Health has long been a gift that we have attempted to give to the rest of the world. Disease eradication programs, vaccination outreach campaigns, and the Western biomedical system have all been spread to countries near and far. These gifts were often colonialist in design, given without community consent, and without regard to culture or custom. Contrary to Thomas Friedman‘s thoughts, the world is not flat. Rather we live in a world that is increasingly connected by technology, but still remains sharply separated by those who have and those who don’t.

When it comes to global health, we no longer have the luxury of saying, “those people over there have health issues.” There is no simple separation between “us” and “them.” Health problems aren’t over there any more than they are right here. In the US, lifestyle choices contribute to heart disease, diabetes, obesity, and lung cancer. When we talk of disparities in access health in other parts of the world, we cannot forget the glaring health disparities in US inner cities and across communities of color.

The curtain has been lifted and hopefully we have looked in the mirror to see that we too have health issues in our country. While the ideas to make health better have long come from the West and developed countries, that paradigm is no longer applicable to global health today. Our world is still expansive, but we are more connected than ever before. With the internet at our finger tips and friends across the ocean only a skype call away, solutions in global health come from around the world. The past demonstrated that “developed” countries believed they were giving something valuable to those who didn’t have what they had. The result was a plethora of failed aid goals, missing life-saving medications, and decrepit health care systems.

Innovations for better health come from all around the world. It is no longer the “developed” giving ideas to the “developing.” The increasing use of mobile phones have inspired some exciting programs for health records management while SMS and texting have led to revolutions in access to health knowledge and care. However, it isn’t always technology ideas that are most effective. Developing countries have reminded us how important and critical health insurance can be, while at the same time demonstrating the severe need for more trained health care workers. Models that train community health workers, access micro-health insurance on your mobile phone, and social enterprises that provide ambulance emergency services have all been launched in “developing” countries. I can only hope that our health care system can take the time to look around the world for ways to improve.

For many years, complex issues in international development and global health have been tackled by simplified single-issue campaigns that have created short-term “band-aid” solutions. This can be attributed to the limited view most Americans have of the world. For many, issues of global health remain remote and abstract. We, young people, have grown up with the internet in our laps, basic knowledge of different cultures around the world in our classrooms, access to easier communications and travel, and more opportunities to study abroad and participate in global exchanges. These factors have made the world seem more connected, and have bestowed upon us the capability to serve as the key drivers of social change.

We must bridge the divide between rich and poor, privileged and oppressed, developed and developing. We, as privileged young people, can be the voice that changes the actions of our largest institutions to focus on programs that work, projects that benefit people in need, and efforts to build healthier communities.

Reposted from the Blog of Americans for Informed Democracy, where I am writing as a Global Health Issue Analyst.

(Photo Credit: Amazon)

History has set African health care up for failure. Lack of trained health workers places a massive burden on many African health care systems, inadequate or non-existent infrastructures make provision of basic needs like food and water impossible, debt and limited budgets move health care to a lower financial priority, medications are expensive and multinational pharmaceuticals want to make big profits, colonialism, apartheid, neo-colonialism, and the effects of an oppressed history perpetuate inadequacies in health care.

The varied record of health in Africa over the past century is inseparable from the history of change in control over political institutions and change in the organization of economic production. In the early years of colonial rule some governments relied on forced labor; in parts of colonial Africa, especially in the eastern and southern parts of the continent, male workers migrated from rural homes, leaving their families behind; in the postcolonial years class differentiation has become more pronounced, with some workers permanently separated from their roots in the countryside.[1]

Feierman and Janzen are right on target again in describing the scene of African health in relation to colonialism, politics, and history. African countries inherited health care systems from colonial authorities, but very often there was no health workforce to fill the void of colonial medical professionals. One Frenchman wrote,

La suele excuse de la colonisation c’est la medecin [the only excuse for colonialism is the doctor] – Hubert Lyantey (1926)[2]

If nothing else colonization was a positive in establishing health care systems and providing professional doctors? I wish I could agree, but mission societies that often ran health services relied on negative images of Africans.[3] The famed Dr. Livingstone was a doctor with the London Missionary Society and is best known for his explorations of the continent that allowed colonial empires to penetrate further into and conquer the African interior.

