Decoloniality and healthcare higher education: Critical conversations

BACKGROUND

We explore the theoretical and methodological aspects of decolonising speech and language therapy (SLT) higher education in the United Kingdom. We begin by providing the background of the Rhodes Must Fall decolonisation movement and the engagement of South African SLTs in the decoloniality agenda. We then discuss the evolution of decoloniality in SLT, highlighting its focus on reimagining the relationships between participants, students, patients and the broader world.

OBJECTIVE

The primary objective of this discussion is to fill a gap in professional literature regarding decoloniality in SLT education. While there is limited research in professional journals, social media platforms have witnessed discussions on decolonisation in SLT. This discussion aims to critically examine issues such as institutional racism, lack of belonging, inequitable services and limited diversity that currently affect the SLT profession, not just in the United Kingdom but globally.

METHODS

The methods employed in this research involve the engagement of SLT academics in Critical conversations on decolonisation. These conversations draw on reflexivity and reflexive interpretation, allowing for a deeper understanding of the relationship between truth, reality, and the participants in SLT practice and education. The nature of these critical conversations is characterised by their chaotic, unscripted and fluid nature, which encourages the open discussion of sensitive topics related to race, gender, class and sexuality.

DISCUSSION POINTS

We present our reflections as academics who participated in the critical conversations. We explore the discomfort experienced by an academic when engaging with decolonisation, acknowledging white privilege, and the need to address fear and an imposter syndrome. The second reflection focuses on the experiences of white academics in grappling with their complicity in a system that perpetuates racism and inequality. It highlights the need for self-reflection, acknowledging white privilege and working collaboratively with colleagues and students toward constructing a decolonised curriculum. Finally, we emphasise that while action is crucial, this should not undermine the potential of dialogue to change attitudes and pave the way for practical implementation. The paper concludes by emphasising the importance of combining dialogue with action and the need for a nuanced understanding of the complexities involved in decolonising SLT education.

CONCLUSION

Overall, this paper provides a comprehensive overview of the background, objectives, methods and key reflections related to the decolonisation of SLT higher education in the United Kingdom. It highlights the challenges, discomfort and responsibilities faced by academics in addressing decoloniality and emphasizes the importance of ongoing critical conversations and collective action in effecting meaningful change.

WHAT THIS PAPER ADDS

What is already known on this subject Prior to this paper, it was known that the decolonial turn in speech and language therapy (SLT) was a recent focus, building on a history of professional transformation in South Africa. However, there was limited literature on decoloniality in professional journals, with most discussions happening on social media platforms. This paper aims to contribute to the literature and provide a critical conversation on decolonising SLT education, via the United Kingdom. What this paper adds to existing knowledge This paper adds a critical conversation on decolonising SLT higher education. It explores theoretical and methodological aspects of decoloniality in the profession, addressing issues such as institutional racism, lack of sense of belonging, inequitable services and limited diversity. The paper highlights the discomfort experienced by academics in engaging with decolonisation and emphasizes the importance of reflection, collaboration and open dialogue for meaningful change. Notably we foreground deimperialisation (vs. decolonisation) as necessary for academics oriented in/with the Global North so that both processes enable each other. Deimperialisation is work that focuses the undoing of privilege exercised by academics in/with the Global North not only for localising their research and education agenda but checking their rite of passage into the lives of those in the Majority World. What are the potential or actual clinical implications of this work? The paper highlights the need for SLT practitioners and educators to critically examine their practices and curricula to ensure they are inclusive, decolonised and responsive to the diverse needs of communities. The discussions emphasise the importance of addressing institutional racism and promoting a sense of belonging for research participants, SLT students and patients. This paper offers insights and recommendations that can inform the development of more equitable and culturally responsive SLT services and education programmes.

Toward decolonial community psychologies from Abya Yala

The epistemologies generated from colonized spaces such as Latin America and the Caribbean have been excluded from the dominant Euro- and US-centric discourses of community psychology. Modern science is compartmentalized into disciplines forming silos and boundaries among them. Historically, psychology has been authored by European or North American White men, claiming superior expertise as detached researchers who study, analyze, interpret, and represent the inferior objects of study. Therefore, we should ask: what type of knowledges does psychology generate, with whom, and for what? Our praxis constitutes a political act which should question and challenge coloniality. In Latin America and the Caribbean, we became increasingly aware of the importance of generating knowledges about the communal (lo común) based on the experiences of Indigenous people in the Americas. Epistemologies from Abya Yala delink from the hegemonic, US-Eurocentric paradigms and address the structural violence of the neoliberal system. To co-create an inclusive and pluriversal discipline of psychology, we need to disrupt the linguistic colonization executed by the imposition of the English language legitimized as universal. We ought to convey the many examples of epistemologies and praxes from Abya Yala that contribute to the co-construction of decolonial psychologies emerging from their own localities and cultures. We propose counterepistemologies that disrupt a monocultural, monolingustic, universal, and hegemonic epistemology. This paper reviews selected decolonial contributions from Abya Yala and sketches pathways toward the making of decolonial community psychologies anchored in pluriversal ecologies of knowledges.

