Says who? Northern ventriloquism, or epistemic disobedience in global health scholarship

Scouring a bookshop in Havana, Cuba, I came across Olive Senior's poem Colonial Girls’ School.1Senior O girls school.in: Ellis K Poetas del Caribe anglophóno. Casa las Américas, Havana2011: 105Google Scholar It teleported me to my mother's and aunts’ musings about their colonial girls’ schools. Borrowed imageswilled our skins palemuffled laughter […]dekinked hairdenied sex gym tunics bloomers […]yoked minds declensions Latinand the language of Shakespeare […]How those pale Northern eyes andaristocratic whispers once erased usHow loudness, laughterdebased usThere was nothing left ourselvesNothing us at all […] laughed that salt-scented, balmy bookstore familiar dissent against “Latin declensions” “bloomers”. Did laugh with amusement? Inherited shame? Perhaps relief stories these women loved, who made me, were not unique. needed no interpretation poem. spoke soul. heard it blood. My ancestors arrived South Africa from India as indentured labourers harvest sugarcane when both countries part British imperial hierarchy. The question “Global health 2021: tells story?”2The Lancet Global HealthGlobal story?.Lancet Glob Health. 2021; 9: e99Summary Full Text PDF PubMed Scopus (21) Google comes worryingly late given global health's extended infiltration into low-income middle-income (LMICs).3Abimbola S foreign gaze: authorship academic health.BMJ 2019; 4e002068Crossref (105) As woman colour, worker, researcher, trained, practising, living country, applaud editors’ resolution “it is unacceptable for gatekeepers producers knowledge continue mirror historical colonisers”.2The worry newly discovered, so-called editorial reflexivity will elevate journals above oratory they pledge uplift. Most university departments are high-income (HICs).4Naidu T Southern exposure: levelling tilt medical humanities education.Adv Health Sci Educ Theory Pract. 2020; 26: 739-752Crossref (10) Contemporary specialists journal editors predominantly white, male, based such countries. To hope this environment akin someone looking hoping see else. Epistemology emerging key site critique Euro-American bias geopolitics knowledge.5Mignolo WD Prophets facing sidewise: difference.Soc Epistemol. 2005; 19: 111-127Crossref (27) scholarship sustains its dominance through suppressing views LMICs methods creation.5Mignolo Scholar, 6Tuhiwai-Smith L Decolonizing methodologies: research indigenous peoples. Zed Books, London1999Google scholarly response threefold; enunciate ideas HICs back traction (which designate ventriloquism); resist by articulating local spaces; or subvert HIC insurgence (scholarly work opposition dominant convention: epistemic disobedience). challenge epistemological has been initiated professionals’ education, calls level “Northern tilt”,4Naidu dismantle “the master's house”,7Paton M Naidu Wyatt TR et al.Dismantling house: new ways knowing equity social justice professions 25: 1107-1126Crossref (18) pass microphone” amplify voices LMICs.8Wondimagegn D Soklaridis Yifter H Cartmill C Yeshak MY Whitehead Passing microphone: broadening perspectives amplifying underrepresented voices.Adv 1139-1147Crossref (4) These important, but do go far enough moving colour promised land transformed scholarship. Health's commitment gender diversity matching intersectionality.9The Editors GroupThe Group's commitments diversity.Lancet. 394: 452-453Summary (39) Yam colleagues’10Yam EA Silva Ranganathan White J Hope TM Ford CL Time take critical race theory seriously: beyond colour-blind lens health.Lancet e389-e390Summary (6) recent community apathy consciously addressing how multiple categorisations—such gender—interact result interlocking oppressions privileges compels corresponding depth breadth LMICs. Otherwise, am just one latest generation have “willed skin pale” “yoked” mind, hankering be speak tongue. Transnational feminist poses anti-racist overlooks colour.11Narayan U Working together difference: some considerations on emotions political practice.Hypatia. 1988; 3: 31-47Crossref (146) 12Moreton-Robinson A Talkin' up woman. Queensland University Press, Brisbane, QLD2000Google 13Anzaldúa G Borderlands/la frontera: mestiza. Spinsters/Aunt Lute, San Francisco, CA1987Google 14Lugones coloniality gender. Worlds & Knowledges Otherwise.https://globalstudies.trinity.duke.edu/sites/globalstudies.trinity.duke.edu/files/file-attachments/v2d2_Lugones.pdfDate: 2008Date accessed: May 18, 2021Google 15Mohanty CT Under western eyes.Boundary. 1984; 12: 333-358Crossref Mainstream feminism women, mainstream anti-racism Black men.16Crenshaw Mapping margins: intersectionality, identity politics, violence color.Stanford Law Rev. 1991; 43: 1241-1299Crossref Anti-racist activism promote HICs’ perspectives. This irresistible provocation tell story invokes Audre Lorde's declaration better / remembering we never meant survive”.17Lorde collected poems Lorde. WW Norton Company, New York, NY1978Google Epistemic active oppression powerful structures displace marginalised socioeconomic knowledge-creating institutions suppress voices. exclusion incessantly erases contributions creation.18Quijano AE Coloniality power, eurocentrism, Latin America.Nepantla. 2000; 1: 533-580Google 19De Sousa Santos B Epistemologies South. Justice epistemicide. Routledge, NY2014Google 20Mignolo darker side modernity: futures decolonial options. Duke Durham, NC2011Crossref issues might reason which exists field.3Abimbola self-sanctioned champions tropical medicine, health, scholars shaped subjective lenses, while claiming objective. Through objectified silencing, insiders treated (re)sources researchers gleaned information produce knowledge, validated legitimised scientific universities HICs.21Grosfoguel R structure Westernized universities: racism/sexism four genocides/epistemicides long 16th century.Hum Archit. 