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Decolonisation and cognitive justice imperatives in health sciencesrelated research supervision

Universities, and in particular the research they produce, are central role players in the knowledge economy of the 21st century.[1] In South Africa (SA), one of the core tenets of the National Plan for Higher Education is the production of Master’s and Doctoral graduates.[2] Postgraduate supervision, therefore, is an essential function of university educators.[3] Apart from overseeing research projects, teaching the research craft, being a role model and providing a supportive relationship to students,[4] supervisors also need to be informed, open and responsive to current debates on global and national platforms. This opinion paper addresses the imperatives of decolonisation and cognitive justice that were emphasised by the Rhodes-Must-Fall movement at the University of Cape Town, SA, in 2015. While these concepts are sometimes interpreted as a call for the total repudiation of existing knowledge from Western origins – an interpretation that is generally unacceptable to the scientific and health domains – this paper draws on the writings of philosophers such as Mbembe, Visvanathan and others to provide interpretations that are different and (at least to some) more realistic. Based on these interpretations, I offer my opinion regarding the current status of research in the health sciences and raise some concerns about two major current and emerging influences that might be in conflict with the calls for decolonisation and cognitive justice. The readings of Mbembe,[5] Ndofirepi and Cross,[6] Visvanathan[7] and Augusto[8] paint a picture of the prevailing situation in many countries, where a large part of the population still feels ensnared by the notion that whiteness is everywhere and that everything (worthwhile) originates/originated from it. This perception of marginalisation flows from the de-valuing of nonWestern populations’ cultural richness and their unique knowledges that are often denied formal recognition[7] on academic platforms. In essence, these authors communicate that the call for decolonisation is not about the disregard of existing knowledge, but a call for knowledge equity, i.e. for recognition from knowledge-production factories, such as universities, that cultures other than Western are also capable of producing valuable knowledge, and that knowledge produced by Western cultures cannot be implemented without regard for the differing cultural contexts worldwide. Visvanathan[7] uses the term cognitive justice for what he explains as the ideal situation of knowledge democracy in contrast to the current situation of knowledge apartheid, referring to the notion that only scientifically produced knowledge is true and that prescientific knowledge, produced by people without scientific backgrounds, is inferior. A second component playing into the concept of knowledge apartheid, relates to the methods of disseminating knowledge that are often inaccessible to some groups, typically those living far away from metropolitan areas, which in essence deprive them of further development. With reference to the abovementioned brief definitions of decolonisation and cognitive justice, postgraduate supervisors need to consider and incorporate appropriate approaches to work towards achieving these ideal situations. Apart from firstly having to engage in critical self-reflection to clarify their personal standpoints, they also have to consider the kind of research they and their students become involved with. In the health sciences, possibilities for decolonised research are limited with regard to purely anatomical and physiological factors, but if one considers the World Health Organization’s definition of health, i.e. ‘... a state of complete physical, mental and social well-being ...’,[9] opportunities for decolonised approaches are ample. This would include culture-sensitive ethical approaches and methodologies tailored to adhere to the Western-originated Belmont Report principles of autonomy, beneficence and justice,[10] but contextualised to the specific cultural or tribal groups’ settings. In this regard, the San Code of Research Ethics[11] is a ground-breaking document with fundamental but simplistic guidelines. In terms of specific topics, one would consider phenomenological studies[12] with research populations consisting of cultural groups other than westernised white groups. Such studies seem to be ample in the health sciences domain and one can but say that at least we are moving in the right direction. In contrast to the seemingly positive direction of postgraduate research in terms of research topics and methodologies, the same cannot be said of the methods used to distribute knowledge produced through research, as these are still mostly done through conference proceedings and publications in peer-reviewed journals, which are mostly inaccessible to groups living in remote areas. These methods very often deny research participants the opportunity to become knowledgeable with regard to the effect of their participation in research and it confirms the claim of knowledge apartheid and inequitable treatment. Much rethinking and new initiatives are necessary in this field. One approach may be to incorporate into research proposals suitable methods of information sharing with cultural and tribal groups before and after data collection in an effort to educate and recognise their contribution to new knowledge. The dissemination of research-produced knowledge is, however, closely related to, and thus influenced by, the financial needs of universities. Whereas universities seem to gain autonomy when state subsidies decrease, they indeed replace their dependence on financial support to paying students, external funders[12] and state institutions such as the Department of Higher Education and Training in SA.[13] These entities play a strong dictating role in terms of the research that has to be done to receive funding and the ways of dissemination that are worthy of subsidies. Research output, and by implication dissemination thereof through mostly westernised methods, plays a further critical role in terms of universities’ positions Decolonisation and cognitive justice imperatives in health sciencesrelated research supervision