Page 28 - GHES-2-2

Global Health Econ Sustain

PERSPECTIVE ARTICLE
Decolonization of health care in Tanzania

1
Sanaa Said , Nateiya Yongolo , Sanjura Biswaro , Richard Walker ,
2
3
2
and Clive Kelly *
4
1 Department of Medicine, Mnazi Mmoja Referral Hospital, Stonetown, Zanzibar, Tanzania
2 Department of Medicine, Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro, Tanzania
3 Department of Elderly Care Medicine, Northumbria Healthcare NHS Hospitals Trust and Newcastle
University, Newcastle, United Kingdom
4 Department of Medicine, James Cook University Hospital, Middlesbrough, United Kingdom

Abstract
Geographical location of residence and socioeconomic status are two primary factors
determining one’s access to health care, which often derail the common goal of
affording equal accessibility of health-care resources to all individuals. The authors,
comprising three physicians from Tanzania and two from the United Kingdom (UK),
share a common commitment to understanding and addressing the consequences
of colonization on health-care provision. Drawing on extensive experience in both
clinical and academic capacities in East Africa, we define decolonization from the
perspective of building sustainable and independent clinical and academic services
in Tanzania, supported by experienced UK clinicians. In this opinion piece, we
describe and discuss workforce and political issues that have shaped the historical
Academic editor: and present influences of the UK in Tanzanian health care. In addition, we highlight
Mihajlo Jakovljevic M.D. Ph.D. MAE
certain successful initiatives that are already improving outcomes in Africa and offer
*Corresponding author: further examples of practices that might improve clinical and academic outcomes for
Clive Kelly
(Clive.kelly2@nhs.net) marginalized populations in the future.
Citation: Said, S., Yongolo, N.,
Biswaro, S., Walker, R., & Kelly, C. Keywords: Decolonization; Health care; Academic collaboration; Tanzania; Education
(2024). Decolonization of health
care in Tanzania. Global Health
Econ Sustain, 2(2): 2299.
https://doi:10.36922/ghes.2299
1. Introduction
Received: November 23, 2023
Accepted: January 4, 2024 The National Health Service (NHS) was established in 1948 to address inequality and
improve access to reasonable standards of health care for all United Kingdom (UK)
Published Online: April 24, 2024
residents, ensuring that it was free at the point of delivery. Despite its well-documented
Copyright: © 2024 Author(s). challenges, the NHS has been described as “the envy of the world.” Over the decades, the
This is an Open Access article NHS has driven the quality and consistency of clinical care within the UK. In addition,
distributed under the terms of the
Creative Commons Attribution alongside universities and various other organizations, it has established a reputation for
License, permitting distribution, excellent academic research and teaching. However, an increasingly recognized aspect of
and reproduction in any medium, the UK’s colonial past casts a long shadow on health-care provision elsewhere. Contrary
provided the original work is
properly cited. to the idea of producing and sharing its “commonwealth” equally with the people
inhabiting the countries it colonized, the UK has faced accusations of exploitation on
Publisher’s Note: AccScience
Publishing remains neutral with several fronts.
regard to jurisdictional claims in
published maps and institutional It is somewhat ironic that indigenous peoples experience higher morbidity
affiliations. and mortality than those who arrived later in the same lands. Although these

Volume 2 Issue 2 (2024) 1 https://doi.org/10.36922/ghes.2299