Pour retrouver les enfants congolais non vaccinés, il est question des fumoirs à poisson et du dialogue inter-religieux

Reda SadkiGlobal health

Au deuxième jour de leurs travaux en direct, les professionnels de la santé congolais sont passés de la découverte à l’exploration des causes profondes qui laissent des centaines de milliers d’enfants exposés aux maladies évitables par la vaccination. Ils découvrent que les racines du problème sont souvent là où personne ne les attend: dans l’économie de la pêche, le dialogue avec les églises ou la gestion des camps de déplacés.

Lire également: En République démocratique du Congo, la traque des enfants « zéro dose » passe par l’intelligence collective des acteurs de la santé

Les analyses, plus fines, révèlent des leviers d’action insoupçonnés, démontrant la puissance d’une méthode qui transforme les soignants en stratèges.

« La séance d’hier, c’était une séance de découverte, mais aujourd’hui, c’était une séance d’exploration. Explorer, c’est aller en profondeur. Il faut sonder ».

Ces mots de Fidèle Tshibanda Mulangu, un participant congolais, résument la bascule qui s’est opérée ce mercredi 8 octobre.

Après une première journée consacrée au partage des défis, la dynamique a changé.

L’objectif n’était plus seulement d’identifier les problèmes, mais de les disséquer avec une précision accrue.

Dans le cadre de l’initiative menée par La Fondation Apprendre Genève et ses partenaires — le ministère de la Santé de la RDC, l’UNICEF et Gavi — les participants ont été invités à appliquer une deuxième fois la méthode d’analyse des causes profondes.

L’effet a été immédiat.

« La séance d’hier m’a permis de comprendre que ce que je pensais être une cause profonde n’était qu’une cause intermédiaire », a ainsi partagé Hermione Raissa Tientcheu Ngounou, illustrant la sophistication croissante des analyses.

Le dialogue rompu entre la foi et la santé publique

Au cœur du Kasaï, un groupe de travail a de nouveau abordé la question des églises de réveil hostiles à la vaccination.

Mais cette fois, l’analyse a dépassé le constat d’un obstacle religieux. « Les fidèles, lorsqu’ils tombent malades, ne vont pas dans les structures sanitaires, mais ils préfèrent rester dans des centres de prière », a expliqué le rapporteur du groupe, décrivant une rupture de confiance avec le système de santé formel.

En poussant la réflexion, les participants ont conclu que le vrai problème était « l’absence d’un cadre de concertation formel entre le système de santé et les confessions religieuses ».

La cause profonde n’était donc pas la foi, mais une faillite institutionnelle.

Une prise de conscience qui a immédiatement fait émerger des solutions.

« Dans le contexte des églises de réveil, les leaders de ces églises doivent être nos alliés », a insisté un participant, Mwamialumba Fidel.

Vacciner dans le chaos de la guerre

Dans le Nord-Kivu, une autre discussion a porté sur la vaccination des populations déplacées.

Confrontés à une cause première comme la guerre, hors de leur portée, les soignants ont fait preuve d’un pragmatisme remarquable.

L’analyse ne s’est pas enlisée dans un sentiment d’impuissance.

Le groupe a rapidement identifié une faille concrète dans le système.

« Pour les déplacés, le grand problème est que les enfants arrivent sans carnet de vaccination, et on ne sait pas comment les intégrer dans le PEV de routine », a partagé Clémence Mitongo.

La cause racine n’était donc plus le conflit, mais « le manque de stratégie spécifique pour la prise en charge de ces enfants » une fois en sécurité.

Le groupe a ainsi transformé un problème insoluble en un défi organisationnel sur lequel il est possible d’agir.

Au-delà des frontières, une leçon d’économie locale

La richesse des échanges a été amplifiée par la participation de professionnels d’autres pays.

Un des cas les plus édifiants est venu de Madagascar, où 93 enfants d’un village de pêcheurs n’étaient pas vaccinés.

