Chapter 6. The dignity of the spectator
p. 81-92
Texte intégral
“Every narration places the spectator in a position of agency.”
Manthia Diawara (1990)
1When I was a child, I was taught by Nigerian teachers, who were teaching a Nigerian curriculum, endorsed by the Nigerian government, in Nigeran public schools, that the River Niger, the largest river in West Africa, was discovered in 1796 by Mungo Park, a Scottish explorer. I did not know that this could not possibly be true. I did not know that it is not possible for an outsider to discover something that has always belonged to another people; that the concept of discovery does not apply in this context. I began to understand this lie in my teenage years, alongside much else that I was taught in school – things calculated to erase the knowledge and agency of my ancestors. The Nigerian educational system proselytised on behalf of the British empire.
2But there is a sense in which British schoolchildren may be taught that their ancestor discovered a river in faraway West Africa. After all, people in Britain did not know the river existed until Mungo Park brought back the news. The claim to have “discovered” such a river can be valid when addressing an audience that did not know about it, an audience far away, an audience on behalf of whom the discovery was made: “Hey, look what I found over there!” The audience for a claim of discovery is an important determinant of what makes the claim make sense. As in the quote by the Malian filmmaker and scholar Manthia Diawara in the epigraph to this essay, “every narration places the spectator in a position of agency” (Diawara, 1990). Yet what I was taught as a child did not place me and my ancestors in that position of agency. It denied our dignity as knowers, as people whose knowledge of the river mattered. We are all entitled to dignity because we possess certain ethically important features. One of those human features is that we are knowers.
3As an academic who studies health systems, I see this denial of people’s dignity as knowers at the heart of how much of academic research works. Especially in fields such as mine, where claims about what is true or new require a primary audience of people where (or from whom) the knowledge was made (Bhakuni & Abimbola, 2021). Denial of dignity manifests, for example, in the acceptance without question that an academic journal in Britain can do for Nigeria what it does for Britain. A researcher studying how to improve the health systems in Nigeria considers a British journal as a choice platform for publication; a choice that stems from colonial conditioning; from being educated and socialised in a way that places Europe at the centre of the world.
4Philosophical Transactions of the Royal Society is the oldest scientific journal (Andrade, 1965; Fyfe et al., 2015; Dolby, 1977). It is still in circulation. It was first published in 1665, just as the printing press, a revolutionary invention, started to be put to mass secular (non-religious) use, and magazines and periodicals began to enter mass circulation (Dolby, 1977; Eisenstein, 1979, 2005). The establishment of such scientific journals made it easier to share ideas and discoveries among scholars with common interests. Groups of scholars had started to grow so large that physical meetings were no longer sufficient. Enabled by advances in printing technology, scientific journals helped to drive a scientific revolution in Europe in the late 1600s (Dolby, 1977; Eisenstein, 1979, 2005; Cohen, 1994; Mokyr, 2005). Scientific journals quickly became a platform around which communities of scientists emerged, organised themselves and networked to critique, correct, test, transform and spread one another’s ideas and discoveries. Today, we continue to rely on journals for the crucial function of connecting us, scientists, to one another; a connection that generates the intellectual sparks which are often necessary to advance science in all its forms.
5The original full title of Philosophical Transactions of the Royal Society was “Philosophical Transactions, Giving some Account of the present Undertakings, Studies, and Labours of the Ingenious in many considerable parts of the World”. But it belonged to England (Andrade, 1965). The “World” was Europe and places it had invaded or claimed for itself. “Ingenious” people were Europeans, including Europeans far from home. Dedicated to natural philosophy (that is, the physical and life sciences), Philosophical Transactions was the kind of journal where the discovery of the River Niger or any other such natural occurrence could be reported. The field of natural philosophy generated knowledge that may be deemed universal or generalisable – that is, natural sciences, which one might expect to thrive and serve their purpose regardless of the location of their audience. Knowledge such as: What is the refractive index of a lens? How does volume change with pressure? What is a new virus made of?
6Yet even authors in the natural sciences choose their idiom, use frames of reference, or assume prior knowledge based on their audience. Early scientific journals did not just connect people who shared a common purpose: authors and audience also often shared a common worldview. The community that Philosophical Transactions of the Royal Society connected was European. In the 1800s, if a team of European “tropical medicine” researchers working in a West African town “discovered” a disease that was new to Europeans (but well known to West Africans local to that region), they would publish their paper in a journal where their European peers would read their findings and be fascinated, but the paper would be written in a way that ignored existing local knowledge and interpretations of the disease by West Africans. What was known locally would not have been the starting point of inquiry.
