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- Convenors:
-
Javier Guerrero-C
(Universidad de los Andes)
Natalia Nino (Universidad de los Andes)
Catalina González-Uribe (Universidad de los Andes)
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- Format:
- Traditional Open Panel
Short Abstract:
The idea of the ‘worldwide context’ is evermore present in the discourse of health funding agencies. How can STS help to make sense of issues of scale in relation to ‘global’ or ‘worldwide’ research projects? How are global reach and local implementation negotiated in practice?
Long Abstract:
The idea of the ‘worldwide context’ is evermore present in the discourse of health funding agencies. Concepts such as Global Health or One Health are mobilized by international agencies and funding agencies in describing problems and solutions related to the health issues they aim to address. Such concepts and ideas are common in areas such as pandemic preparedness, digital health, and the health consequences of climate change. Such discourses create expectations at different levels (Borup, et. al,. 2006) about the results. Nevertheless, such projects require local implementations and have goals aiming to provide solutions at a local level, whereas in communities, regions, or countries. And they are often carried out with the participation of multicountry research partnerships. STS has preoccupied and developed conceptual frameworks to understand the global circulation of cultures, ideas, and objects about Science and Technology (i.e. Mol (1994), Tsing (2000), Pfotenhauer & Jasanoff (2017)), but at the same time understand that science and technology are intimately local. In this panel, we expect to receive proposals exploring the concept of scale in 'global health projects'. We aim both at reflexive exercises of researchers working on such projects, and we look forward to animating the discussion of how they make sense of “worldwide context”? What are researchers’ understandings of the global in worldwide agendas, but also to animate a discussion in relation to questions such as how are funding agendas shaping global and local ideas in health research? What is the meaning of a “global initiative in health”? What kind of tensions are between the local and global in global health projects?
Accepted papers:
Session 1Paula Bronson (UCL)
Short abstract:
For LMIC, the WHO has guidelines for non-medical staff to provide locally informed health care. However, services provided by health professionals are often preferred. Global prefers the local, but the local resists. I argue that this tension would be lessened with more locally informed research.
Long abstract:
This paper will reflect on a project conducted with a small local NGO to train non-medical staff as community-based rehabilitation (CBR) workers to assist stroke survivors in gaining independence. In this region of Southeast Asia, the non-medical staff of the NGO has vigorously promoted stroke awareness through national public education programs and engagement in keeping with the World Health Organization's (WHO) CBR worker guidelines for care delivery. These are global guidelines based on local case studies to develop and implement care, emphasizing services provided by people with similar disabilities within their community within a local context. For example, in this region, there is a particularly younger-than-expected age of incidence. What are some of the causes of this? Hence, effectively researching how and what topics to deliver within local health promotion programs and how to deliver individual rehabilitation care is essential. Therefore, seeing that many chronic conditions, such as post-stroke, are best understood from the lived experience of others with similar conditions became central to WHO's ethos. Nonetheless, the local NGO contended with acceptance of the community-based model within the local and regional context. The dominant view was frequently that only healthcare professionals can provide adequate care. This paradox of a global evidence-based guideline that recommends a local community-based program is played out where the local by the local is often seen as not as beneficial.
Miller Díaz-Valderrama (Universidad de los Andes) Natalia Nino (Universidad de los Andes) Catalina González-Uribe (Universidad de los Andes)
Short abstract:
Global health initiatives emphasize digital transformation in Global South, often portraying local contexts as flawed. However, what could happen if we follow global infrastructures in their flaws? Drawing on two Global Health projects, we explore shifting perspectives on local-global relations.
Long abstract:
Global health projects have long emphasized the digital transformation of Global South countries to align their contexts with global infrastructures. Much of this emphasis is done by pointing at these contexts as flawed: interoperability, standards and classifications, and human capacity as well are seen as insufficient, too local, and disorganized. Consequently, international funding is directed towards enhancing capacity and infrastructure in these regions to facilitate smoother data exchange, with digital transformation promising seamless transitions across different scales. What happens if we conduct an inversion of this narrative? Could we follow global infrastructures in their flaws when meeting “the local”?
