Ryan G. Davis

Decolonizing Evidence-Based Inquiry in Botswana from Crime Fiction to Public Health

Ryan G. Davis

University of Cincinnati College of Medicine

davis3rn@ucmail.uc.edu

Extraction of raw data resources from the Global South to produce knowledge at the ivory towers of the Global North in exchange for patronizing saviorism policies and programs is patently untenable, but even good intentions can insidiously exacerbate the kind of inequities they purport to oppose. While the movement to decolonize global health confronts the extent to which such subjugation persists in research methods, some have gone so far as to reject the universality of truth itself rather than just the claiming of its discovery or the gatekeeping of its access. They espouse the relativist position that there can be no objective standards to decide if a proposition approximates reality or pragmatically solves problems better than another, and that causal inference is an exclusionary vestige of imperialism. While normative public health science methods strain in assessing social health determinates and adapting to the needs of today’s world, calls to discard epidemiology as a colonial relic ignore the periodic history of scientific revolutions and the fundamentally tentative nature of scientific knowledge. Science is informed by the best available evidence, but subject to change when new evidence or new interpretations come to light. When science succumbs to hubris it fails to live up to its own ideals. Reforming epidemiology to advance public health equity around the world requires dismantling hegemony and reconciling alternative frameworks, including those that directly confront systematic power imbalances. Imagining what that change looks like, this essay compares the ways evidence informs conclusions in the crime novels set in Botswana by authors Unity Dow and Alexander McCall Smith. Postmodern and postcolonial analysis of the crime fiction genre reframes our relation to truth, diversifying who can act as fact-seekers, centering marginalized interpretive methods, and extending the kinds of problems worthy of investigation. Unity Dow is a Motswana lawyer-turned-politician and the first woman to serve as judge on Botswana’s high court. Alexander McCall Smith is a Scottish legal scholar and medical ethicist, born in the colony of Southern Rhodesia (now Zimbabwe) to British parents. Both authors are intimately concerned with Botswana’s response to HIV and other public health challenges.

BIOGRAPHY

Dr. Ryan G. Davis is a Lecturer in the University of Cincinnati College of Medicine Department of Environmental and Public Health Sciences where he teaches an MPH course on global health. Past appointments include a Postdoctoral Fellowship in the Department of Immunology and Infectious Diseases at the Harvard T.H. Chan School of Public Health and a Fulbright-Fogarty Fellowship in Public Health at the Botswana-Harvard AIDS Institute Partnership. His research in Zambia and Botswana

innovated resource-constrained screening strategies to interrupt malaria and HIV transmission clusters. Firsthand experience responding to violent conflict and displacement in the Middle East and Africa informs his interest in humanitarian health. He holds a BA in English Literature from Georgetown University, an MD from the Medical School for International Health at Ben-Gurion University of the Negev in collaboration with Columbia University Medical Center, and an MPH from the Johns Hopkins Bloomberg School of Public Health.