This week 3 things inspired this post: 1) re-reading solitude and leadership by Dr. William Deresiewicz, 2) listening to Michelle Obama’s speech and her quoting John Lewis “When you see something that is not right, you must say something. You must do something.” 3) This conversation between Isabel Wilkerson’s new book about America’s Caste system with Anand Giridharadas. They discuss about what it takes to do the right thing during the ‘wrong time’, against monumental pressure and derision. I bring this home to global nutrition research practice.
I took a two-week academic leave (one week requested, but my mentor recommended two weeks because burnout is real). I have been thinking and writing and reflecting a bit. I am deeply frustrated and agonized by some of the research we do in the name of “global health”. I have noticed these things since my doctoral days at Hopkins and my brief time at Harvard but I have been rather quiet because honestly I just wanted to focus, get a degree and training and get out to the world. But getting out into the world means dealing with these 800 lb issues. (Disclosure: I am now a remote postdoc at Purdue living in Austin, Texas). With peer support, I have become more vocal to try to move the discourse on inequities, especially regarding human dignity in global health research…while still trying to find my voice to constructively offer criticisms. So if any of my work upsets you, please tell me why.
Every few years when I experience moments of profound agony like the past few weeks (as evidence by my twitter feed), I come back to this post on solitude and leadership by Dr. William Deresiewicz. There’s a lot I disagree with this article but there’s so much I agree on themes such as: role of bureaucracy, taking time to reflect, reducing multi-tasking, cultivating independent thoughts, figuring who you are and what do to do with your voice. Each time, I read this post in the last few years, some other wisdom sticks out. Its validating and calming essay to help find your voice. See excerpts below:
“Unless you know who you are, how will you figure out what you want to do with the rest of your life? Unless you’re able to listen to yourself, to that quiet voice inside that tells you what you really care about, what you really believe in—indeed, how those things might be evolving under the pressure of your experiences. Students everywhere else agonize over these questions, and while you may not be doing so now, you are only postponing them for a few years.”
“So it’s perfectly natural to have doubts, or questions, or even just difficulties. The question is, what do you do with them? Do you suppress them, do you distract yourself from them, do you pretend they don’t exist? Or do you confront them directly, honestly, courageously?”
So with this, I am going to use my scientific voice to address some issues. Lot of these are meant to be discussed and I know things are also changing for the better in global health nutrition research and practice (thanks in large to the decolonize GlobalHealth movement). [Side-note: I had to unlearn a few bad practices as well.]
1.) Let us not use poor people in Global South as hypothesis playground. See this recent thread on a Kenyan study. But sadly, this happens even in non-randomized control studies and other study designs as well. A quick litmus test, is asking ourselves if we can do a proposed intervention or study or behavior change communication programs (also known as social engineering) in the US/UK/Canada [insert your home country].
Important nuance: This is not just a global north-south thing, it’s a global north-north thing or likely a global south-south thing too. Or more generally, a privileged-marginalized thing, which is more blatantly observed with global north-south dynamics.
Sir Angus Deaton says that researchers need to “think about the ethics of experimentation, and should not simply punt their responsibilities to Institutional Review Boards.”
Lastly, this is also the topic I struggle with the most, asking myself if the projects I am doing are more “saving” or truly showing dignity when we research/ intervene/evaluate. I know that some of the social engineering is not bad (read this story about social engineering in Somalia through ‘American idol’) but who decides that?
Side-note: I do have a folder for these extreme “studies that shouldn’t exist” – and, some of these have given me full blown panic attacks.
2.) Would we write papers without including local staff as co-authors, especially for qualitative data where context, history, politics, culture, and linguistics offer different interpretation? Again, would we do this if we conduct this research in America, among poor or marginalized communities?
On the same note, why do economists go for parsimonious authorship? Is it because they are risk-seeking?
3.) This pandemic has been so stressful for women – childcare while doing fulltime work with reduced access to services. Poor women in LMIC have been facing pandemic every day of their lives and they are supremely time impoverished. Can we talk about interventions/programs that support women and alleviate this burden, as in, can we focus on women’s mental health, diets, health, wellbeing, and time, (and may be children’s/men’s outcomes as a side). Probably starts with donors who put out funding calls but also important for researchers to demand by (*note to young researchers*) publishing on “secondary outcomes” that focuses on women’s outcomes.
I will probably add more to this list if there’s more discussion/nuances.
I do think we can collectively raise awareness through social media like twitter, to improve the quality of global public health research. I know sometimes folks often have to worry about professional persona that is often carefully crafted. But for one moment, can we pretend like we are already tenured, are higher up in amazing think tanks, have wonderful career, and can we pretend like we have that power and talk about these issues with our work team, our friends and colleagues, and amongst social media. Because WE DO HAVE the power – even during times of feeling helpless and hopeless. And trust me, simple like or sharing articles goes a long way.
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And stay tuned, more blogs posts coming this week on safari science/stakeholder engagement, taxonomy of food industries, top favorite titles and qualitative papers, and more!
Thank you for reading.