2013; 11: 73-90Google then touted universal, scant regard existing LMICs.6Tuhiwai-Smith Regardless well intentioned, respectful, reflective researcher space, acting there imposes researcher's world view obscures perspectives.6Tuhiwai-Smith Marginalised pre-emptively silenced denied advance.22Fricker injustice. Power ethics knowing. Oxford Oxford2007Crossref (2705) In submission HIC, suggested LMIC unthinkingly adopt HICs; should enter more directly; technologies medicine obscure technologies. received following reviewers’ comments: first, “are people perfectly willing North epistemologies? Is really done an ‘unthinking’ manner? Might using own purposes, regardless design?”; second, “after almost 400 years presence (in Africa), can even return pre-colonial state?”; third, “what HIV/AIDS? Didn’t ‘we’ save ‘you’ technologies? (Exploring topic good example, you choose give ‘case study’ consideration)”. intended highlight resort epistemologies accepted spaces. use word “unthinkingly” referred scholars’ unquestioning acceptance thinking, position theorists described “colonisation mind”.23Wa Thiong'o N Decolonising mind. politics literature Africa. James Currey, Oxford1981Google 24Mignolo disobedience, independent thought freedom.Theory Cult Soc. 2009; 159-181Crossref (633) 25Bhattacharya vulnerable academic: personal narratives strategic de/colonizing structures.Qual Inq. 2016; 22: 309-321Crossref (45) viewed reviewer's need whether suggesting precolonial times simply condescending. suggestion I, African scholar, legitimise approval case study valorising (the “we”) saved country “you”) HIV AIDS prejudicial context (LMICs). insidious ostensibly unconscious tactics conspire destabilise scholars, framing illegitimate. kind practice intersection colonising discourses microaggressions”.25Bhattacharya Silencing so pervasive smother testimony. along countless other workers trained practising LMICs, considered submitting paper seen myself protagonist among amplifies, previously welcomed “frank, open discussion” “offer solutions on” “own experiences”.2The When manuscripts HIC-based journals, worried imposed credibility deficit severe testimony quieted words heard.26Dotson Tracking violence, tracking practices silencing.Hypatia. 2011; 236-257Crossref (460) Another recently submitted desk-rejected because two similar papers published 2020. By deduction, journal's board peers, emergent warranted discussion than could addressed papers. Sound reasons rejection existed, “lack representation within workforces”2The topics’ failure strengthen current echoed deafeningly. academic, political, economic HICs. social, emotional, survival-related, What meaning LMIC, being advised writing race, gender, too emotive provocative? biases influence decisions? For workers, intersects everyday reality working life. confounded casualty editor's he she remains blissfully unaware or, perhaps, conveniently oblivious. They publish; perish. objectivity science venerates perspective health-care LMIC. aversion emotional deeply decidedly nonetheless presented universal truth.21Grosfoguel Decolonial refer viewpoint zero-point perspective, emanate compared with, fail.27De end cognitive empire. coming age NC2018Google ventriloquism occurs access globally competitive grants publish high-impact journals. uses dictate set priorities content, relevance, timing publications. Academic English marker authorship, collaborate colleagues “westernise voice arguments” ensure publication journals.8Wondimagegn suppression traditional coerces between publishing effect, important career implications, speaks first language, vicarious linguistic privilege Yet, lament sacrifice ancestral tongue understanding different ways, if had forced concede educational context. results mimicking ratification,3Abimbola thus strengthening extinguishing episteme, process scholar de epistemicide.19De risky option bolsters denial negative judgment Fanon28Fanon F skin, white masks. Grove NY1952Google explained lactification, becoming offered potential advantages.Markers whiteness restricted also class, where person becomes proportionately (and closer real human being) direct ratio mastering spoken people, acquiring culture typical attaining certain wealth. faces masks recognised White-dominated world.28Fanon pressures lactify offerings. acts resistance epistomologies disobedience.24Mignolo practice, disobedience involves presenting enacting diverse depose objective measure many.28Fanon delinking, rebellion, opposition, resistance, must heard.24Mignolo Activists act variously counterpoint deleterious effects risking unprofessional, primitive, dangerous, unscientific groups, jeopardising chances promotions funding journals.25Bhattacharya radical and, therefore, threatening disruptive action. Initially unfathomable, contrary ideals, cannot understood frames reference emerges to, break canon.24Mignolo There requirements begin (panel).PanelRequirements scholarship•Editorial boards declaring racial, colonial, experiences (LMICs)•Authors space write emotion health•Supporting spaces administration work, trusting, protecting, advancing value neglected historical, decision making•Promoting abstracts authors’ languages Indigenous locations done•Establishing platforms constructing findings scholarship•Relieving pressure provide problems did create, offering instead opportunity dialogue equal terms •Editorial stifles radically restructure health. Enacting risk further stage. sceptical resolve bring closer. Will anything ourselves comes? Contributors conceptualised, conducted searches, wrote Essay. declare competing interests.