicates his/her position when discussing decolonizing.

The discussions were clear about how knowledge generation and application can exclude others systematically. As a knowledge broker, it clarified how evidence is constructed for decision-making. Platforms like the Center for Rapid Evidence Synthesis (ACRES) in Uganda consider and apply approaches that are cognizant of the uncertainties and limitations of each form. It also meant that as we speak of decolonizing, we can be part of the solution, not facilitate the problem in our settings.

To learn, unlearn, and relearn is critical that helps us view the world from different perspectives. Before the venture, I used the terms ‘empowerment’ and ‘ownership’ without critical reflection. We visited some communities in Medellin (comuna 1, 4, & 13) recovering from years of systematic violence. As we walked through the communities, I was conscious of being slow to conclude. After interacting with different stakeholders within the communities, I was awed by how the communities have embraced their complex history, organized themselves, and created something almost beautiful through participatory processes. For example, a local artist mobilized women and children to pay tribute to the loved ones lost during conflicts by planting flowers around the cemetery. The act was significant in mobilizing the community against the conflict. It would be patronizing to claim that they have achieved their goals as more healing, building, listening, and participation are needed in these communities. With that in mind, I reflected on how we engage communities back home and felt ashamed. Researchers sometimes push their own narratives and not those of the people. Given our positionality (privilege and power), these narratives are hardly questioned, thus becoming injurious to the community.

A roleplay at the EV F2F training in Medellin

This was brought to the fore when I participated in a roleplay acting out a community engagement session. Three community members, a health systems manager, a nurse, and a district chief discussed options to redistribute the healthcare workers within a district to foster equitable access to care. I was selected to represent a “wealthy” town with more healthcare workers and better healthcare indicators. My group entrusted me to represent their views as I passionately argued that it was not about the current problem but how it is framed. It was essential to address the problem as not one of inequitable distribution but inadequate healthcare workers. I reframed and argued that moving the healthcare workers would only compound the problem because healthcare workers would still be inadequate, and redistribution would actually worsen indicators. It was also essential to address other complementary issues, including the lack of equipment and the failure to attract skilled and talented healthcare workers. Aside from the performance, this moment got me to reflect on multiple perspectives that we are often blind to, that we fail to create meaningful alliances to address critical societal challenges.

Lastly, I learned I could get lost in a city like Bogota and find my way (back) through informed intuition, a friendly guide with a phone, and a signal. Researchers often follow others’ footpaths to identify “new’ patterns and are risk-averse to exploring new ventures. In my view, the Emerging Voices venture is an adventure worth exploring, among others to question predetermined notions. The predetermined notions are expected to be signals and not fix researchers in endless loops without innovations.

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