Decolonizing Global Health
By Anshi Purohit
Edited by Mariia Nech
Colonial legacies continue to shape global health practices, creating systemic inequities in healthcare delivery. It may seem paradoxical that efforts to standardize healthcare can perpetuate oppression, yet disparities have only risen—especially after the COVID-19 pandemic. Without decisive action to decolonialize global healthcare and support marginalized countries, we risk failing the very standards we established in this field decades ago.
Advancing health rights on a broader scale requires community-based training, medical pluralism, and flexibility in decision-making. What a population needs is not always what has been standardized. A Western approach is often assumed to be the most novel or effective treatment method—but this is a dangerous misconception. For instance, when doctors administered a C-section to a Nigerian woman, they failed to consider the lack of post-operative care resources in her region. The outcome was devastating: her baby suffered as a result (Initiative). Nigerian American writer Teju Cole describes this pattern as the “white savior industrial complex.”
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Figure 1: Recommended solutions to the White Savior Industrial Complex in Global Health (based on the Social Ecological Model for public health prevention)
Conceptualizing medical conditions requires both Global North and Global South perspectives. Too often, research ethics theories do not take the personal values and traditional customs of resource-deprived countries into account (Pratt). One way to correct this is by shifting medical training models. For instance, organizations like ReSurge have started prioritizing local expertise. Rather than flying in American physicians for short-term missions, they train local doctors, nurses, and support personnel to treat burn injuries (“4 Ways to Decolonize Global Health”).
Our approach must be multidimensional. Multidimensional does not equate to scattering strategy or abandoning projects meant to uplift – rather, it means using bottom-up approaches to allow communities to gain independence from grant systems or corporations that do not have the depth to sustain local programs or improve local access during crises.
When an issue is approached from the point at which it becomes a disaster, the basis for fixing or reconstructing outdated systems is left in pieces. Human lives are at risk where medical professionals are not available (Yamin).
Leading voices should seek distinctive perspectives to frame their blueprints for future action plans. Regional medical journals, participatory studies, and integrating traditional cultural awareness training into all programs might provide emotional relief. Women, children, and marginalized groups - including the Indigenous community - face cultural stigma and apprehension due to lack of cultural awareness.
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Figure 2: World Health Organization, Four domains of the Challenge: 16 subdomains and three key action areas
Political spheres influence every aspect of our lives, from the Internet to casual forms of media consumption. Often, the media we relate and share is in some way influenced by politics or business models. Speaking with other people forces us to share our expertise and influence by offering advice.
Consider how colonialism is present in daily communication and digital knowledge transmission. On Google - or really any web browser - you can search multiple variations on these similar keywords: “global health,” “healthcare disparities,” etcetera. Unconscious prejudices frequently pre-restrict our search outcomes. Depending on the region or country you live in, your search results are already selected to match the relevant content. Buried within combinations of keywords and Western medicine practices are pockets where in-depth resources can be researched. Searches without attention to specificity similar to “global health,” “disparities,” or “barriers for communities to medical treatment” do not yield research studies or recent information from perspectives other than European countries or WHO (World Health Organization).
Our view of healthcare becomes distorted by major suppliers and pharmaceutical companies, some of which have been cited for fraud and championing monopolistic policies. Trust in medicine has declined as ordinary citizens turn to one another and deliberate on whether their doctors view them as patients whose illnesses are a source of income. Who is dealing the cards, then? Where is the assurance we are promised by professionals and pharmaceutical companies? In a society where increasing medication costs are becoming a norm, it is difficult to trust that providers know what is best for their patients.
Within the United States – a country spearheading Western medicine practices – six in ten citizens believe national health authorities act in the public’s best interests (“Topic: Trust in Healthcare in the U.S.”). Trust is influenced by multiple factors in any country, including economic security, gender and demographics.
For this reason, advocacy and challenging conventional narratives is essential. That is why everyone who has the resources and means to conduct the extra research should understand the core cause of injustice. The online world at their disposal ought to give them a sense of empowerment.
By broadening how much culture and experiences we expose ourselves to, our knowledge will catalyze policy improvements. University courses, for instance, are a mere launching point where a small proportion of individuals can get information about approaching health biases. We can move toward constructive change by recognizing the gaps in our collective development.
WORKS CITED: Initiative, HEAL. “The White Savior Industrial Complex in Global Health.” Medium, 16 Apr. 2020, medium.com/voices-from-the-frontline/the-white-savior-industrial-complex-in-global-health-5b759a5d55c5. Pratt, Bridget. “A Multidimensional Account of Social Justice for Global Health Research.” Bioethics, vol. 37, no. 7, 19 June 2023, https://doi.org/10.1111/bioe.13186. “4 Ways to Decolonize Global Health | Hopkins Bloomberg Public Health Magazine.” Magazine.publichealth.jhu.edu, magazine.publichealth.jhu.edu/2022/4-ways-decolonize-global-health. Yamin, Alicia Ely. “Using Human Rights to Advance Global Health Justice in an Age of Inequality.” PLOS Global Public Health, vol. 4, no. 7, 9 July 2024, p. e0003449, https://doi.org/10.1371/journal.pgph.0003449. “Topic: Trust in Healthcare in the U.S.” Statista, www.statista.com/topics/12021/trust-in-healthcare-in-the-us/#topicOverview.