From 'making up' professionals to epistemic colonialism: Digital health platforms in the Global South.

ABSTRACT

Platforms have been studied in terms of their impact on knowledge production and generation of social value. Little however is known about the significance of the knowledge they transfer to the recipient communities-often in faraway countries of the Global South-or its potential perceived colonizing effects. Our study explores the question around digital epistemic colonialism in the context of health platforms involved in knowledge transfer. Using a Foucauldian lens, we study digital colonialism as a phenomenon that emerges from platforms' underpinning power/knowledge relations. Drawing upon a longitudinal study of MedicineAfrica-a nonprofit platform intended to offer clinical education to healthcare workers and medical students in Somaliland-we discuss interview findings from two phases (a) with Somaliland-based medical students who studied MedicineAfrica as part of their medical studies, and (b) with medical professionals who attended a MedicineAfrica Continuing Professional Development (CPD) course on Covid-19 treatment/prevention. Our study shows how the platform 'makes up' healthcare professionals by offering opportunities for learning and skill development whilst instilling work values and ethos resembling Western medical identities. The platform was also perceived to produce subtle colonizing effects as its content embodies knowledge that (a) presupposes medical infrastructures that are absent in the recipient country; (b) is presented in English instead of participants' mother tongue; and (c) neglects the idiosyncrasies of the local context. The platform sets its tutees in a colonial condition in which they cannot fully practice what they learn; they cannot entirely engage with the subject they learn, taught as it is in a different language, and they do not necessarily learn about the medical conditions and the patients they encounter. This alienation from their local context, embraced by the platform's underpinning power/knowledge relations, is at the heart of digital epistemic colonialism and comes together with the social value the platform generates.