We brought together an interdisciplinary roundtable of academics and practitioners working in the
South to discuss critical perspectives of empowerment in the current Global
Health discourse. Our discussion uncovered many internal contradictions and
controversies over the meaning of empowerment, both a ‘thick ethical concept’ (Williams, 1985) and an ‘essentially contested concept’ (Gallie, 1956);
such concepts involve judgments of both fact and value leading to continuous
revisions of our understanding of the concept as our theories about social
reality and societal values evolve, thus encouraging us to remain ever vigilant
and self-critical about its use in our own practice and research.
Many of us experienced
considerable discomfort with a binary between the ‘disempowered’ – passive and
silent victims of circumstance – and the ‘empowered’ – heroic resistors of
tyranny. Disempowerment evokes connotations of violence, force, oppression, unfreedom,
and powerlessness; empowerment evokes choice, opportunity, and liberty.
‘Giving’ agency to a disempowered individual seems patronising and
paternalistic, while ‘relying’ on people’s agency to rescue themselves from
poverty seems neglectful and unrealistic. Yet we found ourselves tied in knots
trying to criticise the notion of empowerment without ourselves using words
such as power, freedom and agency in our critiques.
Many of us criticised the
prevailing focus of empowerment discourse on expanding individual capability
instead of societal transformation; this ignores the roots of the concept in
radical feminist aspirations for a complete overhaul of all systems of
oppression whether based in gender, race, caste, or class (Gita & Grown, 1988). Individualist analyses
cannot deal with the many structural dimensions of unfreedom whether
colonialist legacies, exploitative economic systems, or patriarchal cultures.
Yet, when we reflected on our own role as foreign-based and foreign-funded
academics in addressing structural violence in the Global South, a great unease
arose with the prospect of using our resources to promote one vision of society
over another, for example, by taking sides in Dalit uprisings in North of
India. In such cases, our role might be more one of a documentarian or social
commentator than an interventionist.
Nonetheless, we observed instances
where intervention was called for, particularly with respect to concerns over
the implications for the empowerment discourse for Global Health. Capitalist
industries have co-opted the empowerment concept to promote unhealthy
behaviours – smoking, drinking, and taking drugs – by attaching connotations of
desire fulfilment and choice to their enactment. This allows advertising
companies to profit from the spread of chronic disease, while simultaneously
claiming to ‘empower’ women. We discussed the importance of rigorously defining
the concept of empowerment, precisely to avoid such instances of its meaning
being subverted by unscrupulous industries; broad legislation to prevent
structural harms from the empowerment discourse was direly needed.
This returned us to our
discussion focus: Given the many problems with the empowerment concept and its
potential for subversion and co-optation, should we continue to even use the
term? Should we shift towards talking about ‘rights’ instead of ‘freedoms’? Or
should we use purely local language terms for ‘empowerment’ in academic debates
that might hold radically different connotations of transformation than its
English language equivalents? Only thing was clear: This conversation needs to
Gallie, W. B. (1956).
Essentially contested concepts. In (pp. 167-198). London: Wiley.
Gita, S. & Grown, C. (1988). Development, crises and alternative visions: Third World women's
. New York: Monhtly Review Press.
Williams, B. (1985). Ethics and the
Limits of Philosophy
. London: Fontana Press.
The inspiration for this work stemmed from reflecting upon my own experiences as a young gay man, navigating self-awareness in a society that still perceives sexuality, health risks, and HIV in a way that is misinformed, biased and negatively influenced by stigma. I often found myself confronted with troubling notions pertaining sexuality, sexual orientation and how they supposedly correlate with HIV and other sexually transmitted diseases; these notions inherently affect the way in which sexually marginalised groups are perceived by the wider population.
In this piece, Dr Ayesha Ahmad looks at the silence and silencing of women in the clinic, both in the UK and Afghanistan, and raises concerns about a peculiar trend in mental health of ‘culturing’ in the United Kingdom and of ‘neutralising’ in Afghanistan.
'When authors simply list countless – often mutually incompatible – interpretations, I am left feeling anything can signify empowerment, if one argues sufficiently long and hard.' How, then do we make progress in this area? Alongside his new paper on 'Organising Concepts of ‘Women’s Empowerment’ for Measurement: A Typology', Dr Lu Gram reflects on how, by failing to clarify what we mean by the term ‘empowerment’, we often end up talking past each other instead of forging constructive conversations. Instead, he proposes a framework to encourage greater precision in the use of the term 'empowerment'.
Cervical screening is an important and potentially life-saving procedure, but at the moment 1 in 3 women in the UK feel unable to attend them. This month in the CGGH Blog series Dr Ellie Cosgrave writes about this huge issue for women's health, exploring how we should be promoting uptake as well as adapting medical procedures to make them more accessible. However, all too often campaigns promoting access to this service fail to understand and address the real reasons behind a lack of attendance.