Decolonizing Medicine

Building a World of Care by Learning from Gaza's Doctors

Dr Hussam Abu Safiya—Pediatrician and Director of Kamal Adwan Hospital in Gaza Abducted by Israeli Forces on December 27th, 2024. Over 400 healthcare workers remain hostage.

Voiceover read by

Jimmy Ó Briain Billings

—follow his work.

Ignoring a genocide or pretending it is not happening is not a "difference of opinion." It is a racist ideology. This ideology does not belong in medicine. Decolonizing medicine requires understanding that we will not have health equity as long as racism is baked into the very structures of medicine. Decolonizing medicine is not about tweaking who is at the top of the pecking order or playing into liberal identitarianism, which as Dr King accurately diagnosed, “is more devoted to 'order' than to justice.” Decolonizing medicine requires reimagining the order altogether, because the one that exists was created in a time of subjugating women, queer, Indigenous, chronically ill, Black/brown, immigrant and other people deemed “deplorables” by European colonial standards.

The "Other" in medicine—whether between doctor and patient or doctor and structure—this phenomenon is about power, who has it and who is denied it. Power differentials create health inequities and the differences that exist today were established in a time of colonial conquest. The United States and all of the Global South were colonized by militaries, missionaries and medics. If we want health equity, we have to transform these outdated and harmful structures of power. We must compost them and create the conditions for something more healing to grow.

The Western Physician and Medical System are a Part of the Colonial Order

To do that we must understand the history and context of how these power structures evolved, who is occupying the seats of power today and why. People in power in medicine today will tell you that we do not want to mix politics in medicine. But medicine is politics practiced on the human body. To pretend it is any other way is to ignore the actual realities that are causing harm on marginalized people in a system that was not built to serve us. Those in power prefer to distract us with superficial adjustments rather than structural ones. They tell us we are “unprofessional” when we push for change that will close the gaps on disparities. We can no longer play their game of delay.

History and context are critical to understand so we can stop having people who kill and justify killing inside medicine. Having a genocidal/war criminal for a physician is bad for patient outcomes. We do not have to study it. We can just look at physician Howard Maibach, a devout Zionist who injected 2600 imprisoned people (Black/brown) with pathogens and poisons without their informed consent, reminiscent of the Nazi medical experiments. Before I was slated to speak at the American Medical Association’s first Grand Rounds for Health Equity where we discussed Maibach’s medical racialized violence, Maibach’s lawyer—also “Israel’s lawyer”—Alan Dershowitz pressured my university to prevent me from talking. Dershowitz is now representing Israel in the International Criminal Court hearings calling for the arrest of Netanyahu and Gallant.

Now while Maibach is not a war criminal, he harbors deep-seated racist ideologies. The harm he did and the fact that he remains employed by the University of California reveal the university’s power structure. Maibach’s family donates heavily to the Friends of the IDF, providing material support for the genocide in Gaza. This is a problem. We need doctors who are fully committed to healing and health for all, not killing some because it happens to be in alignment with their political agendas. And we require doctors who allow for discourse, not silencing because “it’s complicated” when people of European ancestry decide it is time to kill again for colonial conquest.

To decolonize medicine is to remove those obstructions to our voices so we can advocate for the health for all, as it is our moral and professional obligation. Since October 2023, medical students from around the country have texted me horrific, violent and even murderous things that pro-Israeli professors have said about Palestinian patients in their presence. Once these students find their courage to speak up, the world is not ready for what they have to share. This is why there is such active repression of medical students and their voices, as Israeli doctors called for the destruction of the entire healthcare system in Gaza and the powers that be in Western medical institutions repress those of us who do speak up. The silence of healthcare workers across the West is a part of Israel’s genocide, and a recent submission to the UN documents exactly how.

In spite of the forces against us, I hope medical students will find their courage and recognize that building a medicine that will serve all will require that courage in order to compost a colonial system. This work requires the daylight of truth. In that daylight, there are incredible doctors ready to build a liberation medicine, one that will be able to address the needs of all the people we serve, not just an elite few— everyone.

I am grateful to medical students like Umaymah Mohammad, whose courage shines as she shares her horror that a professor at Emory went to serve a combat unit during the genocide and came back as if everything was perfectly normal. It is not. Genocide is the most intense expression of racism. Dr. Josh Winer at Emory University is not fit for teaching medical students in a pluralistic society, especially not ones whose family is currently being annihilated by Israel. Umaymah was suspended for speaking up about this violation of her safety and civil rights. Her stance is a moral one—and a missing one—in a colonial medical system that supports genocidal physicians and silences ones who speak up to stop a genocide. The agenda could not be clearer. Please support Umaymah here.

Physicians and other healthcare workers who have been repressed in the West are finding each other, and we are working to teach our colleagues how to cultivate their courage to embark on this transformative work together. We recently held a webinar to launch our peer to peer curriculum—Cultivating Courage—which is a 6-week course to learn and unlearn together as we map out what is needed to build a liberation medicine.

As people across the West wake up and realize that physicians who supported, endorsed and even participated in genocide continue on in their careers as those who stood to make noise about a genocide were defamed, suspended and even fired, they will start to ask themselves questions about their personal safety in the hospital. Physicians who are deeply racist provide poor care to the people they hate. This has been shown over and over again. And the issue is not simply a healthcare issue. It is a matter of civil rights.

People of color have the right to be served by physicians who do not hate them. Arabs and Palestinians have a right to be served by physicians who do not want to see them annihilated. In a pluralistic society, holding deeply racist beliefs should be enough to show that a person does not have the basic competency required to be a physician. Changing one’s belief is not simply a matter of showing up for a DEI workshop or implicit bias training. This work cannot be led by liberals who opened the door to the rightwing exploitation of civil rights laws to silence people of color across the Global North as the West started its bloody campaign in Gaza. This transformative work requires reimagining medicine’s structures, moving people with racist beliefs out of positions of power. It requires creating systems for the most marginalized people who uplift the health of all in practice, not just in speech, to lead.

The decolonization of medicine is happening right now, led by the doctors in Gaza. With moral courage and leverage, they “absorb what is useful” from Western medicine and “discard what is not, add what is uniquely your own,” in the words of martial artist Bruce Lee. That is the path ahead for physicians of conscience. It is the future of medicine. Yesterday, my colleague Dr. Yipeng Ge suggested we change our oath, from the Hippocratic oath to an oath crafted by the doctors in Gaza, one that uplifts that level of commitment to serve the people. Because in the times that are upon us—social upheaval and climate collapse, fascism and food systems deterioration—we will need a different kind of physician and a different kind of medical system. The time to start laying those seeds is now.