Amza Ali: Overcoming bias against research from lower income countries

Each of us is on a lifelong search for legitimacy and authenticity. Often this takes place through the lens of our career and vocation. I am a senior UK- and US-trained neurologist, and a business and management academic. I work in Jamaicaa developing country. Over the years I have had experiences which have made me question legitimacy and authenticity in the context of international academic medicine. Physicians from developing countries not only have to cope with language differences, but also with concealed or even overt biases and, at times, limited expectations of academic capacity.  An insightful colleague once said to me that she felt that second-language differences impose the perception of a 15-point drop in IQ in most native listeners. Years ago at an international academic meeting, I personally experienced the pronounced loss of interest in my opinion once my conference ID tag was scrutinised and my academic “legitimacy” ascertained. On another occasion I was “complimented” for the quality of my English, “other than my accent.” The person complimenting me appeared unaware that English is the official language of Jamaica.

Language and accents can indeed create barriers. I have experienced the distressing insight of realising I myself have devalued a speaker from another developing country using English as his second-language, in part, I still hope, because of a difference of opinion. In an audience, I have found it a useful technique to close my eyes and listen. Content then supersedes other distractions.

Similar issues also permeate academic writing and publishing. Reviewers for major journals have written dismissively of my work, submitted from an international academic institution, when clearly they had not properly read the article, perhaps having already mentally judged its worth by its origin. This tendency has been objectively studied. A recent study showed strong evidence of bias against research from lower income countries. A senior colleague from a prestigious US institution was surprised how difficult it was to publish work when he chose to use his Jamaican honorary affiliation instead of his US academic address.  

Perhaps reviewers of papers that originate from developing countries can try to adopt a different worldview, and to see a paper’s potential relevance to those in different circumstances, and if needed, to guide the researcher towards a resubmission that has an even broader impact and also relevance to readers across the world.

Finally, accents and limited English grammar of colleagues from developing countries do not mean they are unintelligent. As native English-speakers how well do we speak their first languages? Treat people with respect and they will work strenuously with you towards mutual goals. In collaborating, recognise too that peoples’ local circumstances and the confines they face are logistical not cognitive limitations.

Each of us is on a lifelong search for legitimacy and authenticity. Perhaps we may best find it by acknowledging these same needs in all our colleagues.

Amza Ali FRCP is a neurologist at the Kingston Public Hospital and Senior Associate Lecturer in Neurology at The University of the West Indies, Jamaica.

Competing interests: None declared.