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Written by Francisco Mendina, PhD Candidate, Western University, Canada
Attending the Mesoamerican Workshop on Solidarity and Global Health, held in San José, Costa Rica on February 27–28, 2025, prompted me to reflect on the discussions that took place. The two-day workshop featured presentations, roundtable discussions, and group dialogues on solidarity in relation to activism, politics, and global health. Participants from across Central and South America shared insights from their work, discussing how—or whether—solidarity shapes their approaches. The discussions brought to mind the work of Joaquín Torres García: América Invertida (Inverted America), particularly about reorienting our perspectives. Torres Garcia challenges the traditional worldview and forces a reconsideration of global power structures, proposing that geographical maps are constructs that can be manipulated to convey a particular message. Hence his works invite us to reconsider who and what shapes global health initiatives/structures.
From the start, tensions emerged around the concepts of solidarity and global health. Questions were raised about what “global health” really means, who defines it, and where it intersects (or not) with health initiatives in the region. Participants raised doubts as to whether global health really supports the populations it purports to serve or whether, on the contrary, it imposes Eurocentric models alien to their realities. Global health according to whom and for whom? These reflections underscore the importance of shifting the focus to strengthening local capacities rather than imposing external solutions.
This debate on the imposition of external models resonates beyond Latin America, recalling Indonesia’s 2018 response to the Sulawesi earthquake and tsunami. There, solidarity took a different form—one that prioritised local autonomy. Instead of refusing foreign aid, the government established restrictions to prevent the direct intervention of international humanitarian aid organisations without local coordination. This approach strengthened local capacities, ensuring that the response was nationally led and managed (Loy, 2018). By limiting the installation of independent bases by international actors, the government sought to strengthen local capacities and avoid overburdening external resources. This decision forced many international actors to rethink their approach and channel their support through local organisations. In this model, solidarity is not an imposition, but rather recognition and respect for the agency of those directly impacted.
Solidarity, Power, and Language
Solidarity, often seen as a virtue, was revealed to be far from neutral or a uniform concept – it shifts with context, shaped by power dynamics and hidden hierarchies. Rather than romanticising it as a selfless act or free of hierarchies, participants explored its different forms: a force of resistance or activism, or a top-down gesture and charity that fosters dependency. Some argued it should be an ethical obligation; while others, a practice shaped by local realities rather than dictated by dominant North American or Eurocentric visions. Even the idea of free volunteering as the ultimate expression of solidarity was questioned: Who has the privilege to be in solidarity? Is there an implicit hierarchy in who can afford to exercise solidarity?
This critique of the different forms of solidarity was reinforced by a powerful testimony shared during the workshop, from a more personal perspective. At a community health service, a woman asked if she could pray before undergoing a mammogram. The answer was not just permission, rather, the provider responded: “Let's pray.” The shift – from passive allowance to active accompaniment – illustrates a more profound form of solidarity, one that acknowledges vulnerability, valuing our agency, and mutual recognition.
However, translating these ideas into global health frameworks is complex, especially when the definitions and objectives of “global health” remain contested. While international standards exist, they are often unmet, and unenforced, as seen during the COVID-19 pandemic, where the illusion of the shared struggle masked deep inequalities: the narrative said that “we were all in the same boat,” but the reality was different – some were in first class, others in economy, and many barely clinging to the rail. The pandemic also deepened distrust. Why would anyone now invest their time in answering invasive research questions if they don't know if their voice will actually be heard? Rather than dismissing skepticism as selfishness, one must understand the context of that distrust or reluctance to act on what we associate with solidarity. The workshop further explored solidarity as an empty discourse – one used to justify inaction or, an excuse for corruption – raising concerns about governments demanding solidarity while failing to uphold public trust.
In many Latin American countries, we have seen how funds destined for “solidarity” or the common good disappear. Is it fair for the State to demand solidarity while its record has generated distrust in the people, are we penalising the lack of individual solidarity while normalising its instrumentalisation by the State?
At this point, a revealing discussion on language also emerged. The use of the term “empowerment” was questioned, a term usually associated with so-called “solidarity” initiatives, which presupposes that someone lacks power and needs someone else to give it to them. However, people already have knowledge and agency; the problem is not to give them power, but to remove barriers that limit its exercise. It was also discussed how solidarity is often framed in state terms, linked to institutions rather than community practices. So, should it be a tool for states to improve their work or cultivated as an organic practice within communities?
Given these tensions, solidarity, as a concept, perhaps needs to be redefined or complemented with other principles such as justice, autonomy, respect for local experiences, or horizontal collaboration. In this sense, it is not just a theoretical adjustment, but a call for practices better attuned to local realities. This redefinition does not imply discarding solidarity, but rather enriching it, or giving it a last name and adapting it to the concrete circumstances in which it manifests itself.
Ultimately, all of these reflections bring me back to America inverted – Joaquín Torres García's painting 'America Inverted' serves as a compelling visual for this reorientation. Torres Garcia invites us to rethink dominant narratives and to see the world from another angle, which connects directly to the critique of the imposition of external models on global health. For those unfamiliar with the work, it might be useful to think about how global health solutions – just like maps, are constructed to serve certain interests, and how this limits true solidarity and mutual understanding.