Published September 1, 2020
This year, 2020-21, is the year of reckoning of all kinds. We are in the middle of a global pandemic that has exacerbated economic and gender inequalities, as well as those along other dimensions, making clear how unfettered global capitalism is a system of oppression, how certain groups are marginalized for the economic and social benefit of others; how racism, classism, ableism, and sexism are intensified under this economic system that teaches us to value certain traits over others, certain behaviors over others, certain occupations over others, certain people over others.
These systems intersect to create a cycle of oppression in which the marginalized are forever implicated given how social problems are intergenerationally transmitted and maintained over time.
This reckoning has allowed us to introspect and chart a new path for ourselves in the Global Child Team at UB’s Community for Global Health Equity (CGHE). As co-leads for the Global Child Team for the 2020-2021 academic year, we would like to share some of the efforts we will be engaging in moving forward.
What does it mean to be global? When we say “global,” we often mean many things. Sometimes we mean pervasive. At other times we mean outside the borders of the United States (US), because as the hegemon, and as “white” researchers, we often think of the US as the norm and everywhere else as “other.” That other is often what we mean when we say global. As a consequence, global has become the politically correct term for othering that which is non-American.
King and Koski (2020) defined global health as “public health somewhere else,” encouraging researchers to consider the normative dimensions of global health and their impact on aspects of training and practice that lead to unintended consequences and critiques. Additionally, they state that practicing public health somewhere else involves tacit assumptions of an expertise gradient. Indeed, this othering allows us to obscure the problems in our own backyard and see social problems as other peoples’ problems that occur elsewhere. It also allows us to confidently propose solutions based on our own experience and expertise, with confidence that local expertise is a bonus, but not a necessity.
This “elsewhere” discourse is problematic because it assumes the US is free of problems. However, the same interlocking processes of capitalism, racism, sexism, neocolonialism marginalize populations in the US. The neoliberal policies that have kept post-colonial spaces largely low-income are the same ones that left millions unemployed in the wake of de-industrialization in the US.
Clearly, “global” is not a geographical characterization as much as it is a political one emerging from Eurocentric policies that have had far reaching consequences across the world.
Additionally, current events in the US and the #BlackLivesMatter (BLM) movement have highlighted how racism negatively affects health and well-being here. It would be neglectful as researchers to focus on how structural factors like poverty, class and other factors disadvantage populations in primarily low- and middle-income country (LMIC) settings, while ignoring the problem in our own back yard. The BLM movement provides an opportunity to re-examine our own biases and engage in meaningful change to work toward equity, and reinforce the idea that Global South is a geopolitical condition, not a geography. Dados and Connell further explore this terminology, concluding that the term “references an entire history of colonialism, neoimperialism, and different economic and social change through which large inequalities in living standards, life expectancy, and access to resources are maintained.” These influences have marginalized populations within the US as well, and we see this in lower life expectancy, infant mortality, and access to healthcare here.
In recognition of the aforementioned factors, and to reflect our understanding of the Global South as a geopolitical condition, we are moving to integrate research with marginalized populations in the US into our work in the Global Child Big Ideas Team. Some CGHE teams have actively worked in this space (e.g., Food Equity), and we are making a conscious effort to do so in the Global Child Team. Moving forward, we will expand our focus to include research with other marginalized populations in the US as well, to reflect a “global” focus in our health equity work.
Our own efforts in the Global Child Team reflect shifts happening elsewhere within UB and beyond. For example, at UB, the School of Social Work’s strategic plan now refers to “global” instead of “international” as a way to highlight how “Global South” problems are not only present in LMICs, but that locations in high income nations also constitute “Global South.” Indeed, issues of maternal mortality, income security, and others permeate across the Global South—be it in Bangladesh or the United States. Furthermore, the sustainable development goals (SDGs; 2015-2030) in place now are an evolution of the Millennium Development Goals (MDGs; 2000-2015) in that all countries are on the hook to meet the SDGs (a truly “global” perspective), whereas the MDGs did not apply to high-income countries.
The Convention on the Rights of the Child (CRC), the world’s most widely ratified human rights treaty, defines childhood as lasting until age 18. It further elaborates that childhood is “is a special, protected time, in which children must be allowed to grow, learn, play, develop and flourish with dignity.” Accordingly, we will expand the scope of the work that is featured under the Global Child to include adolescents.
