By Beryne Odeny (Washington University in St. Louis, Department of Surgery) and Julia Robinson (PLOS Global Public Health) The first in-person CUGH…
By guest contributors Neha Singh and Michelle Lokot
Within global health, the concept of decolonising has become so casually and even flippantly used, that it has almost lost meaning. At the Health in Humanitarian Crises Centre (HHCC) at the London School of Hygiene and Tropical Medicine (LSHTM), we have been grappling with what it means to meaningfully decolonise our research, teaching and partnerships in the light of the many critiques of tokenistic and superficial efforts to decolonise.
Recent research has shown that unsurprisingly, the LSHTM was set up as a colonial institution and benefited from and contributed to British colonialism in a variety of ways between 1899 and 1960. It is largely due to its role in British colonialism that the LSHTM owes its current power and position as a leader in health research and teaching. Within LSHTM, the HHCC was founded with an aim of advancing health and health equity in crises-affected countries through research, education, and translation of knowledge into policy and practice. While there is no doubt that HHCC members are committed to improving the health of populations affected by humanitarian crisis, limited articulation of what it means to decolonise can mean that decolonising becomes merely aspirational. Despite an increasing number of calls over the year to decolonise global and humanitarian health research, there is almost no practical guidance on how to do this.
The HHCC, formed of over 200 LSHTM staff and over 1400 external actors, decided to undertake a project to develop a Charter and Implementation Guidance to help us decolonise our work. We recognised that in our positioning as an academic institute in the United Kingdom, we held and used power in ways that were often colonial, perpetuating top-down hierarchies and limiting the opportunities for our partners to be involved in decision-making about issues and projects that concerned them. Through a partnership with the FAIR Network at LSHTM, we undertook a research project that included a) a scoping review of existing guidance on decolonising global and humanitarian health, b) interviews and focus group discussions with HHCC staff, as well as external actors such as donors and implementing partners to explore barriers, facilitators and good practices related to decolonisation.
We sought to go beyond simply rebranding and changing the perceptions of the Centre’s work on humanitarian health, and instead try to work on creating a cultural shift at the core of how the humanitarian health research field is understood and practiced by its members. Specifically, we aimed to do this by:
- Creating a HHCC charter and related implementation guidance to describe what the Centre should aim for in terms of decolonising, i.e. a set of practices that HHCC members publicly commit to adhering to, and to measure adherence to. This is a public-facing document that will be shared with partners and donors, and accessible online; and
- Designing internal accountability mechanisms to monitor the implementation of the charter.
The Charter outlines the three key principles to our efforts to decolonise in the Centre: decolonisation as a comprehensive practice, disruption of racialised power dynamics, and change as a continual process. These principles recognise that decolonisation requires systematic action and even the overturning of structures and systems we work within. We recognised how power dynamics within global and humanitarian health are often racialised and required us to intentionally call out and address racism. We positioned decolonisation as an ongoing and continual journey, rather than an outcome we achieve – in order to recognise the long-term work this would require of us as a Centre.
Alongside the principles we identified key commitments: Be led by those from crisis-affected countries; Challenge the assumed neutrality of humanitarian practice; Reimagine risk and capacity; Redistribute resources. In establishing these principles, we recognised the often-leading role we played in determining research and partnerships within humanitarian settings and the need to change this entrenched power dynamic to create space for those closest to humanitarian crises to take the lead. We recognised that despite how it often presents itself, humanitarian practice is not neutral or apolitical, and that taking an intersectional approach would help us in challenging power hierarchies. We sought to rethink how risk and capacity are defined, to dismantle the assumption that global south leadership is riskier, or that our effort is needed to build the capacity of others. Lastly, we wanted to challenge how resources are distributed – whether related to funding or authorship, to ensure greater equity.
We recognised that adhering to these principles and commitments would require new ways of working: for us to change collectively as members, but also to work with other LSHTM Centres and external actors to decolonise, and to use our influence to bring about broader change in the sector. We developed ‘Implementation Guidance’ to help operationalise these principles, commitments and ways of working, structured around reflection questions for our HHCC members to reflect on.
We have committed to creating a monitoring process to measure what has changed as a result of this Charter every two years. In the shorter-term, we are mapping our research projects to help track progress and challenges to decolonising over time, and to follow research projects from the start to the end. We will also be conducting an audit of authorship based on members’ publications. We recognise the importance of moving beyond rhetoric to practical action when it comes to decolonising. For the HHCC, the journey to decolonising has only just begun and will require much more concerted and intentional engagement from us as individuals, as a Centre and as an institution.
About the authors:
Neha Singh is an Associate Professor and co-Director of the Health in Humanitarian Crises Centre at the London School of Hygiene and Tropical Medicine. She conducts interdisciplinary and participatory health policy and systems research using a decolonial lens, aiming to improve the design, affordability, availability and delivery of essential health services for vulnerable populations in humanitarian settings. Under this broad theme, her research fits into 3 areas: (1) health services provision and access; (2) health financing to improve health service delivery and equity; and (3) health policy implementation. She tweets at @neha_s_singh
Michelle Lokot is an Assistant Professor and co-Director of the Health in Humanitarian Crises Centre at the London School of Hygiene and Tropical Medicine. She has experience conducting qualitative research using interdisciplinary approaches. Her research interests include forced migration, gender, humanitarian assistance, gender-based violence, decolonising research and research methods. She has experience conducting decolonial feminist research and supports humanitarian and development organisations in their efforts to decolonise monitoring and evaluation and research. She tweets at @michellelokot
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