The global health community promotes itself as an organization striving for peace and justice. Yet, its actions display ignorance and insensitivity. In humanitarian outreaches throughout the world, there is a clash between culture and medicine. The domain of global health is dominated by ideas of power and alteration of others’ cultures, causing these humanitarian outreaches to not be one of right but a continuation of colonialism.
With the World Health Organization (WHO) announcing the end of the latest Ebola outbreak in Uganda, it is important to reflect on how these institutions of power are managing these epidemics and the biases they carry. Instead of imposing Western-centric solutions, global health institutions need to empower local healthcare providers and their communities.
While the discourse by imperial powers shifted from “civilizing” the Global South to helping them “develop,” the underlying ideological process remains colonial. When the Ebola outbreak was first announced in 2015, the media’s primary focus was Western international aid. The media riled up the Western population with frightening articles, such as the New York Times headline, “Doctor in New York City Is Sick With Ebola,” effectively othering the Global South out of fear.
The idea of “the other” in colonialism is one where the colonized are viewed as inferior and dehumanized to their European counterparts. It was not until Ebola entered the West that the media changed its narrative of the disease from “exotic” to one of an international threat. It was only when the threat entered Western soil that the international community showed interest in addressing this health issue.
A more recent example of this is when the West only addressed the threat of COVID when it directly affected them. The U.S. has put much more funding for the COVID vaccine in comparison to other infectious diseases that do not impact them. Globally, $7.3 billion has been allocated toward the malaria vaccine over a span of eleven years. In contrast, the U.S. alone has spent $9 billion in a year for COVID vaccine development. Countries that are affected by malaria tend to be poorer countries, while the West could not escape the grasp of COVID regardless of its wealth. The disparity in spending is reflective of the West truly only helping when it directly affects their health and economy.
When help is finally sent out, the response is often disruptive to local cultural and health systems in favor of the West’s own beliefs. The “white man’s burden” is the idea that it is the duty of white people to teach and uplift the colonized to their “civilized” ways. This was used as justification for European colonization, and this concept has been sustained into global health. It causes inter-state paternalism to occur, as these health officials are choosing treatments that they believe to be their patients’ best-interests without their input. The biases and bigotry that originally stemmed from colonialism continue to affect the administration and oversight of health crises.
Amy Maxmen, a writer for The National Geographic, wrote about this tension during the 2015 Ebola outbreak, where traditional burial practices in Guinea were ignored. Villagers were not allowed to perform surgery to remove the fetus of a deceased pregnant woman due to the fear of contagion. However, this practice was integral in their traditional Kissi culture, as a woman buried with her fetus disrupts the balance of nature.
Eventually, officials were able to contact an anthropologist familiar with the culture, who knew an alternative way of making reparations to the spirits. By working with individuals who are knowledgeable about the culture, the outsiders slowly establish trust and respect in the doctor-patient relationship.
Health officials often handle epidemics like these solely as a health issue, ignoring the socio-cultural context. By entering the homes of individuals affected by a deadly illness without proper cultural consideration, the officials display a lack of respect towards these individuals.
Oftentimes, the doctors that are sent out from international health organizations are from the West, rather than providing native doctors with the resources to help their people. Though this is frequently because there are less professionally trained doctors in the countries that are affected by these diseases, short-term stints from foreign doctors are not the long-term solution. Access to medicine becomes another tool to exert dominance and subjugate the native people.
The weaponization of medicine leads to an interesting balance of power. As “the colonizers,” health officials now have to fulfill the role they have placed upon themselves. Since they claim they are here to help, officials now have the obligation to follow-through with their actions in providing treatment.
In “Shooting an Elephant,” George Orwell argues that the people in charge are not truly free of responsibility to the natives. Through the lens of his period of stay in Burma, he explores his awareness of the expectations the native Burmese have on him.
“Here was I, the white man with his gun, standing in front of the unarmed native crowd – seemingly the leading actor of the piece; but in reality I was only an absurd puppet pushed to and fro by the will of those yellow faces behind,” Orwell wrote.
Orwell proposes the interesting dynamic between the conquerors and the conquered. In the process of colonizing, colonial powers, in consequence, put themselves in chains, as they become bound to the people they are trying to control.
Similarly, during the Ebola pandemic, while health officials exerted their own beliefs onto African countries, they were still subject to the expectations of the natives. While the international community often does not consider what the global south thinks about the health crises, there is a contrast in the overarching colonialist belief and the reality of individual Western officials living in these countries.
Through the act of using medicine to control others, the global health industry has entered into a mutually dependent relationship. This paradox portrays the inner-turmoil of individuals who are a part of dominant institutions of powers. The overall global health community may not care about the welfare of the global south, but individuals who are part of the institution have the ability to recognize their faults and change for the future.
The international health community must work actively to eliminate colonial attitudes in their practices by recognizing and respecting the cultural and socioeconomic context in which epidemics occur. They also need to involve and empower local communities and their health systems.
After all, this is a mutual interaction. It is time for the global health community to accept responsibility for their actions and make a concerted effort to build a medical and cultural bridge between the West and the rest of the world.
Sriskandha Kandimalla is an Opinion Intern for the winter 2023 quarter. She can be reached at skandima@uci.edu.