Two cases of smallpox from 1540 CE circum-contact (early colonial) Northern Coastal Peru

OBJECTIVE

This project seeks to create a differential diagnosis for lesions found on the skeletal remains of two children as a means to explore the presence of viral disease in 16th- century Peru.

MATERIALS

Extremely well-preserved human remains of two children who died between the ages of 1-2 years old, recovered from the circum-contact (∼1540 CE) cemetery in Huanchaco, Peru.

METHODS

Macroscopic and radiographic analysis.

RESULTS

Both individuals present with cortical thickening, symmetrical destructive lesions, metaphyseal expansion, perforations, exposure of the medullary cavity, resorption of metaphyseal ends and necrosis of the long bones, and deposited reactive new bone. These features are consistent with osteomyelitis variolosa and bacterial osteomyelitis.

CONCLUSIONS

Three features of Individuals IG-124 and IG-493 suggest a highly consistent diagnosis of osteomyelitis variolosa: multiple skeletal lesions, the historical context of the area, and the high mortality rate of non-adults in the circum-contact cemetery.

SIGNIFICANCE

Although viral infections are ubiquitous and well documented historically, their etiologies are often difficult to determine in archaeological populations. Orthopoxvirus variola (smallpox) is one of the many viruses whose archaeological impact is still under explored in skeletal remains.

LIMITATIONS

The absence of smallpox in other children from the Huanchaco cemetery creates difficulty in ascertaining true prevalence rates or information on potential outbreaks.

SUGGESTIONS FOR FURTHER RESEARCH

Further research analyzing aDNA from calculus and/or residues using a DIP-GC-MS method might create a better understanding of how smallpox spread through the region.

Radiologists' Role in Decolonizing Global Health

The colonial origins and power imbalances between Western high-income countries and low- and middle-income countries (LMICs) are barriers to self-reliance and sustained structural improvements to health care systems. Radiologists working in global health (global radiologists) are tasked with improving the state of imaging in LMICs while mitigating the effects of colonial structures and processes. To accomplish this, we need to be aware of factors such as colonialism, neocolonialism, parachute research, and brain drain that contribute to global health inequities. Potential solutions to decolonizing global radiology include commitment to understanding local context; strengthening local capacity for technology advancement, research, and development; and policies and educational programs to combat medical brain drain from LMICs. In this article, we describe how the legacies of colonialism can interfere with improving health in LMICS, despite the best intentions, and provide a call to action for decolonizing our field with intentional approaches and equitable partnerships that emphasize investments in sustainable infrastructure, robust training of personnel, and policies that support self-reliance to match true health system strengthening with our passion for addressing health equity.

The impact of colonialism on head and neck cancer in Brazil: a historical essay focussing on tobacco, alcohol and slavery

Colonialism's enduring impact on Brazil has had significant implications for health and oncology outcomes. This historical essay delves into the profound changes brought about by the transatlantic slave trade from Africa to the Americas, particularly in terms of its influence on the economy, sociocultural habits, and health outcomes. This essay explores the enduring connections between the colonial period's operational dynamics in Brazil and the current epidemiological panorama of head and neck cancer (HNC). The examination provides original insights on the role of tobacco and alcohol production and consumption, alongside the investigation of structural racism, which contributes to disparities in access to diagnosis, treatment, and prognosis for patients with HNC. This article presents novel visions and an analysis of evidence-based strategies to disrupt the adverse impact of colonialism's legacy on the epidemiology of HNC in Brazil.

Knowledge Gaps Regarding Indigenous Health in Occupational Therapy: A National Survey

Background. There is a need for the occupational therapy profession to respond to the Truth and Reconciliation Commission of Canada Calls to Action and work towards supporting the health and well-being of Indigenous Peoples. Purpose. (1) To determine the knowledge gaps of occupational therapists about Indigenous health and (2) to create recommendations to address identified gaps and inform responses from the profession. Method. A national needs survey was created and distributed to occupational therapists across Canada to determine the knowledge of occupational therapists about Indigenous health. Survey results were analyzed using thematic analysis and descriptive statistics. Findings. Data collected from 364 survey responses informed six distinct themes representing knowledge gaps of occupational therapists related to Indigenous health as follows: lack of foundational knowledge, power relations, lifelong learner, need for appropriate tools/approaches, respectful collaboration, and environmental influences. Implications. The project offers insight into the role of the occupational therapy profession in the process of reconciliation. Insights are focused on decolonizing occupational therapy practice, building trusting relationships with Indigenous Peoples, and the provision of appropriate training for occupational therapists to engage in culturally safer practices.

Counter-narratives of active aging: Disability, trauma, and joy in the age-friendly city

Dominant narratives about late life promote active aging, while anti-aging ones mobilize tropes of decline and irrelevance. In contrast, counter-narratives raise questions that spark new conversations about the promising practices that could foster more age-friendly cities. In this article, we describe our feminist and ethnographic approach to interviews and digital storytelling that aim to amplify the voices of marginalized older adults living with disability, violence, and colonialism, and share findings from this endeavor. We discuss the interviews with, and stories shared, by two disabled older adults - an Indigenous woman and a white paraplegic man - and the aging futures their counter-stories suggest. These stories reveal these participants' ongoing struggles to create meaning in their lives, and how their relationships to the physical, cultural, and social environment of the city, including its supports and services, can both support and hinder this becoming.