« Les femmes sont obligées d’accompagner les hommes pour la vente du poisson. Et quand elles reviennent, nos équipes sont déjà parties », a expliqué le rapporteur du groupe.

La cause profonde, révélée par l’analyse, n’avait rien de sanitaire.

C’était l’absence d’un fumoir pour conserver le poisson, qui forçait les femmes à s’absenter.

L’impact de cet exemple a été puissant.

« Ce cas du Madagascar est très édifiant et illustre parfaitement la pertinence de l’analyse approfondie », a commenté Alphonse Kitoga.

Une pédagogie de l’action

Ces cas pratiques illustrent la maturation rapide des participants.

La méthode des « cinq pourquoi », introduite la veille, est devenue un outil maîtrisé, un réflexe analytique.

« C’est une nouvelle approche pour nous », a affirmé Baudouin Mbase Bonganga. « Le fait de travailler en groupe, de partager les expériences, ça nous a vraiment enrichis ».

L’exercice ne vise pas à transmettre un savoir, mais à cultiver une compétence: la capacité de chaque professionnel à devenir un fin diagnosticien des problèmes de sa communauté et un architecte de solutions adaptées.

De l’analyse à l’action

Cette journée d’exploration intensive n’est qu’une étape.

Les participants ont jusqu’au vendredi 10 octobre pour soumettre la première version de leur projet de terrain, où ils appliqueront ces analyses à leurs propres communautés.

L’initiative démontre qu’en s’appropriant les bons outils, les acteurs de terrain peuvent rapidement monter en puissance.

Comme l’a brillamment résumé Papa Gorgui Samba Ndiaye: « Cette méthode permet de contextualiser réellement les problèmes, et ce qui est bien, c’est qu’on sort des solutions toutes faites… Ça nous amène à innover ».

Le mouvement est en marche, et il est porté par ceux qui, chaque jour, sont en première ligne.

Image: Peer learning exercise, as seen from The Geneva Learning Foundation’s livestreaming studio.

En République démocratique du Congo, la traque des enfants « zéro dose » passe par l’intelligence collective des acteurs de la santé

En République démocratique du Congo, la traque des enfants « zéro dose » passe par l’intelligence collective des acteurs de la santé

Reda SadkiGlobal health

KINSHASA et LUMUMBASHI, le 7 octobre 2025 (La Fondation Apprendre Genève) – « Ces jeunes filles qui ont des grossesses indésirables, quand elles mettent au monde, elles ont tendance à laisser les enfants livrés à eux-mêmes », explique Marguerite Bosita, coordonnatrice d’une organisation non gouvernementale à Kinshasa.

« Ce manque d’informations sur les questions liées à la vaccination se pose encore plus, car ces enfants grandissent exposés à des difficultés de santé ».

Sa voix, émanant d’une mission de terrain dans la province du Kongo Central, s’est jointe à des centaines d’autres ce 7 octobre 2025.

Il s’agissait de la deuxième journée d’un exercice d’apprentissage par les pairs de 16 jours visant à identifier et à atteindre les enfants dits « zéro dose » en République démocratique du Congo (RDC).

Ce sont ces centaines de milliers de nourrissons qui n’ont reçu aucun vaccin pour les protéger de nombreuses maladies.

Pour les 1 617 professionnels de la santé inscrits à cet exercice, il ne s’agissait pas d’un webinaire de formation classique, mais d’une étape importante d’un mouvement bien plus large.

Organisé par La Fondation Apprendre Genève, cet exercice est une pierre angulaire du Mouvement congolais pour la vaccination à l’horizon 2030 (IA2030).

Il bénéficie du soutien du ministère de la Santé de la RDC à travers son Programme élargi de vaccination (PEV), de l’UNICEF et de Gavi, l’Alliance du Vaccin.

L’initiative renverse le modèle traditionnel de l’aide internationale.

Au lieu de s’appuyer sur des experts extérieurs, elle part d’un postulat aussi simple qu’il est conséquent.

La meilleure expertise pour résoudre les défis de première ligne se trouve chez les travailleurs de la santé eux-mêmes.

