Reda Sadki

Gender in emergencies: a new peer learning programme from The Geneva Learning Foundation

Reda Sadki September 15, 2025Global health, Leadership

This is a critical moment for work on gender in emergencies.

Across the humanitarian sector, we are witnessing a coordinated backlash.

Decades of progress are threatened by targeted funding cuts, the erasure of essential research and tools, and a political climate that seeks to silence our work.

Many dedicated practitioners feel isolated and that their work is being devalued.

This is not a time for silence.

It is a time for solidarity and for finding resilient ways to sustain our practice.

In this spirit, The Geneva Learning Foundation is pleased to announce the new Certificate peer learning programme for gender in emergencies.

We offer this programme to build upon the decades of vital work by countless practitioners and activists, seeing our role as one of contribution to the collective effort of all who continue to champion gender equality in emergencies.

Learn more and request your invitation to the programme and its first course here.

Our approach: A programme built from the ground up

This programme was built from scratch with a distinct philosophy.

We did not start with a pre-packaged curriculum.

Instead, we turned to two foundational sources of knowledge.

First, we listened to the most valuable resource we have: the firsthand experiences of thousands of practitioners in our global network. Their stories of what truly happens on the front lines—what works, what fails, and why—form the living heart of this programme.
Second, we grounded our approach in the deep insights of intersectional, decolonial, and feminist scholarship. These perspectives challenge us to move beyond technical fixes and to analyze the systems of power that create gender inequality in the first place.

This unique origin means our programme is a dynamic space co-created with and for practitioners who are serious about transformative change.

Gender in emergencies: Gender through an intersectional lens

Our focus is squarely on gender in emergencies.

We start with gender analysis because it is a fundamental tool for effective humanitarian action.

However, we use an intersectional lens.

We recognize that a person’s experience is shaped not by gender alone, but by how their gender compounds with their age, disability, ethnicity, and other aspects of their identity.

This lens does not replace gender analysis.

It makes it stronger.

It allows us to see how power works differently for different women, men, girls, and boys, and helps us to design solutions that do not inadvertently leave behind the people marginalized by something other than their gender.

Gender in emergencies requires learning at the speed of crisis

Humanitarian response must be rapid, and so must our learning.

A slow, top-down training model cannot keep pace with the reality of a crisis.

The Geneva Learning Foundation’s Impact Accelerator is a peer learning-to-action model built for the speed and complexity of humanitarian settings.

It is a ‘learn-by-doing’ experience where your frontline experience is the textbook.

The model is designed to quickly turn your individual insights into collective knowledge and practical action.

You analyze a real challenge from your work, share it with a small group of global peers, and use their feedback to build a concrete plan.

This process accelerates the development of context-specific solutions that are grounded in reality, not just theory.

Your first step: The foundational primer for gender in emergencies

We are starting this new programme with a free, open-access foundational course.

Enrollment is now open.

The course is a quick primer that introduces core concepts of gender, intersectionality, and bias through the real-world stories of practitioners.

It provides the shared language and practical tools to begin your journey of reflection, peer collaboration, and action.

Building a resilient community

This is more than a training programme.

It is an invitation to join a global community of practice.

In a time of backlash and division, creating spaces where we can learn from each other, share our struggles, and find solidarity is a critical act of resistance.

If you are ready to deepen your practice and connect with colleagues who share your commitment, we invite you to join us.

The crisis in scientific publishing: from AI fraud to epistemic justice

Reda Sadki September 14, 2025Global health, Leadership

There is a crisis in scientific publishing. Science is haunted. In early 2024, one major publisher retracted hundreds of scientific papers. Most were not the work of hurried researchers, but of ghosts—digital phantoms generated by artificial intelligence. Featuring nonsensical diagrams and fabricated data, they had sailed through the gates of peer review.

This spectre of AI-driven fraud is not only a new technological threat. It is also a symptom of a pre-existing disease. For years, organized networks have profited from inserting fake papers into the scholarly record. It seems that scientific publishing’s peer review process, intended to seek truth, cannot even tell the real from the fake.

These failures are not just academic embarrassments. In fields like global health, where knowledge means the difference between life and death, we can no longer afford to ignore them. Indeed, the crisis in scientific journals is not, at its heart, a crisis in publishing. It is a crisis of knowledge—of what we value, who we trust, and how we come to know. That makes it a crisis of education.

Crisis in scientific publishing: The knowledge we ignore

Consider what Toby Green has called the “dark side of the moon.” He is referring to the vast body of knowledge produced by established experts in international organizations. Volumes of high-quality reports and analyses come from organizations large and small. They contain immense expertise. Often, not only do they qualify as science. They may be more likely to shape policy and practice than most academic outputs. Yet this “grey literature” is rarely incorporated into the scholarly record. This is why Green is actively implementing projects to find, collect, and index such materials.

If the formal knowledge of some of the world’s leading experts is being left in the dark, what hope is there for the practical wisdom of a frontline nurse?

In the rigid hierarchy of evidence that governs global health, a randomized controlled trial sits at the pinnacle. At the very bottom, dismissed as mere “anecdotes,” lies the lived experience of practitioners. A nurse in a rural clinic who discovers a better way to dress a wound in a humid environment has generated life-saving knowledge that could be useful elsewhere. A community health worker who develops a sophisticated method for building trust with vaccine-hesitant parents has solved a problem in context. Yet, in our current culture, their insights are not data. Their experience is not evidence.

To dismiss such knowledge is an act of willful ignorance. Science, at its best, is a process of disciplined curiosity. Its fundamental purpose is to reduce ignorance and expand our understanding of the world. To willfully ignore entire categories of human experience and expertise is therefore a betrayal of the scientific ethos itself. It is an active choice to remain in the dark.

Crisis in scientific publishing: the architecture of exclusion

This devaluation of practical knowledge is not an accident. It is a feature of a system designed to exclude. The modern ideal of science began with a radically open mission. As the scholar John Willinsky has meticulously documented in his history of Western European science, the creation of scientific journals in the 17th century was intended to create a public commons of knowledge, accelerating progress for the benefit of humanity. The principle was one of access. How was this mission corrupted?

The architecture of modern science was built on a colonial foundation. Its violence was not only physical but also scientific and intellectual. Frantz Fanon, the Martinican psychiatrist who became a theorist of decolonization in the crucible of Algeria’s war of independence, described colonization’s deepest work as the effort to “empty the mind of the colonized.” This is a systematic process of convincing people that our own histories, cultures, and ways of knowing are worthless.

Generations later, the Māori scholar Linda Tuhiwai Smith detailed how this was put into practice. She showed that Western research methodologies themselves were often not neutral tools of discovery but instruments of empire. The acts of observing, classifying, extracting, and analyzing were used to control populations and invalidate their knowledge systems, replacing them with a single, supposedly universal, European model of truth.

This worldview pretends to be a neutral, “view from nowhere,” a concept also critiqued powerfully by the white American feminist philosopher Donna Haraway. She argued that all knowledge is situated—shaped by the position and perspective of the knower. You see the landscape differently from the mountain top than you do from the valley. A complete map requires both perspectives.

Echoing this, her philosophical and geographical sister Sandra Harding argued that by excluding the perspectives of marginalized people, dominant science becomes “weakly objective.” It is blind to its own biases and assumptions.

Crisis in scientific publishing: Fear of knowledge

A common and deeply felt fear among scientists is that embracing diverse forms of knowledge will lead to a dangerous relativism, where objective truth dissolves and “anything goes.”

Harding’s work shows this fear to be misplaced. She argues that the “view from nowhere” provides not a stronger, but a more brittle and fragile grasp of the truth. A truly “strong objectivity,” she contended, is achieved by intentionally seeking out multiple, situated perspectives. This does not mean that all views are equally valid. It means that by examining a problem from many standpoints, we can triangulate a more robust and reliable understanding of reality. We can identify the biases and blind spots inherent in any single view, including our own.

This process is the antidote to the willful ignorance mentioned earlier. It strengthens our grasp of objective truth by making it more complete and more honest.

Can change be paved by good intentions?

Today, the need for a change in research culture is widely acknowledged. The world’s largest research funders publish reports calling for more diversity and inclusion. Yet we observe paralysis rather than progress. The individuals who sit on the decision-making committees of such institutions will almost certainly not fund a project with a primary investigator whose work is not validated by the existing system of prestigious but exclusive journals. Elite global scholars leading the vital movement to “decolonize global health” first established their legitimacy by adhering to conventional norms, then began using the master’s tools to have their critiques of the system heard. Such contradictions illustrate how deeply the exclusionary norms are embedded.

Since top-down change is caught in such contradictions, a meaningful path forward may be to change the culture of science from the ground up. The core challenge is to correct for epistemic injustice: the wrong done to someone in their capacity as a knower. This injustice takes several insidious forms.

The most obvious is testimonial injustice. Imagine the scene. A senior male doctor from a famous university presents a finding and is met with nods of assent. His words carry the weight of evidence. A young female nurse from a rural clinic presents the exact same finding based on her direct experience. Her knowledge is dismissed as a “story” or an “anecdote.” She is not heard because of who she is. Her credibility is unjustly discounted.

