Offline: Flies of our remorse
that of Eugene Richardson Epidemic illusions (2020) is subtitled On the coloniality of global public health. Although listed as the author of the book, he prefers to describe himself as “a single node in a vast, interconnected network of support, mentorship, tolerance, encouragement, inspiration and generosity”. It lists more than 140 “other nodes” – individuals, organizations and groups – to which it owes, with “the double objective of epistemic reconstruction and improvement of human well-being”. While not a textbook on how to decolonize medicine and global health, Richardson delivered what may be the first attempt to explore what decolonization could achieve. His criticism of the business we call public health is striking. As a group of professionals (a word that itself deserves consideration), we tacitly tolerate and continue to deal with inequalities in global health. As an academic discipline, we gladly maintain them. Coloniality is about power – who has it, how it is exercised, and for what purposes. Decolonization must consist in questioning and destabilizing these power relations, and “imagining alternatives”. A first objective of this project of unraveling the links around sanctioned truths is, he argues, to confront the privileged influence of global health data – “an ideological apparatus of protected wealth disguised as an objective investigation”. Instead, we should recognize the political nature of health and its determinants and “begin to parameterize historical and structural forces to shape people’s dispositions towards medicine and health care”. “Global social injustice is,” he writes, “roughly an epistemological injustice”. Enter scientific journals, such as The Lancet, which validate “the types of discourse that society accepts and makes work as true”. Richardson quotes Arundhati Roy: “There really is no ‘voiceless’. There are only the deliberately silenced, or preferably inaudible.
The answer? New health stories, of course, like Megan Vaughan’s Healing their ills: colonial power and African disease (1991) or that of John Farley Bilharzia: A History of Imperial Tropical Medicine (1991). But these are rare examples. A broader shift in perspective is needed. Viet Thanh Nguyen writes on “the problem of representation”. The problem for the colonized is that they are rarely able to represent themselves. They must always be represented by others: the colonizers “own the means of production, and therefore the means of representation”. And “not having the means of representation is also a kind of death”. Let me conclude with Memmi who describes her experience of coming face to face with the consequences of the omnipresent “colonial drama”: the mouths were smiling, but whose eyes, almost all eyes, were teary; I worriedly searched for a non-sick gaze on which to rest mine. Tuberculosis and syphilis, and those skeletal and naked bodies which pass between the chairs of cafes like living dead, sticky like flies, the flies of our remorse ”. So what should be the main objective of decolonization? I am thinking of dismantling a new nascent empire. Not an empire ruled by one person, one government or one country. But an empire that defends a threatening idea: anti-globalization.
Posted: 20 November 2021
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