La composition de cette cohorte témoigne de la profondeur de l’initiative.

Plus de la moitié des participants proviennent des niveaux périphériques et infranationaux du système de santé, là où la vaccination a lieu.

Un professionnel sur cinq travaille au niveau central, assurant un lien essentiel entre les politiques nationales et les réalités du terrain.

Le profil des participants est tout aussi varié.

Un tiers sont des médecins, 30 % des agents de santé publique, suivis par les agents de santé communautaire (13 %) et les infirmiers (9 %).

Fait marquant, près de la moitié d’entre eux travaillent directement pour le ministère de la Santé à travers le Programme élargi de vaccination (le «PEV»).

Cette forte proportion de personnel gouvernemental, complétée par une représentation significative de la société civile et du secteur privé, ancre fermement l’initiative dans une appropriation nationale.

Le regard du terrain

« Les défis sont tellement grandioses », a déclaré Franck Kabongo, consultant en santé publique à Lubumbashi, dans la province du Haut-Katanga.

En effet, les défis décrits par les participants sont immenses.

Il a souligné deux obstacles majeurs.

D’une part, la difficulté d’atteindre les enfants dans les communautés reculées.

Car les problèmes logistiques représentent un « casse-tête» pour de nombreux acteurs de santé impliqué dans la vaccination.

Pour Mme Bosita à Kinshasa, le problème est profondément social.

Son organisation soutient les enfants vulnérables, y compris les orphelins et ceux qui vivent dans la rue, dont beaucoup sont nés de jeunes mères sans suivi médical.

« Il n’y a pas assez de sensibilisation sur le terrain par rapport à cette notion », a-t-elle déploré, expliquant sa volonté d’intégrer la vaccination dans le travail de son association.

Ces témoignages, partagés dès les premières minutes, ont brossé un tableau saisissant d’un corps de métier dévoué.

Ils luttent contre un enchevêtrement complexe de barrières logistiques, sociales et informationnelles qui laissent les enfants les plus vulnérables sans protection.

À la recherche des causes profondes

Le cœur de l’exercice n’est pas seulement de partager les problèmes, mais de les disséquer.

Grâce à une analyse de groupe structurée, les participants s’exercent à la technique des « cinq pourquoi ».

Cette méthode vise à dépasser les symptômes pour trouver la véritable cause fondamentale d’un problème.

Lors d’une session plénière, Charles Bawande, animateur communautaire dans la zone de santé de Kalamu à Kinshasa, a présenté un dilemme courant.

Une forte concentration d’enfants zéro dose parmi les communautés de rue, très mobiles et souvent peu scolarisées.

Au départ, le problème semblait être un simple manque d’information.

Mais au fur et à mesure que le groupe a creusé, une réalité plus complexe est apparue.

Pourquoi les enfants sont-ils manqués?

Parce que les travailleurs de santé communautaires, les relais communautaires, ne disposent pas des informations nécessaires.

Pourquoi n’ont-ils pas ces informations?

Parce qu’ils n’assistent souvent pas aux séances d’information essentielles.

Pourquoi n’y assistent-ils pas?

Parce qu’ils sont occupés par d’autres activités.

« Ils doivent vivre, ils doivent manger… ils sont locataires, ils doivent payer le loyer », a expliqué M. Bawande.

La dernière question a révélé le cœur du problème.

Pourquoi sont-ils occupés par d’autres choses?

Parce que leur travail de relais communautaire est entièrement bénévole.

Alors qu’on attend d’eux qu’ils agissent comme des volontaires, beaucoup sont des parents et des chefs de famille qui doivent donner la priorité à leur gagne-pain.

Un problème qui semblait être un simple déficit d’information s’est révélé être ancré dans la précarité économique du système de santé bénévole.

Une mosaïque de défis partagés

Lorsque les participants se sont répartis en près de 80 petits groupes, leurs discussions ont révélé un large éventail d’obstacles, chacun profondément lié au contexte local.

