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Global Health Econ Sustain Decolonization of health care

differences cannot be entirely attributed to the actions hailed from abroad, with 80% of these professionals coming
of the colonizers, their contributions are undeniable. from Africa and Asia (Office for National Statistics, 2019).
Understanding and reversing this trend has proven to Three years later, this percentage had more than doubled
be a challenge. The potential for settler colonialists to to over 40%, with Africa contributing the largest share. In
rationalize these differences as inevitable, or even normal, addition, overseas doctors accounted for 63% of the 23,838
has been described as a form of racism. The concept new additions to the UK medical workforce in the same
of decolonization in global health has attracted much year (Rimmer 2023). This growing reliance on foreign
publicity but lacks a universally accepted definition (Khan medical professionals amounts to an accelerating brain
et al., 2021). It emerged from the intertwined fields of drain, as many African doctors leave their home countries
tropical medicine and colonial health, which have been after completing their medical training to support the
described as “designed to control colonized populations ailing NHS. They often step in for UK medical graduates
and make political and economic exploitation by European who opt to work overseas in destinations such as Australia,
and North American powers easier” (Hirsch, 2021, p. 189). New Zealand, Europe, or North America. Furthermore,
Physicians from the global north engaging in health-care concerns about exploitation have been voiced over the
initiatives in previously colonized countries face the risk experiences of African nurses working in the UK (Likupe
of inadvertently perpetuating this inequity (Abimbola, 2006). The emigration of medical professionals appears
2018), or at least being perceived as doing so. However, unjust to many Africans, as it often exacerbates the health-
recent articles have highlighted the opportunities to care access challenges in their home countries. Attempts to
develop pathways for improving clinical care and research regulate this issue were made in November 2021 through
initiatives, thus achieving equity and fostering true agreements between the UK government and both Kenya
decolonization of health care (Wispelwey et al., 2023). and the Philippines (Department of Health and Social
Care, 2021). However, the current attitude of the UK
Khan et al. (2021) have proposed a roadmap to guide Government toward immigrants and refugees has turned
decolonization efforts and called for an integrated “Action to increasingly negative and unhelpful. Only those with
Decolonize Global Health.” A recent review discovered that qualifications deemed useful to the UK are welcomed, with
few “no clear norms exist in conceptualizing the definitions health-care professionals treated as “persona grata,” unlike
and processes of decolonization in the reviewed literature many of their less favored fellows. Recent announcements
clear norms exist in conceptualizing the definitions and by the UK government suggest a lamentable lack of insight
processes of decolonization,” but several recent articles into the challenges and sacrifices made by these workers,
were starting to “articulate decolonial processes in manners with proposals that may prevent overseas health-care
that are consistent, cohesive and attentive to the goals workers from bringing their families with them and nearly
of decolonization.” (Narasimhan & Chandanabhumma, doubling their surcharge for accessing NHS services which
2021, p. 306) In Australia, native art and storytelling they help to provide, despite already paying income tax and
have served as vehicles to express the adverse effects of national insurance. The previous thinly veiled exploitation
colonization on indigenous health (Quayle & Sonn, 2019). of overseas health-care workers has evolved into clear
A Botswana-based paradigm proposed a postcolonial evidence that epistemic injustice remains alive and well in
research framework for all (Chilisa et al., 2017), citing the UK, at least.
songs and proverbs as important sources of indigenous Throughout East Africa, hospitals were often established
African wisdom. A practical “framework … that integrates
decolonial processes into health promotion practice” in areas convenient to the colonizers, with disregard for
has been proposed and is gaining wider acceptance the needs and preferences of the indigenous population.
(Chandanabhumma & Narasimhan, 2020, p. 831). In this Although this unfair distribution has improved to a
certain degree, the issue persists for certain populations,
opinion piece, we define how physicians from Tanzania such as the Maasai. They have a long history of using
and the UK are collaborating to develop and apply an traditional healing methods, which colonial physicians
integrated approach toward the decolonization of health in expressed no regard for. This trend continues as Western
East Africa. medicine is touted as superior, despite the absence of

2. Redressing the global imbalance within comparative studies. Furthermore, the lack of any real
health-care access and delivery effort to understand the traditions of different tribes led
the colonists to create artificial borders and restrict the
The NHS has traditionally relied on international medical movement of cattle. This alteration of their way of life has
graduates and overseas nurses, and this trend is accelerating. been irrevocable, contributing to disease and malnutrition.
In 2019, 20% of registered general practitioners in England The enforced introduction of cash crops has replaced

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