Global Health: How Am I Responsible?

By Fleur van Acht

Studying Global Health, I have often wondered about what the term actually means. Regularly explained as ‘public health somewhere else’, global health is often taught in terms of health problems and flawed health systems in settings other than our own. Spending our time, effort and money ‘changing the world’ abroad, (future) global health professionals often forego the opportunity to invest in critical reflection on this practice and the motivation behind it. As a result, many of us are taught to be unaware of the way our knowledge and practices are shaped by society in the pursuit of ill-defined progress. Making decisions in isolation from the context and people of concern, we are often surprised when confronted with the consequences of our actions.

Performance artist Precy Numbi shows his audience what this confrontation looks like. Focusing on individual and collective responsibility, he uses his art to visualize the gaps between our intentions and actions that arise from our increasingly connected world. Walking through the streets of Kinshasa, Goma (Democratic Republic of the Congo) and Brussels (Belgium) and stopping cars, Numbi uses his Kimbalambala costume to show how waste (i.e. old car parts) “reflects who we are and will come back to haunt us”. Reenacting the robots from his childhood dreams in public spaces, he uses these costumes to transcend nationalities, ethnicity and political or religious affiliations to unite people on matters that are relevant for all: the people’s health and wellbeing. From COVID-19, malaria and ebola to mental health, Numbi’s work portrays the interconnectedness of humans, nature and technology in a way that could never be done in articles, lectures or conferences. As described in one of our earlier articles: art enables us to speak differently. Meant to represent life in action, Numbi’s art is designed to be participatory and accessible for everyone, regardless of age, physical and mental abilities, socioeconomic status or gender. Strong in vision, the meaning attached to Numbi’s work changes with the audience. “In Congo, the performance triggers many strong reactions: people follow, flee, and start praying since they think I am an evil spirit with a message. In Europe, the public responds very differently but a dialogue is still born: the cars they have dumped in Africa return to Europe in the form of costumes. Waste has become art.”

Photograph by @madipicture

Sometimes political in a way that is seen as a threat to the authorities, the performance artist and his three companions were once arrested because of their alleged affiliations with rebel groups when using art to speak up about the massacres in Béni and Kasaï. Released after two weeks because of international pressure, Numbi and the others in the artistic movement continue their work as, they describe themselves, ‘educators of the masses’. Reflecting on his own power as an artist, Numbi has been organizing workshops to empower children as well. In one project, Numbi worked together with about 45 children from the military who don’t have access to school, have lost their parents, or have had to flee to create superhero costumes from recycled cardboard. These costumes are then used to create a superhero persona, which allows the children to tell their stories in public spaces, for everyone to see their performance. “The goal is to talk about vulnerability and protection. And the cardboard is to protect yourself in the streets”, Numbi explains. Likewise, his project during the current COVID-19 pandemic focuses on the interactions between protection and vulnerability as well. Wearing a mask and costume while safeguarding human connection, Numbi tries to foster a dialogue on what it is like to live in a society. Only minimal in physical protection, the cardboard costumes and masks used in his work show the complexities when it comes to our approach to safety and security. Through his work, Numbi shows the need for an inclusive dialogue about this.

Image by Percy Numbi

Furthermore, Numbi shows that responsibility is not reserved for a few decision makers. Rather, his work highlights that everyone has this responsibility: an ability to figure out what to do and how to do it in response to the situation. Failure to include those who feel responsible can lead to mistrust, non-compliance and even violence, as was shown during the Ebola crisis in the DRC. Likewise, focusing on participatory engagement cannot only help define the issue, but it also allows for a response that fits the situation at hand. This is exactly what Numbi did during the Ebola crisis, as his performances were used to build partnerships between the people affected and the health professionals during the Ebola and COVID-19 pandemics in the DRC. As Numbi describes, his art has helped to spread the important information while creating a space to voice questions or concerns, hereby fostering trust. Global health being a field in which concepts like ‘empowerment’ and ‘participation’ have become buzz words, adopting a different approach to decision making might be a good return on investment.

Image by Percy Numbi

Seeing meaning as something that is created collectively might be a good way to start. That is, redesigning interventions to make them more valuable can only be done when the different understandings of this value are known: what I find valuable is based on my experience and might greatly differ from what you find important. As is the case for Numbi’s work, knowledge creation is much more dynamic, responsive and valuable taken outside the academic domain, into the public space. According to Numbi, some issues transcend the boundaries we have created between humans, nature and technology. Allowing politics to obstruct the finding of solutions that address the wider context does not only contribute to a waste of time and other resources, it can make the problem even more complex and persistent. For this reason, taking responsibility for the situation needs to come with reflexivity: we need to know how our knowledge and practices are created to understand how we see the world. Only then, we will be able to discuss how we want to respond to the situation as an individual and collective. From there, we can decide who should be involved in what way and formulate strategies on how best to invest what, where and when.

Studying global health, I am often unsure about the meaning of what I know and do. I can cite the website of the World Health Organization and know how to measure the cost-effectiveness of different interventions. I can tell you about the building blocks of the Tanzanian health system and discuss the social determinants of health. However, I struggle to see the value of this when I continue to be confronted with the lack of correspondence to the situations at hand. I want to be responsible, in the broad sense of the word, and I keep on meeting people who feel the same way. It is time to rethink how we think and act, so we can be our own superheroes – and Numbi has shown us a way. 

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