Comrades in Health: U.S. Health Internationalists, Abroad and at Home

Comrades in Health: U.S. Health Internationalists, Abroad and at Home

Comrades in Health: U.S. Health Internationalists, Abroad and at Home

Comrades in Health: U.S. Health Internationalists, Abroad and at Home

Synopsis

Since the early twentieth century, politically engaged and socially committed U.S. health professionals have worked in solidarity with progressive movements around the world. Often with roots in social medicine, political activism, and international socialism, these doctors, nurses, and other health workers became comrades who joined forces with people struggling for social justice, equity, and the right to health.

Anne-Emanuelle Birn and Theodore M. Brown bring together a group of professionals and activists whose lives have been dedicated to health internationalism. By presenting a combination of historical accounts and first-hand reflections, this collection of essays aims to draw attention to the longstanding international activities of the American health left and the lessons they brought home. The involvement of these progressive U.S. health professionals is presented against the background of foreign and domestic policy, social movements, and global politics.

Excerpt

The promotion of corporate interests by the U.S. government takes place in many different forms. Quite frequently it occurs as a military intervention. Indeed, many people in the United States learn geography by looking up the place where the latest U.S. troop intervention has taken place: Iraq, Afghanistan, Yemen, possibly tomorrow Iran, and so on. While military interventions are known for their costs and ineffectiveness, not to mention brutality, their frequency is likely to continue. Further, the “stick” is usually accompanied by the “carrot,” called “humanitarian” aid. and within that aid, health care and medical care take a prominent place. These endeavors tend to attract people with humanitarian and social concerns, which make them vulnerable to being used. Health aid workers typically see their work as altruistic, nonpolitical, and oriented to help those in need. How can one be against feeding hungry children and taking care of sick people whom they aim to help? But the U.S. foreign policy establishment and the big private foundations have logics of their own and determine the objectives and parameters within which those well-intentioned humanitarian workers operate. Regardless of personal motivations, goals, and feelings, reality intrudes and the institutions health professionals work for define what they can do, and these institutions are not always well regarded outside the United States. Many times I have encountered health professionals with the best of intentions who, upon arrival in a country that they personally wanted to help, faced great hostility for their association with institutions that were perceived by the local population as responsible for the poor health conditions those professionals were supposed to alleviate.

Medical care and public health are very political interventions, even though professionals working in these fields may not always be conscious of it. Indeed, the health and well-being of populations depend on political, economic, and social realities, not primarily on medical care or public health interventions. a consequence of this reality is that health improvement should be based on collective efforts aimed at the establishment of healthy (that is, redistributive, equitable, and sustainable) economic, social, and political institutions and policies and not primarily on the delivery of one-on-one care in traditional clinical practice. Thus, a health professional working for a foreign policy branch of the U.S. State Department and posted to a country with an existing dictatorship is not only likely to be ineffective in improving the health . . .

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