Essay Public Health Challenges

Colonial legacies and forms of expertise about the “tropical” world have become naturalized as global health science, with implications for what and whom global health is (Meyers and Hunt 2014, Geissler et al 2016, Packard 2016), and global health has become institutionalized in Northern universities and curricula where students and faculty relish the opportunity to gain hands-on experience working in hospitals, NGOs, and research institutions in the Global South (Kenworthy, Thomas, and Crane 2018).

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challenging American volunteers to Latin America to recognize “[their] inability, [their] powerlessness and [their] incapacity to do the ‘good’ which [they] intended” (1968). Frerichs’ (2016) written from the disciplinary perspectives of Epidemiology, Sociology, and Anthropology, respectively, take up Illich’s provocation, capturing the oscillating violence and care inherent in global health’s well-intentioned enactments in a vastly unequal world.

The texts intersect scholarship in critical global health studies, challenging received knowledge about projects ranging from epidemic responses to global health volunteering to clinical trials and behavioral health interventions.

On epidemics, crises and reparations in Haiti Retired professor of epidemiology and public health Ralph R.

Frerichs’ compelling (2016) tells the story of Haiti’s 2010 cholera epidemic, the worst in recent history.

This review essay inevitably betrays my disciplinary lens, yet I cannot emphasize enough how fruitful it was to read three texts written from different perspectives and for different audiences alongside one another.

Doing so reveals how epidemiological, sociological, and anthropological tools hold different but complementary potential for deepening our understanding of global health’s intentions, actors, unintended consequences, and transactions.As Frerichs demonstrates, the hunt for the origins of the epidemic was politicized and fraught because powerful entities—the UN and WHO—had vested interests in obscuring the fact that UN Nepalese peacekeepers, part of MINUSTAH’s (United Nations Stabilisation Mission in Haiti) effort to preserve “law and order” and known to Haitians as “occupiers,” unwittingly carried the bacteria to Haiti.Frerichs recounts the timeline of events and knowledge production during the epidemic to frame a battle between two theories of cholera’s origin (an environmental theory vs. Frerichs’ account is at its strongest when he draws on his expertise as an epidemiologist to undertake critical readings of artifacts of knowledge that played a key role in how scientists and the public interpreted the epidemic’s events.The logics and technologies of containment and quarantine—and even the global community’s tepid interest in finding the source of epidemic cholera in Haiti–must be read against the backdrop of immediate responses to the successful slave uprising in Saint-Domingue against the French; U. slave owners at the time were fearful that black revolution might spread to the U. Globally dominant states collaborated with aggrieved France to isolate Haiti from trade circuits and to refuse it international recognition.The fear of (free, unfettered, risky) blackness continues to manifest in present day U. neo-imperial relations with Haiti, relations that operate symbolically and materially through racialized contagion, as in the assumption of black criminality that justifies U. and foreign occupation to maintain “law and order” or through efforts to generate compassion via visual representations of pitiful suffering of racialized others often, tellingly, termed “humanization” (Butt 2002, Fassin 2011, Robbins 2013, Beckett 2017).Attending to legacies of debt, financial colonialism, and neoliberal adjustment (see Mullings et al 2010) and the mutation of “settler-humanitarianism” that operates in Haiti (Maxwell 2017) complicates the image of Haiti as simply unlucky or, in Frerichs’ words, a “parched landscape awaiting a match” ahead of the 2010 epidemic and earthquake (2016: 226), particularly considering U.S.-based disaster capitalism’s uncanny ability to turn humanitarian work into highly profitable business amid the rise of new racial capitalisms furthered by carceral projects (Adams 2013, Forgie 2014, Wang 2018).The authors urge us to look beneath the surface of global health’s success stories, propped up by quantitative evidence and sentimental representations of suffering strangers waiting to be saved by Northern science, technology, and do-gooders.Global health is an unwieldy thing, difficult to pin down, yet something everyone agrees is worth doing (Fassin 2012, Taylor 2018).The book is a detective story that documents how epidemiologists and others sought to quantify, decode, and combat cholera, and provides a firsthand look at the politics of medical humanitarianism.Frerichs draws primarily on firsthand accounts from the protagonist of his story, French epidemiologist Renaud Piarroux who was in Haiti during the epidemic, which are complemented by analyses of media coverage and selected maps, charts, and graphs.


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