The words we choose matter: recognising the importance of language in decolonising global health

Abstract

The words we choose matter: recognising the importance of language in decolonising global health Recognition of the relevance of colonial history to the contemporary practice of global health is not new, but the recent increase in visibility and prominence given to it by global health institutions and flagship journals is welcome when accompanied by meaningful reflection and action. 1 The goal of decolonising global health is to critically reflect on its history, identify hierarchies and culturally Eurocentric conceptions, and overcome the global inequities that such structures perpetuate. 2 We must reflect on the terminology we use when we discuss global health challenges, phrase research questions, write papers, teach students, or interact with patients, research participants, and the public. Although our choice of words shapes an audience's understanding of global health, the restricted range of expressions and terms prevents us from offering more nuanced and appropriate perspectives. The conceptualisation of English terms in other languages is often limited to literal translation that struggles to reproduce the same meaning, as highlighted by recently emerging technical terms, such as social distancing. Thus, to make real progress in the process of decolonising global health in our minds and practices, awareness, reflection, and change of language are fundamental.Most global health literature is still published in English only. This Anglocentrism narrows engagement with many international readers and poses a barrier to authorship for researchers whose working language is not English, which reinforces the power dynamics of the field. 3 By contrast, it is neither generally required nor practiced for foreign researchers working in low-income and middle-income countries to learn the language(s) of the country or region they are working in. This tendency, plus the absence of mechanisms to connect research networks operating in parallel in different languages, means that an English-speaking academic has little incentive and restricted capability to engage with scientific advances being published in Mandarin, Spanish, French, Arabic, and other widely spoken languages. Finding ways to bridge these language barriers in research and bibliographic databases is a fundamental pathway to knowledge co-production and equal research partnerships.

The need for an integrated, contextual, and holistic, minimum essential data collection tool for leprosy and lymphatic filariasis disability in India

“…Another drawback of universal tools is that the conceptualization of English terms in other languages is often limited to literal translation that makes it difficult to capture nuanced meanings and experiences. 14 We have given some examples under our review of tools, where nuanced questions in English sound exactly the same when translated for the local understanding and context.…”

Decolonizing global health: what should be the target of this movement and where does it lead us?

“…Building on years of critical reflection within the global health community from a post-colonial perspective [ 6 , 8 ], this movement gained momentum from a few key publication in 2018 [ 8 , 17 , 18 ], and was amplified by student conferences across major universities in the developed world [ 19 – 22 ], with continuous social media engagements from beyond academia [ 23 ]. By March 2021, major global health journals have joined the discussion, publishing articles ranging from a general description of what a decolonized global health would look like [ 24 , 25 ] to focused discussion on a specific topic such as the choice of terms [ 26 ]. All seem to recognize that the status quo in global health does not offer fair opportunities for LMICs, and to identify the root cause, one must go back to the colonial era when resources were taken out of Africa, Asia, and Latin America by coercion or outright brute force.…”

Powerful ideas? Decolonisation and the future of global health

“…Calls to ‘decolonise’ global health have intensified in recent years, as reflected in the rapid growth of the academic literature on this concept 1–6. This body of work (henceforth: ’the literature‘) draws on the conceptual frameworks and interpretive lenses of Critical Race Theory and related analyses of structural racism in Western countries 7 8 alongside postcolonial theory and related analyses of colonialism’s cultural, psychological and material impacts and legacies, especially in the ‘Global South’ 9 10.…”