“First, do no harm.” Navigating Paradigms of Power in U.S. Global Health Education: A Case Study in Córdoba, Argentina

• In Event: Discourses and Issues in International Education

Proposal

Introduction:
This dissertation research study is situated within the field of international higher education. Specifically, it is positioned within the emerging movement of critical internationalization studies, which consists of scholars, and a broader community of practice, looking to critically examine the processes of internationalization of higher education in the United States and around the world. Such critiques, or anti-hegemonic approaches, highlight and illuminate the problematic neoliberal and neocolonial elements embedded into current internationalization practices and, more generally, in the dynamics of the field of international education.

This movement, relatively new in the trajectory of scholarly literature within international higher education, offers scholars and practitioners alike pathways to more equitable practices that do not reproduce or reinforce the unequal power dynamics that currently exist and persist. Not surprisingly, the delineation of inequality and asymmetry is largely seen between educational actors from the Global North (e.g. U.S. and Europe) and educational actors from the Global South (e.g. Latin America, Africa, and Asia). As can be surmised, these dynamics follow and repeat the historical patterns and ongoing legacies of colonialism. This particular Global North-Global South dynamic served as the contextual centerpiece of this study.

Among the various manifestations of internationalization efforts in U.S. universities, education abroad enjoys significant visibility among enrolled students, prospective students, their families, and the general public. There is a public consciousness around the virtue of student mobility programs and the multitude of benefits (academic, professional, and personal) conferred upon their participants. Furthermore, the resulting intercultural learning, language learning, and academic content learning are ubiquitously acknowledged and celebrated.

However, historically, there has been little attention paid to how differences in power, e.g. economic, political, and cultural, are experienced and understood, particularly when U.S. students travel to countries in the Global South. In this case study, the central objective was to examine the experiences of a group of U.S. medical students who traveled to Córdoba, Argentina in June 2023 and to examine how they understood power differentials. The study’s central research questions were: ‘1-What are the experiences of U.S. college students who participate in a socially-conscious, ethics-informed global health education program to Argentina?’ and 2-‘How do U.S. college students understand power differentials in Global North-Global South community engagement in a global health education program to Argentina?’

Background Literature:
To situate this study in the existing body of literature, a brief overview of the related scholarly discourse is offered here. This review mapped the evolution of internationalization within higher education over the past 25 years (Knight & de Wit, 2018), while also highlighting a newer branch of scholarly discourse around critical internationalization studies (Stein, 2019; Stein & McCartney, 2021). Also included were the field-specific calls to decolonize global health and global health education programming (Eichbaum et al., 2021; Kwete et al., 2022). Lastly, post-colonial theory served as the study’s theoretical framework for its utility in directly centering and addressing the historization of relations between global peoples within hierarchical structures of power. Because this research centered on Global North-Global South educational encounters, post-colonial theory was a relevant guide that could inform the research’s objectives and analysis and is consistent with other scholars’ usage (Caton & Santos, 2009; Chakravarty et al., 2020; Razack, 2009).

Methodology:
This qualitative research was designed as a case study that focused exclusively on the experience of 12 cohorted participants in a global health education program to Argentina through the organization Child Family Health International (CFHI) in June 2023. The objective was to generate a rich description of the experience of this cohort of students. In that spirit, multiple data collection instruments were used throughout the three-phased approach of pre-departure, on-site, and re-entry components of the experience.These included a pre-departure survey, on-site observations and focus groups, and 1:1 semi-structured interviews upon return. Throughout the process, document review of organizational literature, itineraries, and, most notably, pre-departure modules and readings was conducted. The unique aspect of this case study was that the U.S. provider, Child Family Health International (CFHI), embodies a socially-conscious and ethics-informed ethos in its global health programming.

Findings/Discussion:
After a rigorous two-cycle coding process, six key themes emerged as answers to the study’s two central research questions. From those, the study concluded that a strong learner-teacher dynamic was struck with U.S. students positioned as the learners and Argentines as their teachers. Also, students largely adopted and embodied an asset-based orientation (not deficit) of Argentina, its people, its culture, and its medical system. Thirdly, there was a notable duality in the embodiment of characteristics of the neoliberal consumer and the global citizen.

In this case study, traditional power paradigms were moderately disrupted, rather than simply reinforced and reproduced. This study demonstrates the potential, when realized, for educational interventions and intentional pedagogy in U.S. education abroad programming to act as counteracting forces to traditional hierarchies of global power and as pathways to greater global equity.

Overall, this study offers a pathway to consider ways in which program models, via both policy and practice, can act to reshape U.S. student learning experiences in the Global South and to effectively disrupt traditional power paradigms to create more equitable, decolonizing learning experiences for students.

In the spirit of the CIES 2026 theme, Re-Examining Education and Peace in a Divided World, this research ought to serve as encouraging evidence that learning models, which actively and courageously address divisions in our world, have the potential for individual consciousness raising and for the collective proliferation of empathy, action, and peace.

Author

• Erin Gahimer, University of Illinois at Urbana Champaign