Threading a decolonial feminist response to COVID-19: One community psychologist's reflection on the assemblages of violence

To challenge and interrogate the assemblages of violence produced by racial capitalism, and exacerbated by the COVID-19 pandemic, community psychologists must engage in a transdisciplinary critical ethically reflexive practice. In this reflexive essay, or first-person account, I offer a decolonial feminist response to COVID-19 that draws strength from the writings of three women of Color decolonial and postcolonial feminist thinkers: Gloria E. Anzaldúa, Sylvia Wynter, and Arundhati Roy. Through their writings I share my reflections on the sociopolitical moment associated with COVID-19. Of importance, I argue in support of engaging a decolonial feminist standpoint to understand the inequitable and dehumanizing conditions under COVID-19, and the possibilities for transformative justice. I offer this reflexive essay with the intention of summoning community psychology and community psychologists to look toward transdisciplinarity, such as that which characterizes a decolonial standpoint and feminist epistemologies. Writings oriented toward imagination, relationality, and borderland ways of thinking that are outside, in-between or within, the self and the collective "we" can offer valuable guidance. The invitation toward a transdisciplinary critical ethically reflexive practice calls us to bear witness to movements for social justice; to leverage our personal, professional and institutional resources to support communities in struggle. A decolonial feminist standpoint guided by the words of Anzaldúa, Wynter, and Roy can cultivate liberatory conditions that can materialize as racial freedom, community wellbeing, and societal thriving.

Reverence and Reciprocity in Prioritization of Care to a Parent: The Role of Cultural Ecologies and Implications for Decolonizing Relationality

Relationship research in the dominant psychological science portrays the prioritization of conjugal over consanguine relationships as a healthy standard. We argue that this "standard" pattern is only evident in cultural ecologies of independence. Drawing on the Confucian concept of filial piety, we conducted five studies and two mini meta-analyses to normalize the prioritization of mother over spouse. Cultural ecologies were operationalized by a variety of indexes, including histories of residential mobility, country, manipulated relational/residential mobility, and race. While participants situated in cultural ecologies of independence prioritized care to spouse over mother, participants inhabited in interdependence prioritized care to mother over spouse. Both American and Chinese participants showed greater prioritization of care for mother over spouse when they imagined a relational ecology of interdependence versus independence. Authoritarian filial piety mediated cultural-ecological variation on relational prioritization. Results illuminate cultural-ecological foundations of care and naturalize love as dutiful fulfillment of obligation.

Decolonizing ELT teacher education by incorporating knowledge of local communities in the teaching practicum

Despite significant advances in the epistemological frameworks that guide teacher education in Colombia and elsewhere, it continues to be governed mostly by traditional Eurocentric paradigms. Decolonizing teacher education requires epistemological moves to resignify the plurality of local knowledges and praxis. This article aims at reporting a qualitative research project carried out with three student teachers of a teacher education program with emphasis on English, at a public university in the northeast of Colombia. The main objective was to explore and reflect on how EFL pre-service teachers incorporated knowledge of local communities as resources for language teaching and learning during the practicum. Data were gathered over a three-semester period through pre-service teachers' lesson plans, materials, a final academic report, and a semi-structured interview. Data were analyzed based on the principles of thematic data analysis. Findings revealed that student teachers approached knowledge from an ecological perspective coming from different ways of knowing, seeing, being and living in the world. At the same time, the ecology of knowledges helped them to overcome the challenges they faced during the project.

Seeking utopia: Psychologies' waves toward decoloniality

This paper provides a review of empirical studies published with a decolonial epistemic approach in psychology. Our goal was to better understand how decolonial approaches are being practiced empirically in psychology, with an emphasis on community-social psychology. We first discuss the context of colonization and coloniality in the research process as orienting information. We identified 17 peer-reviewed empirical articles with a decolonial approach to psychology scholarship and discerned four waves that characterize the articles: relationally-based research to transgress fixed hierarchies and unsettle power, research from the heart, sociohistorical intersectional consciousness, and desire-based future-oriented research to rehumanize and seek utopia. Community-social psychology research with a decolonial approach has the potential to remember grassroots efforts, decolonizing our world.

