Eliminating the White Supremacy Mindset from Global Health Education
Abstract: The term “decolonization” has been increasingly used to refer to the elimination of the colonial experience and its legacy. However, the use of this overarching term masks the real root of the problem. European countries, whose populations are majority white,used their assumed supremacy as justification for the colonization of current low- and middle-income countries (LMICs) where the majority of non-white people live. This clear overlap between geographic and skin color differences explains how the white supremacy ideology triggered European colonization. Therefore, calls to decolonize global health education must focus on the roots of colonization and fight for the elimination of white supremacy ideology that is one of the pillars of the current ills of our global health architecture. A step in this process acknowledging the expertise that emerges from LMICs, alongside challenging the traditional high-income country (HIC) hegemony over knowledge and strengthening universities in LMICs to provide quality medical and global health education. Additionally, we also need to reevaluate curricula, research selection, and design as well as partnerships. Students need to be equipped with the skills to question norms and contribute to the creation of equitable, mutually beneficial partnerships. This needs to accompanied by the adoption of transdisciplinary education to address critical societal challenges. By challenging the white supremacy ideology, we can shift the center of gravity in global health to respect the right to equal say in education and research according to the disease burden and the distribution of the world population.
‘Decolonising the Medical Curriculum‘: Humanising medicine through epistemic pluralism, cultural safety and critical consciousness by Sarah
H.M. Wong
In this article, we describe the pioneering efforts to decolonise the undergraduate medical curriculum at UCL Medical School (UCLMS), London, by a group of clinician educators and students, with the aim of training emerging doctors to treat diverse patient populations equitably and effectively. Throughout this process, students, faculty and members of the public acted as collaborative ‘agents of change’ in co-producing curricula, prompting the implementation of several changes in the UCLMS curriculum and rubric. Reflecting a shift from a diversity-oriented to a decolonial framework, we outline three scaffolding concepts to frame the process of decolonising the medical curriculum: epistemic pluralism, cultural safety and critical consciousness. While each of these reflect a critical area of power imbalance within medical education, the utility of this framework extends beyond this, and it may be applied to interrogate curricula in other health-related disciplines and the natural sciences. We suggest how the medical curriculum can privilege perspectives from different disciplines to challenge the hegemony of the biomedical outlook in contemporary medicine – and offer space to perspectives traditionally marginalised within a colonial framework. We anticipate that through this process of re-centring, medical students will begin to think more holistically, critically and reflexively about the intersectional inequalities within clinical settings, health systems and society at large, and contribute to humanising the practice of medicine for all parties involved.
Decolonising the Medical Curriculum Reading List by Sarah Wong, Tina Plowman, Ife Nwibe, Hope Chow, Amal Puri et al.: The Decolonising the Curriculum (DtC) movement in higher education has primarily been led by the arts and humanities, with medical schools trailing behind in adopting a decolonising approach to their curricula. This inertia may in part be attributed to how colonial-era hierarchies are deeply entrenched in the infrastructure that supports the medical profession, perhaps unsurprisingly in light of the intricate relationship between medicine in the ‘West’ and colonial history. In this reading list, we have organised resources according to key themes that may be used to interrogate the structure, content and delivery of medical curricula through a decolonial lens.The resources below outline key issues such as the exploitation of ethnic minority and indigenous people groups in historical knowledge production in medicine, socially and culturally determined health inequalities, how these groups continue to be misrepresented or under-represented in medical research, discrimination against ethnic minority doctors within the medical profession, and negative attitudes against alternative health beliefs and practices. While issues of systemic racism, racial inequality and Black history feature regularly in this list, resources specific to #BLM are included in the final section and there are many amazing reading lists out there to explore. We hope this reading list will enable more of us to enter into the discussion of what needs to change and provide a starting point for reflection, learning and more effective conversations.