Even deeper is hermeneutical injustice. This is the wrong of not even having the shared language to make your experience understood by the dominant culture. The community health worker who builds trust with hesitant parents may have a brilliant system, but if they cannot articulate it in the formal jargon of “implementation science,” their knowledge remains invisible. They are wronged not because they are disbelieved. They are wronged because the system lacks the concepts to even recognize their wisdom as knowledge in the first place.

Projects like Toby Green’s grey literature repository or initiatives like Rogue Scholar, pioneered by Martin Fenner, that assign a permanent Digital Object Identifier (DOI) to science that was not previously in the scholarly record, are practical interventions. But this not a technological problem. It is an educational one. Changing a culture that perpetuates these injustices is the primary work. Within this larger project, new tools can serve as tactics of resistance. As such, they can be used to support acts of epistemic defiance, for example by creating a formal, citable record of knowledge that exists outside the traditional gates. Yet they remain tools, not the solution.

The science of knowing

You cannot fix a broken culture by patching its systems. You must change its DNA. The crisis haunting science is not ultimately about publishing, fraud, or peer review. It is a crisis of education—not of schooling, but of how we come to know. If physics is the science of matter, education is the science of all sciences. It provides the architecture of assumptions and values that shapes how every other field discovers and validates truth.

A new philosophy of education is needed, one that includes these three principles:

It must recognize that the most durable knowledge comes from praxis—the cycle of acting in the world and reflecting on the consequences.
It must be built on collaborative intelligence, understanding that the most difficult problems can only be solved by weaving together many perspectives.
It must pursue strong objectivity, not by erasing human perspective, but by intentionally seeking it out to create a more complete and honest picture of reality.

To change science, we must change how scientists are taught to see the world. We must educate for humility, for critical self-awareness, and for the ability to listen. This is the work of creating a science that is not haunted by its failures but is directly contributes to a more just and truthful account of our world.

References

Boghossian, P., 2007. Fear of knowledge: Against relativism and constructivism. Clarendon Press.
Couch, L., 2021. Wellcome Diversity, equity and inclusion strategy [WWW Document]. Wellcome. URL https://wellcome.org/what-we-do/diversity-and-inclusion/strategy (accessed 11.8.22).
Fanon, F. (1963). The wretched of the earth. Grove Press.
Fenner, M., 2023. The Rogue Scholar: An Archive for Scholarly blogs. Upstream. https://doi.org/10.54900/bj4g7p2-2f0fn9b
Gitau, E., Khisa, A., Vicente-Crespo, M., Sengor, D., Otoigo, L., Ndong, C., Simiyu, A., 2023. African Research Culture – Opinion Research. African Population and Health Research Center, Nairobi, Kenya. https://aphrc.org/project/african-research-culture-opinion-research/
Green, T., 2022. Wait! What? There’s stuff missing from the scholarly record? Med Writ 31, 44–48. https://doi.org/10.56012/ajel9043
Haraway, D. (1988). Situated knowledges: The science question in feminism and the privilege of partial perspective. Feminist Studies, 14(3), 575–599. https://doi.org/10.2307/3178066
Harding, S. (1991). Whose science? Whose knowledge? Thinking from women’s lives. Cornell University Press.
Smith, L. T. (2012). Decolonizing methodologies: Research and indigenous peoples (2nd ed.). Zed Books.
The Social Investment Consultancy, The Better Org, Cole, N., Cole, L., 2022. Evaluation of Wellcome Anti-Racism Programme Final Evaluation Report – Public. Wellcome, London. https://cms.wellcome.org/sites/default/files/2022-08/Evaluation-of-Wellcome-Anti-Racism-Programme-Final-Evaluation-Report-2022.pdf
Wellcome Trust, 2020. What researchers think about the culture they work in. Wellcome, London. https://wellcome.org/reports/what-researchers-think-about-research-culture
Willinsky, J., 2006. The access principle: The case for open access to research and scholarship. MIT press Cambridge, MA.

Against chocolate-covered broccoli: text-based alternatives to expensive multimedia content

Reda Sadki September 13, 2025Writing

The great multimedia content deception

Learning teams spend millions on dressing up content with multimedia.

The premise is always the same: better graphics equal better learning.

The evidence tells a different story.

The focus on the presentation and transmission of content represents a fundamental misunderstanding of how learning actually works in our complex world.

Multimedia content: the stakes have changed

In a world confronting unprecedented challenges—from climate change to global health crises, from artificial intelligence to geopolitical instability—the stakes for learning have never been higher.

We need citizens and professionals capable of critical thinking, navigating uncertainty, grappling with complex systems, and collaborating effectively with artificial intelligence as a co-worker.

Yet much of our educational technology investment continues to chase the glittering promise of multimedia enhancement, as if adding more visual stimulation and interactive elements will somehow transform passive consumers into active knowledge creators.

The traditional transmissive model—knowledge flowing one-way from expert to learner—has become counterproductive.

In a world where information is abundant but wisdom is scarce, the critical question is not how to transmit information efficiently, but how to create environments that cultivate higher-order capabilities.

If not multimedia content, then what?

Bill Cope and Mary Kalantzis identify seven affordances that distinguish effective digital learning from traditional instruction.

None involve multimedia enhancement.

Instead, they emphasize ubiquitous learning that transcends boundaries; active knowledge production by learners themselves; recursive feedback that transforms assessment into dialogue; collaborative intelligence that emerges from structured interaction; metacognitive reflection that builds learning capacity; and differentiated pathways that personalize without sacrificing community.

This framework reframes education’s purpose: not delivering content, but designing ecologies for knowledge creation.

Consuming multimedia content is not learning

The critical distinction lost in educational technology discussions is between learning resources and learning processes.

A video or simulation is content—not learning itself.

Learning is the activity that the learner does.

At The Geneva Learning Foundation, we work with over 70,000 health practitioners globally using a structured cycle of action and reflection.

The main medium is text.

But the role of text is far more profound than content delivery.

In our climate and health programme, for example, the primary learning resource is a collection of text-based eyewitness accounts from learners in our Teach to Reach programme.

A practitioner in Nigeria shares a written story of how extreme heat forces people to sleep outdoors, increasing their exposure to malaria-carrying mosquitoes.

Learners read this and many other real-world experiences.

The learning activity is not to memorize this fact.

Instead, a learner in Brazil will analyze a “chain reaction” from change in climate to health consequences in writing, grounded in their own experience with flooding and diarrheal disease.

Then, she will receive structured, written feedback from colleagues in Chad, Ghana, and India, guided by a detailed rubric.

The “content” is the collective written experience of the peer group.

Similarly, in our 16-day peer learning exercise on health equity, learners do not study abstract theories of justice from a textbook.

Instead, they write a detailed project analyzing a real-world inequity they face.

A health worker might document how their system’s design consistently fails to reach nomadic pastoralist communities.

The learning happens in the subsequent, text-based peer review, where colleagues use a rubric to help the author deepen their root cause analysis and refine their action plan.

In both cases, the engine of learning is the activity—creating, analyzing, evaluating, collaborating—and text is the medium for that activity.

We do not invest in costly multimedia production because the engagement happens in robust, structured peer interactions that drive authentic learning.

The experiences shared by learners, what they construct individually, becomes the collective corpus through which learning becomes continuous – and helps turn knowledge into action.

The cognitive case for the superiority of text over multimedia content

Cognitive Load Theory explains that working memory—where we process new information—is extremely limited.

This mental capacity has three components: intrinsic load (the material’s inherent difficulty), extraneous load (effort wasted on poorly designed instruction), and germane load (productive effort leading to deep learning).

Critical thinking, analysis, and metacognition have very high intrinsic loads.

Learners are already engaged in demanding mental work.

Any instructional element adding unnecessary complexity steals finite cognitive resources from actual learning.

Multimedia “enhancements”—distracting animations, irrelevant images, redundant text—do precisely this.

They may feel engaging, but research shows this perceived engagement does not translate to better outcomes and can be detrimental.

Well-structured text is cognitively “quiet.”

It presents information cleanly, allowing learners to dedicate maximum mental energy to understanding and applying complex ideas.

The unique affordances of text

Text possesses structural characteristics exceptionally suited for higher-order thinking.

Its linear nature builds coherent, sequential, evidence-based arguments, modeling logical reasoning processes.

Unlike transient video or audio, text is stable—it can be revisited, scrutinized, annotated, and cross-referenced at the learner’s pace, enabling the deep analysis required by our peer review rubrics.

Written language excels at conveying abstract concepts, nuanced theories, and complex principles—the building blocks of fields requiring sophisticated thinking and “thick knowledge”.

Studies consistently show writing improves critical thinking skills like analysis and inference.

Comparative studies in Problem-Based Learning (PBL) reveal that adding multimedia does not reliably improve outcomes.

Some find no significant difference between text-based and multimedia-enhanced cases.

Others find video actively hinders learning by making it harder to identify and review key information during collaborative analysis.

The virtual reality paradox

Some education innovators continue to be mesmerized by the promise of virtual or augmented reality.

They are often the same individuals who previously touted “gamification” as a panacea for learning.

Virtual reality represents the ultimate multimedia format, promising immersive simulations that proponents claim will revolutionize education.

Yet the biggest investments so far have been spectacular failures.

