We received several questions during this year’s UC Global Health Day! As promised, here are a few of your questions that our panelists answered post event.

Regional Indigenous Perspectives Panel

Question: How can the University of California further strengthen its relationship with California Indian tribes as a land-grant institution in regard to healthcare and education?

Answer:

• Give land back to California Tribes
• Present opportunities to co-manage land
• Tuition waiver for California tribal members
• Preferential admission to California tribal members
• Require UC Medical Schools to interview qualified California tribal applicants for admission to Medical School
• Repatriate all cultural items, funerary items, and human remains currently in possession to appropriate California and other tribes

Question: I would like to hear more about how those who have chosen not to be vaccinated are being supported. My mid 70s part-native father does not want to be vaccinated and it is a tremendous source of stress for me.

Answer:

• Distrust is the most frequent answer given regarding the vaccine, in addition there are issues of misinformation related to unfounded claims that the vaccine impacts fertility or alters DNA.
• The best course of action is to have a humble approach with elders. They have seen and lived through a lot. I start by valuing their opinion, validating concerns and working to address misconceptions and misinformation with information that is counter to their current narrative.
• Affirm that vaccination is a choice, and the indigenous people have every right to not trust the government; and note the negative disparities associated with AIAN and COVID-19.

Question: Hello! I’m (They/Them), a graduate student from the Philippines! I’m interested in hearing and understanding what have been some of your best practices in advocating for indigenous knowledge, frameworks, and practices into health and environmental policies, especially when you work with individuals who are not part of Indigenous People groups?

Answer: Shift the lens! Sometimes you have to fight fire with fire, which means using western methods of science to affirm traditional methods.

Question: Would it be possible for each of our inspiring speakers to share links after this gathering to learn more about how they are implementing their innovative efforts?

Answer: www.ccuih.org

Question: Is the healing ceremony open to the public (those sensitive and respectful to the traditions)?  I would like to attend and am an elder myself.

Answer: www.crihb.org – Here you will find information regarding the traditional Indian health gathering, its open to the public is typically posted on this website.

Early Career Professionals Panel

Question: What would the biggest challenge be in decolonizing global health?

Answer (Laura Mkumba): I have found the biggest challenge in decolonizing global health is remembering the true meaning of decolonizing. Not everyone in this conversation works with the same definition of decolonizing. As a result, some folks use decolonizing as a metaphor for reform or diversity, equity, and inclusion (DEI). While reform and DEI are actions to aim for in certain spaces, they are not the same as decolonizing and equating them to decolonizing is dangerous and maintains the status quo of oppressive systems. 

Question: How do you suggest balancing self-care and rest with the sense of urgency many of us feel in the need to move towards decolonization and create change in each given moment?

Answer (Laura Mkumba): I am still learning and practicing how to create and maintain the balance between self-care and action. I always remind myself that I cannot act if I do not exist, and, therefore, I have to take care of myself in order to exist and do the work to decolonize. I also always remind myself that as a Black woman, self-care is resistance and creates change because White supremacy and capitalism want me to be in a constant state of work and exhaustion. When I prioritize myself, rest, and take care of myself, I am fighting against White supremacy and capitalism. Whenever, I feel the need to act and create change, I always take a moment to check in with myself about my capacity to act and the appropriateness of my action. There will be times when we are incapable of acting because we need to take care of ourselves first and other times when it is not our place to act or create change. I am not advocating for complacency, but rather I am advocating for taking a moment to check in with ourselves and critically reflect on the impact of our actions. 

Question: Does the UC system have any opportunities to empower international doctoral students to address global health inequity? The GloCal Health fellowships are only applicable to American PhD students. As an African student it’s a little disheartening watching US citizens go to Africa for this fellowship, but actual African students are not eligible for this. I feel this promotes colonialism and doesn’t address it.

Answer (Craig Cohen): UCGHI is fully committed to training scientists from Africa and other regions of the world. GloCal is open to post-doctoral fellows from the 20-participating low- and middle-income country institutions and U.S. trainees. In fact, about half of our fellows are from LMICs. GloCal, like the other five Fogarty International Center (FIC)-funded consortia needs to follow the guidance set forth in the original request for proposals (RFP) that pre-specified that for PhD and professional students, only U.S. citizens and residents were eligible to apply. The U.S. and LMIC faculty that lead the six Fogarty Global Health Fellows & Scholars programs, like GloCal advocate with the FIC leadership to embrace equity between U.S. and LMIC trainees. In fact, until the COVID-19 pandemic, the FIC encouraged the LMIC fellows to spend up to a month in the U.S. to solidify mentoring relationships prior to engaging in the research in their home country. In addition, UCGHI does support other training programs funded by FIC, including the Sustainable Development for HIV Health (SD4H) in partnership with Maseno University and the Kenya Medical Research Institute—all PhD and Masters level trainees are from Kenya or a neighboring country. More work is required to develop and sustain equitable partnerships, and to advocate with funders and donors not just to work to decolonize global health, but also to ensure that the best and most relevant science moves forward to develop solutions that addresses local health needs.

Question: Thank you to all the panelists and organizers for these provocative and important conversations. I am interested to learn from the panelists: how can redistributive justice practices contribute to decolonizing global health?

Answer(Nykki Velora Jones):  There are many redistributive justice practices that can contribute to decolonizing global health, here are a few:

• Reclaim our cultural traditions and practices: a paradigm shift in order to move towards equity: Embrace difference of thought, approach, systems, solutions. Let's reclaim our cultural traditions and practices and bring them forward
  • i. e midwifery and doula support to reduce Black maternal health disparities 
• Create Pathways to power for BIPOC people to do the work of decolonizing global health
  • Representation is not enough though, we need BIPOC folks with a social justice lens 

• Fund researchers who study and support BIPOC lead racial health equity work on examining and addressing structural racism. Before last year, most folks didn't care about us doing this research, specifically health equity work that centers Blackness, and we need to compensate and support faculty, students and community members doing this challenging work

Question: Thank you to all the panelists and speakers, I feel so inspired! I am wondering how we can even begin to decolonize global health when the very institutions in which we are working to decolonize, sit on colonized land. Shouldn’t the first step of decolonizing be to give back the land we are occupying? How is the UC system working to give back land? How can we, as students in global health, support this important action?

Answer (Nykki Velora Jones): YES, we do need to. Naming the root cause of health disparities as structural racism (slavery, colonialism, segregation, 13th amendment, etc.) is the first step! I agree the UC system needs to acknowledge the land that was stolen and take steps towards reparations. Land Acknowledgements are a nice gesture, but we need economic justice to indigenous peoples. How that actually looks, I would turn to Indigenous peoples to lead that effort. In the Black/African American community we are exploring how reparations can help restore some justice for descendants of enslaved Africans whose lives built and financed many Ivy League institutions, including Princeton, we have explored guaranteed admission, economic investment into descendant communities, and free tuition for enslaved descendants. At the BARE minimum I think this racist history within higher ed needs to be built into the foundational general education requirements for students and dollars need to be invested into BIPOC communities.

Question: How do we get young people involved in thinking globally rather than it is all about me or MY country? Also do you all work with the UN efforts such as UN Women department?

Answer (Nykki Velora Jones):  I think we need to stress that global starts local. In the USA, we all are immigrants to some degree, unless you are Indigenous, even then you are still likely displaced from your homeland. Furthermore, we have immigrant communities from all over the world and their experiences and health outcomes are deeply connected and impacted by our domestic policies and programs. I would encourage folks to share with people that we are not separate, it is not “us vs them” we all are interconnected, and our choices impact one another deeply.