History, A Determinant of Health: Global Health And Its Colonial Footprints

In the summer of 2006, the government of England launched a nation-wide campaign to educate and engage the public on the important roles that history played in quality of life that they were experiencing. The campaign’s famous slogan, “History matters–pass it on”, was a tool used to spark conversation between neighbors, historians, and politicians. The great thing about this slogan is that it can be universally applied to all sectors of society. From art and culture to economics and business, history has footprints in every aspect of our lives. We see these footprints every time we drive past our parliament buildings in the middle of our busy cities. We see these footprints in our siblings, as the color of their eyes and the dimples on their cheeks reflect those of our grandparents’. We see these footprints every time we visit our libraries and read about the people who came before us, but most importantly, we see these footprints in the depths of our health sectors and the methods we have used to approach Global Health.

In the last decade, Global Health has increased in its prominence and visibility. Its footprints can be seen in research priorities, media coverage, and even philanthropy trends (Jens Holst, 2020). The roots of Global Health can be traced back to the 19th and early 20th centuries to its earliest predecessor, “colonial medicine”. Although Global Health is generally viewed as a form of foreign policy and associated with equitable international health security, in its earliest development, it was used by European colonial rulers to preserve their health and shield them from the tropical diseases that they encountered in their conquests (Jens Holst, 2020). The primary focus of colonial medicine was to study the infectious diseases prevelant in the colonies and develop solutions that would prevent the colonizers from catching these diseases and spreading them back home in Europe (Unite For Sight, 2020). Along with this, the structure of colonial medicine allowed colonial powers to ensure their supremacy and create a dependency in the regions they ruled over (Jens Holst, 2020). Knowingly and unknowingly, the colonizers often introduced non-native diseases on top of the pre-existing diseases in the various colonies (Renzo Guinto). Seeing as the focus of colonial medicine was to benefit the colonial rulers and ensure their safety, efforts were never made to control the spread of disease. Anytime an intervention was considered, it was used to create a leverage for the colonists and further deprive the colonies of any sort of freedom (Unite For Sight, 2020). With the constant extraction of wealth from these regions by European rulers, many of these colonies entered continuous cycles of poverty and disease with no chance of relief as their colonizers indulged in their wealth (Unite For Sight, 2020).

Surprisingly, although the world has moved on from “colonial medicine” and adopted the more health equity focused model of Global Health, the footprints of colonialism still linger.

The concept of the Global North and the Global South was developed as a means to identify the gaps in development and wealth that existed between countries. Most of the wealthy countries (with the exception of Australia and New Zealand) were found to be located in the Northern Hemisphere while the poorer countries were predominantly in tropical regions and the Southern Hemisphere. With this sort of categorization, the idea of the Global North “helping” the Global South has dominated the field of Global Health and caused much of the world to approach the health of the Global South with a subconscious colonial mindset.

During colonization, the imbalance of power was quite obvious and heavily associated with the ideology of racial superiority, however, there are still unequal power dynamics that can be found in the field of Global Health through racism, classism, and the “residual exploitations of a terrible colonial past” (Abraar Karan, 2019). This imbalance in power can be seen when western doctors travel for two-weeks to “improvised” regions to help the “less-educated” locals but take no time to learn the history of the community they will be working in, form solid connections with the locals, or effectively work alongside those who are already familiar with the existing infrastructures. We see this imbalance in power when doctors and health professionals from the Global South are seen as less when compared to their “Northern” counterparts. We see this imbalance in power when graduates from the Global North with little to no experience or knowledge of the region, arrive in low-income countries to advise their doctors and policy makers on the “right” way to govern and approach their health needs. We see this imbalance in power in Global Health research as entities from the Global North/high-income countries dominate research publications and journals.

“Any western medical institution more than a century old and which claims to stand for peace and justice has to confront a painful truth — that its success was built on the savage legacy of colonialism.”

Richard Horton, editor of The Lancet

Directly and indirectly, the footprints of colonialism can still be seen in Global Health, and just like it harmed various populations under colonization not so long ago, it is harming the populations that are living now. Until these colonial mindsets and structures are addressed and dismantled, equity between the Global North and South in health, wealth, and development will always be bound by the remnants of colonialism.

As we step further into this series, we hope that join us in taking time to reflect on the influence and power that the Global North has over many countries. We want to ask ourselves, in what ways has our help brought harm instead of relief? The aid that we provide, is it jaded? When we grant access to resources, are our intentions to better ourselves and stroke our egos or are we genuinely seeking to make a difference? If we believe we are making a difference, have we ensured to leave any remnants of a colonial mindset behind us or are we subconsciously and subtly mimicking the actions of those who came before us?

Together we can make an impact on the health of the nations and the generations to come.

The mission of WHEF is to increase accessibility to medications and supplies for healthcare facilities in Guatemala and Grenada. If you are interested in hearing more about the work we are doing, or in connecting with us, you can visit our website, check out our instagram or facebook, or sign up to receive our newletters. If you would like to support us in our work, please donate here.

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