For example, Mark Zuckerberg’s massive bet on virtual learning environments, despite billions invested, failed to demonstrate educational superiority over traditional methods.

The pattern repeats across educational technology: the more immersive and visually impressive the technology, the more it distracts from the cognitive work learning requires.

This helps to understand why, by contrast, text-based generative AI chatbots so rapidly became part of teaching and learning.

Students may be amazed by virtual experiences, but amazement does not translate to learning outcomes.

The AI factor

As artificial intelligence becomes capable of generating sophisticated multimedia content, human learners need complementary skills: critical analysis of AI-generated materials, collaborative meaning-making across perspectives, and creative synthesis of complex information.

Text-based learning environments naturally develop these capabilities.

When students analyze written arguments, provide peer feedback through structured rubrics, and revise thinking based on diverse perspectives, they practice the analytical and collaborative thinking that will distinguish them in an AI-enhanced world.

The economic dead end of multimedia content

Multimedia content may become obsolete quickly, requiring constant updates.

A typical multimedia learning module is expensive to develop and maintain.

A thoughtfully structured text-based peer review process costs a fraction of that amount but creates value every time learners engage with it, building individual skills and collective knowledge that compound over time.

In our programmes spanning multiple continents and diverse health contexts—from emergency response training to climate health education—we demonstrate measurably better learning outcomes with text-based approaches.

Our methodology focuses on evidence-based peer learning emphasizing learner autonomy, competence, and community connection—outcomes that text-based environments support more effectively than multimedia alternatives.

Beyond the false choice

This argument does not advocate technological poverty in education.

Digital platforms enable collaboration and knowledge sharing impossible in previous eras.

Innovation and investment are vital.

The key lies in distinguishing between technology that amplifies human interaction and technology that attempts to substitute for it.

Text-based learning environments scale to support thousands while maintaining human connections essential for deep learning.

They accommodate diverse learning styles without sacrificing intellectual rigor.

They integrate seamlessly with AI tools that help organize and synthesize ideas without replacing human judgment and creativity.

Most importantly, they focus investment where learning happens: in structured interaction between learners, feedback loops that refine understanding, collaborative processes that create knowledge, and metacognitive reflection that builds learning capacity.

The path forward

The multimedia deception persists because it aligns with intuitive but erroneous beliefs about learning and technology.

More sophisticated presentations seem like obvious improvements.

But learning operates by different rules than information processing.

Institutions serious about educational effectiveness should reject the multimedia mirage.

This means redirecting technology budgets from content production to learning infrastructure.

It means training experts to facilitate text-based dialogue scaffolded by rubrics and experience, rather than spend time building multimedia presentations.

It means measuring learning outcomes rather than student satisfaction scores.

In a world demanding critical thinking, systems awareness, and collaborative intelligence, we need approaches that develop these capabilities directly.

The multimedia bells and whistles that capture our attention and resources actively impede the kind of learning our complex world requires.

The future of educational technology lies in thoughtful structuring of human interaction and knowledge creation.

Text provides the foundation precisely because it demands the active cognitive engagement that multimedia often circumvents.

References

Berrocal, Y., Regan, J., Fisher, J., Darr, A., Hammersmith, L., Aiyer, M., 2021. Implementing Rubric-Based Peer Review for Video Microlecture Design in Health Professions Education. Med.Sci.Educ. 31, 1761–1765. https://doi.org/10.1007/s40670-021-01437-1
Cope, B., Kalantzis, M., 2013. Towards a New Learning: The Scholar Social Knowledge Workspace, in Theory and Practice. E-Learning and Digital Media 10, 332–356. https://doi.org/10.2304/elea.2013.10.4.332
Cope, B., & Kalantzis, M. (Eds.). (2016). e-Learning Ecologies: Principles for New Learning and Assessment. Routledge. https://doi.org/10.4324/9781315699935
Feenberg, A., 1989. The written world: On the theory and practice of computer conferencing, in: Mason, R., Kaye, A. (Eds.), Mindweave: Communication, Computers, and Distance Education. Pergamon Press, pp. 22–39.
Fenesi, B., Sana, F., Kim, J. A., & Shore, D. I. (2014). Learners misperceive the benefits of redundant text in multimedia learning. Frontiers in Psychology, 5, 710. https://doi.org/10.3389/fpsyg.2014.00710
Mayer, R. E. (2008). Applying the science of learning: Evidence-based principles for the design of multimedia instruction. American Psychologist, 63(8), 760-769. https://doi.org/10.1037/0003-066X.63.8.760
Pereles, A., Ortega-Ruipérez, B., Lázaro, M. (2024). The power of metacognitive strategies to enhance critical thinking in online learning. Journal of Technology and Science Education, 14(3), 831-843. https://doi.org/10.3926/jotse.2721
Rivas, S. F., Saiz, C., & Ossa, C. (2022). Metacognitive strategies and development of critical thinking in higher education. Frontiers in Psychology, 13, 913219. https://doi.org/10.3389/fpsyg.2022.913219
Sweller, J. (2005). Implications of cognitive load theory for multimedia learning. In R. E. Mayer (Ed.), The Cambridge Handbook of Multimedia Learning (pp. 19-30). Cambridge University Press. https://doi.org/10.1017/CBO9780511816819.003
Sweller, J., Ayres, P., & Kalyuga, S. (2011). Cognitive Load Theory. Springer. https://doi.org/10.1007/978-1-4419-8126-4
Tarchi, C. (2021). Learning from text, video, or subtitles: A comparative analysis. Computers & Education, 160, 104034. https://doi.org/10.1016/j.compedu.2020.104034

Richard Mayer’s research on multimedia for learning actually proves text works better

Reda Sadki September 13, 2025Writing

Educational technology professionals cite Richard Mayer’s 2008 study more than any other research on multimedia instruction.

They are citing the wrong conclusion.

Mayer did not prove multimedia enhances learning.

He proved multimedia creates cognitive problems requiring ten different workarounds – and accidentally built the case for text-based instruction.

What Richard Mayer actually found

Through hundreds of controlled experiments, Richard Mayer identified ten principles for multimedia design.

The pattern is striking: most principles involve removing elements from presentations.

Five principles focus on reducing “extraneous processing” – cognitive waste that multimedia creates.

Remove irrelevant material.
Highlight essential information buried among distractions.
Eliminate simultaneous animation, narration, and text because learners perform better with only two elements.
Place corresponding words and pictures close together.
Present them simultaneously, not sequentially.

Three principles manage “essential processing” when content is complex.

Break presentations into learner-controlled segments.
Use spoken rather than printed text with graphics.
Provide pre-training before complex multimedia instruction.

Two principles foster deeper learning.

Combine words and pictures rather than words alone.
Use conversational rather than formal language.

The hidden message: multimedia instruction is so cognitively demanding that it requires ten specialized principles to avoid harming learning.

Richard Mayer’s split attention revelation

Mayer’s modality principle seems to endorse multimedia: learners perform better with graphics plus spoken text than graphics plus printed text.

Educational technologists celebrate this as proof that multimedia works.

They miss the real insight.

Graphics with printed text create split attention – learners cannot simultaneously look at pictures while reading words.

They must constantly switch between visual elements, wasting cognitive resources on coordination rather than learning.

Richard Mayer’s solution uses different channels: visual graphics with auditory narration.

But this still requires complex mental coordination between multiple input streams while maintaining focus on learning objectives.

Text-based instruction eliminates split attention entirely.

(There are deeply-rooted cultural and historical reasons for the distrust of text.)

Learners process information through one coherent channel that naturally supports sequential, analytical thinking.

The damage control principles in Richard Mayer’s principles

Step back from individual findings and Mayer’s principles reveal themselves as damage control.

The coherence principle removes distractions that multimedia introduces.

The redundancy principle eliminates conflicts between competing inputs.

The segmenting principle provides control that multimedia complexity demands.

The pre-training principle prepares learners for cognitive challenges that simpler instruction avoids.

Each principle represents additional design constraints requiring specialized expertise and extensive testing.

They exist because multimedia instruction is fundamentally problematic.

Text extends Richard Mayer’s logic

At The Geneva Learning Foundation, we work with 70,000 health practitioners using text-based peer learning.

Nigerian practitioners write about extreme heat forcing people to sleep outdoors, increasing malaria exposure.

Colleagues in Brazil, Chad, Ghana, and India read these accounts, analyze climate-health connections, and provide structured feedback through expert-designed rubrics.

No graphics.

No audio coordination.

No split attention problems.

Read our article: Against chocolate-covered broccoli: text-based alternatives to expensive multimedia content

Direct engagement with content that supports rather than complicates learning.

This approach achieves Richard Mayer’s goals through elimination rather than optimization.

Ultimate coherence by presenting only essential information.

Zero redundancy through single-channel processing.

Natural segmenting through text’s inherent reader control.

No pre-training needed because text presents information in logical, sequential structures.

The multimedia principle reconsidered

Mayer’s most famous finding – people learn better from words and pictures than words alone – deserves scrutiny.

This emerged from comparing passive multimedia consumption to passive text reading.

It equates learning with recall.

Neither condition included structured peer interaction, collaborative analysis, or iterative revision that characterize more complex learning.