Les rapports des groupes ont dressé une carte riche et détaillée des freins à la vaccination à travers le vaste pays.

Près de Goma, dans le Nord-Kivu, le groupe de Clémence Mitongo a identifié l’insécurité due à la guerre comme une barrière principale qui a déplacé les populations et perturbé les services de santé.

Dans la province du Kasaï, le groupe de Yondo Kabonga a mis en lumière l’impact des rumeurs, de la désinformation et des barrières géographiques comme les ravins et les rivières.

Ailleurs, d’autres groupes ont fait état de la résistance issue de convictions religieuses, certaines églises enseignant à leurs fidèles que la foi seule suffit à protéger leurs enfants.

Un autre groupe a discuté du cas des réfugiés revenus d’Angola, où l’ignorance des parents concernant le calendrier vaccinal constitue un obstacle majeur.

Ce diagnostic collectif a démontré la puissance du modèle d’apprentissage par les pairs.

Aucun expert ne pourrait à lui seul posséder une compréhension aussi fine et étendue des défis à l’échelle nationale.

Une nouvelle façon d’apprendre

Cet exercice est fondamentalement différent des programmes de formation traditionnels.

Il s’agit d’un parcours pratique où les participants deviennent des créateurs de connaissances et leaders des actions qui en découlent.

Au cours du programme, chaque participant développera son propre projet de terrain, qu’il partagera avec son équipe, son centre de santé ou son district.

Il s’agit d’un plan concret pour s’attaquer à un défi « zéro dose » dans sa propre communauté.

Après avoir soumis une version préliminaire d’ici le vendredi 10 octobre, ils entreront dans une phase d’évaluation par les pairs.

Chaque participant recevra les retours de trois collègues et, en retour, en fournira à trois autres, contribuant ainsi à renforcer le travail de chacun par l’intelligence collective.

Tracer une voie à suivre

L’étape suivante pour ces milliers de professionnels de la santé est de consolider leurs discussions de groupe et de poursuivre le travail sur leurs projets individuels avant l’échéance de vendredi.

Le parcours se poursuivra avec des phases consacrées à l’évaluation par les pairs, à la révision des projets et, enfin, à une assemblée générale de clôture pour partager les plans améliorés.

Cet exercice intensif est plus qu’un simple événement.

Il est un catalyseur pour le Mouvement congolais pour la vaccination à l’horizon 2030.

L’objectif est de traduire la stratégie mondiale du Programme pour la vaccination à l’horizon 2030 en actions tangibles, menées localement, qui produisent un impact réel.

La solution, comme le suggère ce mouvement, ne se trouve pas dans des lignes directrices venues de Genève, mais dans la sagesse, la créativité et l’engagement combinés de milliers de praticiens congolais, travaillant ensemble à travers tout le pays.

Illustration: The Geneva Learning Foundation Collection © 2025

Colonization, climate change, and indigenous health from Algiers to Acre

Colonization, climate change, and indigenous health: from Algiers to Acre

Reda SadkiGlobal health

I sat in a conference hall in Rio Branco, Acre State, Brazil.

My mind was in a sanatorium of Algiers, Algeria.

This was where my mother was sent as a girl.

They told her she got tuberculosis because she was an “indigène musulman”.

In 1938, the year of my mother’s birth and after over a century of colonization, about 5 out of every 100 Algerian people got infected with tuberculosis each year.

French colonial reports show that Algerians died from tuberculosis at much higher rates than French settlers.

They claimed the disease was endemic due to the supposed inferiority of our people.

And that she was going to die.

Colonialism is a liar.

She survived.

And it took less than eight years for an independent Algeria, free of the scourge of colonialism, to eradicate the scourge of TB.

Listening to the leaders at Brazil’s First National Seminar on Indigenous Health and Climate Change, I heard that same lie being dismantled.

The body of the territory, the body of the people

I listened.

I heard a diagnosis specific to their lands and histories, and recognized a familiar pattern.

The territory is a living body, they said.

When it is sick, we are sick.

