Whose Voice Do I Speak? Walking the Tightrope of Positionality and Gaze in Global Health
Before becoming an independent researcher in health systems, I worked for almost 4 years as a full-time researcher at a global health research institute in India, headquartered in global north. Among the many research projects that I was anchoring, I felt closest to a homegrown project on equitable research partnerships in global health. We started it during the pandemic as a survey with a small group of researchers to understand how researchers consider equity related principles in their projects. With support of an institutional seed grant we expanded the project to develop a framework for researchers to help integrate equity, not just as an outcome of research, but also in the research process. Over the years, I read almost all the paper proposing frameworks on what an equitable partnership in global health should look like. Noticeably, most of them were based in global north institutions.
“At the core of the inequity in research collaborations that we are trying to solve today using multiple frameworks is coloniality and epistemic injustice.”
Soon, I acquired a vocabulary to represent the project based on my understanding of the research community in global health from my time spent in this field. I learnt to soften my otherwise provocative voice on issues of injustices around gender, coloniality, and health. I embodied a language of careful benevolence that I perceived as acceptable to my present and imagined audience in the institute and to make my – an outsider – way into global health. Just like the other frameworks and papers I had read; I spoke of a ‘normative’ to the audience based on the framework we proposed. Over the years, without me realizing, it soon changed how I related to people around me. When I would visit my hometown, I was not the same person criticizing a local politician’s apathy towards water shortage in the locality or annoyingly confronting my neighbors for the smoke from burning dried leaves every evening. I felt like I was watching and making sense of their actions from a distance with a softened benevolent critique playing in my mind.
My friends from work would express interest in our framework but felt that it did not have answers to the problems that they were facing in their projects in India. While it is not my place to detail the problems here, I could see that their experiences (and mine) were invisible from the discourse on equitable research partnerships making rounds every year in global health in the form of new frameworks and guidance documents. Shortly after, I left my full-time role (mostly from a burnout) in the pursuit of an independent journey as a researcher, and I carried the feedback I had received from my friends at work. I continued to follow the latest in the space of equity in research and knowledge production practices. I realized that while frameworks and guidelines proposing principles on equitable research is bourgeoning, the experiences of research actors working in global health projects continue to be missing – how do global south research actors experience their participation in global health projects?
At the core of the inequity in research collaborations that we are trying to solve today using multiple frameworks is coloniality and epistemic injustice. It is epistemic injustice when experiences and realities of global south research actors are invisible in mainstream discourses in global health; when the latter have to adopt a language and a persona to fit into the discourse which is in complete denial of their internal realities and experiences. Questions posed in global health through a lens of ‘epistemic injustice’ are uncomfortable but confronting uncomfortable questions is the only way towards true change and healing.
I did not know what to call this experience – where I continue with conviction on gender and health equity but practicing being an “insider” in global health felt exhausting. I would discuss this experience with my friends from the global health community for hours and we struggled to give this experience a name. As I spent my 2024 contemplating on such questions, Dr Seye Abimbola’s book The Foreign Gaze came out in 2025 and was open access. As I was reading the book, I came across these lines:
“The foreign gaze can make a local expert write like an expatriate. This tendency is often detectable in the language of local experts who work closely with foreign experts, or in post-colonial literary fiction written for the foreign gaze. This phenomenon can also corrupt the local expert’s own sense of reality. In the process of massaging, simplifying and altering reality, the local expert also risks losing their own sense of reality; the sense of complexity and of multidimensional reality that is often necessary to solve problems in global health. (pg. 34)
Our pose in relation to a place or issue is ours to decide and declare. While it is possible to do “representative thinking” à la Hannah Arendt, to imagine oneself into the “standpoints of those who are absent”, and to imagine, how one might feel, think, and interpret if one “were in their place”, is a difficult thing to do and often impossible to do well. No matter how expansive one’s imagination or self-awareness, it is always limited. Hence the need to carry out reflexivity in the open.(pg. 37)”
I had a jaw drop moment while resonating deeply with what these lines conveyed. I felt like now I have some words to closely describe my experience. I had altered my voice in global health for a foreign gaze and in the process acquiring the pose of a careful and benevolent critic.
I have moved away from the capital city and closer to my hometown in the northeast region of India for a few months while continuing to provide my research services in the region for an HIC based institution. Although I was born here, I have spent several years in the capital city working with HIC institutions and individuals especially in global health. People in my hometown do not address me in my mother tongue anymore – they use Hindi or English and often comment that I do not ‘look like’ I am from the area. I feel that I now bring back with me more power than what I had left my hometown with. Of course, the power is not only related to my affiliations with global health but the embodiments I now carry from the years of navigating local power relations while moving from the remotest corner of the country to reaching the mainland.
The table has turned for me now. It is my turn to be aware of the power I embody and be curious about people’s voices and experiences here and be led by them, outside of a framework on research practices. It is easier said than done; regardless we have to keep space for difficult and uncomfortable questions especially from groups with lesser power than us. Perhaps not everything needs a problematization and solution but better listening. I will end by drawing on a few more lines from The Foreign Gaze:
“The awareness of my foreignness is a cautionary stance. It reminds me to tread gently, to be slow to form opinions, to hold my opinions lightly, to defer judgement as long as necessary –or forever. It is a caution against being “colonial”, especially towards people in relation to whom I have more power. Not being cautious or humble about the limits of one’s pose is at the root of colonial love. (pg. 37)”