When learners create knowledge through text-based peer learning, they achieve outcomes that passive consumption of any media cannot match.

The effect size for active text-based learning exceeds Mayer’s multimedia findings while avoiding cognitive coordination problems.

The economic evidence

Mayer’s ten principles exist because multimedia design is expensive and complex.

Each principle represents additional constraints demanding specialized expertise.

Typical multimedia modules are expensive.

Text-based peer learning costs a fraction of this amount while producing superior outcomes.

Resources should flow toward learning infrastructure such as expert rubrics and facilitated dialogue – elements that actually drive learning rather than manage cognitive problems.

The real choice

Educational technology leaders face a fundamental decision: invest in managing multimedia’s problems or adopt approaches that avoid those problems entirely.

Mayer’s research illuminates multimedia’s cognitive costs.

His ten principles represent sophisticated damage control, not learning enhancement.

They minimize harm rather than maximize potential.

Text-based instruction honors Mayer’s deeper insights while rejecting surface implications.

It achieves the cognitive efficiency his principles attempt to restore to multimedia environments.

References

Berrocal, Y., Regan, J., Fisher, J., Darr, A., Hammersmith, L., Aiyer, M., 2021. Implementing Rubric-Based Peer Review for Video Microlecture Design in Health Professions Education. Med.Sci.Educ. 31, 1761–1765. https://doi.org/10.1007/s40670-021-01437-1
Clark, R.C., Mayer, R.E. (Eds.), 2016. e‐Learning and the Science of Instruction: Proven Guidelines for Consumers and Designers of Multimedia Learning, 1st ed. Wiley. https://doi.org/10.1002/9781119239086
Feenberg, A. The written world: On the theory and practice of computer conferencing. Mindweave: Communication, computers, and distance education 22–39 (1989).
Mayer, R.E., 2008. Applying the science of learning: Evidence-based principles for the design of multimedia instruction. American Psychologist 63, 760–769. https://doi.org/10.1037/0003-066X.63.8.760
Mayer, R.E., 2005. Cognitive Theory of Multimedia Learning, in: Mayer, R. (Ed.), The Cambridge Handbook of Multimedia Learning. Cambridge University Press, pp. 31–48. https://doi.org/10.1017/CBO9780511816819.004
Mayer, R.E., Heiser, J., Lonn, S., 2001. Cognitive constraints on multimedia learning: When presenting more material results in less understanding. Journal of Educational Psychology 93, 187–198. https://doi.org/10.1037/0022-0663.93.1.187
Mayer, R.E., Moreno, R., 2003. Nine Ways to Reduce Cognitive Load in Multimedia Learning. Educational Psychologist 38, 43–52. https://doi.org/10.1207/S15326985EP3801_6
Mayer, R.E., Moreno, R., 2002. Animation as an Aid to Multimedia Learning. Educational Psychology Review 14, 87–99. https://doi.org/10.1023/A:1013184611077
Plass, J.L., Chun, D.M., Mayer, R.E., Leutner, D., 2003. Cognitive load in reading a foreign language text with multimedia aids and the influence of verbal and spatial abilities. Computers in Human Behavior 19, 221–243. https://doi.org/10.1016/S0747-5632(02)00015-8
Sweller, J., 2005. Implications of Cognitive Load Theory for Multimedia Learning, in: Mayer, R. (Ed.), The Cambridge Handbook of Multimedia Learning. Cambridge University Press, pp. 19–30. https://doi.org/10.1017/CBO9780511816819.003

How practitioners in Ukraine and across Europe built a self-sustaining peer learning network to support children

Reda Sadki September 11, 2025Global health

When military fathers started arriving at her centre in Bulgaria, sharing challenges they faced with their own children, Irina V. found herself drawing on lessons learned not from textbooks, but from conversations with fellow practitioners scattered across a war zone.

“What I learned about providing psychological first aid (PFA) to children actually helped me in working with parents of children in crisis,” Irina explained during a recent video call with professionals across Europe supporting children affected by the humanitarian crisis in Ukraine.

That call was the first annual meeting of an entirely volunteer-driven network of practitioners – some working within kilometres of active combat – who teach each other how to better support children. This network emerged from an innovative certificate peer learning programme supported by the European Union’s EU4Health programme, developed by The Geneva Learning Foundation (TGLF) with the International Federation of Red Cross and Red Crescent Societies (IFRC).

An organization like “Everything will be fine Ukraine” maintains operations within 20 kilometres of active fighting while supporting 6,000 children across three eastern regions. During online peer learning activities, some participants manage air raid interruptions, power outages, and repeated displacement of both staff and families they serve.

“The most powerful solutions often emerge when professionals can learn directly from each other’s experience,” TGLF’s Charlotte Mbuh noted. “But knowledge sharing and learning are necessary but insufficient. Through the ‘Accelerator’ mechanism, we showed that participation results in measurable improvements in children’s wellbeing.”

Learning in crisis

The programme that connected Irina to her peers has achieved something that aid organizations typically spend years trying to build. In less than a year, 331 organizations representing 10,000 staff and volunteers joined a peer learning network that now reaches over one million Ukrainian children. Ninety-one volunteers across 13 countries now serve as focal points, recruiting participants and adapting materials to local contexts. The cost per participant is 87 per cent lower than European training averages. And rather than winding down as initial funding expires, the network is expanding.

Most remarkably, 76 per cent of participants are based in Ukraine itself—not in the European host countries the programme originally planned to serve.

IFRC’s longstanding commitment to integrating mental health into humanitarian response created the institutional framework that made this achievement possible. Speaking at the EU4Health final event in Brussels in June, IFRC Regional Director for Europe Birgitte Bischoff Ebbesen called IFRC’s effort “the most ambitious targeted mental health and psychosocial support response in the history of the Red Cross and Red Crescent.”

TGLF’s specific focus was to explore how online peer learning could support Red Cross staff and volunteers, together with other organizations and networks that support children.

IFRC’s Panu Saaristo explains: “Peer learning creates a horizontal approach where practitioners facing similar challenges can support each other directly. This is really consistent with our community-led and volunteer-driven action led by local volunteers. When tools and approaches are shared peer-to-peer, we see solutions that are both more sustainable and more locally owned.”

The power of learning from and supporting each other

What makes this network different is its rejection of the traditional aid model, where experts tell local workers what to do. Instead, practitioners learn from and support each other.

The approach addresses a fundamental problem in crisis response: conventional training cannot keep pace with rapidly evolving challenges on the ground. When a teacher in Poland encounters a child showing signs of distress linked to their experiences, she can connect within hours to a social worker in Ukraine who has dealt with similar cases.

Katerina W., who worked with Ukrainian refugee students in Slovakia, described creating “safe corners” and “art corners” where children could communicate when trauma left them unable to speak. She shared these techniques not with a supervisor, but with hundreds of peers facing similar challenges across Europe.

“The practical knowledge and real-life examples inspired me to adapt my methods and approach challenges with greater empathy and creativity,” said Jelena P., an education professional from Croatia who participated in the network.

Jennifer R., who founded Teachers for Peace to provide free online lessons to war-affected Ukrainian children, explains the urgent need: “Many of my students show signs of distress that affected their learning. My challenge is to equip volunteer teachers with the right tools so they can feel confident and support the students beyond language learning.”

Building something that lasts

The network provides resources for what aid workers call “psychological first aid” or “PFA” for children—the immediate support provided to children experiencing crisis-related distress. This includes listening without pressure, addressing immediate needs, and connecting children with appropriate services.

But the real innovation lies in how knowledge spreads and gets turned into action. Practitioners connect to share challenges and problem-solve solutions. The agenda emerges from their actual needs, not predetermined curricula.

“At traditional training, we acquire knowledge and practice skills to get diplomas or certificates,” explained Anna Nyzkodubova, a Ukrainian PFA leader who became a facilitator to support her colleagues. “But here, when we learn through peer-to-peer principles, we grow professionally and make our contribution to solving real cases and real challenges.”

This peer learning model has proven so effective that the Geneva Learning Foundation announced in August it would continue the programme for five additional years.

“We saw that amongst those we had reached, this included practitioners working close to the front lines of armed conflict, working in very difficult conditions,” said Reda Sadki, Executive Director of The Geneva Learning Foundation, which coordinates the network. “Rather than limiting effectiveness, these challenging conditions revealed significant demand for peer learning. This is why we decided to continue these activities.”

Scale through connection

The network’s growth defies conventional wisdom about aid work. Rather than adding overhead, the growing size of the network enhances learning by providing more diverse experiences and perspectives. A social worker in eastern Ukraine might develop an approach that helps a teacher in Croatia facing similar challenges.

Participants access six different types of activities, from short self-guided modules in multiple languages to intensive month-long programs where they implement specific projects and document results. The variety accommodates practitioners with different schedules and experience levels while maintaining quality through peer review and a strong child protection and mutual support framework.

A different kind of aid

The programme represents a broader shift in how international assistance might work. Rather than extracting knowledge from affected communities to inform distant decision-makers, it amplifies local expertise and creates connections between practitioners facing similar challenges.

For Irina, working with Ukrainian refugees far from her home country, the network provided something invaluable: the knowledge that she was not alone, and that solutions existed within her professional community.