The Impact of Colonialism on Surgical Training Structures in Africa Part 1: Contextualizing the Past, Present, and Future

Since the first African country attained independence from colonial rule, surgical training on the continent has evolved along 3 principal models. The first is a colonial, local master-apprentice model, the second is a purely local training model, and the third is a collegiate intercountry model. The 3 models exist currently and there are varied perceptions of their relative merits in training competent neurosurgeons. We reviewed the historical development of training and in an accompanying study, seek to describe the complex array of surgical training pathways and explore the neocolonial underpinnings of how these various models of training impact today the development of surgical capacity in Africa. In addition, we sought to better understand how some training systems may contribute to the widely recognized "brain drain" of surgeons from the African continent to high income countries in Europe and North America. To date, there are no published studies evaluating the impact of surgical training systems on skilled workforce emigration out of Africa. This review aims to discover potentially addressable sources of improving healthcare and training equity in this region.

The Impact of Colonialism on Surgical Training Structures In Africa Part 2: Surveying Current and Past Trainees

BACKGROUND

As a result of gradual independence from colonial rule over the course of the past century, Africa has developed and evolved 3 primary surgical training structures: an extracontinental colonial model, an intracontinental college-based model, and several smaller national or local models. There is consistent evidence of international brain drain of surgical trainees and an unequal continental distribution of surgeons; however there has not, to date, been an evaluation of the impact colonialism on the evolution of surgical training on the continent. This study aims to identify the etiologies and consequences of this segmentation of surgical training in Africa.

METHODS

This is a cross-sectional survey of the experience and perspectives of surgical training by current African trainees and graduates.

RESULTS

A surgeon's region of residence was found to have a statistically significant positive association with that of a surgeon's training structure (P <0.001). A surgeon's professional college or structure of residency has a significantly positive association with desire to complete subspecialty training (P = 0.008). College and structure of residency also are statistically significantly associated with successful completion of subspecialty training (P < 0.001).

CONCLUSIONS

These findings provide evidence to support the concept that the segmentation of surgical training structures in Africa, which is the direct result of prior colonization, has affected the distribution of trainees and specialists across the continent and the globe. This maldistribution of African surgical trainees directly impacts patient care, as the surgeon-patient ratios in many African countries are insufficient. These inequities should be acknowledged addressed and rectified to ensure that patients in Africa receive timely and appropriate surgical care.

Reflective questioning to guide socially just global health reform: a narrative review and expert elicitation

Recent research has highlighted the impacts of colonialism and racism in global health, yet few studies have presented concrete steps toward addressing the problems. We conducted a narrative review to identify published evidence that documented guiding frameworks for enhancing equity and inclusion in global health research and practice (GHRP). Based on this narrative review, we developed a questionnaire with a series of reflection questions related on commonly reported challenges related to diversity, inclusion, equity, and power imbalances. To reach consensus on a set of priority questions relevant to each theme, the questionnaire was sent to a sample of 18 global health experts virtually and two rounds of iterations were conducted. Results identified eight thematic areas and 19 reflective questions that can assist global health researchers and practitioners striving to implement socially just global health reforms. Key elements identified for improving GHRP include: (1) aiming to understand the historical context and power dynamics within the areas touched by the program; (2) promoting and mobilizing local stakeholders and leadership and ensuring measures for their participation in decision-making; (3) ensuring that knowledge products are co-produced and more equitably accessible; (4) establishing a more holistic feedback and accountability system to understand needed reforms based on local perspectives; and (5) applying systems thinking to addressing challenges and encouraging approaches that can be sustained long-term. GHRP professionals should reflect more deeply on how their goals align with those of their in-country collaborators. The consistent application of reflective processes has the potential to shift GHRP towards increased equity.

News and Perspectives: Words matter in primatology

Postings on social media on Twitter (now X), BioAnthropology News (Facebook), and other venues, as well as recent publications in prominent journals, show that primatologists, ecologists, and other researchers are questioning the terms "Old World" and "New World" due to their colonial implications and history. The terms are offensive if they result in erasing Indigenous voices and history, ignoring the fact that Indigenous peoples were in the Americas long before European colonization. Language use is not without context, but alternative terminology is not always obvious and available. In this perspective, we share opinions expressed by an international group of primatologists who considered questions about the use of these terms, whether primatologists should adjust language use, and how to move forward. The diversity of opinions provides insight into how conventional terms used in primatological research and conservation may impact our effectiveness in these domains.

The Anatomical Collection at the University of Jena: Reinventing an exhibition of human remains based on ethical considerations

Emphasizing scientific and cultural-historical aspects of human remains, we describe the historical background and present status of the Anatomical Collection at the University of Jena. In addition to safekeeping issues and exhibition practice, we provide typical examples of provenance research in the Collection and refer to relevant literature and recommendations. A reappraisal of the Anatomical Collection culminated in the implementation of a new exhibition concept that diverts attention away from dead bodies as mere anatomical objects and emphasizes ethical considerations, such as consented body donation. The visitor is encouraged to respect the deceased as human subjects who are individuals with their personal biography and entitled to human dignity also after death. A particular focus of our approach is on contexts of colonial injustice and racism, which require a high degree of ethical sensitivity. By providing practical hints on how to conduct provenance research, we want to encourage other anatomists to have a closer look at their historical collections. While some human remains can be restituted, others will probably stay in the collections for various reasons. Concepts for the appropriate handling of these remains have yet to be developed. In conclusion, we argue that, with a renewed understanding and sensitivity, the importance and value of the historical anatomical collections can be recognized once again.

