By Jill Allison
We walk in the heat and humidity of an early afternoon in Nepal’s monsoon season. We are heading down a road that is a curious combination of dust and mud owing to the rain, the powdery quality of soil and the sun. We arrive at the Health Post that is our destination just as a busy family planning clinic is coming to a close. Women in blue saris with the swirl symbol that is the uniform of the Female Community Health Volunteers are shepherding other women out the door and back down the paths to outlying communities. All are carrying large buckets with a variety of household items given as incentives to come forward for the insertion of ImPlant – a tiny cylinder of contraceptive that will stall their fertility for up to seven years. I think about the history and role of family planning programs the international development world. I am intensely curious about how much these women understand about what they have just had done to them. But I don’t have time to ponder this for long. This is 2015 in post earthquake Nepal. I have come with a group of medical learners to explore the complexity of working in this field we call global health. We are here to meet with the local health assistant.
The health assistant is a serious man and wants to know who we are and how we have come to be at his health post. Fair question. We have been sent by the local District Health Office I explain. He sighs deeply. His sigh conveys a kind of understanding. We have come from the global North, the well endowed places in the world, the beneficiaries of an inequitable postcolonial world. What exactly do we want, he asks. I try to explain that we are seekers on a learning journey. This is what I want my students to take away from our month long experience in the International Summer Institute for Global Health Training (InSIGHT) - that endeavours in global health should be about learning, no matter the extent of one’s experience. The health assistant then tells us about how, just a few months before, many people from the global North descended on his community in the days following the earthquake that cracked the earth and shattered homes and lives in this district. He had already travelled around his community setting broken bones, stitching wounds and tending to the injured as best he could. But when these people arrived to help he felt it was important to give them a good experience. He wanted them to feel good about their attempts to rescue Nepal from itself and its seismic topography. Wait…. I stop breathing for a moment. Did you just tell me that you felt you had to find things for these humanitarians to do? You had to ensure that they had a productive humanitarian experience. You felt you had to affirm their humanitarianism for them. This is the contradiction of the imaginary hero.
This moment consolidated for me the lessons I had learned and have been trying to impart against a rising tide of what used to be called “white saviour complex”. The new incarnation, as we move beyond tropical medicine and international health, into something we have called global health, is a kind of imaginary hero complex. We must talk about ourselves as heroes, eclipsing the fact that we are working in a hierarchy of developing and developed that is the legacy of colonialism. The objects of our work are no longer the focus – we are not saving people. The focus is on us and what we experience – the hardships and the exhilaration of being a humanitarian or a development worker, the adventure and the risk. We continue to perpetuate the colonial based on wealth and privilege and training advantages. We rarely come as learners who are open to examining the true origins of global inequality. We work with partners in low income countries and we aim to solve problems that create health and social inequalities. And yet we continue to see ourselves at the centre rather than the health assistants and doctors and nurses and vaccinators who always work with few resources in the context that makes us appear heroic. We rarely put them at the centre of our efforts to build equity. We still collect the research grants and travel into the world. And rarely if ever, do we ask the right questions and open ourselves up to learning or to challenging the true origins of this inequality. Then we would have to recognize ourselves as part of the problem. Then we would have to be willing to shift the balance and share the opportunities, resources and privilege that allows us to continue the conversation about development. As the health assistant’s story suggests, the global North still gives and receives all at once.
The real magic is when we come to recognize that we are all learners in this process. If we are receptive to the idea that we are receiving so much more than we give in this kind of work. And if we recognize the value of what we learn for whatever practice we undertake or whatever role we play in our lives, we become more receptive to true partnership in problem solving instead of the hierarchical and inequitable story of development.
The blog is part of the DevelopMEnt Blog Series launched during International Development Week. The blog series aims to highlight stories, journeys, and perspectives of people associated with the development sector. It also aims to highlight how journeys, shaped by the knowledge and experience our guest authors have amassed, has helped, and can help shape the world. Any views and opinions expressed in the blogs are of the guest authors.