“I realized the importance of separating psychotherapeutic long-term assistance and psychological first aid, especially when working with children who may be at risk of harming themselves,” she said, describing an insight that emerged from group discussions about recognizing when cases require specialist referral.

As the programme enters its next phase, its founders are proposing additional innovations, including apps where practitioners can log experiences and reflect on challenges while building evidence of what works across different contexts.

The model suggests a fundamental reimagining of how knowledge can strengthen local action in crisis response—not from experts to recipients, but between peers who understand each other’s reality because they live it every day. If properly supported, this model could reinforce its importance in the blueprint for future humanitarian action.

References

Sadki, R., 2025. How practitioners in Ukraine and across Europe built a self-sustaining peer learning network to support children. https://doi.org/10.59350/25pa2-ddt80
Sadki, R., 2025. PFA Accelerator: across Europe, practitioners learn from each other to strengthen support to children affected by the humanitarian crisis in Ukraine. https://doi.org/10.59350/redasadki.21155
Sadki, R., 2025. Peer learning for Psychological First Aid: New ways to strengthen support for Ukrainian children. https://doi.org/10.59350/dgpff-n9d63
Sadki, R., 2024. Support of children affected by the humanitarian crisis in Ukraine: Bridging practice and learning through the sharing of experience. https://doi.org/10.59350/zbb4v-hay69
The Geneva Learning Foundation and the International Federation of Red Cross and Red Crescent Societies, 2025. Діти у кризових ситуаціях, спільноти підтримки – Застосування першої психологічної допомоги для підтримки дітей, які постраждали від гуманітарної кризи в україні. https://doi.org/10.5281/ZENODO.14901474
The Geneva Learning Foundation, International Federation of Red Cross and Red Crescent Societies, 2025. Children in Crisis, Communities of Care – Psychological first aid for children affected by the humanitarian crisis in Ukraine. https://doi.org/10.5281/ZENODO.14732092
The Geneva Learning Foundation and the International Federation of Red Cross and Red Crescent Societies, 2024. Перша психологічна допомога дітям, які постраждали внаслідок гуманітарної кризи в Україні – Досвід дітей, опікунів та помічників. https://doi.org/10.5281/ZENODO.13730132
The Geneva Learning Foundation and the International Federation of Red Cross and Red Crescent Societies, 2024. Psychological first aid in support of children affected by the humanitarian crisis in Ukraine: Experiences of children, caregivers, and helpers. https://doi.org/10.5281/ZENODO.13618862

The initial development and implementation of this programme (2023-2025) was funded by the European Union through a project partnership with the International Federation of Red Cross and Red Crescent Societies (IFRC). All ongoing activities, content, and their delivery from 1 September 2025 are the sole responsibility of The Geneva Learning Foundation (TGLF).

Certificate peer learning programme for equity in research and practice

From diagnosis to duty: health workers confront their own role in inequity

Reda Sadki September 11, 2025Global health

A thirteen-year-old girl in Nigeria, bitten by a snake, arrived at a hospital with her frantic family. The hospital demanded payment before administering the antivenom. The family could not afford it. The girl died.

This was one of the stark stories shared by health professionals on September 10, 2025, during “Exploration Day,” the third day of The Geneva Learning Foundation’s inaugural peer learning exercise on health equity. The previous day had been about diagnosing the external systems that create such tragedies. But today, the focus shifted.

“Yesterday, we looked at the problem,” said TGLF facilitator Dr María Fernanda Monzón. “Today, we look in the mirror. We move from analyzing the situation to analyzing ourselves, our own role, our own power, and our own assumptions”.

The practitioner’s role

The day’s intensive, small-group workshops challenged participants to move beyond naming a problem to questioning their own connection to it. Groups brought their findings back to the plenary, where the work of exploration continued.

Oyelaja Olayide, a medical laboratory scientist from Nigeria, presented her group’s analysis of a child’s death following a lab misdiagnosis. The group’s root cause analysis pointed to a systemic issue: the lack of a quality management system in the laboratory. But then the facilitator turned the question back to her. “What was your role in this?”.

The question hung in the air, shifting the focus from an abstract system to individual responsibility. This pivot is central to the learning process, and the cohort’s diversity is a core element of its design. The majority of participants are frontline health workers—nurses, midwives, doctors, and community health promoters. They work side-by-side as peers with national-level staff and international partners, with government employees making up over 40% of the group. This mix intentionally breaks down traditional hierarchies, creating a space where a policy-maker can learn directly from the lived experience of a clinician in a remote village.

Learn more about the Certificate peer learning programme for equity in research and practice https://www.learning.foundation/bias

After a moment of reflection, Olayide acknowledged her role as a professional with the expertise to see the gap. “My role is to be an advocate,” she concluded, recognizing her duty to push for the implementation of quality control systems that could prevent future tragedies.

From reflection to a plan for action

This deep self-reflection is the foundation for the next stage of the process: creating a viable action plan. For the remainder of the day, participants worked on the third part of their course project, which is due by the end of the week.

The programme’s methodology insists that a good plan is not made for a community, but with a community. Participants were guided to develop action steps that involve listening to the people most affected and ensuring they help lead the change. This requires practitioners to think honestly about their position and power and how they can share it to empower others.

The day’s exploration pushed participants beyond easy answers. It asked them to confront their own biases, acknowledge their power, and accept their professional duty not just to treat patients, but to help fix the broken systems that make them sick. By turning the analytical lens inward, they began to forge the tools they need to build a more equitable future.

About the Certificate peer learning programme for equity in research and practice

The Geneva Learning Foundation is an organization that helps health workers from around the world learn together as equals. It offers the Certificate peer learning programme for equity in research and practice, where health professionals work with each other to make health care more fair for everyone, both in how care is given and in how health is studied. The first course in this program is called EQUITY-001 Equity matters, which introduces a method called HEART. This method helps you turn your experience into a real plan for change. HEART stands for Human Equity, Action, Reflection, and Transformation. This means you will learn to see unfairness in health (Human Equity), create a practical plan to do something about it (Action), think carefully about the problem to find its root cause (Reflection), and make a lasting, positive change for your community (Transformation).

The practitioner as catalyst: How a global learning community is turning frontline experience into action on health inequity

Reda Sadki September 10, 2025Global health

“In this phase of my life, I want to work directly with the communities to see what I can do,” said Dr. Sambo Godwin Ishaku, a public health leader from Nigeria with over two decades of experience. His words opened the second day of The Geneva Learning Foundation’s first-ever peer learning exercise on health equity. They also spoke to the very origin of the event itself.

The Geneva Learning Foundation’s Certificate peer learning programme for equity in research and practice was created because thousands of health workers like Dr. Ishaku joined a global dialogue about equity and demanded a new kind of learning—one that moved beyond theory to provide practical tools for action.

This inaugural session on 9 September 2025, called “Discovery Day,” was a direct answer to that call. It was not a lecture, but a three-hour, high-intensity workshop where the participants’ own experiences of inequity became the curriculum.

The goal for the day was one step in a carefully designed 16-day process: to help practitioners see a familiar problem in a new way, setting the stage for them to build a viable action plan they can use in their communities.

The anatomy of unfairness

The session began with practitioners sharing true stories of systemic failure. These accounts gave a human pulse to the clinical definition of health inequity: the avoidable and unjust conditions that make it harder for some people to be healthy.

To demonstrate how to move from story to analysis, the entire cohort engaged in a collective diagnosis. They focused on a first case presented by Dr. Elizabeth Oduwole, a retired physician, about a 65-year-old man unable to afford his diabetes medication on a meager pension. Together, in a live plenary, they used a simple analytical tool to excavate the root causes of this single injustice.

The tool, known as the “Five Whys,” is less about power and more about simplicity. Its strength lies in its accessibility, providing a common language for a cohort of remarkable diversity. In this programme, community health workers, doctors, nurses, midwives, and others who work for health on the front lines of service delivery make up the majority of participants. They work side-by-side as peers with national-level staff and international partners. Government staff comprise over 40% of the group.

The group’s collective intelligence peeled back the layers of Dr. Oduwole’s story. The man’s inability to afford medicine was not just about poverty (Why #1) , but about a lack of government policy for the elderly (Why #2). This, in turn, was linked to a lack of advocacy (Why #3) , which stemmed from biased social norms that devalue the lives of older adults (Why #4). The root cause they uncovered was a deep-seated cultural belief, passed down through generations, that this was simply the natural order of things (Why #5). In minutes, the problem had transformed from a financial issue into a profound cultural challenge.

A crucible for discovery

With this shared experience, the practitioners were plunged into a rapid series of timed, small-group workshops. In these intense breakout sessions, they applied the same methodology to situations each group identified.

The stories that emerged were stark. One group analyzed the experience of a participant from Nigeria whose father died after being denied oxygen at a hospital because the only available tank was being reserved for a doctor’s mother. Their analysis traced this act back to a root cause of systemic decay and a breakdown in the ethics of the health profession. Another group tackled the insidious spread of health misinformation preventing rural girls in a conflict-afflicted area from receiving the HPV vaccine, identifying the root cause as an inadequate national health communication strategy.