The problem of heteronormativity in family-based health promotion: centring gender transformation in Ontario, Canada

OBJECTIVES

Social scientists have demonstrated that family health work is interlinked with heteronormative gender inequities. Yet family-based public health interventions rarely incorporate a gender transformative approach or address heteronormativity as a potential health barrier in North America. Instead, attention to gender surfaces primarily in family health interventions conducted in low- to middle-income countries with majority Black and racialized populations. The objective of this article is to establish the importance of designing health interventions that account for heteronormative relations in Ontarian families by drawing on empirical data from the Guelph Family Health Study (GFHS).

METHODS

We draw on data (February-October 2019) from (1) semi-structured interviews with 20 families and with 4 health educators facilitating the GFHS home visits and (2) observational data of 11 GFHS home visits and 1 health educator training day. Informed by gender transformation theory, data were analyzed and coded to understand the impact of gender, sexuality, and place in family health interventions.

RESULTS

Pre-existing heteronormative parenting relations were reinforced through GFHS participation: the GFHS was mother-led, increasing some mothers' stress levels. Fathers tended to consider paid work a justification for disengaging from the GFHS, and their detachment sometimes obstructed mothers' intervention efforts. Health educators (all women) were caught in these relations, feeling like because of their gender, they were viewed by parents as confidants and marriage counsellors.

CONCLUSION

Findings emphasize the need for expanding the epistemic and methodological approaches to family-based health interventions, changing the demographic and geographic emphasis within the field, and designing interventions that focus on societal-level changes. Heterosexuality has not been analyzed as a risk factor within the public health field, but our findings indicate the need for further study.

Persistence of Matrilocal Postmarital Residence Across Multiple Generations in Southern Africa

Factors such as subsistence turnover, warfare, or interaction between different groups can be major sources of cultural change in human populations. Global demographic shifts such as the transition to agriculture during the Neolithic and more recently the urbanization and globalization of the twentieth century have been major catalysts for cultural change. Here, we test whether cultural traits such as patri/matrilocality and postmarital migration persist in the face of social upheaval and gene flow during the past 150 years in postcolonial South Africa. The recent history of South Africa has seen major demographic shifts that resulted in the displacement and forced sedentism of indigenous Khoekhoe and San populations. During the expansion of the colonial frontier, the Khoe-San admixed with European colonists and enslaved individuals from West/Central Africa, Indonesia, and South Asia, introducing novel cultural norms. We conducted demographic interviews among Nama and Cederberg communities representing nearly 3,000 individuals across three generations. Despite the history of colonial expansion, and the subsequent incorporation of Khoe-San and Khoe-San-descendant communities into a colonial society with strong patrilocal norms, patrilocality is the least common postmarital residence pattern in our study populations today. Our results suggest that more recent forces of integration into the market economy are likely the primary drivers of change in the cultural traits examined in our study. Birthplace had a strong effect on an individual's odds of migration, distance moved, and postmarital residence form. These effects are at least partially explained by the population size of the birthplace. Our results suggest that market factors local to birthplaces are important drivers of residence decisions, although the frequency of matrilocal residence and a geographic and temporal cline in migration and residence patterns also indicate the persistence of some historic Khoe-San cultural traits in contemporary groups.

Reshaping Egyptian funerary ritual in colonized Nubia? Organic characterization of unguents from mortuary contexts of the New Kingdom (c. 1550-1070 BCE)

Samples taken from the canopic jars of Djehutyhotep, chief of Tehkhet (Debeira), Lower Nubia, and local versions of Egyptian canopic jars from Sai, Upper Nubia, suggest that the materials used for mortuary ritual unguents in Nubia may have differed from those used in Egypt. Nubian samples consisted of plant gum and bitumen, whereas those from Egypt conformed to the standardizing black resinous liquid recipe used for mummification and other funerary rituals. However, there may be time frame issues to be considered as most samples analyzed from Egypt date to later periods. A standard black funerary liquid was used at Amara West, Upper Nubia, probably poured over a wrapped body, which might suggest that the gum and bitumen mixture was reserved for filling canopic jars, perhaps indicating that the use of canopic jars in Nubia differed from their use in Egypt. Evidence from the canopic jars of Djehutyhotep, local versions of canopic jars from Sai, and the sample from Amara West also indicate a source of bitumen that was not the Dead Sea, which was the main (although not only) source used in Egypt. The new results from the analysis of the Djehutyhotep canopic jars and previously published results from Sai point towards alternative ritual practices associated with local conceptions and uses of canopic jars in colonized Nubia. These samples and data from Amara West further reveal that the bitumen used in mortuary contexts in Nubia originated elsewhere than bitumen used in Egypt, which might have implications for our understanding of colonized Nubia as part of other trade networks independently from Egypt.

Conceptualizing Puerto Rican migration to the United States

Migration to the United States is an intricate part of Puerto Rican life ever since Puerto Rico became a colony of the United States in 1898. Our review of literature on Puerto Rican migration to the United States reveals that this migration is primarily associated with cycles of economic turmoil that result from over a century of U.S. colonialism in Puerto Rico. We also discuss how the pre- and post-migration context Puerto Ricans face influence their mental health. Emerging theory suggests that Puerto Rican migration to the United States should be conceptualized as colonial migration. Within this framework, researchers argue that U.S. colonialism in Puerto Rico not only creates the conditions that help explain why Puerto Ricans migrate to the United States but also the circumstances they encounter upon migration.

A qualitative study exploring access barriers to abortion services among Indigenous Peoples in Canada

OBJECTIVE

This paper reports on findings from our exploratory qualitative study that aims to advance knowledge around access to and experiences with abortion services among Indigenous Peoples in Canada.

STUDY DESIGN

We applied an Indigenous methodology to engage with 15 Indigenous Peoples across Canada utilizing a conversational interview method. Our study was informed by an Indigenous Advisory Committee consisting of front-line service providers working in the area of abortion service access and/ or support across Canada.

