Annabel Sowemimo (Wellcome Collection)
THERE is a paradox at the heart of Western medicine. It is built on a legacy of white doctors and scientists obsessed with skin colour, who were striving to demonstrate the inferiority of people with skin darker than theirs to justify European colonisation and transatlantic slavery. This persists today in the form of racial biases in medicine, which contribute to widely documented health disparities.
Yet Western medicine also ignores darker skin, from to poor education of healthcare workers on how the symptoms of certain conditions look on .
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Annabel Sowemimo, a writer, activist and doctor in the National Health Service in the UK, wants the ways in which past and present racism continue to shape healthcare to be recognised.
“At no point in my medical education – nearly a decade of university, three degrees and countless hours spent on the wards – did anyone mention how the legacies of colonialism and racism affect my decisions as a doctor,” she writes in her book, Divided: Racism, medicine and why we need to decolonise healthcare.
She retells the history of Western medicine for a new generation of doctors and health workers, with a view to understanding and eliminating racism in healthcare. That history begins with the invention of race and scientific racism by European doctors and scientists at the height of colonisation and slavery.
It is an invention that affects medical practice today, from the , to the continued use of medical devices with embedded adjustments for measuring racially “different” lung function.
“Scientific” racism was used to perpetuate false notions of racial inferiority and superiority, with colonised and enslaved people often placed at the bottom of an imagined biological hierarchy. But, as Divided powerfully illustrates, many “Western” advances can be credited at least in part to the exploitation of those same people.
Take the life of James Marion Sims, long celebrated by scientific and medical institutions as the father of gynaecology. Sims honed his surgical techniques in 19th-century Montgomery, Alabama, performing painful procedures on enslaved Black women without the use of anaesthetic. from New York City’s Central Park in 2018 following widespread protests.
Racist and colonial ideas around medical experimentation remain pervasive, as a towards the start of the covid-19 pandemic shows. “If I can be provocative,” said Jean-Paul Mira at Cochin Hospital, Paris, during a televised discussion about the development of a covid-19 vaccine in 2020, “shouldn’t we be doing this study in Africa, where there are no masks, no treatments, no resuscitation?”
Mira subsequently apologised. But, as Sowemimo reflects, his words “revealed a wound that was still festering and had been ignored for far too long: Africa and other former European colonies have historically been seen as a playground for those who wish to test their scientific hypothesis or refine their medical skills”.
In addition to being used as unconsenting medical research subjects, colonised and enslaved people and their descendants have also long been exploited for their medical knowledge.
For example, the slave owner and puritan minister Cotton Mather is known for helping spread the practice of smallpox inoculation across the US and its colonies, but , renamed Onesimus by Mather. , used in his country of origin, possibly modern-day Ghana. Mather is credited with promoting the idea, but the input of Onesimus isn’t widely known.
Such stories are important, says Sowemimo, because they challenge the narrative that Black and Indigenous populations weren’t engaging in scientific pursuits before Europeans arrived. Divided restores them to the history of medicine and makes a convincing case for decolonising healthcare.
Layal Liverpool is a writer based in Berlin