A learning community was born in these workshops. They became a crucible where practitioners, often isolated in their daily work, connect with peers who understand their struggles. By unpacking a real-world problem together, they practice the skills needed for their final course project: a practical action plan due at the end of the week, which they will then have peer-reviewed and revised.

The process is designed to generate unexpected insights. Day 2, “Discovery,” is followed by Day 3, “Exploration,” both dedicated to this intensive peer analysis. By the end of the journey, each participant will have an action plan to tackle a local challenge, one that is often radically different from what they might have first envisioned, because it targets a newly discovered root cause.

The session ended, as it began, with the voices of health workers. The chat filled with a sense of energy and purpose. “We are all eager to learn, to know more, and to make an equitable Africa,” wrote Vivian Abara, a pre-hospital emergency services responder . “We’re really, really ready to go the whole nine yards and do everything, help ourselves, hold each other’s hand and move.”

About The Geneva Learning Foundation

The Geneva Learning Foundation is an organization that helps health workers from around the world learn together as equals. It offers the Certificate peer learning programme for equity in research and practice, where health professionals work with each other to make health care more fair for everyone, both in how care is given and in how health is studied. The first course in this programme is called EQUITY-001 Equity matters, which introduces a method called HEART. This method helps you turn your experience into a real plan for change. HEART stands for Human Equity, Action, Reflection, and Transformation. This means you will learn to see inequity in health (Human Equity), create a practical plan to do something about it (Action), think carefully about the problem to find its root cause (Reflection), and make a lasting, positive change for your community (Transformation).

From Murang’a to the world: remembering Joseph Ngugi, champion of peer learning for community health

Reda Sadki August 1, 2025Global health, Leadership

“What keeps me going now is the excitement of the clients who receive the service and the sad faces of those clients who need the services and cannot get them.” Joseph Mbari Ngugi shared these words on May 30, 2023, capturing the profound empathy and dedication that defined his life’s work. This commitment to serving those most in need—and his deep awareness of those still unreached—characterized not only his career as a senior community health officer and public health specialist in Kenya’s Murang’a County, but also his extraordinary five-year journey through the Geneva Learning Foundation’s most rigorous learning programmes.

It was the morning of the first day of August, 2025. The message from his daughter was simple and devastating: “Hello this is Wanjiru Mbari Ngugi’s Daughter. I am the one currently with his phone. This is to inform you that Dad passed away this morning.”

Joseph’s passing represents more than the loss of a dedicated health worker in Kenya’s Murang’a County. It marks the end of an extraordinary journey that saw him evolve from participant to peer mentor within the Geneva Learning Foundation’s learning networks—a community where over 60,000 practitioners now connect across country borders and between continents to learn from and support each other to solve problems and drive change from the ground up.

Joseph Ngugi: The making of a global health scholar

Over the years, Joseph shared his personal story. His path to leadership in this global community began with family tragedy. “When I was young, my sister contracted malaria number of times, leading to numerous hospital visits and long periods of missed school,” he told us. “These experiences were not only distressing but also financially draining for my family, as medical costs piled up and my parents had to take time off work to care for her.” That childhood experience of watching illness devastate a family became the foundation for his professional mission.

In November 2020, when the world was grappling with the challenges of the COVID-19 pandemic, Joseph joined the Foundation’s COVID-19 Peer Hub—a groundbreaking initiative launched in April 2020 that connected over 6,000 health professionals from 86 countries to face the early consequences of the pandemic. Unlike traditional training programmes that positioned experts as sole knowledge sources, the Peer Hub recognized that frontline workers like Joseph possessed crucial insights about overcoming vaccine hesitancy that needed to be shared across borders.

The timing was significant. When news of the first vaccines came, participants decided to examine how they had previously helped communities move “from hesitancy to acceptance of a vaccine.” Joseph’s case study, developed through peer collaboration between November and December 2020, drew on his extensive experience with routine immunization programs in Murang’a County. His documented approach to building trust with communities became a teaching resource for colleagues across Africa and beyond—knowledge that would prove invaluable when COVID-19 vaccines began arriving in Africa months later, starting with Ghana and Côte d’Ivoire in March 2021.

Joseph Ngugi: The Scholar’s progression

Joseph’s engagement with what would become the Movement for Immunization Agenda 2030 (IA2030) reflected his deepening sophistication as both learner and teacher. The Movement initiative, launched globally in support of the ambitious aims of the world’s immunization strategy to leave no one behind, required more than technical knowledge—it demanded practitioners who could analyze complex local challenges and adapt global strategies to diverse contexts.

Starting with the WHO Scholar Level 1 certification in 2021, Joseph mastered the Foundation’s approach to structured problem-solving. But it was his progression to the 2022 Full Learning Cycle, where he earned certification with distinction, that revealed his true analytical capabilities. His systematic deconstruction of vaccine storage challenges in Murang’a County exemplified this growth.

Rather than accepting equipment failures as inevitable, Joseph deployed rigorous root cause analysis: “Why are vaccines not stored properly? Because the refrigeration units are often outdated or malfunctioning.” But he didn’t stop there. Through five levels of inquiry, he traced the problem to its fundamental source: “The most important root cause: inadequate training and information dissemination among healthcare workers and administrators.”

This insight—that knowledge gaps, not resource constraints, lay at the heart of vaccine storage failures—helped colleagues in other countries to address similar challenges in very different contexts.

Joseph Ngugi: From local practice to global knowledge

Joseph’s work exemplified how the Foundation’s network transforms individual insights into collective wisdom. His malaria prevention campaigns in Murang’a County carried particular personal significance—having witnessed his sister’s repeated malaria infections as a child, he understood intimately how the disease devastated families. Now, as a health professional, he could take systematic action to prevent other families from experiencing similar suffering.

“Local leaders, health workers, and volunteers went door-to-door distributing nets and educating families about their importance,” he shared. “The project was successful due to the collaborative effort and the support of local influencers who championed the cause. This grassroots approach helped build trust and ensured widespread adoption of bed nets.” The boy who had watched helplessly as his sister endured “numerous hospital visits and long periods of missed school” had become the health worker who could mobilize entire communities for prevention.

Meanwhile, his immunization work achieved impressive results by using lessons learned and shared across the network. His measurable success spoke to the power of peer-tested approaches: “My county was listed in 2nd position with 95% with the highest percentage of children (aged 12-23 months) who are fully vaccinated for basic antigens as per basic schedule compared with the leading at 96% and the lowest with 23%.”

Through peer learning that he helped facilitate – giving and receiving feedback– both his malaria prevention methods and immunization strategies became available to thousands of colleagues facing similar challenges. When global immunization leaders engaged with TGLF’s network, asking for feedback on a new framework to support integration of immunization into primary health care, Joseph’s feedback illustrated this knowledge multiplication effect. “I have referred to [the] framework more than once and shared with my colleagues and supervisors and it has been very useful,” he reported. “My colleagues were excited to know such a tool existed and were ready to use it. The framework made a difference in solving the vaccine advocacy as it has the solutions to most of my challenges.”

Joseph Ngugi: Crisis leadership in a changing climate

When Kenya’s devastating 2019 floods tested every assumption about health service delivery, Joseph emerged as an innovative crisis leader whose documented responses became learning resources for the Foundation’s growing focus on climate change and health. His detailed accounts revealed both the scale of climate disruption and the ingenuity required to maintain health services under extreme conditions.

Working with local government and humanitarian agencies, Joseph helped coordinate emergency airlifts using helicopters to deliver essential medical supplies to isolated communities, with the Kenya Red Cross playing a critical coordination role. When helicopter transport was unavailable, his team improvised: “We resorted to unconventional means, such as using motorbikes and porters to deliver medicines to stranded populations.”

His documentation captured both community solidarity and the chaos of disaster response: “People were incredibly supportive, offering shelter and food to those displaced. Local youth groups helped clear debris from roads, making some areas passable. On the other hand, there were instances of looting of medical supplies during the chaos, which slowed down our efforts.”

Joseph’s prescient observations about the health impact of climate patterns became increasingly relevant: “Over the years, I’ve noticed that such weather-related disruptions have become more frequent and severe, a clear sign of climate change. The rainy seasons are no longer predictable, and their intensity often overwhelms existing infrastructure.” His first-hand accounts became part of a growing body of evidence showing how health workers worldwide are witnessing climate change impacts firsthand—knowledge that often precedes formal scientific documentation by years.

Joseph Ngugi, the equity advocate

Perhaps nowhere was Joseph’s moral clarity more evident than in his systematic approach to health equity challenges. When he witnessed an elderly rural woman being ignored at a hospital registration desk while younger, well-dressed patients received immediate attention, he documented both his direct intervention and his proposed systemic solutions.

“I later engaged hospital staff in a discussion about unconscious bias and the need to treat all patients with dignity,” he explained. His characteristically systematic solution—implementing a token system for patient queuing that would ensure first-come, first-served service regardless of appearance or language—provided concrete guidance that colleagues could adapt to their own contexts.

Joseph’s approach to neglected tropical diseases demonstrated similar principled persistence. Working on lymphatic filariasis in Murang’a County, he documented comprehensive community intervention approaches that included support groups for affected patients and collaboration with traditional healers to address cultural misconceptions. “Building partnerships and fostering ownership within the community were crucial in sustaining our efforts and driving positive change,” he noted—an insight that resonated across the Foundation’s network of practitioners facing similar challenges with stigmatized conditions.