RESULTS

We conducted conversations from September and November 2021. Participants identified with Métis, Cree, Dene, Inuit, Haudenosaunee, Anishinaabe, and Mi'kmaq nations, across nine provinces and territories. Participants spoke to six themes encompassing challenges and potential solutions around abortion access experiences among Indigenous Peoples in Canada. These included (1) logistical barriers, (2) poor treatment, (3) stigma, (4) impacts of colonialism on attitudes towards abortion, (5) traditional knowledge, and (6) follow-up care and support.

CONCLUSION

Our study demonstrates that Indigenous Peoples experience abortion access barriers that are different than non-Indigenous Canadians, and that these barriers are closely linked to colonialism.

IMPLICATIONS

Indigenous knowledges and practices that honour reproductive choice that pre-dates settler colonialism, must be brought forward into today to enhance the quality of abortion care.

Coloniality, Elite Networks and Intersectionality: Key Concepts in Understanding Biomedical Power and Equity in Health Policy Processes Comment on "Power Dynamics Among Health Professionals in Nigeria: A Case Study of the Global Fund Policy Process"

To understand the role of power in health policy processes in low- and middle-income country (LMIC) contexts, it is necessary to engage with global and local power structures and their historical contexts. In this commentary, we outline three dimensions that shape a dominant power in health policy processes-the biomedical power. We propose that understanding the linkages between medical power and colonialism; the close connection of public health, medicine and elite networks; and the intersectionalities that shape the powers of medical professionals can offer the means to examine the biomedical hegemony in health policy processes. Additionally we suggest that a more nuanced understanding of the interaction of local powers with global funding can offer some entry points to achieving more equitable and interdisciplinary health policy processes in LMICs.

Height and standard of living in Puerto Rico from the Spanish enlightenment to annexation by the United States, 1770-1924

This preliminary work presents a first series of heights of male adults in Puerto Rico. The sample, made up of 6000 prisoner records. the estimates were systematically assessed for selectivity, and we find that selectivity is quite negligible for the main results. The text studies the extreme dependence of the standard of living on the evolution of the price of sugar, a dependence which caused the progressive deterioration of material well-being in the country. Only between 1860 and 1880 did Puerto Ricans enjoy some improvement and a higher level of height. We measures the negative short-term effects of the 1898 annexation Puerto Rico by the United States.

Healthy Eating Policy: Racial Liberalism, Global Connections and Contested Science

The challenges to designing and implementing ethically and politically meaningful eating policies are many and complex. This article provides a brief overview of Anne Barnhill and Matteo Bonotti's Healthy Eating Policy and Political Philosophy: A Public Reason Approach while also critically engaging with the place of racial justice, global interconnectedness, and debates over science in thinking about ethics and politics of public health nutrition and policy. I do not aim to burden Barnhill and Bonotti with the responsibility to fully address these issues, but considering the interconnection of these issues and the ever pressing effects of climate change on local and global food systems, we collectively need to turn to these difficult and pressing questions about what a just food system looks like, what concerns are centred, and who is left out. I group these engagements with Barnhill and Bonotti under three headings: racial liberalism, global food system, and contested nutrition science. I conclude with some remarks about locality.

Relaying station for empires' outcasts: managing 'lunatics' in pre-World War II Hong Kong

This article explores how 'lunatics' emerged and how they were managed beyond the capacity of institutionalization in colonial Hong Kong in the second half of the nineteenth century and the first half of the twentieth century. The story contests the conventional historiography about madmen that focuses on institutions. Unlike in Britain or in other East Asian colonial cities, inpatients stayed at the asylum only for very short periods. Instead of psychiatric admission, they were then transported by ship, either to Canton in China or to London for further care until after World War II. This article analyses how this was done to maintain a 'clean' cityscape, as well as an instrument to ensure the smooth operation of the port city.

Centering Indigenous Voices: The Role of Fire in the Boreal Forest of North America

PURPOSE OF REVIEW

Indigenous perspectives have often been overlooked in fire management in North America. With a focus on the boreal region of North America, this paper provides a review of the existing literature documenting Indigenous voices and the historical relationship of Indigenous peoples in northern North America to fire and landscapes that burn.

RECENT FINDINGS

Early research on the topic explored how Indigenous people used fire in the boreal forest, with most research coming out of case studies in northern Alberta. Emerging research in the last two decades has broadened the geographic focus to include case studies in Alaska, Ontario, Labrador, and other regions in North America. This broadening of focus has shown that the diversity of Indigenous peoples in North America is reflected in a diversity of relationships to fire and landscapes that burn. Of note is an emerging interest in Indigenous fire knowledge in the wake of settler colonialism.

SUMMARY

Indigenous peoples in the boreal forest have applied fire on their landscapes to fulfill numerous objectives for thousands of years. More than a tool, Indigenous peoples in the boreal view fire as an agent, capable of movement, destruction and creation, acting on the landscape to create order, within a living, connected environment. Unfortunately, restrictions on the application of Indigenous fire knowledge and practice initiated during early colonial times remains a contemporary challenge as well.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40725-022-00168-9.

