Acknowledging inequalities in global health

Ramya Raman

15/12/2023 4:10:38 PM

The history of colonialism has left an indelible mark on societies worldwide, and the field of health and medicine is no exception.

Diverse group of healthcare workers
We are all responsible to ensure healthcare is a fundamental human right accessible to all.

Colonisation in many parts of the world left behind deep-seated prejudices and practices that continue to shape healthcare today.
There is increasing demand for ‘decolonisation’, described recently by Dr Annabel Sowemimo, author of Divided: Racism, Medicine and Why We Need to Decolonise Healthcare – reviewing how systems of race, class and gender have been shaped by colonial history, and how we move to establish a more equitable society.
Worldwide, there is a continual need to acknowledge this concept in health and the teachings of medicine on a global scale.
This process involves unearthing and addressing our cultural histories; challenging structures of power; recognising how colonial legacies persist in healthcare; and reinforcing inequalities and dependencies.
This starts with educating health professionals on colonial context, helping them understand how these ideas have shaped modern healthcare. It also requires addressing disparities in healthcare outcomes, such as racial profiling and unequal access to quality care.
To embed the concept of ‘decolonisation’ in healthcare, the existing societal structures of power must be critically examined.
Health professionals and organisations must embrace grassroots and community-based experience and expertise, which requires a redistribution of resources and a re-evaluation of how healthcare decisions are made.
Medical and healthcare professionals must engage with local communities, recognising the value of traditional healing practices and Indigenous knowledge. Education syllabuses need continuous reform to teach cultural humility, and include critical examinations of colonial histories and their impact on healthcare – fostering the next generation of health practitioners who are aware of the complexities of global health inequalities.
Decolonising health and medicine may be a controversial headline; however, it is imperative for a more equitable society.

Tackling this topic necessitates acknowledging the past, challenging the status quo, and redefining power dynamics in healthcare.
The responsibility falls on the shoulders of governments, health organisations and all of us to prioritise a health approach that respects and empowers local communities, and ensures healthcare is a fundamental human right accessible to all – regardless of their race, gender or place of origin.
This article originally appeared in Medicus, which is produced by the AMA (WA), and is republished with permission. This article is an opinion piece, not an official RACGP position.
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A.Prof Christopher David Hogan   19/12/2023 1:32:40 PM

As the Curator of the RACGP museum & collections I most strongly agree that we must examine our history - all of our history.

A.Prof Christopher David Hogan   19/12/2023 5:37:22 PM

By all means examine our history to see why & how we have developed our structures & behaviours.
However, the motivation for their existence alone is not reason enough to change.
We should only change if the structures & behaviours are inappropriate, unfair & inefficient.
World wide there are now massive issues in the funding of healthcare, access & equity.
If healthcare is to be available to all ,we must adapt to an improved paradigm of care.

Dr Roy Mariathas   19/12/2023 7:26:09 PM

Thanks for raising an important issue, much needed. This is the second time I've read about cultural humility, the first with a paper written by Karen Price. Decolonising healthcare is goal worth striving for to ensure fair and accessible care for all. My concern would be in the implementation, as boats will be rocked. Aligning stakeholders to this vision is challenging. It requires not just awareness but also a commitment to re-evaluate and change longstanding practices. The holders of power inevitably let go of power easily, and in our profession those that make a scene or engage in political change can be frowned upon. It's a hard task - hard to see come to fruition and hard on those that advocate for change. I really hope our profession and College will rise to it.