A family committed to learning

Joseph’s commitment to collaborative learning extended to his household. His wife Caroline participated alongside him in Foundation activities, making their home a center of both local health advocacy and global knowledge sharing. Caroline documented her own community engagement successes: “Positive response from the community on the importance of taking their children for immunization. Able to reach pregnant mothers and sensitized them the importance of starting antenatal care clinic early.”

Their partnership embodied the Foundation’s philosophy that effective global health work requires both deep local engagement and broad network connections. Joseph’s honest assessment of community health work captured both its frustrations and profound rewards: “The worst part of my job is when you reach out to the community for services and [they] are not willing. The best part is when you reach the community members and they listen to you and hear what you have brought in the ground.”

The pioneer’s final exploration

Even in his final months, Joseph continued pushing boundaries in ways that reflected his lifelong commitment to innovation. His recent exploration of artificial intelligence tools as potential aids to health work represented not disengagement from human learning but rather his latest attempt to incorporate emerging capabilities into community health practice—a continuation of the innovative thinking that had characterized his entire journey with the Foundation.

For The Geneva Learning Foundation’s Executive Director Reda Sadki, Joseph was “a pioneer exploring the use of artificial intelligence” within global health contexts, demonstrating how practitioners could thoughtfully experiment with new technologies while maintaining focus on community needs.

A voice that bridged worlds

From November 2020 through August 2025, Joseph Ngugi completed an extraordinary progression through the Foundation’s most demanding programmes: the COVID-19 Peer Hub, WHO Scholar Level 1 certification, the Movement for Immunization Agenda 2030’s first Full Learning Cycle with distinction, Impact Accelerator certifications, and advanced collaborative work with the Nigeria Movement for Immunization Agenda 2030, which connected over 4,000 participants across Nigeria’s diverse health system.

His Nigeria collaborative work, completed in July 2024, demonstrated his evolution into a mentor for colleagues in countries other than his own, facing similar challenges. Through structured peer review processes and collaborative root cause analyses, Joseph helped dozens of Nigerian health workers develop their own systematic approaches to immunization challenges—knowledge that will continue influencing practice long after his passing.

“What I have learned from sharing photos and seeing photos from colleagues: we share common challenges, challenges are everywhere, love for human being is universal, health is wealth, immunization is the best investment in the world,” he wrote, capturing the spirit of global solidarity that sustained his work and connected him to practitioners worldwide.

A legacy of networked learning

Joseph Mbari Ngugi’s death leaves a profound void in a global learning network where his thoughtful analyses, generous mentorship, and systematic documentation created lasting value for thousands of colleagues. His comprehensive body of work—from detailed root cause analyses to innovative crisis responses, from equity advocacy to climate adaptation strategies—represents one of the most complete records of how a dedicated practitioner can evolve into a sophisticated analyst and effective advocate through structured peer learning.

His progression from childhood dreams inspired by witnessing healthcare compassion to becoming a leader in global health networks demonstrates the transformative potential of connecting local practice with worldwide learning communities. In an era of unprecedented health challenges—from climate change to emerging diseases to persistent inequities—Joseph’s documented approach offers a roadmap for practitioners worldwide seeking to make systematic change while remaining deeply rooted in their communities.

Joseph Ngugi’s voice may now be silent, but his contributions continue speaking through the colleagues he mentored, the frameworks he helped refine, and the thousands of health workers who will encounter his insights through the Foundation’s ongoing work. His legacy reminds us that the most effective global health leadership often emerges not from traditional hierarchies but from practitioners who combine deep local knowledge with the courage to share their experiences across borders, creating networks of learning that can respond to our world’s most pressing challenges with both precision and compassion.

Photo credit: Matiba Eye and Dental Hospital, Murang’a County Kenya. Joseph Mbari Ngugi submitted this photo for World Immunization Week in 2023. Here is what he told us about the image: “This is me, and Grace M Kihara, nursing officer, on the 15th of March 2023 at the Kenneth Matiba Eye and Dental Hospital in Murang’a County, Kenya. My work includes explaining to clients the importance of measles immunization and other vaccines, and advocating for immunization.”

Climate change and health: a new peer learning programme by and for health workers from the most climate-vulnerable countries

Reda Sadki July 23, 2025Global health

GENEVA, Switzerland, 23 July 2025 (The Geneva Learning Foundation) –Today, The Geneva Learning Foundation (TGLF) announces the launch of “Learning to lead change on the frontline of climate change and health,” the inaugural course in a new certificate programme designed by and for professionals facing climate change impacts on health.

Enrollment is now open. The course will launch on 11 August 2025.

English: https://go.learning.foundation/tglf/c/20132
French: https://go.learning.foundation/tglf/c/21450

Two years ago today, nearly 5,000 health professionals from across the developing world gathered online for an unprecedented conversation. They shared something most climate scientists had never heard: detailed, firsthand accounts of how rising temperatures, extreme weather, and environmental changes were already devastating the health of their communities.

The stories were urgent and specific. A nurse in Ghana described managing surges of malaria after unprecedented flooding. A community health worker in Bangladesh explained how cholera outbreaks followed every major storm. A pharmacist in Nigeria watched children suffer malnutrition as crops failed during extended droughts.

“I can hear the worry in your voices,” one global health partner told participants during those historic July 2023 events, “and I really respect the time that you are giving to tell us about what is happening to you directly.”

Connecting the dots from individual impact to systemic crisis

While climate change dominates headlines for its environmental and economic impacts, a parallel health crisis has been quietly unfolding in clinics and hospitals across Africa, Asia, and Latin America. Health workers have become first-hand witnesses to climate change’s human toll.

Dr. Seydou Mohamed Ouedraogo from Burkina Faso described devastating floods that “really marked the memory of the inhabitants” and led to cascading health impacts.

Felix Kole from Gambia reported that “wells have turned to salty water” due to rising sea levels, while extreme heat meant “people are no longer sleeping inside their houses,” creating new security and health complications.

Rebecca Akello, a public health nurse from Uganda, documented malnutrition impacts directly: “During dry spells where there is no food, children come and their growth monitoring shows they really score low weight for age.”

Health professionals like Dr. Iktiyar Kandaker from Bangladesh already get that this is a systemic challenge: “Our health system is not prepared to actually address these situations. So this is a combined challenge… but it requires a lot of time to fix it.”

These health workers serve as what TGLF calls “trusted advisors”—over half describe themselves as being like “members of the family” to the populations they serve. Yet until now, they have had no structured way to learn from each other’s experiences or develop coordinated responses to climate health challenges.

Learning from those who know because they are there every day

“It is something that all of us have to join hands to be able to do the most we can to educate our communities on what they can do,” said Monica Agu, a community pharmacist from Nigeria who participated in the founding 2023 events. Her words captured the collaborative spirit that has driven the programme’s development.

The new certificate programme employs TGLF’s proven peer learning methodology, recognizing that health workers are already implementing life-saving climate adaptations with limited resources. During the 2023 events, participants shared examples of modified immunization schedules during heat waves, cholera outbreak management after flooding, and maintaining health services during extreme weather events.

“We believe that investing in health workers is one of the best ways to accelerate and strengthen the response to climate change impacts on health,” explains TGLF Executive Director Reda Sadki.

The programme has been developed from comprehensive analysis of health worker experiences documented since 2023. Most observations come from small and medium-sized communities in the most climate-vulnerable countries.

For health, a different kind of climate action

Unlike traditional climate programmes focused on policy or infrastructure, this initiative recognizes that effective climate health responses must be developed by those experiencing the impacts firsthand. The course enables health workers to share their own experiences, learn from colleagues facing similar challenges, and develop both individual and collective responses.

Dr. Eme Ngeda from the Democratic Republic of Congo captured this approach during the 2023 events: “We are all responsible for these climate disruptions. We must sensitize our populations in waste management and sensitize how to reform our healthcare providers to face resilience, face disasters.”

The programme connects leaders from more than 4,000 locally-led health organizations through TGLF’s REACH network, enabling them to become programme partners supporting their health workers in developing climate-health leadership skills.

Building global solutions by connecting local, indigenous knowledge and expertise

The inaugural course offers health professionals worldwide the opportunity to learn from documented experiences of colleagues who are facing unprecedented consequences of climate change on health. Rather than lectures or theoretical frameworks, the programme employs structured reflection and peer feedback cycles, enabling participants to develop actionable implementation plans informed by peer knowledge and global guidance.

The course covers four key areas based on health worker experiences:

Climate and environmental changes: Recognizing connections between climate and health in local communities.
Health impacts on communities: Understanding direct health impacts, food security, and mental health effects.
Changing disease patterns: Managing infectious diseases, respiratory conditions, and healthcare access challenges.
Community responses and adaptations: Implementing local solutions and innovations from peer experiences.

Participants earn verified certificates aligned to professional development competency frameworks. Upon completion, they join TGLF’s global community of health practitioners for ongoing peer support and collaboration.

The urgency of now

The programme launches at a critical moment. Climate change impacts on health are accelerating, particularly in low- and middle-income countries where health systems are least equipped to respond. Yet these same regions are producing innovative, resource-efficient solutions that could benefit communities worldwide.

