Whose Voices?

I am about to share the most significant experience as part of my IDR journey to date, which feels very exciting indeed. It all started with my attendance at the hospital and healthcare workers conference, where practitioners from across the Australian public and private healthcare sector shared their knowledge and experiences with regards to occupational violence and aggression. In effect, the conference was meant to be a comprehensive account of existing initiatives and research to prevent acts of violence in healthcare settings.

Before attending the conference, I read a lot about the typology and definition of violence, about how it may be inflicted, interpreted, experienced, embodied, glorified, or silenced. This list is by no means exhaustive. Violence is systemic. Stopping it is not just about the behaviour of individuals, but about changing the culture and environment in which it occurs. In many ways, reported incidents of violence against healthcare workers can be thought of as the tip of an iceberg. What lies below the surface is an accumulation of attitudes, words, and actions that trivialise, make light of, or justify violence. Incidents of violence and aggression are chronically underreported, thus remain invisible to many. Assumptions, biases, and stigma (aggravated by the COVID-19 pandemic) continue to drive discrimination and the abuse of power. Amidst all the chaos, I was left wondering: Who is actually facilitating this discussion? Who is amplifying voice and access to this discussion in the first place? In other words, who gets a seat at the table and who is being excluded?

During the two-day conference, I listened to health practitioners sharing best practice examples on how to manage the health and safety risks of workplace violence and aggression. On the matter of terminology, the language used by the group of experts remained mostly limited to mainstream definitions of violence. At times, it seemed as though panellists were discussing technical problems that rely on technical solutions. What seemed to be a presentation on body-worn cameras ended up being a sales pitch of the event’s sponsoring partner. My point being that the context in which participation took place entitled a small group of experts to privilege their thinking and conclusions in promoting their ideas. There was the widespread assumption among participants, including myself, that critical knowledge and expertise were to be found among this group of professionals (of which none were representing Indigenous Australia, be it in the form of health peak bodies or research institutes). I do not mean to say that those experts were not credible or knowledgeable. Quite the contrary is true: I have gained invaluable insights that ultimately helped me conceptualise a framework around which my research is now evolving. Situating my experiences within the broader literature I have read as part of the ID degree, as well as within the specific context of violence in healthcare, helped me articulate my own position as a researcher in this space.

My thinking evolved into a more full-fledged critique by the time I started to identify a pattern across initiatives, remembering broader discussions about participation and voice, particularly in Learning and Participation, Development Fieldworks and Theories of Development. For Escobar (cited in Sahle, 2012), ‘discourse is the process through which social reality comes into being … [it is] the articulation of knowledge and power, of the visible and expressible’. With this in mind, I started seeing the invisible and the inexpressible. While diverse in their approaches, experts formed a fairly homogenous group, in effect mirroring Australia’s representational system, of which healthcare is an integral part. This leads to the inevitable question: Does my research simply reproduce a dominant social reality in which Indigenous Australian knowledge is systematically underrepresented?

According to LaRocco, Shinn and Madise (2019, p. 24), ‘positionality is an inward-looking exercise in which we demand of ourselves an examination of our constructed cognitive frameworks’. Hence, what are the implications of my specific positionality to obtain broader insights for researching this topic? Can we really discuss violence without paying attention to the knowledge and expertise of Aboriginal practitioners? Further, what is the role of language in the production of meanings embodied in this discourse? In other words, how does the typology and definition of violence change when the voices of those who tend to be marginalized or excluded by mainstream initiatives are being accounted for? These reflections helped me formulate questions for the interviews with various ICRC field missions, which ultimately set the course for further research into the insights I am hoping to receive.

I cannot wait to be sharing some of those insights very soon.

Best for now, Adrian. 

References: 

LaRocco, A, Shinn, J & Madise, K 2019, ‘Reflections on Positionalities in Social Science Fieldwork in Northern Botswana: A Call for Decolonising Research’ Politics and Gender, pp. 1-29.

Sahle, E 2013, ‘Post-development and alternatives to development’, in P Haslam, J Schafer & P Beaudet (eds), Introduction to International Development: Approaches, Actorsb, and Issues, Oxford University Press, pp. 68-85.