Department of Anthropology, University of Washington, Seattle, WA, USA.
NMW, Mama Amaan, Seattle, WA, USA.
Glob Public Health. 2022 Nov;17(11):3076-3089. doi: 10.1080/17441692.2021.1986736. Epub 2021 Nov 17.
Mama Amaan Project (MAP) delivered perinatal education and doula services to underserved refugee and immigrant communities in Seattle, Washington. MAP presented at a 'global to local (glocal)' workshop for US-based global health agencies redirecting their experience and resources to address domestic health crises. Glocal models reference Global South anti-colonial social transformations through Primary Health Care (PHC) - 'health for all as a right' and investment in strong public sectors. As Black women working in our communities, we resisted labelling MAP glocal. Western donors and NGOs appropriate PHC's community participation narratives, meanwhile implementing World Bank/IMF economic structural adjustment health system cuts - thereby shifting austerity-related resource shortfalls to communities. In US contexts of neoliberal shrinking social safety nets and workers' rights, similar strategies to address austerity-related health disparities are promoted as 'global to local'. Projects like MAP cannot substitute quality public services. They expose gaps and build community empowerment to demand quality healthcare. Drawing on MAP and 'global health' experience in Mozambique, we call for re-embracing PHC's activist values - agitating for health as a universal human right for all, rather than putting the burden and blame on underserved communities. We propose decolonising the 'glocal' paradigm by embracing 'transnationality', 'relationality' and 'mutuality'.
阿曼妈妈项目 (MAP) 为西雅图的服务不足的难民和移民社区提供围产期教育和导乐服务。MAP 在一个面向美国全球卫生机构的“全球到本地 (glocal)”研讨会上展示,这些机构正在重新调整其经验和资源,以应对国内卫生危机。glocal 模式通过初级卫生保健 (PHC) 参考了全球南方的反殖民社会变革——“人人享有健康是一项权利”和对强大公共部门的投资。作为在我们社区工作的黑人女性,我们反对将 MAP 标记为 glocal。西方捐助者和非政府组织挪用了 PHC 的社区参与叙事,同时实施了世界银行/国际货币基金组织的经济结构调整卫生系统削减——从而将与紧缩相关的资源短缺转移到社区。在美国新自由主义缩小社会安全网和工人权利的背景下,类似的策略被用来解决与紧缩相关的健康差距问题,被称为“全球到本地”。像 MAP 这样的项目不能替代高质量的公共服务。它们暴露了差距,并增强了社区的权能,以要求提供优质的医疗保健。借鉴 MAP 和莫桑比克的“全球卫生”经验,我们呼吁重新拥抱 PHC 的激进主义价值观——将健康作为所有人的普遍人权来争取,而不是将负担和责任归咎于服务不足的社区。我们提议通过拥抱“跨国性”、“关系性”和“相互性”来使“glocal”范式非殖民化。