By Dr Christine Ngaruiya
As I headed home on the plane, my mind was abuzz. The engines steadily hummed in the background, dulled only by the even louder thoughts that raced through my mind. The plane lights were dim. Snores ebbed and flowed around me, my neighbors nothing but still heaps piled under blankets. Meanwhile, I sat wide awake, staring ahead into space, unable to settle down.
I was on my way back to the US after a 3-week span of conferences and research project work in East Africa. This exercise isn’t new to me, however. I am a penultimate example of the “reverse diaspora,” where a particular area of expertise (my academic research) which is focused in Kenya has landed me there for increasingly more frequent stints every year for the past several years. While I was born in America to Kenyan immigrant parents, I was raised in Kenya from a young age.
I went on to pursue secondary education in America, and now hold a faculty appointment at a US institution. In some shape or form, I knew that I’d return some day.
Like others who share passions of contributing to Africa’s progress in the diaspora, though, returning has come at a high cost, which has included navigating a murky and frequently harshly unwelcoming system, countless hours of unsalaried time, and personal resources, typically to the tunes of thousands of dollars, just to find one’s footing. The only thing that kept me going was a vision that I had, one like any other Kenyan, for what I’d love my country to be, and to achieve. I knew that I had something to contribute, and could see a gap that I could potentially help fill.
I’ve spent the better part of the past 5 years of my life in this cycle. I’ve worked with a variety of public health organizations and individuals in East Africa, including mentoring and teaching several hundred junior faculty, trainees and students on public health, research and academics. And while I, and others, have worked tirelessly in these efforts, they are but a dent in the overall scheme of things. And like any intervention, without infrastructure, are futile for sustainable change.
As it stands, sub-Saharan Africa accounts for <1% of the world’s research output and these scientific products remain only nominally cited. Meanwhile, public health decisions and guidelines are being enacted upon the continent from the highest echelons in spite of this lack of primary data. There are guidelines for national health targets and clinical care that are set based on the experience and data that are not necessarily transferrable, or ideal, for the African context. How then are we expected to thrive if the rule book is written using a blueprint that never quite accounted for our setting in the first place, anyway?
Unfortunately, this lack of research and academic productivity, the science that is so needed to advance knowledge on issues of importance to public health, is not expected to change in the foreseeable future.
While promising initiatives such as Consortium for Advanced Research Training in Africa (CARTA) and the Medical Education Partnership Initiative (MEPI) have emerged in the past few decades, they are drops in the bucket in terms of what is needed to see real change occur.
Furthermore, they are not comprehensive – they focus on a handful of institutions, with the real reach of such programs then limited even if their intentions and methods are good. An overhaul of the system is needed. A significant change in the culture and prioritization of academics and research is needed at the government level. Ministries of education, supported and ratified by the African Union and funding bodies need to prioritize the academic in the African setting for sustainable change to occur.
And one population that has glaringly been left out of the equation, and who have demonstrated the willingness and a desire to engage is – the diaspora. One of my favourite quotes pertaining to equity for women in the workplace states that you would not pick the best “team” from just half of the population. And in this case, with 170 million of us across the world, I am confident that our “teams” could do better.
Furthermore, as estimates have shown, diasporans are making financial contributions to the continent at an unprecedented level – as much as $35 billion. A wise Indian proverb says: “If you give a man a fish, you will feed him for a day. If you teach him to fish, you feed him for a lifetime. “ While the value of such financial investment cannot be undermined, the exposure, expertise and knowledge from this same body could and should also be leveraged as fervently in helping to advance the continent. This includes for its science and academic economy.
Some might ask, why not move back? That would solve the issue. I hesitantly debate that point of view. The late, great Harvard professor, Calestous Juma was validated in knowing that he, like others, was better placed where he was, at Harvard.
Quite simply, some of the resources, the opportunities and the exchange that can be leveraged to benefit the continent still remain invaluable. Realizing this, how can we sustainably tap into this giant think tank, an untapped resource of knowledge and passion? More needs to be done to make it a softer landing for them to return. And we need to be creative about this. Potential jobs or exchange programs for academics could be facilitated, research funding to support research by African governments for African science need to be fortified, and African science needs to be supported and advocated for furiously.
This isn’t a plea for a handout, applause or any special treatment for the diaspora either. Not at all, quite the opposite. If that was the business we were in, many of us would have given up a long time ago. All we ask for is an opportunity – to be able to give back. And channels to be able to do so, so that each person, is not having to reinvent the wheel each time. A frequently recited African proverb says: “If you want to go fast, go alone. If you want to go far, go together.” Let’s go together.
The writer is an academic physician at Yale University with a research focus on public health in Africa firstname.lastname@example.org