The Case for Decolonising the Dental Curricula in the UK

Students across disciplines in UK universities are demanding decolonisation of their education. These demands aim to resist the white European colonial endeavour that create racist inequalities. To address racial inequalities, the dental discipline has predominantly focused on diversity rather than decolonisation. By using two inter-related referents of decolonisation to dental caries and cosmetic dentistry, this article demonstrates the epistemic violence exerted through the objective hierarchised knowledge practices in dentistry. First, by starting from the position of racisms, empire and slavery, the enduring colonial patterns of power and hierarchies come into view. We see how knowledge production in dentistry has neglected the interconnected histories of colonialism, racial capitalism and patriarchy that continue to shape oral health inequalities and work towards promoting white supremacist beauty ideals. Moreover, the interconnected character of inequalities - race, class and gender - begin to emerge. Second, by proceeding from the place of colonialism, the limits of dental knowledge and the violence embedded in knowledge practices emerge. This highlights the need for new ways of knowing. To decolonise is to confront and weaken the dental discipline's entanglement with the enduring colonial patterns of power and hierarchies that are complicit in maintaining inequalities. Diversity without decolonisation will simply subsume marginalised voices into the existing hierarchised knowledge paradigm and continue to reproduce a hierarchised, unequal world. I argue that if dental schools want to address racial and intersectional inequalities, they need new transformative ways of learning and knowing to equip students to work towards social justice in the outside world.

Indigenous Peoples and occupational therapy in Canada: A scoping review

Background. Calls to Action outlined by the Truth and Reconciliation Commission (TRC) necessitate critical reflection and urgent action to improve occupational therapy with Indigenous Peoples in Canada. Purpose. This scoping review aims to synthesize the literature related to Indigenous Peoples and occupational therapy practice, research, and education in Canada, and appraise empirical research using adapted Indigenous Health Research criteria. Method. A scoping review was conducted across published academic and grey literature with additional appraisal of empirical studies. Findings. A total of 6 themes emerged from 47 articles spanning from 1970 to 2020: recognizing colonial history, responding to the TRC, participating in personal and professional reflection, identifying Western ideologies, engaging in partnership in practice, and recognizing social and systemic barriers. Empirical studies met appraisal criteria inconsistently. Implications. To meaningfully engage in reconciliation, the profession of occupational therapy must generate Indigenous-led and relevant research, critically transform curricula, and address tensions between themes in practice.

Endemic fatalism and why it will not resolve COVID-19

OBJECTIVE

The main objective of this commentary is to provide historical insight into the term endemicity and to demonstrate why framing COVID-19 as endemic in early 2022 is a misguided approach.

STUDY DESIGN

The history of epidemiology as well as current data on COVID-19 as provided by the United States Centers for Disease Control, the World Health Organization, and the Johns Hopkins COVID-19 Resource Center was surveyed.

METHODS

Records of the Epidemiological Society of London for the period 1850-1900 were analyzed, and several key publications on how infectious diseases were considered endemic were identified.

RESULTS

The term endemicity has a long and twisting history, changing from its meaning in the mid-nineteenth century until our use of it today. The concept has long been tied to historical patterns of colonialism.

CONCLUSION

Framing COVID-19 as an endemic disease in early 2022 is a misguided attempt and a result of cultural and political forces.

Mahamari Plague: Rats, Colonial Medicine and Indigenous Knowledge in Kumaon and Garhwal, India

Colonial approaches to animal and zoonotic diseases are often scrutinized in terms of their recognition or dismissal of indigenous knowledge. In this article I examine British colonial approaches to “Mahamari plague” in mid-nineteenth century Kumaon and Garhwal, in the Indian Himalayas. Discussing two key colonial medical expeditions in the region, I argue that the eventual recognition of the validity of Kumaoni and Garhwali knowledge of Mahamari and its relation to rats intensified intrusive colonial intervention on indigenous lifeways. I examine this neglected impact of the colonial recognition of indigenous knowledge and urge for approaches that place more emphasis on the practical impact of colonial epistemologies.

How blood met plastics, plant and animal extracts: Material encounters between medicine and industry in the twentieth century

Twentieth-century medicine saw the remarkable rise of complex machines and infrastructures to process blood for medical purposes, such as transfusion, dialysis, and cardiac surgery. Instead of attributing these developments to technological ingenuity, this article argues for the primacy of material encounters as a promising focal point of medical historiography. In fact, blood's special properties consistently clashed with most materials used in medical practice, provoking a series of material exchanges. Drawing on a combination of epistemological and network approaches, three exemplary cases are presented to examine blood's encounters with plastics, plant and animal extracts: William M. Bayliss's (1860-1926) injections of dissolved gum acacia to expand diminished blood volume; Charles H. Best's (1899-1978) production of the anticoagulant heparin from animal organs; and the preservation of fragile blood cells by silicone coatings inside of John H. Gibbon Jr.'s (1903-1973) heart-lung machine. The case studies demonstrate how the complementarity of blood and these materials produced hybridizations between medicine and a range of industrial branches, from colonial forestry and meatpacking to commercial chemistry. In this light, the paper concludes by discussing the dependencies of today's healthcare environments on globally distributed, capitalistically appropriated resources in the face of crises like the COVID-19 pandemic.

Decolonising money: learning from collective struggles for self-determination

As a reflection of our politically engaged research, this paper addresses the multiple challenges of transforming money for the emergence of the Pluriverse, arguing that practical efforts of emancipation and autonomy need to dismantle the colonial nature of our current monetary system: the flip side of the colonial state. On the one hand, we look into Chiloé, a territory marked by long-term relations of colonialism, dependency and extraction, where the arrival of monetised forms of work in extractive industries has meant the destruction of former ways of inhabiting the territory. On the other, we explore the emergence of the Circles project, in Berlin, that aims at creating a basic income from the bottom-up, whereby people in different communities issue money equally and exchange with each other without the need for state cash. More than assuming that money in itself is 'bad', we suggest that a recovery of the social and ecological fabric of life could be done through local money systems, designed and managed by the communities themselves, delivered and redistributed as a basic income. Moving to a plural monetary system based on relations of care would lead to a recovery of history as a project of collective self-determination.