Too often, adolescents are expected to carry out adult responsibilities or are assumed to have the capacities of adults, when in fact, scientific advances over the past decade have increased our understanding of the adolescent brain as a ‘work in progress’. Cerebral transformations that take place during adolescence are influenced by interactions between the evolving adolescent brain and the environment. But we must also recognize that the responsibilities borne by children and adolescents are rooted in poverty as well as cultural experiences. For example, as children provide labor to earn additional income for their low-income families, child labor laws that are meant to protect children often end up harming them because they no longer have the additional income that they needed to survive. Similarly, household-targeted anti-poverty programs can have the dual effect of both increasing school attendance while simultaneously increasing children’s participation in labor.
There exists a paradox whereby infantilization of adolescents occurs that allows their oppression in many ways, while certain bodies are stripped of any innocence that is associated with children. For example, Black and Brown scholars, mostly women, often report that they are not taken seriously while Black children in the US, research shows, are often treated as adults in the justice system and in schools where they are rarely presumed innocent. Research also shows that for the same actions Black children are punished more severely in schools than their white counterparts. In countries like Pakistan, Bangladesh, and India early marriage effectively turns young girls into women with responsibilities that should never have been theirs. At the same time, their autonomy may be restricted in terms of movement, ability to complete schooling, choice of marriage partner. Further, gender and economic inequalities may increase their vulnerability to adverse outcomes including unwanted childbearing, transactional sex, HIV infection, and school drop-out. In many cases, these outcomes may appear as the result of “choices” made by the adolescent – choices to drop out of school, engage in risky behaviors, and more.
Nevertheless, a fuller contextual understanding of these decisions can highlight how factors outside the control of adolescents strongly contribute to these “choices.” These are global concerns that ring true in Bangladesh, in Tanzania, in Ireland, and in the US. Our research seeks to highlight these influences and examine programs and policies that mitigate these adverse outcomes.
Global health as a field needs to be decolonized. Proponents at Duke University argue that global health has evolved from colonial medicine and tropical health and that “oppressive roots of global health, such as colonialism, slavery, and racism are often hidden by a focus on interventions that alleviate human suffering. As a result, many global health practitioners and researchers, despite good intentions, perpetuate the very systems of oppression in which colonial medicine was embedded.”
In our work under the Global Child Team, we will make conscious efforts to “decolonize” the nature of our collaborations with partners in LMIC settings. We will do this through multiple actions, some of which are already operating principles at CGHE, including:
We have highlighted our broad objectives for the Global Child Team. In the short-term, we have a plan to bring scholars across UB together. To do so we have two major recurring events to build collaborative working relationships.
We think that If we meet together as “writing groups” to present work in progress that others are interested in and have thoughts about, we can build on those thoughts together to create meaningful partnerships at UB. This comes from years of being in meetings where we share ideas but don’t know how to plug our work together. Our idea for these writing groups is for scholars (both at UB and their partners in the Global South) to receive input at earlier stages of their work and to engage collaborators if there is a need. What will this look like? Each session will feature a scholar who will present an early-stage research project – or even an idea -- for which they may be looking for collaborators (or not!). Attending scholars will critically engage with the scholarship and through this engagement find ways in which they can potentially work together. In this way, we also hope to encourage Black voices and other voices from Global South communities to influence the work that our Global Child Team does.
Takeover Tuesdays will be our mechanism for featuring the work of Global Child Team members on social media via which we wish to engage with the community at large. Watch the @UBGlobalHealth twitter space on Tuesdays to learn more!
In addition to these new changes, we will continue building on our successful efforts to date in conducting interdisciplinary research and disseminating findings in accessible formats with broad stakeholders including the public. Examples of recent efforts related to engagement with stakeholders can be found here and here.
Banati and Balvin (Ed). (2017). “The Adolescent Brain: A second window of opportunity.” UNICEF Office of Research - Innocenti: Florence, Italy. https://www.unicef-irc.org/publications/pdf/adolescent_brain_a_second_window_of_opportunity_a_compendium.pdf
de Hoop, J., Groppo, V., & Handa, S. (2019). Cash Transfers, Microentrepreneurial Activity, and Child Work: Evidence from Malawi and Zambia. The World Bank Economic Review. https://academic.oup.com/wber/advance-article/doi/10.1093/wber/lhz004/5611144
Dados, N., & Connell, R. (2012). The global south. Contexts, 11(1), 12-13.
King, N. B., & Koski, A. (2020). Defining global health as public health somewhere else. BMJ Global Health, 5(1).