Cristina Heppner Alonso

Ongoing discussions on what is “wrong” with global health or how to decolonialize global health tend to focus exclusively on structural shortcomings, such as effectiveness of global platforms and institutions or lack of truly participatory consultation strategies (downstream perspective). Thereby they fail to capture alternative approaches to global health leadership (upstream perspective) and to recognize the sovereignty of non-Western knowledge and the intrinsic value of community regeneration in all its forms as a key ingredient for effective global health practice. Women’s perspectives have been largely relegated to the gender agenda (balance, parity, equity) or proposed as models on “how to lead better” based on preconceived, male-based notions of what constitutes “effective” leadership, including setting and prioritizing goals. Instead of creating hierarchies of priorities, we must understand the complexity of human experience and the power and inequality patterns it is embedded in, and remain open to or embrace apparent contradictions when designing support mechanisms. This chapter centers on the disproportionate impact of COVID-19 in the lives of Latin American immigrants in Chelsea, Massachusetts, United States, during the 2020 pandemic. The chapter explores how public health prioritization of basic needs neither captured the relationship between impact and social response nor acknowledged the interplay between the different needs of people. Employing an insider’s look, we describe how the women leaders of the local organization La Colaborativa called upon culturally accepted codes to reverse power roles, questioned scientific definitions of needs and led their community out of potentially irreversible consequences of the crisis in a holistic and sustainable way. Their leadership serves as an example of how self-governed, women-led organizations that are rooted in the community may address the real needs of its members during a global catastrophic event.