AFROPUNK Solution Session 2: Decolonize and Reimagine Health (Key Takeaways)
On September 9th, 2022, in Brooklyn, NY, AFROPUNK gathered six medical professionals–4 Black Women doctors, one Black male nurse, and one Latinx doctor turned tech and digital health innovator— for a panel entitled Decolonize and Reimagine Health: A Discussion. Moderated by Medical Student and Healthcare TikTok/Instagram Influencer Joel Bervell, the discussion focused heavily on envisioning strategies for breaking down structural racism, and colonialism as well as acknowledging the inherent biases present in modern medicine and their respective roles in it as representatives of the system.
This lively and honest discourse was ripe with thought-provoking ideas featuring the following panelists:
- Dr. Uché Blackstock (@ucheblackstockmd)
Board Certified Emergency Medicine Physician/ Founder, Advancing Health Equity/CNBC contributor
- Dr. Meena Singh (@drmeenasingh)
Board Certified Dermatologist/Dermatologic and Hair Transplant Surgeon/ Cast Member, TLC’s Bad Hair Day
- Dr. Rachel Villanueva (@drrachelsays):
Board Certified OB/GYN/ Former President of the National Medical Association/ Minority Health Advocate for Equity
- Nurse Sean Treadvance
Former United States Airmen/Nurse working in the NYC and Maryland healthcare systems
- Dr. Michelle Morse:
Internist and Public Health Doctor/ New York City Health Department’s Chief Medical officer/ Deputy Commissioner for the Center for Health Equity and Community Wellness
- Dr. Félix M Chinea (@felixmchinea)
Head of Health Equity & Inclusion Strategy at Doximity
Here are the key takeaways:
#1 Diversity, inclusion, and equity can be cute, but decolonization is not. Joel started the discussion off with the powerful question, “What does decolonization look and feel like?” The panelists did not shy away from the heft of the issue. The answers to this question gave rise to the fact that decolonization is both multifaceted and multidimensional. It is also quite difficult.
Dr. Chinea started the panel off by reminding the collective that decolonization and reimagining health is not new work. He highlighted the fact that this work is already in motion by saying:
“I feel like simply it feels like self-determination, it feels like community. It feels like, you know, feeling seen and seeing yourself in a space and in where you’re going. I think that’s the simple way to think about it […] There’s a lot of scholarly work in this space, and I think it’s important to take some of these terms that we kind of throw around and that we talk about and to realize that, you know, a lot of people have been doing really meaningful, impactful work in this space that we need to lean on. There are [existing] frameworks.”
Nurse Treadvance believes that incorporating Black and Brown healthcare narratives into the healthcare policies and norms will help to prevent the overlooking and/othering of Black and Brown health experiences:
“I think that our experiences are often looked over and, by overlooking us, it kind of holds us into something, into a group that we don’t necessarily fit into. So I think that if we kind of go back to the basics and, and, and let our experiences kind of like talk and let them be known and, or maybe working into the educational system a lot more, I think that that should definitely help with kind of deconstructing.”
While Dr. Villanueva felt strongly that decolonization would begin by naming it and scratching below the surface of the trendy ‘diversity, equity and inclusion,” to do the hard work of unpacking structural racism and not accepting/allowing DEI measures as decolonization:
“It’s so cute, right? But that’s it– a nice little package, but it’s not that package. And they just want to talk about the surface, and they don’t want to delve into what the real work needs to get done. The years of oppression, and the inhumanity that black and brown bodies were subjected to promote medicine and is the foundation of what we studied.”
Dr. Singh took what could be perceived as a more radical stance in terms of challenging traditional ways that Black and Brown healthcare professionals show up in healthcare environments–rejecting assimilation:
“thinking about decolonization, what first came to my mind is the opposite of assimilation.[..]Colonized, you’re forced to adopt a different look, a different language, a different religion, and lose your own heritage. And so the act of decolonization is the opposite of assimilation and embracing your own, embracing everything that is your own. It’s interesting because, I mean, obviously, I’m focused on hair, but hair is such a big deal. Is it a big aspect of how we’re looked at, at how we’re treated? The fact that we need to [straighten] our hair to make others feel comfortable–So the opposite of assimilation is forcing everyone else out of their comfort zone. It’s not our job to make other people feel comfortable.”
Dr. Blackstone undergirded Dr. Singh’s perspective by recounting how an observation that all women at the National Medical Association Conference as a preteen influenced her to straighten her hair at one point.
In terms of her vision of decolonization, Blackstone went on to put forth the thought that centering the patient’s humanity is key.