Based on a robust tradition of reflections in Science and Technology Studies, Critical Global Health, and Critical Data Studies about context (De Laet M., 2000; Tsing, A., 2005; Adams, 2016; Biehl 2016; Montgomery, C. M., Kingori, P., Sariola, S., & Engel, N, 2017; Lee, F 2021; 2023; Hepp, A; Jarke J; Kramp L 2022), we propose a symmetrical understanding of local-global relations in Global Health projects and enterprises. For this, we offer some examples in which we can see the operation of this kind of understanding, drawing from our involvement with two global projects on emergency preparedness, targeting the production of technologies for the analysis and control of infectious diseases.
Deepika Easwaran (The Banyan) Barbara Regeer (Athena Institute, Vrije Universiteit Amsterdam) Mrinalini Ravi vandana Gopikumar (The Banyan, The Banyan Academy of Leadership in Mental Health)
Short abstract:
This paper presents the work of The Banyan, an Indian organization, that develops and scales up services for homeless persons and low-income households experiencing mental health issues. It explores linkages between the ‘global’ and ‘local’ in services and research, in the context of two examples.
Long abstract:
Growing research on mental health, drawing parallels across global contexts, has helped make broad inferences, and implement new learnings. However, considering that local practices strongly influence outcomes, how do we understand the interplay of ‘global’ and ‘local’ in mental healthcare services and research?
The Banyan is a 3-decade-old Indian organisation that develops and scales up services for homeless persons and low-income households experiencing mental health issues. This paper will facilitate dialogue around the “global”, “local,” and culturally congruent scale-up, using examples of two projects at The Banyan. First, Home Again, a model that offers community-based housing and supportive services across 3 LMICs - India, Sri Lanka and Bangladesh. Second, reflections will be presented from an ongoing process of expanding a research and social action program, focusing on children of parents with mental illness.
While Home Again was first limited to one district in India, feedback loops and evaluations of outcomes have contributed to value frameworks and protocols, scale-up across geographies, and evidence upon which global funding has been garnered. In the context of child and adolescent mental health, a systematic consolidation of evidence from other low-and-middle-income countries, in combination with the participation of locally present youth advocates, and intuitive care practices practised historically at the organisation, contribute to an evolving framework for action. Using these examples, the paper explores the trickle-down of the ‘global’ into the ‘local’ and vice versa, the mechanisms of local contextualization in global projects, and the process of linking theories such as transdisciplinary research to practice.
Ana González Ramos (The Spanish National Research Council (CISC)) Gema Serrano-Gemes (Universidad de León. Campus de Ponferrada.) Rafael Serrano-del-Rosal (Spanish National Research Council) Nicolás Ureña Bautista Isabel García Lourdes Biedma Velázquez (CSIC) José Antonio Cerrillo (University Pablo de Olavide)
Short abstract:
The IBC research group has been working for a decade to understand the social dimension of different types of pain. In this work, we present an ongoing project in which we are learning about the different perceptions that exist across countries and cultural differences.
Long abstract:
It is as important to learn about human pain as it is to know the origins and the remedies used to take care of illnesses. There is a common understanding of pain as a multidimensional and complex concept, involving physical, psychological and social factors.
The theoretical background of this project explores how national health systems, religion and social values, socio-economic vulnerability, economic model (neoliberal, welfare, etc.), health resources (public/ private system, accessibility, etc.) and gender regimes may play a role in the subjective and social perception of pain. We foresee that these findings will reveal synergies between these dimensions, that would explain patterns and relationalities rooted in the social structure of pain.
By exploring the theoretical framework of these structural dimensions, the IBC research team seeks to contribute to the investigation of the extent to which pain is homogeneous/heterogeneous depending on social factors and local conditions for certain types of problems (e.g. back pain, migraine and death of a family member). Subjective and social patterns, which may vary in local and global contexts, are ignored by the biomedical model of pain management. The literature examination seeks to understand the entanglement of the local and the global, to understand how social structure shapes human pain and how the biomedical approach (un)fits with cultural diversity.