Ceiça Pitaguary is an indigenous leader and activist from the Pitaguary people in Brazil.

The crisis, she explained, is a daily reality of “prolonged droughts, devastating floods, intense storms, and the rise in temperatures” that represents “real losses experienced in the body and on the territory”.

This is a wound with many layers.

There are the physical symptoms an epidemiologist would recognize: respiratory illnesses from fire and waterborne diseases from floods.

But the deeper sickness that speakers diagnosed, one after another, is a systemic decay.

I listened as Wallace Apurinã stated that when the floods come, “traditional medicine, which is such an important and fundamental knowledge for our subsistence… this ends”.

It is a crisis that creates what Elisa Pankararu named a “collective sadness”.

“Our people are sad,” she said, because the world is in imbalance.

This is a spiritual wound, like the one Juliana Tupinikim described.

She said the Krenak people lost not just a river to a mining disaster, but “fundamental elements of their spirituality and cultural identity”.

The crisis, Gemina Shanenawá insisted, is not abstract.

“It has a face, a name, and a territory: the face of Indigenous women”.

She gave voice to their struggle: “‘I lost everything, I lost my house, I lost my pigs, my chickens. And now? What am I going to do?’”.

The architecture of failure

There is a pathogen worse than fossil fuel.

It is colonialism.

I recognized its stench in the testimony of the leaders.

It is a system designed to fail its most vulnerable.

Weibe Tapeba, Brazil’s Secretary of Indigenous Health, described the paralysis.

“Today, our Indigenous territories are not understood as federal units,” he said.

This means that they are unable to issue crucial decrees themselves, which severely hinders their ability to prepare for, respond to, and recover from increasingly frequent catastrophic events.

“We do not have the autonomy to issue such a decree ourselves”.

This intentional powerlessness leaves communities exposed.

It creates the chain reaction that researcher Renata Gracie detailed in the Yanomami territory, where illegal mining leads directly to “an enormous increment in the occurrence of malaria, trachoma, measles, tuberculosis, malnutrition”.

The state’s response—culturally inappropriate food baskets were one example I heard—is changing.

It was impressive to see how government, with leadership from Tapeba and others, engages in meaningful, open dialogue by and for indigenous communities.

What you call anecdote, we call ancestral science

An invisible but profound violence of colonization is the dismissal of a people’s way of knowing.

Your science is ’data’.

Ours is ’folklore’.

The entire seminar was a rebellion against this lie.

In my own talk, I spoke about how health workers’ expertise – what they know because they are there every day – is often devalued as mere “anecdote”.

Putira Sacuena provided the most powerful rebuttal.

She spoke of a small frog in the Xingu territory.

“We stopped hearing its sound in the territory”, she explained.

The frog’s silence predicted the rise in respiratory illness and diarrhea.

She said: this is ancestral science.

It is a signal from a highly sophisticated, multi-generational system of environmental monitoring.

Our existing systems do not just miss this data.

They are structurally incapable of recognizing it as data in the first place.

The challenge, then, is to begin the work of unlearning the colonial biases that prevent us from seeing the knowledge that is right in front of us.

It requires us to abandon the “high, hard ground” of our self-referential expertise.

The fight for health here is, more than we realized, a fight for cognitive justice, a demand that such knowledge be seen not as a cultural artifact, but as essential data.

As Ceiça Pitaguary declared, “The fight against the climate crisis will not be won without Indigenous peoples”.

That is not a political slogan.

It is a vital, scientific truth of our time.

It demands that we, in our institutions and our fields of practice, dismantle the systems that are causing this devastation.