The slow demise of colonization did not end Western interference in Africa. Well into the 1980s and 1990s some African populations remained under the oppressive control of Western and minority populations. This control led directly to the ill health of those populations, notable South Africa and Mozambique. Black South Africans were denied basic health care services, training, and other needs.[4] South Africa fought a proxy war in Mozambique that specifically targeted the destruction of health care infrastructures. In African countries that gained earlier independence there were other powers to face.

[...] the IMF and World Bank have much to answer for. [Their] policies have eroded Africa’s health care systems and intensified the poverty of Africa’s people. – Salih  Booker[5]

Structural Adjustment Programs (SAPs) and other policies forced by Western institutions made the development from colonialism to independence that much more difficult for African countries. As Hunter writes, these policies often increased the poverty of African populations as opposed to providing for their basic needs. Health became a lower priority as African countries fell into debt because of loans from the IMF and SAPs of the World Bank. Even today with the economic recession African governments are cutting their health budgets to make ends meet. Health services should be the last item cut from a budget as health is central to all other human development.

Health is a major issue in Africa as the basic needs becoming increasingly difficult to provide and there have already been numerous reforms and attempted mechanisms to provide adequate health care.

[2] Hunter, 136.

[3] Ibid, 144.

[4] Hill, 6.

[5] Hunter, 47.

Thursday and Friday I attended many of the Africa focused workshops – most were very exciting and engaging. They really brought the African perspective into the ideas of the US Social Forum and made delegates think about the US role in issues affecting communities on the African continent.

24 Thursday 10am-12pm

African Unity Towards What? (Pan-Africanism & Nationalism is not enough!) by: University of Kmt

I still haven’t exactly figured out this group and what they do. They run the Kmt Press which publishes books and journals, but all of their sessions that I attended were focused on teaching with an African historical perspective. Their missions states that they are dedicated to educating the new generation of African leaders. Interesting that they are in Detroit and I wonder if they know of the Detroit Public School (DPS) Initiative starting in 1992 where Africa was integrated into school curriculums from math to literature.

24 Thursday 1-3pm

Prioritizing Africa & the African Diaspora Agenda from Detroit to Dakar (D2D) by: Priority Africa Network (PAN)

This People’s Movement Assembly was geared towards bringing African perspectives into the US Social Forum and continue the discussion as preparations are made for the 2011 World Social Forum in Dakar, Senegal. The room was full of delegates from many African countries, Detroit, and US Africa Advocacy groups.

Briggs Bomba, Director of Campaigns at Africa Action, spoke strongly about building solidarity with those most affected in Africa. He said, “corporate led globalization has harshest effects on those in the perifery, the underdeveloped.” He reminded us that all of us the privilege to attend conferences like these and make the policies need to prioritize the communities most affected.

A delegate from South Africa spoke eloquently about the social apartheid of displacement – ideologically, locations, in decision-making and governments; in voting process lack of people power and transformational action, and in the social mainstream. “We cover many issues, but it is the same struggle. We come from different areas, but share common experiences.” (i.e. colonialism)

Some top issues that came out of the PMA:

• Militarization in the Congo (DRC)
• HIV & STDs from Detroit to Africa
• political economy – effects seen in everyday Africa
• African defense (defend communities), liberation (not yet liberated), and autonomy

An exciting and dynamic session that really makes me excited for the World Social Forum in Dakar!

24 Thursday 3:30-5:30pm

The New Africa Command & U.S. Military Involvement in Africa by: African Security Research Project (aka: Daniel Volman)

This session was an interesting overview of AFRICOM by some leading scholars on the topic of US national security interests in Africa. The attendees were less diverse than the Detroit to Dakar session and most people came to learn more because it looked interesting and had studied Africa to some small degree in the past.

Most interesting was when the discussion turned to private military contractors (PMCs) in Africa responsible for fighting wars in Libera, Southern Sudan, and Somalia. A Ugandan delegate actually talked about being trained by PMCs in Iraq to then return and fight the Lord’s Resistance Army in Northern Uganda. Great to hear the perspective of the Ugandan delegate and Dan Volman as well as to see so many people interested in learning more about African issues!

