Commentary | Decolonizing healthcare

Attitudes to medical practices must change

Capitalist norms in our society reach much deeper than just the economy. They dictate the lifestyles of many: prescribing their working hours, food, and consumption habits. These norms also contribute to a squeeze on the amount of time available to people; there aren’t enough hours in the day to do everything and still spend quality time with family, friends, or even yourself. This phenomenon of time limitation and a search for the highest efficiency in every walk of life also affects healthcare.

Due to globalization, Western medicine and capitalist norms spread overseas, where it was often forced on people, without addressing their culturally specific needs. Because of a history of systematic oppression toward these people (not only in the fields of religion, language, and culture), healthcare is colonized, with a clear hierarchy that promotes Western medicine as the ideal.

This focus on Western medicine and the prejudice against potential alternatives are a result of a capitalist, neo-colonial society in which Western supremacy legitimizes the dismissal and stigmatization of alien practices. Our medical practices are typically accepted, irrespective of their failures. For example, many harmful drugs are registered on the market by government agencies because they guarantee a profit for pharmaceutical companies, not because they benefit consumers. The pain medication Propoxyphene is a good illustration of this phenomenon. It was on the market for 55 years, only to be banned in 2010 when renewed examination of the drug revealed that its harmful side effects far outweighed the benefits.

This focus on Western medicine and the prejudice against potential alternatives are a result of a capitalist, neo-colonial society

The way our medical practices are usually legitimized is the scientific method: a hypothesis is put to the test, and then the experiment is replicated to determine the validity of the result. While this method is reliable, and has led to enormous progress in conventional Western medicine, there are other systems of knowledge creation. Unfortunately, medicine in the West only accepts knowledge if it conforms to the scientific method. Any other knowledge is fetishized, seen as mystical and different.

This view is not only racist, ethnocentric, and neo-colonial, it also ignores the needs of a wide array of people, mainly from outside the West, by limiting their healthcare options. Focusing on the needs of a specific demographic in healthcare can lead to inaccessibility for people with different religious and cultural practices. ‘Traditional’ knowledge (if we want to use an umbrella term and generalize the knowledge obtained by a huge variety of peoples) often cannot be defined in the context of the scientific method.

In societies that do not employ this method as the main legitimizer of thought, traditional knowledge has been accumulated over many generations. This kind of knowledge can come from experience, be passed down verbally or by script. According to the paper Traditional Healing and Western Medicine: Segregation or Integration? by Caroline Kangwa, traditional healers do not measure their medicine using the same measures of standardized doses that Western medicine uses. The healers base the dosage on their experience and vary it based on intuition. The fact that the working processes of these kinds of healing systems cannot be understood by Western standards does not make them any less legitimate.

During colonial and missionary times, doctors and missionaries would label people’s beliefs that differed from their own as “belonging to the devil.”

There are also concrete downsides to Western medical practice. In the case of illness or disease, we often focus on quick fixes. Rather than using holistic methods, many are interested in reductionist approaches, which in many cases only suppress symptoms. “Implicit within this practice is the deeply rooted belief that each disease has a potential singular target for medical treatment. For infection, the target is the pathogen; for cancer, it is the tumo[u]r; and for gastrointestinal bleeding, it is the bleeding vessel or ulcer,” according to a group of scholars at the National Center for Complementary and Alternative Medicine, a U.S. government agency. While this might be very effective in some cases, it does not allow for the disease to be seen in its wider context. The scholars continue to explain, “A young immuno-compromised man with pneumococcal pneumonia usually gets the same antibiotic treatment as an elderly woman with the same infection. The disease, and not the person affected by it, becomes the central focus.”

In contrast, alternative medical practitioners will not just focus on the reduction of symptoms, but on long-term changes within the lifestyle of the patient, such as changes in environment and attention to the community to which an individual belongs. Including this perspective in Western medicine could be hugely beneficial.

The dichotomy that exists between Western medicine and alternative or traditional medicine leads to mistrust on both sides. The West does not trust ‘traditional’ medicine, because it often cannot be understood using current scientific thinking. People using ‘traditional medicine’ often do not trust Western medicine, because it is ethnocentric and does not respect different cultural practices and beliefs. During colonial and missionary times, doctors and missionaries would label people’s beliefs that differed from their own as “belonging to the devil.” The oppression experienced by colonized peoples only expanded feelings of mistrust toward practices coming from the West.

Decolonizing attitudes in general, but especially in medical terms, would thus be favourable, as both medical systems could benefit from each other if they were more integrated.

Decolonizing attitudes in general, but especially in medical terms, would thus be favourable, as both medical systems could benefit from each other if they were more integrated. This involves dismantling prejudiced and oppressive attitudes that took root during the colonial era.

However, perceptions of alternative medicine still exist, and they are not helped by a largely negative press in the West. The media usually focuses only on select areas of alternative medicine, such as homeopathy, a practice whose efficacy has repeatedly been called into question by doctors and researchers. Because of this kind of negative attention, people ignore, or at least do not realize, the wide array of disciplines that are included in alternative medicine. These include Indigenous healing practices, chiropractic therapies, massage, or herbalism (the use of plants for medical purposes), all of which, according to the Public Health Agency of Canada, can be complementary to Western medicine. If they accompany Western medical practices, these practices could offer people a wider array of options pertinent to their individual needs.

Due to the structures of inequality within our society, however, people, especially from minority groups who do not identify with Western cultural standards, find healthcare systems inaccessible. They cannot access certain treatments because of mistrust of the system and lack of accommodation to their culture. Healthcare should be a universal right – it needs to be decolonized and made accessible to all.


Joelle Dahm is a U3 Environmental Studies student, and can be reached at joelle.dahm@mail.mcgill.ca.


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