I work in the global health education field, and along with many other terms, the concept of "decolonizing global health" has been a popular topic to discuss. Medicine's role in colonizing the world is not far from religion's (missionary) role. Much harm has been done in a field that's first notion is to "do no harm". 

Addressing power asymmetries in global health: Coloniality is but one manifestation of supremacy. Therefore, undoing supremacy will require much more than decolonisation. Image source: Madhukar Pai, with artwork by Sophie Lane.

Since I started reading about the interpretive methods, I have been applying the inquiry frameworks to the everyday concepts I tackle with at work. When thinking about "decolonizing global health", I realized my scepticism about this concept stemmed from the AGENCY aspect of meaning making. When we pause and ask ourselves who is doing the "decolonizing" or who should be/can do the "decolonizing", I think what plays in front of our eyes can really become a bit of a parody. 

"The implication that the discipline of global health adopted by HICs represents a reframing of LMICs’ reality should give us pause to question from whose perspective global health is being branded and pursued. In exploring this question, we must reexamine the role that colonialism continues to exert in tensions and assumptions in global partnerships. We must also consider what the growing awareness of colonialism’s impact and the associated calls for “decolonization” mean for global health practice and education." (Eichbaum et al., 2021) 

In an attempt to parse out who is doing the act of decolonizing, I wanted to bring the functions of agency framework (Cope&Kalantzis, 2020) as a way to observe this phenomenon. 

Agency 

1. Event: Predication of the concept "decolonizing global health" comes from the colonizing countries. Much research is done on this subject in the global north or the wealthier Western nations, mainly the US. As far as the transactivity, the patterns of actions between High Income Countries (HICs) and Low Income Countries (LMICs) are not based on equitable notions. In global health education field alone, what we expect from our partners in the Low Middle Income Countries is very different and almost unattainable if our partners in the LMICs. 

2. Role: Since most research and debate comes out of the colonizing nations, self that talks about decolonizing becomes the colonizer's voice. The "other" becomes the entity that is colonized. Even though more and more research is done collaboratively between the people from the colonizing and the colonized cultures on the topic, the imbalance of power dynamics makes it impossible to ignore the role of the colonizer in this matter. 

3. Conditionality: Entities in global health have decision making powers, such as the World Health Organization, United Nations, along with other NGOs, as well as scholars, researchers and practitioners in the field. The "others" in global health are those who do not have leadership roles in the global health field and are categorized as "under-resourced" or are typically regarded as in "need" of help. In this context, the requirements are mainly based on what the colonizers should NOT (requirements) do, and instead what they CAN (possibilities) do. 

What does it mean to "decolonize"? 

In a recent article by Forbes Magazine the section called "Do we really know what “decolonizing” is supposed to mean?" is a perfect example of the importance of agency in the decolonizing space. The auther approached a variety of practitioners and scholars from the "colonized" or "need to be decolonized" cultures, and asked what "decolonizing means" to them. The answers demonstrate the problem of agency in this arena. Below are a few quotes I thought were head on: 

"Who is decoloniality for? The colonizer or the colonized?’ “At present, there are well meaning Global North scholars who have misconceptions that this is the social justice wing of academia. Decolonial inquiry, theory and praxis cannot be separated from resistance to colonialism or neo-colonialism."  Chisomo Kalinga, a Chancellor’s Fellow and medical humanities scholar at the University of Edinburgh. 

"To develop new frameworks disconnected from indigenous and African-based methodological framework feels like an attempt to make decolonizing more palatable to the white gaze. We don’t need new leaders or new definitions, we need to create a shared base knowledge rooted in the exposure of the erasure and even sometimes the exposure of the attempts to erase the erasure itself." Emilie Koum Besson, a researcher at the London School of Hygiene & Tropical Medicine

"On one hand, as a global health practitioner in the south, I subscribe to the ideals of the movement, but on the other hand, I don't want to be the object of other people's good intentions to "decolonize" me and my circumstances. I therefore find the whole term still colonial. The DGH movement must bring in more voices and perspectives from those "colonized" to take over the movement and shape it in the way they feel represents their aspirations best. Ultimately, this will be a movement that will achieve its aims if there are many sides working together - at the center of any strategy must be the agency of us. I therefore see a role for me and others in driving change from the ground up.”

Catherine Kyobutungi, Director of African Population and Health Research Centre, and Editor-in-Chief of PLOS Global Public Health.

Interpretive methods allows us to apply well established critical thinking methods to everyday concepts. This is allowing for a fresh look into our everyday practices, and challenges us to think about new ways of making meaning. I think there are many concepts in global health and global education spaces to be parced out through these methods. Of all functions, I think agency is one of the most important ones to think about particularly when we are in spaces of power and oppression. 

Cope, B., & Kalantzis, M. (2020). Making Sense: Reference, Agency, and Structure in a Grammar of Multimodal Meaning (1st ed.). Cambridge University Press. https://doi.org/10.1017/9781316459645

Eichbaum, Q. G., Adams, L. V., Evert, J., Ho, M.-J., Semali, I. A., & van Schalkwyk, S. C. (2021). Decolonizing Global Health Education: Rethinking Institutional Partnerships and Approaches. Academic Medicine, 96(3), 329–335. https://doi.org/10.1097/ACM.0000000000003473