25 Friday 1-3pm

Power-sharing Deals in Africa: Implications for Democracy – The Case of Zimbabwe & Kenya by: Africa Action

This was by far the most organized session that I attended at the US Social Forum. The Africa Action team did an amazing job of gathering great speakers, formatting the session, and bringing people into the room for the discussion. Many African voices were heard from delegates representing Zimbabwe and Kenya.

In both cases of power-sharing, the speakers agreed that the power-sharing deal was a sigh of relief that stopped the fighting and opened their doors to the international community and economy again. However, they also all recognized that power-sharing was a positive in the short-term, but can be positive as in the case of South Africa when Mandela and de Klerk signed a power sharing deal until the national democratic elections.

Here are some take-aways:

• A weak state can and will be manipulated (i.e. Museveni in Uganda – waiting for a similar situation as Kenya and Zimbabwe soon, elections next year)
• “The people” are separated from the power – people-centered in needed
• Power-sharing allows for lessened tensions and time to create national unity towards something better
• Coalition governments show defeat of “people power”

Four modern-day explorers in Expedition Africa (from History Channel)

Reminiscent of the 1800s, a new History Channel show describes a team of explorers, dressed in their colonial khaki, set out to discover the perils of the African continent.

Four modern-day explorers retrace the most famous search in history through 970 miles of hell. They face countless dangers from predators and insects to disease and nature’s own fury. Check out the television event of the summer!

Miles of hell in Africa, oh my! Don’t forget the natural danger!

Between Zanzibar and Ujiji, there are 970 miles of high seas, steep hillsides, scorching plains, fast-moving rivers and mud-filled swamps. Danger lurks around every corner, and any step could be their last.
(Expedition Africa, History Channel)

The webpage for the expedition show describes how the explorers will be following in the footsteps of the great explorers, “heroes” to some of these ‘modern-day’ explorers, Sir Henry Morton Stanley and Dr. David Livingstone.

Stanley a Welsh journalist, who spent a number of years of his life in the US, is best known for finding Dr. Livingstone after he was thought lost in the African bush. Regarded as one of the premier African explorers, a little known fact about Stanley’s African exploration is that he laid the foundation, through his exploration, for the takeover of the Congo (now DRC) by King Leopold II of Belgium. The King was interested in spreading Western civilization and religion to the region as well as claim land. This has led to a still destabilized region where some of the longest running African conflicts are located. Allegedly his expeditions were marked by violence and brutality. He is quoted, “the savage only respects force, power, boldness, and decision.” On a health related note for the central African region, the spread of trypanosomiasis is attributed to the movements of Stanley’s enormous baggage train.

Livingstone’s African exploratory era was marked by the greatest European penetration of the continent. He began his African explorations as a Protestant missionary, but supposedly did not force his preaching on unwilling ears as his main interest was exploring. He was known to travel lightly and was able to negotiate with local chiefs. Livingstone was a man in love with the continent and popularized the search for the source of the Nile. After being ‘found’ by Stanley he refused to return without completing his mission. Just 50 years after his death, colonialism exploded across the continent and was able to penetrate further into the interior due to his work. However, this also allowed missionaries to provide education and health care services to more central Africans. Livingstone was also a staunch abolitionist and made many friends among the African chiefs and populations.

Both men are examples of the Western colonial mindset scarring the African continent. While Livingstone was perhaps a step forward in Western engagement of Africans, Stanley is far from a figure to emulate. The History Channel fails to take note of the important contributions these men made to the destruction of the continent. Instead they focus on the meeting of the two in a popular media tale of discovery in the African wilderness.

Four Westerners with varying experience with the African continent will be followed on their journey that will pit them against the harsh natural environments of Africa. But, this show isn’t about Africa, learning about African peoples, remembering African history or highlighting the difficulties faced in Africa. The show makes generalizations about the continent and perpetuates the myths of Africa as primarily a place of danger. It focuses on Africa as “the unknown, the interior of Tanzania.” If I’m not mistaken people have been living on the African continent longer than any other place on earth. It may be a dangerous, unknown hell full of nature to outsiders, but it is far from a mystery to those who live there. The show seems to be all about these four privileged individuals and the story of their personal journeys. The explorers are worried about mosquitos, disease, death, and surviving. Rightly so in some regards, but what if the story included the people that actually live there?

When will Africa cease to be represented solely by its nature, its dangers and its forgotten history?