Challenging power and unearned privilege in physiotherapy: lessons from Africa

Power and unearned privilege in the profession of physiotherapy (PT) reside in the white, Western, English-speaking world. Globally, rehabilitation curricula and practices are derived primarily from European epistemologies. African philosophies, thinkers, writers and ways of healing are not practiced widely in healthcare throughout the globe. In this invited perspectives paper, we discuss the philosophies of Ubuntu and Seriti, and describe how these ways of thinking, knowing, and being challenge Western biomedical approaches to healthcare. We believe implementing these philosophies in the West will assist patients in attaining the health outcomes they seek. Further we call for Western professionals and researchers to stand in solidarity with their African counterparts in order to move towards a diversity of practitioners and practices that help to ensure better outcomes for all.

After inclusion. Thinking with Julian Go's 'Thinking against empire: Anticolonial thought as social theory'

This contribution engages Go's generative invitation to think against empire by thinking through the epistemic and disciplinary implications of such endeavour. I zoom in on the need to explicitly address the purpose and ethos of scholarly inquiry and how that translates into decolonial academic praxis. Thinking with Go's invitation to think against empire, I feel compelled to constructively engage the limitations and impossibilities of decolonising disciplines such as Sociology. I glean from the various attempts at inclusion and diversity in society and argue that adding or including Anticolonial Social Thought/marginalised voices and peoples in the existing corridors of power-such as canons or advisory boards-is at best a minimal rather than a sufficient condition of decolonisation or going against empire. This raises the question of what comes after inclusion. Rather than offer a 'correct' or single alternative anticolonial way, the paper explores the pluriversally inspired method(ological) avenues that appear when we commit to thinking about what happens after inclusion when the goal is decolonisation. I expand on my 'discovery' and engagement with the figure and political thought of Thomas Sankara and how this led me to abolitionist thought. The paper then offers a patchwork of methodological considerations when engaging the what, how, why?-questions of research. I engage with questions of purpose, mastery, and colonial science and turn to the generative potential of approaches such as grounding, Connected Sociologies, epistemic Blackness, and curating as methods. Thinking with abolition and Shilliam's (2015) distinction between colonial and decolonial science, between knowledge production and knowledge cultivation, the paper invites us to not only think of what we need to do more of or better when taking Anticolonial Social Thought seriously, but also what we might need to let go of.

Dwelling in epistemic disobedience: A reply to Go

In Thinking Against Empire: Anticolonial Thought as Social Theory, Julian Go continues his vital work on rethinking and redirecting the discipline of sociology. Go's piece relates to his wider oeuvre of postcolonial sociology - found in works such as his Postcolonial Thought and Social Theory (2016) as well as multiple journal articles on epistemic exclusion (Go 2020), Southern theory (Go 2016), metrocentrism (Go 2014), and the history of sociology (Go 2009). In this response article, my aim is to think alongside some of the central themes outlined in Go's paper rather than offering a rebuttal of any sorts. In particular, I want to think through how the recent work on 'decoloniality' may play more of a central role in Go's vision of sociology and social theory than he acknowledges. In doing so, I hope to engage in Go's prodigious scholarship through centering discussions of the geopolitics of knowledge, double translation, and border thinking. Before proceeding to this discussion, I will offer a brief review of my reading of Go's paper.

"It Was All Wrong and Shameful to Beat Her": Discursive Analysis of Men's Talk of Intimate Partner Violence

In this article, our aim is to foreground men's discourses on gender-based violence as linked to gendered hierarchies, power struggles, and social respectability in Ghana. Situated within decolonial feminist theories and drawing on interviews, we argue that men's interpretations of masculinity and the possibility of perpetrating violence against women is significantly mediated by such intersectional factors as sociocultural background, education, and broader societal normative requirements. The findings deepen the understanding of the ambiguities and contradictions that characterize men's talk of violence. The article discusses how these ambiguities and contradictions serve as important domains for engendering critical attitudes toward violence against women.

