(by Anish Parekh, one of our PGY-2 residents)
Global health is a nebulous term that basically means providing healthcare to people (either in the US or abroad) who are not part of the global privileged elite. This includes underserved city-dwelling poor and reservation-dwelling Native American Indians.
Often when people talk about global health it’s a very “Us against Them” discussion among privileged, mostly white, liberals who want to “do good” for the world. The Illich article really resonated with me for this reason, which is that global health is almost always just a proxy for neocolonialism. There are much better ways for people to support those in low income countries (and just all people around the world, generally) by opposing predatory and exclusionary economic policies, championing the rights of underserved in our own country, and agitating for environmental justice and sustainability. Privileged White “global health practitioners” mostly fail to acknowledge that their complicity, unconscious or not, with the status quo perpetuates the injustices that they feel the need to travel to another country to solve. The goal of these individuals is to try to make systems, paradigms, and cultures of other countries more similar to those of Western society.
I have had a decent amount of experience with this also in college when I started an ill-fated nonprofit organization whose goal was to ship unused medical supplies to other countries. We also realized that this whole process was like using a dirty bandaid to close a surgical wound — there was a much greater risk of shipping trash to people who had less capacity to dispose of it than there was a reward of getting the supplies to them in the first place. Not only that, we made no headway against the systemic and structural issues causing poor health outcomes in the countries we sought to help.
I have quite a pessimistic view on global health as it is practiced today. The mosh pit of nonprofits and NGOs that engage in global health, international service, and medical missions in many instances serve as an outlet for privileged Americans and Europeans to slum it up in another country and feel like they did something good. There are countless examples of organizations that actually harm the population they ostensibly are meant to help, either through negligence or by siphoning funds that could have been better used by someone else in the community.
Ultimately, I believe that most people do not attain the level of introspection necessary to overcome their privilege, and that global health driven by moral, economic, and social imperatives of the privileged will fail to provide much benefit to the majority of the world.