People First, Data Second: A Humanitarian Research Framework for Fieldwork with Refugees by War Zones

War begets crises that are among the most urgent areas requiring help from the international HCI/CSCW community; yet too few scientists address it using context-based, participatory field methods and by engaging in country and regionally based, longitudinal partnerships. Drawing on the author’s ongoing eight-year engagement as a design ethnographer with UNHCR Jordan and region for the Syrian War, this paper discusses Humanitarian Research as a framework for guiding HCI/CSCW research in conflict zones with displaced persons. Based on the principle of “People First, Data Second,” Humanitarian Research is explained with illustrative examples along with the nature of war and UNHCR’s protection mandate, the research challenges and ethical roles of HCI scientists in conflict zones and how these roles entwine with refugee stakeholders, NGOs, country actors, and university IRBs.

The Comprehensive Communal Trauma Intervention Model (CCTIM), an Innovative Transdisciplinary Population-Level Model for Treating Trauma-Induced Illness and Mental Health in Global Vulnerable Communities: Palestine, a Case Study

This paper explores how Western medicine may not fully understand and address post-traumatic stress disorder (PTSD) and other trauma-induced illnesses in a culturally appropriate manner in marginalized communities and offers a theoretical framework to develop comprehensive, effective, and sustainable solutions that comprehensively address and treat the trauma on both a collective and individual level. Focused on Palestinians, this paper discusses the collective trauma Palestinians experienced and how it manifests in transgenerational effects on the body and mind that may be post-traumatic stress disorder (PTSD) or perhaps another distinct condition that is yet to be codified in the Western medical lexicon. It describes local alternatives to Western medical diagnostic tools like the "ease to disease" diagnostic scale and the sociopolitical context-in this case, the Palestinian fight for karamah, or dignity-from which such alternatives arise. Based on these findings, a novel theoretical framework, the comprehensive communal trauma intervention model (CCTIM), a truly transdisciplinary population-level model for treating mental health in vulnerable communities globally, is proposed. It articulates the need to address the root cause of collective trauma, make modifications to the healthcare system, and cultivate strategic equity-oriented and research-based partnerships.

Heart work: Indigenous doulas responding to challenges of western systems and revitalizing Indigenous birthing care in Canada

BACKGROUND

In Canada, there has been a significant increase in the training of Indigenous doulas, who provide continuous, culturally appropriate support to Indigenous birthing people during pregnancy, birth, and the postpartum period. The purpose of our project was to interview Indigenous doulas across Canada in order to document how they worked through the logistics of providing doula care and to discern their main challenges and innovations.

POPULATION/SETTING

Our paper analyzes interviews conducted with members of five Indigenous doula collectives across Canada, from the provinces of British Columbia, Manitoba, Ontario, Quebec and Nova Scotia.

METHODS

Semi-structured interviews were conducted with members of the five Indigenous doula collectives across Canada in 2020 as part of the project, "She Walks With Me: Supporting Urban Indigenous Expectant Mothers Through Culturally Based Doulas." Interview transcripts were approved by participants and subsequently coded by the entire research team to identify key themes.

RESULTS

Our paper examines two themes that emerged in interviews: the main challenges Indigenous doulas describe confronting when working within western systems, and how they navigate and overcome these obstacles. Specifically, interview participants described tensions with the biomedical approach to maternal healthcare and conflicts with the practice of Indigenous infant apprehension. In response to these challenges, Indigenous doulas are working to develop Indigenous-specific doula training curricula, engaging in collective problem-solving, and advocating for the reformation of a grant program in order to fund more Indigenous doulas.

CONCLUSIONS

Both the biomedical model of maternal healthcare and the crisis of Indigenous infant apprehension renders Canadian hospitals unsafe and uncomfortable spaces for many Indigenous birthing people and their families. Indigenous doulas are continually navigating these challenges and creatively and concertedly working towards the revitalization of Indigenous birthing care. Indigenous doula care is critical to counter systemic, colonial barriers and issues that disproportionately impact Indigenous families, as well as recentering birth as the foundation of Indigenous sovereignty and community health.

'I am Dying a Slow Death of White Guilt': Spiritual Carers in a South African Hospice Navigate Issues of Race and Cultural Diversity

Culturally appropriate spiritual care is increasingly recognised as a crucial component of spiritual care. As part of a larger study, we were interested in cultural and racial issues as experienced by spiritual carers in a hospice in Cape Town, South Africa. We conducted one-on-one interviews and focus group discussions with a cohort of spiritual care workers, who, being volunteers and relatively privileged South Africans, discussed their sensitivity to cultural issues, but also mentioned a host of political, racial and identity issues which profoundly affect their work. The data suggest that the concept of culturally appropriate care must be understood and acted on contextually. We note that the work of transformation of care cannot be separated from broader questions of social inequality and change.