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  27. Soares, G.H., Jamieson, L., Biazevic, M.G.H., Michel-Crosato, E., 2022. Disparities in Excess Mortality Between Indigenous and Non-Indigenous Brazilians in 2020: Measuring the Effects of the COVID-19 Pandemic. J. Racial and Ethnic Health Disparities 9, 2227–2236. https://doi.org/10.1007/s40615-021-01162-w
  28. Thebaud, A., Lert, F., 1985. Maladie subie, maladie dominee, industrialisation et technologie medicale: Le cas de la tuberculose. Social Science & Medicine 21, 129–137. https://doi.org/10.1016/0277-9536(85)90081-4
  29. Thomas, A., 2024. Colonization as a Determinant of Health. Western University Global Health Equity.
  30. US Environmental Protection Agency, 2025. Climate Change and the Health of Indigenous Populations. EPA.
  31. World Health Organization, 2025. Global Plan of Action for Health of Indigenous Peoples. WHO.

Image: The Geneva Learning Foundation Collection © 2025

Gender in emergencies

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

Reda SadkiGlobal 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.

Image: The Geneva Learning Foundation © 2025

The crisis in scientific publishing from AI fraud to epistemic justice

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

Reda SadkiGlobal 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:

  1. It must recognize that the most durable knowledge comes from praxis—the cycle of acting in the world and reflecting on the consequences.
  2. It must be built on collaborative intelligence, understanding that the most difficult problems can only be solved by weaving together many perspectives.
  3. 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

  1. Boghossian, P., 2007. Fear of knowledge: Against relativism and constructivism. Clarendon Press.
  2. 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).
  3. Fanon, F. (1963). The wretched of the earth. Grove Press.
  4. Fenner, M., 2023. The Rogue Scholar: An Archive for Scholarly blogs. Upstream. https://doi.org/10.54900/bj4g7p2-2f0fn9b
  5. 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/
  6. Green, T., 2022. Wait! What? There’s stuff missing from the scholarly record? Med Writ 31, 44–48. https://doi.org/10.56012/ajel9043
  7. 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
  8. Harding, S. (1991). Whose science? Whose knowledge? Thinking from women’s lives. Cornell University Press.
  9. Smith, L. T. (2012). Decolonizing methodologies: Research and indigenous peoples (2nd ed.). Zed Books.
  10. 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
  11. Wellcome Trust, 2020. What researchers think about the culture they work in. Wellcome, London. https://wellcome.org/reports/what-researchers-think-about-research-culture
  12. Willinsky, J., 2006. The access principle: The case for open access to research and scholarship. MIT press Cambridge, MA.

Image: The Geneva Learning Foundation Collection © 2025

Text-based alternatives to expensive multimedia content

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

Reda SadkiWriting

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

  1. 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
  2. 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
  3. Cope, B., & Kalantzis, M. (Eds.). (2016). e-Learning Ecologies: Principles for New Learning and Assessment. Routledge. https://doi.org/10.4324/9781315699935
  4. 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.
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. Sweller, J., Ayres, P., & Kalyuga, S. (2011). Cognitive Load Theory. Springer. https://doi.org/10.1007/978-1-4419-8126-4
  11. 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

Image: The Geneva Learning Foundation Collection © 2025

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

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

Reda SadkiWriting

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.

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

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

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

Two principles foster deeper learning.

  1. Combine words and pictures rather than words alone.
  2. 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

  1. 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
  2. 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
  3. Feenberg, A. The written world: On the theory and practice of computer conferencing. Mindweave: Communication, computers, and distance education 22–39 (1989).
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. 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

Image: The Geneva Learning Foundation Collection © 2025

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

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

Reda SadkiGlobal 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

  1. 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
  2. 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
  3. Sadki, R., 2025. Peer learning for Psychological First Aid: New ways to strengthen support for Ukrainian children. https://doi.org/10.59350/dgpff-n9d63
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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).

Image: The Geneva Learning Foundation Collection © 2025

Certificate peer learning programme for equity in research and practice

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

Reda SadkiGlobal 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).

Image: The Geneva Learning Foundation Collection © 2025

Certificate peer learning programme for equity in research and practice

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

Reda SadkiGlobal 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 ) , but about a lack of government policy for the elderly (Why ). This, in turn, was linked to a lack of advocacy (Why ) , which stemmed from biased social norms that devalue the lives of older adults (Why ). 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 ). 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).

Image: The Geneva Learning Foundation Collection © 2025