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There is more than White Supremacy in Global Health: On the Biases Within

By Fabu Moses
on November 2, 2022
 “That’s so ridiculous” I mumbled under my breath. I was on a Zoom call with a multinational group of global health practitioners when my white, female colleague, in her North American accent began to berate another colleague from the West Indies for, well…having an accent! She lamented about how my colleague’s way of speech was affecting the overall quality of the meeting. I didn’t agree; though accents may take getting used to, it is the cadence, respectful tone and language, and technical soundness that count most in any engagement. Unfortunately, we from the Global South quite often do not “have our say” because of bias. In this case accent bias.

Bias, however, extends beyond accents and beyond the North- South divide. We in the Global South are also very guilty of it among ourselves.  
 Cuba was my first experience living, studying and working in a culture and language starkly different to my own. I come from Guyana, a relatively conservative and religious English- speaking country; so the culture shock of Cuba from the way they dressed to the way they prepared meals took a lot of getting used to. My accent and appearance made me easily identifiable as a foreigner and this placed me in situations where I was not given the chance to express myself or attend to patients. People concluded that since my accent was different, and required more patience for one to understand what I was trying to express, I probably didn’t know what I was doing.

Interestingly enough, we do not pay (enough) emphasis to the role that we from the Global South play in promoting biases within the Global Health space.

How do we?

Well, we take a lot more pride, demand more recognition and respect for our opinions and research once we have studied at universities in the Global North; our research, conducted in the Global South  has little influence if it has not been published in a journal based in the Global North.

I acknowledge that there are stellar, well-funded institutions from the North that have contributed significantly to Global Health and Health Systems globally; but is that a strong enough argument to label our own institutions as second- rate?

I am guilty of what I speak about here. A few years ago, during a meeting in Guyana with a North American professor and local colleagues, the professor proclaimed that she did not trust any local professional who had not been trained in North America. The irony: we were discussing a tropical disease. Nevertheless, I soon found myself obsessed with researching programmes at North American universities. I had to have a North American conferred degree to be relevant in the space of Tropical Medicine!

Unconscious internal bias?

More serious than accent bias, geographical bias and institutional bias are the biases based on gender, sexual orientation, race and colour that seep out of the social system of the Global South and into our work in global health. While there is nothing wrong with advocating for a particular group or race, we tend to work in silos for our voices to be heard.

We can still address our individual causes, but we urgently need to put our biases aside.  Many of these biases were conferred to us by those who colonized us, but we have taken them on as part of our own culture. And this, in turn, prevents us  from uniting against oppressive practices. To strengthen the influence that we have in the Global South, we have to support and advocate on issues affecting other Global South or minority groups that aren’t our own. Genuinely. I hope you’ll try it.

So yes, there’s more than just white supremacy, we should also be aware of our own, internalized biases.  The key to addressing biases is making the effort to empathize with other minority groups . Empathy is more than making an effort to understand another’s situation: it is making sure that there is representation in our data, and that we are disseminating/ using that data, that we are pressing for accountability, promoting solidarity among minority groups, and building trust among minority and non-minority groups. This is the only way we can begin to amplify our voice    and build as a strong, global force from the Global South.

About Fabu Moses

Fabu is a medical doctor by profession and public health specialist whose passion is ensuring community empowerment and health equity across disciplines. She is a consultant in the Communicable Diseases and Environmental Determinants of Health Unit at the Pan American Health Organization/ World Health Organization, Guyana where she provides technical support, implementation, and monitoring and evaluation for malaria, one health and infectious disease elimination initiatives. Her research interests include use of qualitative evidence in policy making, and community-led initiatives towards vector-borne disease elimination and control.
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