The struggle of Freemasonry and Islamic ideology in the twentieth century during colonialization in Indonesia

Dutch colonialization with a colonial pattern indirectly left the perpetuation of the devide et impera politics among indigenous elites in Indonesia. The use of the natives as colonizers had resulted in conflicts and increased competitiveness patterns between priyayi and santri. Consequently, the clash of religious ideology with the new aristocratic model (Dutch priyayi) was inevitable. Freemasonry's propaganda successfully recruited many indigenous elites and significantly contributed to Dutch Colonialism. This study was historical research with several stages: heuristics, criticism, interpretation, and historiography. Dutch Colonialism's upbringing was projected to successfully deal with the rise of santri organizations, such as Syarikat Islam (SI), Muhammadiyah, and Nahdlatul ‘Ulama (NU). These organizations aggressively revived resistance against the Dutch colonial in the 1920s. Freemasonry succeeded in clashing Javanese culture with Arabic (Islamic) culture to separate the indigenous elite from religious groups, considered radical and threatening Western colonialism. Freemasonry aimed to reject various forms of religious fanaticism and was an anti-religious dogma. The practice of colonialism and the role of Freemasonry has a common interest resulting in a mutually beneficial relationship.

The Politics of Imagery: Understanding the Historical Genesis of Sinophobia in Pacific Geopolitics

The weaponization of racialized imagery has been a common feature of geopolitical contestation in contemporary history. The paper critically examines the historical genesis of Sinophobic narratives, which have been common features of the big power geopolitical contestation in the Pacific. The globalization of capitalism in the nineteenth century and the West's attempts to penetrate the Chinese market and exploitation of its resources led to tension, skirmishes and wars. The myth of racial European superiority and corresponding inferiority of the Chinese was weaponized as an ideological justification for colonial domination, exploitation of cheap labour and appropriation of China's resources and wealth. In recent years, the Sinophobic paranoia has been exacerbated by China's Belt and Road initiative, a strategy at global economic and technological supremacy to counter the West's dominance. This competition for global hegemony is played out in various parts of the world and the Pacific included. The paper critically discusses various historical factors associated with Sinophobia in the context of the USA, France and Australia and how these have influenced these countries' contemporary approaches to Chinese expansionism.

Unnatural Resources: The Colonial Logic of the Holmesburg Prison Experiments

This article focuses on medical trials performed by Dr. Albert Kligman on the inmates of Philadelphia's Holmesburg Prison between 1951 and 1974, which have been widely criticized as exploitative. I seek to investigate the mechanics behind the "ethical blind spot" that enabled the American medical community to laud Kligman for his efforts while simultaneously condemning the medical atrocities of the Holocaust and supporting the development of the Nuremberg Code. I argue that this nonrecognition hinges on a colonial logic by which certain populations are produced as waste, both rhetorically and materially. Drawing on the incarcerated men's accounts included in Allen Hornblum's books on the subject, I trace the process by which human beings come to be reclassified as natural resources and their exploitation recast as industrious cultivation.

The World Health Organization and the global standardization of medical training, a history

BACKGROUND

This article presents a history of efforts by the World Health Organization and its most important ally, the World Federation for Medical Education, to strengthen and standardize international medical education. This aspect of WHO activity has been largely ignored in recent historical and sociological work on that organization and on global health generally.

METHODS

Historical textual analysis is applied to the digitalized archives and publications of the World Health Organization and the World Federation for Medical Education, as well as to publications in the periodic literature commenting on the standardization of international medical training and the problems associated with it.

RESULTS

Efforts to reform medical training occurred during three distinct chronological periods: the 1950s and 1960s characterized by efforts to disseminate western scientific norms; the 1970s and 1980s dominated by efforts to align medical training with the WHO's Primary Healthcare Policy; and from the late 1980s to the present, the campaign to impose global standards and institutional accreditation on medical schools worldwide. A growing number of publications in the periodic literature comment on the standardization of international medical training and the problems associated with it, notably the difficulty of reconciling global standards with local needs and of demonstrating the effects of curricular change.

The impact of colonial-era policies on health workforce regulation in India: lessons for contemporary reform

BACKGROUND

Regulation is a critical function in the governance of health workforces. In many countries, regulatory councils for health professionals guide the development and implementation of health workforce policy, but struggle to perform their responsibilities, particularly in low- and middle-income countries (LMICs). Few studies have analyzed the influence of colonialism on modern-day regulatory policy for health workforces in LMICs. Drawing on the example of regulatory policy from India, the goals of this paper is to uncover and highlight the colonial legacies of persistent challenges in medical education and practice within the country, and provide lessons for regulatory policy in India and other LMICs.

MAIN BODY

Drawing on peer-reviewed and gray literature, this paper explores the colonial origins of the regulation of medical education and practice in India. We describe three major aspects: (1) Evolution of the structure of the apex regulatory council for doctors-the Medical Council of India (MCI); (2) Reciprocity of medical qualifications between the MCI and the General Medical Council (GMC) in the UK following independence from Britain; (3) Regulatory imbalances between doctors and other cadres, and between biomedicine and Indian systems of medicine.

CONCLUSIONS

Challenges in medical education and professional regulation remain a major obstacle to improve the availability, retention and quality of health workers in India and many other LMICs. We conclude that the colonial origins of regulatory policy in India provide critical insight into contemporary debates regarding reform. From a policy perspective, we need to carefully interrogate why our existing policies are framed in particular ways, and consider whether that framing continues to suit our needs in the twenty-first century.

The colonial struggle over polygamy: Consequences for educational expansion in sub-Saharan Africa

Christian missions in colonial Africa have contributed significantly to the expansion of formal education and thereby shaped the continent's long-term economic and political development. This paper breaks new ground by showing that this process depended on local demand for education. It is argued that disagreements over norms, and in particular the struggle over polygamy, which resulted from missions' insistence on monogamy in traditionally polygamous areas, lowered African demand for education. Analyses of geocoded data from historical and contemporary sources, covering most of sub-Saharan Africa, show that the struggle is associated with worse educational outcomes today. Effects are not limited to formal attainments but carry over to informal outcomes, in particular literacy. The findings attest to considerable heterogeneity in missionary legacies and suggest that local conditions should be given greater consideration in future studies on the long-term consequences of colonial-era interventions.