As one health worker reflected during the 2023 events: “Although climate change is a global phenomenon, it is affecting very, very locally people in very different ways.” The new programme acknowledges this reality while creating pathways for local solutions to inform global responses.

The course is available in English and French, designed to work on mobile devices and basic internet connections. It is free for health workers in participating countries.

For health workers who have been managing climate impacts in isolation, the programme offers something unprecedented: the chance to learn from colleagues who truly understand their challenges and to contribute their own expertise to a growing global knowledge base.

As the climate health crisis deepens, the solutions may well come from those who have been living with its impacts longest—if we finally give them the platforms and recognition they deserve.

WHO Global Conference on Climate and Health: New pathways to overcome structural barriers blocking effective climate and health action

Reda Sadki July 22, 2025Global health

After the World Health Assembly’s adoption of ambitious global plan of action for climate and health, global and country stakeholders are meeting in Brasilia for the Global Conference on Climate and Health, ahead of COP30. Three critical observations emerged that illuminate why conventional global health approaches may be structurally inadequate for the challenges resulting from climate change impacts on health.

These observations carry particular significance for global health leaders who now possess a WHA-approved strategy and action plan, but lack proven mechanisms for rapid, community-led implementation in the face of an unprecedented set of challenges. They also matter for major funders whose substantial investments in policy and research have yet to be matched by commensurate support for the communities and health workers who will be the ones to translate better science and policy into action.

Signal 1: When funding disappears and demand explodes

Seventy percent of global health funding vanished, virtually overnight. This collapse comes precisely when the World Health Organization projects a shortage of 10 million health workers by 2030—six million in climate-vulnerable sub-Saharan Africa.

The World Bank calculates that climate change will generate 4.1-5.2 billion disease cases and cost $8.6-20.8 trillion by 2050 in low- and middle-income countries alone. Health systems must simultaneously manage unprecedented demand with drastically reduced resources.

Traditional technical assistance—flying experts to conduct workshops, cascade training through hierarchies—is more difficult to resource. By comparison, peer learning networks can reduce costs by 86 percent while achieving implementation rates seven times higher than conventional methods. Furthermore, 82 percent of participants in such networks continue independently after formal interventions end. Peer learning is especially well-suited to include health workers in conflict zones, refugee settings, and remote areas where climate vulnerability peaks—precisely the locations where traditional expert-led capacity building proves most difficult and expensive.

The funding crisis makes it more of an imperative than ever before to examine which approaches can scale effectively when resources contract. Organizations that recognize this shift early could achieve breakthrough results as traditional approaches become unaffordable.

Signal 2: Global expertise meets local reality

The World Health Assembly continues producing comprehensive action plans backed by thousands of expert hours. The climate and health action plan represents the pinnacle of this approach—technically excellent, evidence-based, globally applicable.

Yet the persistent implementation gap reflects deeper challenges about how knowledge flows between institutions and communities. Current theories of change assume that technical expertise, properly communicated, will lead to improved outcomes. Local knowledge gets framed as “barriers to implementation”, rather than recognized as essential intelligence for adaptation.

This creates a paradox. The WHO recognizes that “community-led initiatives that harness local knowledge and practices” are “fundamental for creating interventions that are both culturally appropriate and effective.” Health workers possess sophisticated understanding of how global frameworks must adapt to local realities. But systematic mechanisms for capturing and integrating knowledge and action remain underdeveloped.

Climate change manifests differently in each community—shifting disease patterns in Kenya differ from changing agricultural cycles in Bangladesh, which differ from altered water availability in Morocco. Health workers witness these changes daily, developing contextual responses that often remain invisible to global institutions. The question becomes whether global frameworks can evolve to recognize and systematically integrate this distributed intelligence rather than treating it as anecdotal evidence.

Signal 3: The policy-people gap widens if field-building ignores communities and is disconnected from local action

Substantial philanthropic funding is flowing toward climate and health policy and evidence generation. Some funders call this “field-building”. Research institutions develop sophisticated models. Policy frameworks become more comprehensive. Scientific understanding advances rapidly. These investments are producing genuinely better science and more effective policies—essential progress that must continue.

Yet investment in communities and health workers—the people who must implement policies and apply evidence—remains disproportionately small. This disparity creates concerning dynamics where knowledge advances faster than the capacity to apply it meaningfully in communities.

The risk extends beyond implementation gaps. When sophisticated policies and evidence develop without commensurate investment in community relationships, communities may reject even superior science and policies—not because they are irrational or too ignorant to recognize the benefits, but because the effort to accompany communities through change has been insufficient. Health workers, as trusted advisors within their communities, are uniquely positioned to bridge this gap by helping communities make sense of new evidence and adapt policies to local realities.

Health workers serve as trusted advisors within communities facing climate impacts. When investment patterns overlook this relationship, sophisticated policies risk becoming irrelevant to the people they aim to help. The trust networks essential for translating evidence into community action – and ensuring that evidence is relevant and useful – receive less attention than the evidence itself.

The pathway forward: Health workers as knowledge creators and leaders of change

These three signals point toward a fundamental misalignment between how global institutions approach climate and health challenges and how communities experience them. The funding crisis makes traditional expert-led approaches unsustainable. Implementation gaps persist because local knowledge remains systematically undervalued. Investment patterns favor sophisticated frameworks over the human relationships needed to apply them effectively.

When a community health worker in Nigeria notices malaria cases appearing earlier each season, or a nurse in Bangladesh observes heat-related illness patterns in specific neighborhoods, they are detecting signals that epidemiological studies might take years to document formally. This represents a form of “early warning system” that current approaches tend to overlook.

Recent innovations demonstrate different possibilities. Networks connecting health practitioners across countries through digital platforms treat health workers as knowledge creators rather than knowledge recipients. Such approaches have achieved, in other fields, implementation rates seven times higher than conventional technical assistance while reducing costs by 86 percent. There is no reason why applying these approaches would not result in similar results.

For the World Health Organization, such approaches could offer pathways to operationalize the Global Plan of Action through the very health workers the organization recognizes as “uniquely positioned” to champion climate action while building essential community trust.

For major funders, these models represent opportunities to complement policy and research investments with approaches that strengthen community capacity to apply sophisticated knowledge to local realities.

The evidence suggests that failure to bridge these gaps could prove more costly than the investment required to close them. But the returns—measured in communities reached, knowledge applied, and trust maintained—justify treating health worker networks as essential infrastructure for climate and health response rather than optional additions.

Three questions for leaders

As leaders prepare for the Global Climate Change and Health conference in Brasilia and begin work to implement climate and health commitments, three questions emerge from the World Health Assembly observations:

For institutions with comprehensive plans: How will technical excellence translate into community-level implementation when traditional capacity building approaches have become economically unsustainable?
For funders investing in research and policy: How can sophisticated evidence and frameworks reach the health workers and communities who must apply them to local realities?
For all climate and health leaders: What happens when policies advance faster than the trust relationships and implementation capacity needed to apply them effectively?

The signals from the World Health Assembly suggest that conventional approaches face structural constraints that incremental improvements cannot address. The funding crisis, implementation gaps, and investment disparities require responses that recognize health workers as partners in creating climate and health solutions rather than merely implementing plans created elsewhere.

The choice is not whether to transform approaches—resource constraints and community realities make transformation inevitable. The choice is whether leaders will direct that transformation toward approaches that strengthen both global knowledge and local capacity, or risk watching sophisticated frameworks fail for lack of community connection and trust.

References

Miller, J., Howard, C., Alqodmani, L., 2024. Advocating for a Healthy Response to Climate Change — COP28 and the Health Community. N Engl J Med 390, 1354–1356. https://doi.org/10.1056/NEJMp2314835

Sanchez, J.J., Gitau, E., Sadki, R., Mbuh, C., Silver, K., Berry, P., Bhutta, Z., Bogard, K., Collman, G., Dey, S., Dinku, T., Dwipayanti, N.M.U., Ebi, K., Felts La Roca Soares, M., Gudoshava, M., Hashizume, M., Lichtveld, M., Lowe, R., Mateen, B., Muchangi, M., Ndiaye, O., Omay, P., Pinheiro Dos Santos, W., Ruiz-Carrascal, D., Shumake-Guillemot, J., Stewart-Ibarra, A., Tiwari, S., 2025. The climate crisis and human health: identifying grand challenges through participatory research. The Lancet Global Health. https://doi.org/10.1016/S2214-109X(25)00003-8

Sadki, R., 2024. Health at COP29: Workforce crisis meets climate crisis. https://doi.org/10.59350/sdmgt-ptt98

Sadki, R., 2024. Strengthening primary health care in a changing climate. https://doi.org/10.59350/5s2zf-s6879

Sadki, R., 2024. The cost of inaction: Quantifying the impact of climate change on health. https://doi.org/10.59350/gn95w-jpt34

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Building global solutions by connecting local, indigenous knowledge and expertise

The urgency of now

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Signal 1: When funding disappears and demand explodes

Signal 2: Global expertise meets local reality

Signal 3: The policy-people gap widens if field-building ignores communities and is disconnected from local action

The pathway forward: Health workers as knowledge creators and leaders of change

Three questions for leaders

References

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