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Decolonizing health in our times: a cross-epistemic exercise

By Daniela Maria Ochaita Santizo
on November 1, 2022

Health is a holistic and integral concept: defining it as the absence of disease or physical ailments is reductionist and limited. WHO defines health as as a complete state of well-being, which can only be achieved if human rights are fully respected, without distinction of any kind. Sadly, this concept, of which the relevance is global, does not cease to pose great challenges in unequal and diverse contexts. It goes without saying that most current societies are facing these sorts of challenges, often for a long time already (and the recent crises times don’t really help). In settings like these, societal approaches become relevant for the strengthening of pertinent research approaches to health care at the community, regional and national levels, as well as for the generation of effective solutions for diverse populations.

This claim is not new: by the middle of the 20th century, international organizations already recognized the importance of social sciences, first of all to recognize (and get access to) communitarian knowledge (Seppilli, 1955; 2012), in order to tackle societal issues in a pertinent way. Advances in this field have been broad and range from the rise of primary and community health care during the 60’s and 70’s, to the criticisms of development models in the 90’s and early 21st century. The multiple debates in this regard led to the approval (in 2017) of the Policy on Ethnicity and Health by Pan American Health Organization (PAHO) member states. This initiative urged the recognition of differences, challenges, needs and historical contexts for a more relevant provision of health care, using an intercultural approach.

Modern science should be at the service of our society and its development, as well as the generation of dignified living conditions for the groups, communities, and individuals that comprise it. It is from this perspective that approaches such as inter and transdisciplinarity become relevant as research should not only ensure high scientific rigor, but also high social rigor. The opportunities to develop research processes in public health today involve an exercise towards perspectives’ integration from different disciplines with non-academic groups, institutions, civil society, government, and companies in order to mobilize research and generate sustainable and relevant solutions, thus addressing the major health problems of the country.

Today, more than ever, it is crucial to create spaces for dialogue of knowledge among different actors, social sectors and epistemic communities. Generating this critical debate also implies the recognition of the historical, political and structural context and, above all, of the power relations between these actors. It is an uncomfortable but necessary exercise, because the creation of new ideas is an urgent demand of our times, of our sciences, and of humanity in general. Global issues also require the construction of a scientific community that contributes to health systems while capitalizing on other (i.e. not just biomedical) scientific as well as non-scientific knowledge, and respecting the cultural and social rights of our diverse environments.

This is where the theoretical-methodological approach of “frontier science” comes into play (see  here and here ), a space of encounter between scientific and social knowledge. Although often (only) used as a tool, for decades, social sciences have also been building bridges between different systems of knowledge and understandings of the world by diverse human groups. It’s time to go one step further. It seems crucial to re-think science paradigms, in order to face the multiple current health challenges. The Covid-19 pandemic has shown that it’s not just about  availability and access barriers –  adequacy, acceptability, and other social and cultural aspects are also central in the agenda to strengthen health systems. The hope is to promote trans-border science platforms that engage users, researchers, policy-makers, and communities, while taking into consideration historical, political, and economical dimensions. Above all, discussions and dialogues are necessary tools for a comprehensive approach to health and, why not, for individual and collective transformation!

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