BY ANABEL STAROSTA
Professor Joanna Radin is an Assistant Professor of History of Science and Medicine, and last semester taught a course called Historical Perspectives on Global Health. Today, the term global health describes a crucial, widespread framework that brings together public health workers, philanthropists, economists, politicians, activists, and students worldwide. But global health did not simply spring up out of nowhere. Historical legacies, both good and bad, dictate our current notions and practices of global health. So, how did we get here? I sat down with Professor Radin to find out.
First, how did you become interested in the history of medicine, and specifically, the history of global health?
The short answer is that I’ve always been interested in ideas about risk – relations of risk of public health and how people who have expertise about science and medicine share that expertise with the people who are affected. Before getting my PhD, I worked for a consultancy that helped the CDC to do media relations. My job, essentially, was to make scientific information legible to people who weren’t epidemiologists or might not be inclined to think in terms of statistics. This type of work made me realize that there was potential in learning about the history of the entire apparatus that enables us to [understand] health and disease. I actually didn’t plan to become a professor, I just wanted to be able to do the type of work I had been doing, but more effectively. But, then, I went to graduate school for History and Sociology of Science and I fell in love with ideas and with teaching… and here I am.
What did you focus on while you were in graduate school?
I wrote my dissertation about blood samples; I got really interested in the kinds of invisible infrastructures that make it possible for scientists to learn about health, identity and disease. I realized that there were massive collections of blood samples, and was interested in the way that knowledge, risk, and power accrued through science by looking at this resource that isn’t a specific disease or a particular place. Anyone who has worked in a biomedical lab has dealt with some sort of biospecimen—a tissue that originally came from a person or non-human animal—and I wanted to think about what it meant to collect such material and preserve it for the future and what kinds of problems and opportunities that created.
Did you learn anything interesting from the blood samples?
In doing this research, I was looking at the WHO’s involvement in creating the infrastructure for maintaining the collections of blood as early as the 1950s so that they could go back to these blood samples if a new disease emerged and try to understand it.
They maintained collections for both known and unknown purposes – people knew that there would be unpredictable problems in the future, so they wanted to have a system that would let them be responsive.
How did you get involved with global health?
I got interested in global health in doing this work and looking at the WHO’s involvement because I started to appreciate how the creation of this type of infrastructure enabled an international body that was created after WWII to be responsible for detecting and curtailing epidemics whose impacts would transcend national borders.
What led you to teach your Historical Perspectives on Global Health course?
When I came to Yale, I knew there was enormous student interest in global health on campus and I knew the classes that were being offered were really trying to help the students become practitioners of global health; how to hit the ground running. I thought that one thing I could provide as a historian of science and medicine was a class that could put those experiences into context and give students a way to think about ‘what is global health, why do we have it, where did it come from, and what does it mean to engage with it?’
What do you hope that students will gain from studying the history of global health?
I’m trying to give students critical tools for making sense of their own experiences. I’m not interested so much in giving students dates and places but in helping them appreciate how they can use history to cultivate a sensibility – a way of asking the question ‘what does it mean to help’ and examining their own motivations for wanting to help.
Why might people be driven toward global health?
Part of the appeal of global health is in the recognition that there are problems that are very severe and need to be conceived of on a global scale. I think most people feel compelled to help but it’s hard to know what to do and how to evaluate the various ways you can do it. That’s why [in class] we try to think about things like humanitarianism as a historical concept, about what the nation-state is, and colonialism, and how each of these has facilitated some of the uneven relations in global health today.
What outcomes do you hope will result from this class?
It’s my hope that students who take this class or look at the history of global health think differently about what it means to participate in global health and maybe even gain insight that helps them think differently about other enterprises they’re engaged with. For example, maybe they’ll think differently about New Haven. Maybe they were attracted to some of the exotic dimensions of health overseas but they can use these lessons and start realizing that maybe New Haven is the global to them.
What are some historical moments that have influenced global health?
Colonialism isn’t a moment, but it’s not possible to understand global health without having an appreciation for colonialism and for missionary medicine, both of which continue today. The inter-war period after World War I, which saw the creation of the League of Nations and its health office, set a precedent for the WHO, which was created after WWII. The rise of pharmaceuticals, of ideas of modernization following the Cold War, and the realization that chronic diseases, not just infectious disease, can be massive problems are all important.
What kinds of organizations have shaped global health?
The World Health Organization and its different investments at different times in primary health care versus vertical disease eradication campaigns have shaped global health’s trajectory. The Rockefeller Foundation’s role in the early 20th century is the first example of the kind of philanthropy that people like Bill Gates build and model their own approaches off of today. The creation of World Bank and the financialization of health is also important. The creation of large-scale international bodies that control and redirect funds and political authority really shapes experiences of global health.
Are these large-scale controlling bodies beneficial or detrimental to global health?
It’s not really possible to answer that question in that way. We always can benefit from multiple different registers of intervention and any one person or organization with too much power is something that I, personally, think should be regarded critically.
What is an instance in which we should be critical?
Philanthropy is incredibly important, but we should be careful before we celebrate someone’s generosity – we should ask what is motivating how his or her money is being distributed. For example, Bill Gates has as much power, if not more, in the WHO as some individual nations. It is an incredible phenomenon that he has dedicated his wealth to these health causes, but also worth noting that his original reason for getting involved with global health had to do with interests in population control, which is not often recognized.
Why has Gates been criticized in the media?
Critics of someone like Gates have dealt with his focus on technology – technology can be good, but sometimes it’s not enough. I think Gates is starting to become attentive to this; he’s starting to read history! He’s also starting to realize that these problems are not as simple to solve as he thought they would be.
Even if there is no definite “good” or “bad” in regards to health, what should we be wary of?
I don’t think there’s a set good and bad, but what I do think is bad is when people set out to help but they’re really trying to help themselves. It’s important for us to examine our motivations and think: Do we want to go far away to help people that we don’t even know so that we can say we went far away to help people we don’t know or are we willing to commit to people who live in our own community? Are we willing to start there? I hope this class helps people figure out how to confront what it means and has meant to help others.
____________
Anabel Starosta is a senior in Morse College majoring in History of Science, Medicine and Public Health. She hopes to be a doctor and also work at the intersection of medicine and public health. She is from South Florida and her parents are from Mexico and Venezuela, making her specifically interested in health inequities in Latin America. In her free time, she likes to paint, dance, and travel.
Yale Global Health Review 