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Social Determinants of Health

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From:
Chrystal Ocean <[log in to unmask]>
Reply To:
Social Determinants of Health <[log in to unmask]>
Date:
Thu, 25 May 2006 15:19:21 -0400
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Theresa, thank you. --Ocean.

On Thu, 25 May 2006 11:54:08 -0700, Theresa Healy <[log in to unmask]> wrote:

>Hello all:
>
>This strikes at a topic dear to my heart and one I am struggling with in
>an attempt to find honour in my work. (Who was it said "Let what you
>love be what you do"?)   
>
>I think the statement: "Universities are creators and keepers of
>knowledge, some of it based on, or relevant to, the community" is an
>accurate depiction of the situation. As other researchers have written
>if "Europe was the colonizer, research was the flagship." (My paraphrase
>of excellent work done by others, like the Indigenous Peoples Research
>Institute.)
>
>Whether we like it or not, our universities, and the careers of those
>who work in them, are built on the appropriation and ownership of
>knowledge often taken from others. There may be politically driven and
>philosophically grounded individuals within university (I'd like to
>think of myself as one) who do not conform or subscribe to this but the
>reality is that the institution's reason d'etre is the manufacture of
>knowledge and the economy and currency of the academy is built on the
>ownership of  knowledge. There is a reason why plagiarism is a bigger
>sin than adultery in academic circles.
>
Too often the community is the original source of knowledge, which is
>transformed, translated and acquired through standards that often
>further harm the community while enhancing the cvs and publication lists
>of researchers, and the prestige and award granting status of the
>university. I know I do not have to review the list of egregious crimes
>researchers have visited on communities. For me, the sad fact is that
>too often there are smaller, almost everyday crimes against the dignity,
>the progress and rights of community folks because of the power held by
>universities and the unconsidered application of that power, by
>researchers.  This is what Hannah Arndt described as the everydayness of
>evil and is what she said made the evil of Nazi Germany possible. If you
>were hired to build a road to the concentration camp you didn't have to
>think about the trucks carrying Jews, homosexuals and communists to
>certain horrific death. And I think there are things we do as
>researchers that we don't think of in the bigger context of people's
>lives.  For example, I have seen researchers carrying out interviews and
>never returning a transcript or an acknowledgment of what was done with
>the interview to the interviewee, with no concern for how the person
>emerged from the research event. 
>
I also believe the community has knowledge that is relevant and timely
>but it is not perceived as knowledge - it is "anecdote" or "experience"
>or "a bunch of stories".  I sit at community tables and hear discussions
>that describe emerging trends, and analyze conditions. Often the
>discussions are far more cogent and to the point and insightful then
>some graduate student's classes I have sat in or taught and long before
>the issue shows up on university radar.  These issues require fast and
>effective response. But community voices are not heard and it is not
>till a university based researcher has "acquired and validated" the
>knowledge that action is taken. This is often too late, and the
>community and the issue have moved farther and further down the road.
>The deep listening and thoughtful actions that could be generated by a
>relationship of equity and meaningful partnership is lost. The
>opportunity to go deep is lost. The chance to address spiritual and
>cultural dimensions is lost.
>
I believe there was somebody - or a group of somebodies - who believed
>the community could be an effective and equal partner in research and
>that belief was behind the CURAs and the move to the CIHRs. I saw an
>attempt to leverage research monies into projects and programs that
>could benefit communities liaising with university researchers; that
>research money could have an added value component based in the capacity
>building and community development inherent in a meaningful research
>endeavour.  I don't know how much of that got lost in the translation.
>My perception is that small universities and community based research
>are still getting the short end of the stick: the money still flows to
>the big universities and the big names. And research partnerships still
>disadvantage the community partners. The kind of research that can
>actually make a real difference while it is implemented is overlooked in
>favour of reaching gold standards and getting published. My major
>challenge when I undertake a research project - convincing the community
>it will be okay to make changes to look at what we are learning, as we
>are learning and it take actions. Community based and participatory and
>utilization, - call you what you will, if it is practiced with respect
>and mutual learning, will make a difference.
>
There is frustration in communities and it is time we within university
>walls listened and learned. I heard a farm woman at a conference in
>Saskatchewan accuse the researchers present of "researching" the farm
>crisis literally to death. Farmers, friends were dying, she said,
>committing suicide, acquiring poor health and earlier deaths while the
>researchers argued. I have heard many Aboriginal people use the same
>phrase "researched to death."  And they too, mean it literally. I have
>Aboriginal friends dying of AIDS, while a colleague tells me I can't use
>the term epidemic to describe what is happening to Aboriginal people in
>Northern BC. Where did we lose touch with the fact one death would be
>too many? 
>
There is a challenge here - for all of us, to consider our own ethics
>and practice; to struggle to find the fine line of balance of excellence
>in academic standards with relevance, timeliness and respect for
>communities. (And balance implies equal weight.) I believe it can be
>done and it will get us not only better research but meaningful
>progress.  I want to see true relationships with meaningful dialogue and
>it will take time to build these, and it will take time to build /
>repair trust with community folks. If there is true relationship, a
>circular model, where community skills and expertise have as much
>credence and power as the university degree and each feeds and supports
>the other, then we could be doing research that makes a difference for
>everyone. 
>
I am happy to say that every day I meet new people who care about both
>the polish of university standards and the shine of community needs. My
>heroes are those who can walk in both worlds with honour and compassion.
>The challenge is for all of us, community based or university based, to
>find the hybrid that carries the best of both worlds. 
>
In the spirit of more light - as we said in Mozambique when I lived
>there - A luta continua (the struggles continues.)
>
>Theresa

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