7But that is only part of the story. The content of what is shared is one thing – that is, the nuances that get left out because the audience in Europe lacks knowledge, or what is mistaken or not fully known by the researchers because there were no local West African interlocutors. The effects of how it is shared is another – the lost opportunities to connect knowledge and interpretations about the disease in parts of West Africa to one another. A discovery in Europe by European researchers would have lead to such a connection. Instead of building on knowledge and interpretations in West Africa about the disease, whatever is “discovered” gets extracted to Europe where it lands on a blank slate, generating falsehoods and misinterpretations. What gets published is mistaken; a result of the failure to respect the dignity of West Africans as knowers.
8The discovery of a disease is a middle point along a spectrum. The point where the natural world meets the social world; where the aspect of the natural world being figured out has social meaning. On one end of the spectrum is the natural world untouched by the social – say, how does volume change with pressure? On the other end is the social world hardly touched by the natural – say, how do gifts work as a means of exchange? But in the middle, you have questions such as: How does a new disease manifest? How do people respond to it? The audience matters greatly, and even much more at the social end of the spectrum. Inquiry is about social systems. Connection is the point. What is being connected are communities of people: scientists, activists, policymakers, practitioners, ordinary people. As the American systems theorist Margaret Wheatley said, “To create a healthier system, connect it to more of itself […] so that it can learn more about itself from itself” (Wheatley, 2001).
9In the 1900s, if a team of US researchers conducted a study on the social organisation of sanitation, or the political prioritisation of women’s health in Lagos, Nigeria, and they chose to publish their findings in a US journal, we may ask which system they were trying to connect to “more of itself”. If they published a study on sanitation and women’s health in Michigan or Alabama in a US journal, then the answer is obvious – but not so much for the Nigeria study. What if the Nigeria study has lessons for the United States? Both countries are, after all, large and federally governed. If that is the case, useful as it might be for the United States, the article could not serve to connect Nigeria to more of itself in the same way or to the same extent. The article written for a US audience will not be the same as the one for Nigerians. The difference is not just in terms of where it is published, but also how it is written, the assumed prior knowledge that frames the research question, and the purpose that informs the data analysis and interpretation.
10What then is the point of academic papers if they so often fail this basic test of connection? They fail because passing the test has not been their primary goal, although it should be. There is a deeply held but unspoken assumption that the location or nature of the audience does not matter; that where an article is published matters mostly for prestige and visibility. That assumption can only be sustained if one believes that the British Medical Journal can possibly do for Nigeria what it does for Britain. Since the 1800s, the British Medical Journal has helped to connect scholars, activists, policymakers, practitioners (within and across these categories) to improve health and equity in Britain (Smith, 2006; Frampton, 2020a, 2020b). Something else did the same thing in 1800s Britain: the regular publication of death rates disaggregated by districts, which led to comparisons and learning within and across districts and over time; and also led to debates about causes of deaths and differences in rates, and efforts to reduce death rates to match those of better performing districts (Crook, 2016). The rates “pointed to those spaces that were ahead and those that were behind; or as it was sometimes expressed, those that were winning and those that were losing” such that “ultimately, civic pride was at stake” (Crook, 2016). From the late 1800s to the mid-1900s, local and national newspapers in Britain and medical journals including the British Medical Journal actively published death rates and commentaries interpreting them for the public and politicians, and for health practitioners and policymakers. This contributed to a period of significant improvements in health and equity in Britain, with similar dynamics elsewhere in Western Europe and in North America (Cutler et al., 2006; Costa & Khan, 2017).
11In the 2000s, if a team of Nigerian researchers conducts a study on the organisation of the health systems in Nigeria, they might publish their work in a US journal, an outcome that Nigerian researchers see as desirable for prestige and visibility outside Nigeria. But by their choice of question (will it appeal to a US audience?), method (will US scholars consider it cutting edge?), framing (will it contribute to a conversation US scholars want to have?), idiom (will a US audience understand it?) or recommendations (will a US audience find them palatable or feasible?) the researchers de-optimise their work for Nigeria. A study of great value for Nigeria may be irrelevant for the United States or inscrutable for US audiences. Where a researcher plans to publish their work can therefore corrupt the choices that they make about what they study, on what basis, how it is studied and how it is presented.
