On disrupting colonial assumptions in health promotion

The Waiora, Rotorua, and Tiohtià:ke Statements

Between 2019 and 2022, the International Union for Health Promotion and Education (IUHPE) released three notable legacy statements. First, delegates at the 2019 IUHPE World Conference in Rotorua, Aotearoa/New Zealand developed the Rotorua Statement WAIORA: Promoting Planetary Health and Sustainable Development for All (1) and the Waiora Indigenous Peoples’ Statement for Planetary Health and Sustainable Development (2). Acknowledging that Western knowledge and practices that separate humans from nature have disproportionately contributed to the risk of ecological collapse, IUHPE delegates called for prioritizing Indigenous voices in promoting planetary health and sustainable development around four key areas.

In 2022, delegates at the IUHPE World Conference prepared the Tiohtià:ke Statement with the theme “Catalyzing policies for health, well-being and equity (3)”. Tiohtià:ke is a Kanienʼkéha (the language of the flint people spoken by the Kanienʼkehá꞉ka) word that refers to the ancestral place known as Montreal, Canada where the conference was held. The Tiohtià:ke Statement builds on the action areas proposed in the Rotorua Statement, outlining steps toward privileging Indigenous voices in health promotion and committing to decolonization.

As an emerging scholar from Mexico currently living in Canada, I am particularly drawn to the Tiohtià:ke Statement’s call to “unlearn and disrupt past assumptions and biases”. In this editorial, I share insights into what unlearning has meant for me in the context of health promotion. Inspired by the non-directive ways of sharing knowledge of Anishinaabe communities, I do not intend to share my insights in a tone of prescription. Instead, the readers are welcome to reflect on whether these insights apply to their contexts and how.

Knowing where you come from before setting your course

In a recent podcast interview (4), Dr. Michael Hart from the Fisher River Cree Nation said that settler societies tend to be too goal-oriented without necessarily reflecting on why the chosen goals were set. From the perspective of his nation, it is imperative to know who you are, where you come from, and the values of your originating communities before doing any project. Only then shall you be well-prepared to set goals about where you want to go.

Following Dr. Hart’s advice, I must share a few words about my origins. Born and raised in Guadalajara, Mexico, I have lived in Canada for six years. I am a mestizo (a non-Indigenous identity category assigned to people of mixed ancestry in Latin America); most of my ancestors are native to Mexico, with one known relative from Spain. In the context where I come from, historic and ongoing processes of colonialism have attempted to impose Eurocentric governance systems, institutions and knowledge on the diverse peoples inhabiting the land today known as Mexico. The naturalization of Eurocentric assumptions and practices can be exemplified through the consolidation of Mexico’s public education system in the 20th century. Public schools reinforced Eurocentric knowledge, asserted Spanish as a dominant language and overlooked a rich diversity of Indigenous knowledge on environmental stewardship, governance systems and community development.

Unfortunately, anti-Indigenous racism remains widely extended among mestizos, limiting our ability to learn from the knowledge, spiritualities and practices of Indigenous Peoples. Some of the most well-known examples of Indigenous leadership on the social and ecological determinants of health in Mexico include CheránK’eri, a P’urhépecha community that successfully defended their forests from organized crime and governmental corruption (5); and the Zapatista movement, a multi-ethnic Indigenous movement that has developed one of the world’s most inspiring examples of anti-capitalist economic and community development (6).

Decolonization is for everyone

While my background as a mestizo has sparked a deep interest in questioning Eurocentric assumptions, decolonial theory has taught me that decolonization processes may interest anyone, no matter their background. What is often referred to as “Western” or “Eurocentric” in health promotion literature refers to a particular way of being, knowing and doing that philosophers have called “modernity”. Modernity does not refer to something “new” but to a form of existence that emerged over 500 years ago. Modernity expanded within Europe and towards the rest of the world through European colonialism, the ideas of the Enlightenment, the consolidation of nation-states and the expansion of capitalism (7). With the advance of modernity, pre-existing ways of being in the world – some of which share relational premises associated with Indigenous knowledge systems – were dismissed or eliminated.

