Our observations on, and judgments of, human affairs depend, heavily, on how we frame and re-frame the subject(s) of our inquiry, and on the data we select, either purposefully or without recognition, to inform and support our views. The gravity and importance of this point bear vocalization, particularly because of forces (whether or not well-meaning) that obscure the role of selection among non-pre-ordained alternatives that, once selected, appear to lead inexorably to a conclusion cloaked in an objectivity that conceals the (un-selected) underlying alternatives.
An article in this week’s New England Journal of Medicine – “Ebola in a Stew of Fear” – powerfully relates the linkages of advances in Western medicine and healthcare to illnesses and their ravages elsewhere. I quote from the article:
“It was, in fact, a 1926 Harvard medical expedition to Liberia, undertaken on behalf of Firestone, that had brought my film team to the Liberia–Guinea border in 2014….. In 1926, the eight-member team had traveled for 4 months through the Liberian interior, collecting blood, tumors, urine, and photographs of diverse ethnic groups. Some people ran away when they saw these strangers. The routes the expedition traveled were those used by European and West African slave traders, white missionaries, and Liberian soldiers recently sent to conquer the interior. Why stick around when strangers had been such potent contributors to the local ecology of fear?…..
American medical research profited from the blood, parasites, and viruses collected on these expeditions. Such materials were the stuff of Nobel Prizes, professional prestige and fame, and medical breakthroughs that benefited people throughout the world. The 1951 Nobel Prize awarded to Max Theiler, a member of the 1926 Harvard expedition, for his work on a yellow fever vaccine, is one example. But biomedical research did little in return to help build medical knowledge and public health capacity within Liberia. When Liberian friends now post on Facebook links connecting the Ebola outbreak to past American biomedical research, they point to the history and memory of exploitation and extraction that run deep in West Africa. These roots of medical extraction in Africa contribute to the ecology of fear.
Modern medicine owes a debt to West Africans for past sacrifices made in the advancement of global health. This week’s announcement by President Barack Obama of a U.S. commitment to build 17 Ebola treatment centers in Liberia, train medical workers, provide testing kits, and offer logistic support is a welcome and needed response. It should be the start of a long-term, concerted effort to strengthen the public health infrastructure, which is critical to the region’s future stability.”
When we consider our “foreign aid,” we would do well to bear in mind that our aid is not a one-way street and the very conceptualization of “aid”, insofar as it connotes unilateral assistance, ought not to obscure the fundamental, tangible, and very real reciprocity that precedes and supports, enables and perpetuates, foreign aid.