12We have created or been handed a knowledge infrastructure built on a premise that ignores what may be its most fundamental function – to connect a system to more of itself. Whether this is done by West African or European scholars, Nigerian or US scholars, or whether in the 1800s, 1900s or the 2000s, the effect is the same. It has never been right. It was never right anywhere, or at any time in history. When the dignity of the audience or people it should be connecting is not respected – especially their dignity as knowers – as we make, use and share knowledge, we will perpetuate falsehoods and promote wrong interventions.
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13In 1911, the German philosopher Hans Vaihinger published his magnum opus, which would later be translated in English as The Philosophy of “As If”: a System of the Theoretical, Practical and Religious Fictions of Mankind (Vaihinger, 1924). In it, he argued that we willingly accept things we know to be false or fictitious in order to function in a complex world. We construct fictional explanations of how the social world works and proceed “as if” those explanations reflect reality. Our inherent cognitive limitations as humans hardly allow us to function otherwise. We think of the world in stories. We make sense of the world with metaphors. These stories and metaphors are socially produced, used, reinforced and transmitted. When we set out to describe a social reality or change it, we draw on this stock of stories. The ancient Indian parable of the blind people and the elephant is an enduring example of such a process (Figure 10). In this parable, the elephant is a metaphor. It represents complexity; that which is difficult to grasp – a social system or a social reality. As the largest living land animal, the elephant is often used in metaphors around the world. When Yorùbá people want to remind you to acknowledge a significant thing, person or event, or chide you for not doing so, they say: T’abá r’érin, ká sọ pé a r’érin, àjànàkú kọjá mo rí nkan fìrí (“When you see an elephant, there is no other way to describe what you’ve seen than to say you’ve seen an elephant – you cannot say you saw something just pass by in a jiffy”). An elephant is too big, too unique to mistake for or be described as anything else. But what if you cannot actually see it?
Figure 10 | Six blindfolded people and an elephant.

Source: Directional Church Board Members (2019).
14In the Indian parable, six blind people who had never seen an elephant try to describe what it is like, limited to their sense of touch and positioned next to different parts of the animal. The blind people rely on metaphors to describe the elephant based on what they perceive. The person standing next to its tail thinks the elephant is like a rope; the person next to the trunk thinks it is like a snake; the person next to its ear thinks it is like a fan; the person next to the leg thinks it is like a tree trunk; the person next to its side thinks it is like a wall; and the person next to the tusk thinks it is like a spear. Each person’s assessment is partly right, but also wrong. An elephant is more than whatever metaphors its individual parts might suggest. In a popular telling of this parable (Saxe, 1873), there is the suggestion that if they do not get a chance to exchange notes or shift positions, the six blind people would disagree furiously among themselves. But that if they do speak to each other and move around and feel different parts of the animal, together they might figure out what an elephant is really like (Thatamanil, 2020).
15Your account of a social system or a social reality says a lot about your audience. But as the parable shows, it also says a lot about where you stand. Indeed, your account says more about where you stand (pose) and who your assumed audience (gaze) is, than it says about the system or reality you seek to describe. The audience needs to know the metaphors beforehand – needs to recognise, in Vaihinger’s words, the useful fictions. What is often left out in the telling of the parable is the audience of the six blind people’s conjectures. The audience must know what a rope, snake, fan, tree trunk, wall and spear are. Each object must mean the same thing to each metaphor-making blind person and their audience. Without having “useful fictions” in common, their effort at connection fails. We humans grow up learning through daily interactions to frame our messages with the useful fictions we have in common with our audience. We learn to respect our audience’s dignity as knowers.
16Even then, there is another sense in which useful fictions are at work in the parable. There is an assumption in its popular telling that blind people rush to conclusions and are overly confident about what they can glean by touching an object at a single position. But the Australian writer and theologist John M. Hull, who became blind in his 40s, argues that “this is precisely what the blind do not and cannot afford to do […] the blind know better” (Thatamanil, 2020). He explains that tactile knowing is deliberately slow, gradual, patient and incremental (Hull, 2013). The presumably sighted storytellers must have made assumptions about blind people; assumptions they could only make without blind people in their audience, or without respecting the dignity of blind people as knowers. This metaphor – as with other useful fictions – reflects the pose and gaze of the people who crafted it in ways that risk perpetuating a falsehood that blind people are either rash or not credible knowers.
