One of the most significant concerns we have felt in the development of the EPT Agenda 2023 is the genuine risk of, paradoxically, perpetuating a kind of ‘eco-colonialism’ where the health and survival of people and planet provide yet another vehicle for spreading and imposing particular, cultural, economic or political interests and values on the rest of the world (Sachs, 1992; 2015). To provide some context, colonialism has, amongst many other things, also been exposed as a significant contributor to our current planetary health predicament, inciting large-scale environmental degradation in a manner that continues to pervade modern-day, growth-based global economics (Enfield & O’Hara, 1999; Rees, 2010; Saravanan, 2004; Willow, 2014). In addition to this, colonialism has also been recognised as not only an issue of economic and territorial, or terrestrial undoing and taking over, but also of culture, thought and education. Recent years have therefore seen a steady increase in calls for decolonising science and education (Battiste, 2019; Battiste, Bell & Findlay, 2002; Boshoff, 2009; Dahdouh-Guebas et al., 2003; Nagtegaal & de Bruin, 1994; Gorski, 2008).
We consider it important to acknowledge upfront this difficulty and consider the role of colonialism as a contributor to our current crises, whether this be geographical, cultural, ideological, or scientific. By extension, this also implies acknowledging the paradox complicity of Western healthcare and tertiary education cultures in creating the global health and environmental crises of our time and, ultimately, the need for a diversity of other modes of thinking and doing together that will enable us to transition into a more sustainable, and environmentally and socially just future.
Beyond acknowledging this problem, we have therefore tried to address and minimise it by introducing a variety of strategies into the EPT Agenda 2023, all while being fully aware of the paradox nature of doing so in a global call to action that is seeking to engage an entire profession. The first of these strategies consists of leaving the exact content and methods by which sustainability and environmental physiotherapy might be introduced as minimal, nondescript and non-binding as possible. As discussed throughout this Agenda, we hope that this will help draw out a diversity of national, regional, and local approaches to environmental physiotherapy education relative to the historical, cultural, ecological, social and political context of each respective physiotherapy education institution.
Secondly, the issue of de/colonialising curricula also affords an additional exciting opportunity for innovation in environmental physiotherapy education. It could, e.g. consist of focussing precisely on this issue as its primary or starting content. In this way, speaking about colonialism and its complicity in global environmental degradation, bio/diversity loss, environmental injustice, and so on, and the resultant impacts on planetary health could itself be exceptionally fertile grounds for collaborative teacher and student engagement with sustainability and environmental perspectives in physiotherapy. Choosing such issues over other, potentially more apparent, or less contentious ones might help draw out the actual complexity of planetary health and environmental physiotherapy. It would also highlight that reaching conclusions quickly, might have to begin with or, at least, be accompanied by thinking more deeply and thoroughly.
Finally, it has also been argued that working in partnership with students is an essential strategy for the decolonialisation of medical curricula and practice (Nazar et al., 2015). This underscores the sense that environmental physiotherapy education might be an especially amenable field for engaging decolonialisation because precisely its relative novelty opens it up to collaborative exploration and development. We hope that students and teachers will find this an exciting opportunity that could help us address and take responsibility for an unjustly distributed global issue in more locally and globally just ways.