The Politics of Clinic and Critique in Southern Brazil

Drawing on a historical ethnography of how Brazil's post-dictatorial psychiatric reforms have shaped young people's lives, this paper builds on Eve Sedgwick's analysis of the hermeneutics of suspicion to show that narrow applications of Foucault's biopower concept nurture forms of resistance to bio-reductionism centred primarily on epistemic deconstruction. To unsettle this hermeneutic, I put young people's theories of power into conversation with Georges Canguilhem's concept of the milieu and with feminist scholars' work on prefigurative politics. I introduce the concepts of threading and unthreading to consider how one subject of biopower, the child-like biobehavioural figure, was continuously being threaded within a specific milieu and in relation to another key figure: the elite angst-ridden 'storm-and-stress' adolescent. Young people's subsequent unthreading and reweaving politics, flourishing in co-construction with what I call the politicizing clinic, illustrate how decolonial pedagogies can incrementally change the patterning of social life.

Unsettling knowledge boundaries: the Indigenous pitiki space for Basotho women's sexual empowerment and reproductive well-being

Indigenous knowledge systems embody a holistic, inclusive view of the world and foreground interconnectedness for the promotion of life. Through reflective engagement with the author's positioning as an Indigenous researcher, this article explores Indigenous knowledges of sexual, reproductive health and motherhood shared by Basotho women. It draws on the life stories of twenty never-married women and uses decolonial African feminist approaches to challenge the assumed universality of conceptions of sexual and reproductive health that are both deeply embedded and produced within specific relations of power. It illuminates the Indigenous pitiki space as an Indigenous knowledge hub purposed to empower Basotho women's sexual and reproductive health. Within this space, Indigenous knowledges and skills are shared amongst women, with the elderly imparting knowledges to the young women. In the context of unsurmountable health disparities, the article shows how Indigenous knowledge-sharing outside the exclusive 'westernised' health systems enables communal support for the well-being of women and children in African contexts. It emphasises the need for inclusive and expansive knowledge production systems not only to better inform equitable health solutions for Indigenous communities but also for epistemic redress in the discipline of Sociology.

Deconstructing institutional racism and the social construction of whiteness: A strategy for professional competence training in culture and migration mental health

The position presented in this article draws on the professional insights of the authors, reflecting on issues of global political importance in culture and migration mental health. As institutional theory perspectives continue to develop, solutions to complex social problems such as racism require embodied knowledge if the lines of authority and basic occupational routines are to be meaningfully renegotiated. Embodied knowledge is socially situated and self-reflexive and reflects cumulative and marginalized experiences that contribute to a better understanding of institutional racism and the social construction of whiteness. The authors foreground the development of critical consciousness and emotional literacy in order to be more professionally competent in institutional contexts of mental health training, education and practice. To this end, elements of due process, transparency, inclusiveness, community engagement and accountability are at the center of a political and intellectual movement towards epistemological justice to promote antiracism and social justice in culture and migration mental health. The authors define decolonial intersectionality as a clear philosophical vision outlining how best to respond to those at risk of experiencing racism and the associated mental health burdens.

Do your first works over

This article presents in four parts various understandings of the deep roots of the current climate emergency, some thoughts about alternative transitional paths forward, and the ways the discipline of psychology might be relevant. In Section two, we explore environmental and ontological critiques and analyses that developed in the academic world in the 1990s after the 500th anniversary of the arrival of Columbus in the Americas. In Section three, we analyze the recent emergence of new materialisms and their connections to indigenous relational ontologies and practices in what has been called "the ontological turn" or "the decolonial turn." In Section four, we trace the effects of coloniality in education. In Section five, we explore approaches to alternative world visions, new educational projects, the possible role of the discipline of psychology in transition discourses, and the urgency of the present moment.

Decoloniality in physiotherapy education, research and practice in South Africa

Background

Historically, the profession of physiotherapy in South Africa has closely aligned itself with our former colonial master, the United Kingdom. Whilst efforts have been made in recent years to transform our profession, numerous challenges remain. An improved understanding of the topic of decoloniality is a useful and necessary way of beginning to address these challenges.

Objectives

The aim of this opinion piece is to encourage further dialogue amongst South African physiotherapists working in all sectors – a dialogue that must focus on genuinely transforming our profession to be better suited to serving the majority of South Africans.

Method

Global and local literature related to decoloniality is summarised for readers, followed by a closer scrutiny of how this topic relates to some of the challenges faced by the profession of physiotherapy in South Africa.

Results

The evidence presented demonstrates that whilst some efforts have been made to transform South African physiotherapy, significant work and dialogue is required to bring about a true transformation of the profession.