17Revisiting Hans Vaihinger’s work more than 100 years later, the Ghanian-British-American philosopher and writer Kwame Anthony Appiah draws out some of the implications of Vaihinger’s ideas in his book As If: Idealisation and Ideals (Appiah, 2017). Appiah reminds us that the “elegant simplicity” of useful fictions – a line illustration, a mathematical equation, a chemical formula, or a conceptual abstraction – brings into sharp relief certain features of what they describe. We need useful fictions sometimes because what we want to describe, its feature that we want to see, focus on, analyse or make sense of “becomes legible”, Appiah wrote, “only through a loss of exactitude.” But that legibility, partial and incomplete as it is, can be seductive. We get carried away, thinking that these fictions are true, and that they are complete representations of reality. We are misled by the fictions we create. But when useful fictions work, Appiah argues, they do because “We use them in two steps – first by ignoring a range of phenomena in order to build a model of a world without them, and then, once we have grasped how that model works, by adding more and more of the world gradually back in.” Much too often, we forget the second step.
18Seduced by our models, we blissfully ignore that our conceptions of the world are incomplete. Our useful fictions are reinforced, projected back at us by an audience that is (like) us, an audience whose dignity as knowers we respect. But what happens when our model is about other people’s worlds, people who are excluded from our audience? It is the kind of exclusion that makes claims like “discovering” the River Niger or the parable of the blind people and the elephant possible. It is what happens if one of the blind people, say the one standing next to its side, is physically restrained, and can only talk to other blind people who have only ever stood next to its side. They all might be fully certain that the elephant is a wall. It may be difficult to convince them otherwise. But if the other five blind people could move around and talk among themselves, they would quickly have a better grasp of what the elephant is like, even if none among them has ever stood next to its side. We researchers are often that one restrained blind person, or category of blind people – only in our case, we are self-restrained – while the other five blind people are people with direct expertise and lived experience as activists, policymakers, practitioners or ordinary people. That one self-restrained blind person can also be foreign in other ways – as someone working at a distance marked by space, power, gender, class, caste or status – while the other five blind people occupy proximate positions.
19If where you stand limits what you can grasp, and if useful fictions are socially constructed based on where you stand and who is within earshot, then the task of connecting a system to more of itself imposes certain responsibilities. Respecting your audience grounds you. If you speak in the same register as your audience, you modify your useful fictions to align with or include theirs, and yours is richer for it. You are reminded to repopulate your models of the world with a broad range of useful fictions: yours, theirs, others’. But you must first acknowledge that other useful fictions exist, and that yours is not complete. As Appiah argues, “Our best chance of understanding the world must be to have a plurality of ways of thinking about it” (Appiah, 2017). Then, we must connect the plurality of ways to one another. But each way of thinking about the world must have the chance to flourish in its own right and place. Otherwise, the useful fictions being connected are unequally yoked.
20In a documentary film about her life and writing titled The Pieces I Am, the African-American writer Toni Morrison describes how she went about her work: “I wanted to speak to [Black people] […]. The first thing I had to do was to eliminate the white gaze… that little white man that sits on your shoulder and checks out everything you do and say. I wanted to knock him off” (Greenfield-Sanders, 2019). A writer or scientist’s choice of gaze or audience – to the extent that they get to choose – is about connection, responsiveness, transparency, accountability, feedback, collective self-knowledge, and other relational qualities that make a system healthy. But a writer or a natural scientist or a social scientist is not stuck with just one type of “local” audience. Anywhere, the audience may include scientists, activists, practitioners, policymakers and ordinary people. Connecting a place or system to “more of itself” means all these actors can speak, hear and respond to one another. Each place must get the chance to build its own connections – and after that, to connect with others.
21Serving and being accountable to a local audience does not mean you are not relevant outside that space. It is, in fact, what makes you relevant outside that space. In Toni Morrison’s words, “I never asked Tolstoy to write for me, a little coloured girl in Lorain, Ohio […]. If I tried to write a universal novel, it would be water” (Morrison, 1994). That need for specificity, and finding the universal in the specific, was what the African-American writer James Baldwin meant when he said in an interview, “It was Dostoevsky and Dickens who taught me that the things that tormented me most were the very things that connected me with all the people who were alive, or who ever had been alive” (Howard, 1963). What you offer the world as a writer, as a person who studies and interprets social systems and realities, what the world benefits from your perspective on a subject, is greatly enriched by addressing yourself primarily to an audience of people who know about, are local to, and are intimately connected with that subject, that system, or that reality.
