Hub and spokes by Robert Couse-Baker

Against the hegemony of the ‘International Trainer’: Transforming learning to decolonize global health

Reda SadkiWriting

If it keeps on rainin’, levee’s goin’ to break. When the levee breaks, I’ll have no place to stay. – Led Zeppelin

While the International Trainer lands at the airport, is chauffeured to her hotel, and dutifully reviews her slides and prepares her materials, a literally and figuratively captive audience has been herded at great cost to that same hotel, lured in by a perverse combination of incentives. The costs are mostly related to the incidentals of travel and accommodation, but the stakes are significant. Never mind that the outcomes are unlikely to be evaluated in any meaningful way. The symbolism of such ‘learning theater’ is well-rehearsed. Its funding is seldom questioned. In any case, questioning its value does not seem to slow down expenditure, much less lead to meaningful change in practice. 

The whole affair is a fascinating microcosm of the broader power relationships that underpin global development. Let us explore how this could be, from the vantage point of the International Training Specialist.

You love training. It is indeed a powerful experience to be the ‘sage on the stage’, presenting, explaining, and demonstrating. Nowhere is that power more evident than in the architecture of an international training. It is power, and in fact it is by analyzing the imbalance of power that we are more likely to make sense of the peculiar role ascribed to the International Trainer in global health.

Bringing knowledge to those who are assumed not to know, to lack capacity, feels rewarding but is based on an assumption of superiority over others. Yet, it feels like you cannot possibly be doing anything wrong. How could teaching be harmful? You are here to help them, after all. For you, it is a profoundly humanizing experience to spend quality time with a small group, at great cost. You are intuitively convinced that it is time and money well-spent. You have observed your trainees’ eyes light up with the knowledge you have given them. They are consistently grateful. You love training. And you are convinced that they love being trained. Here they are, lined up in neat rows or – if you are a progressive trainer – circles, smiling and seemingly eager to receive your expertise.

Yes, there are lingering questions about outcomes. You seldom hear how things turn out after flying back to Atlanta. Your job, you tell yourself, is to deliver training. Mission accomplished. Measuring learning, you tell yourself, is difficult. But this does not worry you. You feel that it is working, and that is good enough for you. No one is really questioning your work, anyway. Every project has a budget line to cover travel, accommodation, and per diem. Job security seems guaranteed and lifelong. What a wonderful business to be in: a cost center that is tacitly accepted as necessary.

Empowered by such convictions, you are offended when you first hear about teaching machines. The idea seems simply absurd. You do not take it seriously. Its advocates are outsiders to the ‘training space’ that is your preserve. They are a strange bunch, seemingly passionate about things that make no sense to you. It sounds like they want to replace the complex human experiences that you love with something else. And that you may not be part of that ‘something else.’

You scoff at the potential use of technology to support learning. “They [your trainees] will never have access”, you exclaim. “It is too expensive and they do not even have X.” (X will first be electricity, then wifi, then mobile connectivity, but you dismiss the fact that things are changing quickly.) The proponents of digital learning obviously do not know everything you know about the reality of work and learning in the field.  You do not question how you know what you know. Your assumptions form blinders that you do not know you wear.

Managers and donors may occasionally challenge you. You have become quite effective at advocating for more training. Managers, you say, need to support staff development by accepting that people should stop work in order to learn. You have persuaded donors that training is the solution, even though you add that it is not always that. They have invested hundreds of millions of dollars, with no evidence of impact, but, curiously, remain willing to blindly invest more. You feel that this is an accomplishment, evidence of the validity and success of your craft.

You do not, by any means, feel responsible for the lack of evidence. Your experience, on a personal level, is sufficient. You are an International Trainer. Let the evaluators deal with that. Change at the level system, you think, is above your pay grade. You have no incentive to question your role in that system. You get paid at the end of each month, no matter the outcomes.

For as long as you can, you deny that meaningful learning can happen online. You ignore the conclusions of the two largest meta-analyses comparing modes of learning (face-to-face, blended, and online). 

Because you sit in an institution that is a key player in global health, your denial does have consequences. Your “expertise” results in startlingly ineffective and improductive investments. Yet no one is holding you accountable for your convictions, your priorities, or your disregard for evidence. Your seniority leads others to consider you as the authority in your domain of expertise. You wield authority without accountability, with all the risk that entails, but somehow manage to remain unscathed.

Denial becomes harder to maintain over time. Reluctantly, you timidly recognize that perhaps online learning may be used to transmit information, albeit in limited ways. You become an advocate for click-through e-learning modules that are proliferating in international organizations, often promoted by human resources departments. Once again, you disregard the evidence already available about the limited effectiveness of this kind of “e-learning”. In a way, the inefficacy of such modules is your job security. At best, your teaching methods are being mimicked in an inferior digital format. That is reassuring. The technology is so imperfect and frustrating, you tell yourself that a machine presenting slides will never be as compelling as you can be in that hotel auditorium. And good luck getting the participants to show up and pay attention online, while your audiences remain captive.

Peer learning scares you. Experts teach. Not everyone can or should. Peers can, at best, share their experience. You are convinced that this should not happen without proper supervision. If peers support each other in a country in order to get something done, but there is no International Trainer present to observe, assess, or validate it, how could it be making a difference? More generally, you dismiss self-reporting as unreliable, doubting in both your trainees’ honesty or perhaps their intellectual ability to describe or analyze what they are doing or how they are doing it. You are the only one who can truly know. You are the International Trainer.

As donors timidly begin to question the value of your model, you double down on training as you have always done it. You look for arguments to undermine emerging approaches. Some are fragile innovations being offered by new entrants no one had ever heard of. Like the earlier proponents of digital learning, their mental models are completely foreign to you. You are convinced that your prevailing model is correct and therefore does not need to be questioned. When they present promising results, you either dismiss them or look for limitations and frailties. The latter are inherent to any innovation, but you use your established institutional position to dismiss, undermine, and marginalize. You believe that is your role. Your ability to influence is primarily negative, because the approaches you have advocated have so clearly failed. In fact, you hope that no one will start to ask questions about your outcomes. And, luckily, no one does.

Scaremongering does seem to work with your global health colleagues. Innovation may be a buzzword but it is nowhere in their work plans or performance objectives. They are already risk-adverse in order to keep their jobs, even those who have “innovation” in their titles. It is implicitly an existential question: if people in countries turned out to have indigenous expertise of their own contexts, and global knowledge is increasingly available through digital networks, this would threaten a number of prevailing assumptions about why and how the International Trainer is needed.

Then came the pandemic.