Conclusion

An honest and transparent conversation about decoloniality and transformation can assist in realising the potential of our profession, thereby improving the health and well-being of all South Africans.

Clinical implications

Real engagement with this topic can assist in transforming who enters our profession, what we teach, where and why we conduct research and how we can ensure that physiotherapy practice contributes to real social justice by benefitting the majority of our population.

Food autonomy: decolonial perspectives for Indigenous health and buen vivir

INTRODUCTION

Indigenous peoples' food systems have weakened as a result of pressures exerted by agro-commercial policies and chains, which has led to the dependency and deterioration of their ways of life. It is in this context that the construction of perspectives on food autonomy positions itself as a potential and strategic field of social decolonial mobilization for indigenous peoples' health and buen vivir.

OBJECTIVE

The aim of this study was to analyze the meanings of food autonomy from the perspectives of a Nasa Indigenous community in Colombia.

METHOD

This was a qualitative study, involving 38 Indigenous people belonging to the Nasa Huila Indigenous community, aged between 18 and 73, with different occupations. The information was obtained by means of discussion groups and processed through content analysis. The project had the consent and ethical endorsement of the indigenous community.

RESULTS

According to the study group, food autonomy is related to the Nasa identity, today weakened by territorial conditions, proximity to non-indigenous populations and the external influence of institutional food programs. Food autonomy develops by means of practices aimed at the production, distribution, preparation and consumption of healthy, chemical-free, homegrown food products from the family level, for self-consumption and in resistance to dependence on external commercial chains.

CONCLUSION

Food autonomy positions itself as a community and political strategy that integrates the strengthening of family gardens, the adaptation of a food program menu, education and governance towards the development of autonomous processes from a decolonial perspective, for the promotion of health and buen vivir.

Rethinking development interventions through the lens of decoloniality in sub-Saharan Africa: The case of global health

There has been much talk about decolonizing global health lately. The movement, which has arisen in various communities around the world, suggests an interesting critique of the Western dominant model of representations. Building upon the 'decolonial thinking' movement from the perspective of Francophone African philosophers, we comment on its potential for inspiring the field of global healthinterventions. Using existing literature and personal reflections, we reflect on two widely known illustrations of global health interventions implemented in sub-Saharan Africa - distribution of contraceptives and dissemination of Ebola virus prevention and treatment devices - featuring different temporal backdrops. We show how these solutions have most often targeted the superficial dimensions of global health problems, sidestepping the structures and mental models that shape the actions and reactions of African populations. Lastly, we question the ways through which the decolonial approach might indeed offer a credible positioning for rethinking global health interventions.

Decoloniality and community-psychology practice in Puerto Rico: autonomous organising (autogestión) and self-determination

Psychology, as a diverse social practice, must take a stance regarding the colonial world-system that legitimises the hegemonic production of knowledge. Decolonising community psychology requires the transformation of its practices to face cultural and institutional systems that reproduce inequality in colonial contexts as well as the validating of indigenous knowledge. Reflecting on an intervention in response to the devastation of Hurricane Maria in Puerto Rico, this paper highlights the importance of a community psychological practice that promotes the search for self-determination and autonomous organising or autogestión. Following the notion that community psychologists should be social change agents whose professional activity constitutes a political act, our proposal is to stress decoloniality as a pedagogical practice, incorporating its principles to everyday interactions with diverse people, groups, organisations and communities. Self-determination refers to the ability for people, groups, neighbourhoods and communities to recognise the demands of their contexts and respond in ways that potentiate control over their own lives simultaneously with the search and action for collective well-being. Autonomous organising aims at individual and collective empowerment, to demand from official institutions and agents what their rights are, when they need it, by organising contestant responses to the systematic injustices and the abandonment of colonial instances.

Decolonial visual resistance as a public health strategy in post-María Puerto Rico

In this article, we explore the use of the image as a strategy to understand how natural disasters and coloniality impact the health of marginalized communities. We focus on the aftermath of Hurricane María in Puerto Rico and aim to describe how local people used the image as a strategy to challenge the invisibility fostered by coloniality and advocate for a more humane, equitable and effective public health response. We implemented a mixed methods research design including: (1) ethnographic observations, (2) qualitative in-depth interviews with 67 representatives of the health care system, (3) photographs they had taken as part of their experiences during and after the hurricane and (4) images from local newspapers and social media. In light of the findings we argue that Puerto Ricans engaged in decolonial visual resistance to manage the aftermath of the hurricane. Thus, while surviving the natural disaster, they challenged the traditional use of the image in public health endeavours.