#2 The work of decolonization begins internally. Exploring the duality and scars of being both a product of and othered within an oppressive system was a recurrent underlying theme throughout the discussion. Many of the healthcare professionals acknowledged the stress and pain of being the only person of color in their work and/or training environments, as well as blind spots brought on by the structure wherein they were educated. Dr. Blackstone said that the pandemic made her aware that many [Black and Brown] patients view these Black and Brown healthcare professionals as part of the oppressive mainstream healthcare system and that it is important that they remember that they might unconsciously perpetuate some of the biases they are actively trying to work against. Joel confirmed that as products of the system through medical training, it is often difficult to identify when they are doing so. Two notable quotes on this topic were:
“Like we all know the things that make our blood pressure go up or like, you know, give us goosebumps or make us or whatever it is. And if you’ve ever been like the black doctor on rounds and you’re the only black face, right? It is beyond stressful. So, like, part of the reason I loved living and working in Haiti as long as I did was I was working with all black nurses, all black doctors, all black patients. It was completely different than being on rounds at Harvard Medical School, for example”– Dr. Michelle Morse.
“ I think the other thing is thinking about this, basically this Western biomedical that we use and how we care for patients and thinking about this, you know, the health care professional and the patient, and that is sort of this dyad relationship as opposed to thinking about how that happens in our lives, right? Like where we work, where we live, where we play, and how that impacts our health. […] Talk about becoming structurally competent healthcare professionals, understanding how our society works, understanding how economic policies or the kind that we fact that we live in a capitalist system, the fact that we live in a racist society, and how that impacts the social determinants of health, which more downstream impact the health outcomes that we see.”
– Dr. Uché Blackstone
#3 A willingness to call out inequity and racism is paramount to decolonization. With the undercurrent of structural racism and several comments permeating the conversation and the on-the-ground efforts to achieve colonization, Nurse Treadvance addressed what he deemed a fear of calling it out.
“I think that I think that one of the major things that I kind of experience is that we’re kind of scared to call it out, right? Like we never just say, you know what? why? Why aren’t there any all-black cohorts? [why] can’t we shamelessly do that the same way that they do those things right?[…] It’s pretty blatant. You can go on any of these websites, and you can look at any nursing cohort, and you know that you’re going to see the token people, right? From every demographic, but you never see an entire [black cohort] unless maybe a historically black college, of course— we’re afraid to call it out. We have to call it out like you have to say its name in order to identify and to change what’s happening.”
Joel encouraged the panelists to delve deeper into this point by asking, “How does structural racism prevent or slow us down from reimagining health overall?”
Dr. Villanueva expounded on Sean’s point by saying:
“People become personally offended when you start talking about racism because they think you’re talking specifically about them in the class. Right. We know that, you know, we have colleagues who were fired from their jobs for just discussing the fact that racism exists. Right. Because somebody felt offended by that. But I think therein lies the problem, right?”
Dr. Morse brought up how structural racism has created division amidst African diasporan medical practitioners living and working in the United States and beyond:
“African immigrants in the U.S., black American descendants of slaves, Caribbean immigrants, all the different ways in which we are a part of the African diaspora can be our greatest source of strength, but can also be division. […] Because racism is also internalized. Internalized racism is like me thinking the black doctor is as good as the white doctor, right? Or, like within a black physician conversation, there being competition. [..] It’s meant to divide and conquer and hold power among white people.”
Dr. Chinea explored the impact of structural racism on the design of healthcare products. He brought forth the intentional ‘baked-in bias’ of new technologies to prevent people of color from taking up space in the mainstream healthcare space.
#4 Wakanda is within us. Looking forward to the future, Joel posed the question, “What would [your own] Wakanda look like?”
Dr. Singh started off by saying Black and Brown people have to look inward and build within their own communities and with each other. She later referenced the manner in which Jewish communities harness resources and invest in communal spaces that teach heritage, healthcare, etc.
Dr. Blackstone doubled down on Dr. Singh’s assertion by referencing the communal framework that was put in place by the Black Panther Party in the 1960s and 70s, as well as the work of the Young Lords.
Nurse Treadvance asserted that tackling technology will be the way forward. He acknowledges that there are algorithms that are stacked against Black and Brown people. He spoke fervently about the need for tech and data that actively build programs to combat the structural racism that lives within the mainstream system.
Dr. Morse spoke about cultivating a new generation of healthcare professionals from younger generations who are being raised in an era of active anti-racism and helping to channel their fire.