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22Our idea of scientific communication is stuck in a past in which the “world” was just Europe and its outposts. That idea needs updating, especially in fields of research that require a local audience of knowers to serve their purpose. What we have come to accept as the structure of a research paper is itself a tool for building useful fictions. A research paper is necessarily a constructed narrative. By design, it selectively emphasises some features of science and leaves out others. The features of science that get excluded are often the ones that have the potential to link it to a local audience of knowers. If we are keen to fulfil the responsibility of science to connect a system to more of itself, and to respect the dignity of people in that system as knowers, then we would need to modify the structure of research papers. What the traditional structure of research papers leaves out is often far more important than what it includes. The useful fictions we craft based on that form must be enriched by reinstating some of what we traditionally exclude.
23In the typical “Introduction” or “Background” section of a research paper, we make claims that we are filling gaps in the literature, and we proceed as if the literature is a storehouse of all available knowledge (note: “as if” signals a useful fiction). Yet people often know what the literature does not. While gaps sometimes do exist in the literature, the bigger need is to fill real gaps in the knowledge of real people and real gaps in the connections between real people in a real place. When we respect the dignity of the people in that place as knowers, our inquiry starts with what they already know, what they are doing with that knowledge, and what their learning needs are – not with gaps in a vaguely defined global literature. If we start with what is known or unknown in a place, the learning needs to be served become different, and we become aware of the real gaps in the knowledge of real people that need to be filled or the connections between them that need to be made or made stronger.
24The interpretive tools, framings or useful fictions that shape the knowledge and connection gaps in a place are central in deciding the methods we use to investigate a problem or answer a research question in that place. Writing the “Methods” section should therefore be an exercise in juxtaposing useful fictions. The method should not be chosen based on an arbitrary yardstick of rigour or the researcher’s preference, but on what contributes to an ongoing conversation about connection and learning in that place. The experience of conducting the inquiry changes the researchers as much as it generates knowledge and facilitates connections. The “Results” section then should not just be what researchers found, but also what researchers learned; how we and our methods changed, how we modified and repopulated our useful fictions, and how new knowledge or stronger connections helped to solve real problems of real people in that particular place.
25In the “Discussion” section, the results should not just be put in conversation with the literature, but much more in conversation with the place, with where the knowledge was made. The discussion should be about how the results helped local learning and action. The recommendations should be what people in the place (and not the researchers) want to do or want done, systematically sourced and documented. A study is not yet ready for publication until this cycle of connection is complete. What we have done up to this stage may be written up and published in a temporary, work-in-progress form as pre-print, but the full manuscript should not be deemed ready to be sent for peer review or published in its final form until it completes the cycle of connecting a system to more of itself.
26Beyond repurposing the form we use in constructing our useful fictions about what happens during research, we must call into question the delivery platform. The design of the traditional platform for scientific communication – scientific journals – is also partial and incomplete in its conception of how the world works. It was designed for another time, place and purpose. By seeing the role of journals differently, we can reinstate what we have excluded so far. It is time to let go of the idea that local journals – which allow local connections and respect for the dignity of local audiences as knowers – are inferior. European and North American journals are local journals too. They primarily serve their local audiences. Even when a journal is not defined by a place in its name or scope but serves a field or discipline, it still carries the intellectual imprints – the useful fictions – of where that field or discipline originated or is local. Local journals strengthen local systems. By establishing, nourishing and supporting local journals, we can put them in the service of making local systems stronger outside Europe and its outposts. But perhaps it is time to imagine new platforms that are altogether more fit for purpose than journals.
27Scientific communication has not changed much in the almost 400 years since the first scientific journals were published. Not even with the internet’s potential for new forms and platforms that could democratise and decentralise knowledge systems. It is an endlessly remarkable stubborn anachronism that research papers and scientific journals are the default mode of scientific communication in academic global health. It is time to let go of designs made on behalf of non-social natural sciences that knowledge must aggregate in a universal sense first and foremost. That design is not fit for knowledge that is socially constructed, locally used and circulated; when novelty, relevance and resonance are locally determined; when, to avoid false conclusions or wrong assumptions, we must respect the dignity of local audiences as knowers.
28In scientific communities that are not solely European, or that are not European at all, we must examine which of our traditional useful fictions need updating. Our choices of the forms and platforms to use for scientific communication are not just about science, they are also about ethics; about what is morally right or wrong. In any field where we write about others, decisions about gaze or audience are at the same time decisions about ethics. They are never neutral. When we carry on as if they are not choices about ethics, we risk gaslighting local audiences of knowers – like the parable of the six blind people and the elephant when told to a blind person. Or like the misguided Nigerian school teacher, teaching Nigerian children that what was always known to their ancestors was discovered by a European explorer. We gaslight knowers, whether we know it or not, when we fail to respect their dignity as knowers.

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