Learning about the expansion of modernity and colonialism throughout the world makes me think that no matter where we come from, at some point, our human ancestors practiced ways of existence that were attuned to the ecosystems they inhabited and guaranteed the continuation of life. Reconnecting with such forms of living and actualizing them to current contexts could be a valuable source of guidance for facing the Anthropocene.

Unlearning (modern) assumptions and biases

Reconnecting with ancestral wisdom traditions may be challenging for those of us overly socialized through modern institutions, as we may inadvertently de-contextualize ancestral practices from their originating worldviews and re-interpret them through the assumptions of modern thought (8). For this reason, familiarizing ourselves with modernity’s premises can be a step within lifelong journeys toward decolonization (9). Modernity’s assumptions include the following (7,9):

When the Tiohtià:ke Statement calls to unlearn and disrupt past assumptions, I think about the above-listed assumptions of modernity, many of which remain rarely scrutinized in various scientific traditions, including Western health promotion. Modernity’s assumptions starkly contrast with the core features of Indigenous worldviews featured in the Waiora Statement, including the interactivity between the material and spiritual realms, the location of humanity as part of a living Mother Earth, and an emphasis on relationships and interdependence among all that exists.

Hospicing modernity

While there is no recipe for challenging colonial assumptions in health promotion or elsewhere, I find Vanessa Andreotti’s work on “hospicing modernity” (9) inspiring for acting on the Tiohtià:ke Statement’s call to question our assumptions and biases. Andreotti (a.k.a. Machado de Oliveira) describes modernity as a single story about the world that fiercely protects its uniqueness by dismissing or eliminating other stories. Of course, modernity is not good or bad by itself. The issue is that many of us are so intellectually, emotionally and relationally invested in modernity’s teachings that we now struggle to engage with other stories. This problem is unfortunate because enacting the assumptions of non-modern stories may be essential for sustaining human and ecosystem health in the Anthropocene. Andreotti proposes the practice of “hospicing” modernity within and around us so that we help modernity die in a way that honors its teachings while also opening room for other stories to guide our relationships with each other and the land. Those stories may come from Indigenous Peoples and other communities (e.g. peasants, grassroots community groups) who have been forced to survive within the most challenging conditions of capitalism, colonialism and patriarchy in the Global South (including the South in the North).

Towards engaging diverse knowledge traditions in health promotion

The metaphor of “hospicing modernity” along with other notions like the Mi’kmaw Etuaptmumk (also known as Two-Eyed Seeing) (10), Ermine’s ethical space (11) and de Sousa Santos’ ecologies of knowledge (12) can help us establish respectful relationships between modern science, Indigenous knowledge systems and other knowledge traditions. If one accepts that modern science is just one way of knowing among many other equally valid knowledge systems, then it follows that modern ideas like “health”, “health promotion” and “sustainable development” do not necessarily need to be at the center of our conversations.

Taken together, the Waiora, Rotorua and Tiohtià:ke Statements lead me to think that notions like the Mäori Waiora (13), the Anishinaabe Mino Bimaadiziwin (14) or the Quechua Sumak Kawsay (a.k.a. BuenVivir in Spanish) (15), may be equally – and perhaps better – able to convey the types of principles, relationships and knowledge that are needed to foster a healthy and balanced planet in the Anthropocene. By stemming from Indigenous relational worldviews, these notions (i) speak to the interconnections between humans, nature and the spiritual realm, (ii) go beyond Western understandings of health and well-being to include teachings on cultural identity, social participation, respect and interdependence among all beings, and (iii) mobilize ancestral wisdom to ensure proper conditions for the continuation of life today and for generations to come.

My hope for those engaged in health promotion is that we can increasingly shape our understanding and practice through the similarities, differences and incommensurabilities of diverse knowledge traditions. Developing this competency may involve being well-versed in Western notions like “health” and “sustainable development” and the local notions and knowledge traditions of the communities we come from and work with. Such a task is deeply relational because, as Etuaptmumk reminds us, each individual and community carries only one piece of the puzzle, a limited part of the knowledge and embodied practices needed to sustain life within Earth’s living metabolism. Let’s continue putting those pieces together.