Obstacles along the path of women enterprises in Africa: A case study of Ogotun women in Ekiti state, Nigeria

African women have a history of entrepreneurship dating back to the pre-colonial era, but in this 21st century, women in Africa are assessed by the World Bank to be at the lower deck of economic breakthrough in comparison to men. Although both men and women operate in the same business climate, women are usually poorer and are harder hit by adverse economic situations. Oftentimes, they self-develop their businesses and skills; they also seek, create and self-fund opportunities, but these efforts are usually met with huge obstacles and barriers. Therefore, this study aims to identify some of the obstacles and barriers plaguing the success and growth of women entrepreneurial activities and proffer solutions that could ameliorate the problems. The study uses a qualitative case study research design to uncover the experiences of women in a rural community of southwestern Nigeria. The data for analysis were collected through twenty in-depth interviews, two participants observations, and four focus group discussions. Some documents were analyzed to triangulate the data sources to ensure credibility. Findings include obstacles such as a traditional patriarchal culture that inhibits women from achieving personal development, complete subordination to male domination, colonial vestiges that gendered entrepreneurship in Africa, and lack of support by male-dominated government. The implication of these is that women continue to struggle to develop their entrepreneurial activities without much breakthrough. They remain economically impoverished and suffer greatly to care for themselves and their families, and to be part of social development. The study recommends that relevant organizations and government continue to work to develop strategies to remove these barriers.

Public mental health care in colonial Lesotho: themes emerging from archival material, 1918-35

This paper identifies some of the themes that emerge from a study of official archival records from 1918 to 1934 on the subject of mental health in colonial Lesotho. They include: difficulties experienced by colonial medical doctors in diagnosing and treating mental illnesses, given the state of medical knowledge in the nineteenth and early twentieth centuries; impact of shortage of financial and other resources on the establishment and operation of medical services, especially mental health care; convergence of social order, financial and medical concerns as influences on colonial approaches to mental health care; and the question of whether Basotho colonial society saw institutionalization of their relatives as 'hospitalization' or 'imprisonment'. Two case studies are presented as preliminary explorations of some of the themes.

The past and present of pandemic management: health diplomacy, international epidemiological surveillance, and COVID-19

The establishment of international sanitary institutions, which took place in the context of rivalry among the great European powers and their colonial expansion in Asia, allowed for the development of administrative systems of international epidemiological surveillance as a response to the cholera epidemics at the end of the nineteenth century. In this note, I reflect on how a historical analysis of the inception of international epidemiological surveillance and pandemic management helps us to understand what is happening in the COVID-19 pandemic today.

A process of healing for the Labrador Innu: Improving health and wellbeing in the context of historical and contemporary colonialism

In light of the negative effects of historical and contemporary colonialism on the Labrador Innu, healing initiatives grounded in self-determination, renewal of cultural practices, and non-reliance on Western bio-medicine, are known, taught and widely practiced among the Innu. The value of Indigenous healing practices in the treatment of Indigenous people is well-recognized in Indigenous wellness literature, yet non-Indigenous health practitioners know little about healing processes. Moreover, to our knowledge, no studies have examined any contemporary Labrador Innu healing process. The main aim of this paper is to describe the process of healing among the Innu. Although there may be multiple processes of healing, we shed light on a major process that emerged from interviews and focus groups with 39 participants. Five stages of healing were described: being "under the blanket"; finding spiritual strength; extending hands out; finding strength and power; and helping others. Findings highlighted enablement of healing through spiritualities, support from Elders, return to culture, and resistance to negative stereotypes. We provide health professionals with valuable information for considering Innu healing as a model that expands their views for the benefit of Innu seeking mental health services. Implications for non-Innu health and social service providers are about broadening their understanding of the significant role of self-determination among Innu, learning Innu ways-of-knowing and being, recognizing one's own biases, and acknowledging the power imbalances between themselves and Innu people.

Black bodies and Bioethics: Debunking Mythologies of Benevolence and Beneficence in Contemporary Indigenous Health Research in Colonial Australia

We seek to bring Black bodies and lives into full view within the enterprise of Indigenous health research to interrogate the unquestioned good that is taken to characterize contemporary Indigenous health research. We articulate a Black bioethics that is not premised upon a false logic of beneficence, rather we think through a Black bioethics premised upon an unconditional love for the Black body. We achieve this by examining the accounts of two Black mothers, fictional and factual rendering visible the racial violence Black bodies have been subjected to. We call for a Black bioethics that reimagines the Black body as beautiful and belonging-to both someone and somewhere.

Race, Reproduction, and Biopolitics: A Review Essay

This review essay critically examines Catherine Mills's Biopolitics (2018) and Camisha Russell's The Assisted Reproduction of Race (2018). Although distinct works, the centrality of race and reproduction provides a point of connection and an opening into reframing contemporary debates within bioethics and biopolitics. In reviewing these books together I hope to show how biopolitical theory and critical philosophy of race can be useful in looking at bioethical problems from a new perspective that open up different kinds of analyses, especially around historically embedded problems like institutional racism and the legacies of colonialism in healthcare.

The racialization of privacy: racial formation as a family affair

A right to family privacy is considered a cornerstone of American life, and yet access to it is apportioned by race. Our notion of the "racialization of privacy" refers to the phenomenon that family privacy, including the freedom to create a family uninhibited by law, pressure, and custom, is delimited by race. Building upon racial formation theory, this article examines three examples: the Native American boarding school system (1870s to 1970s), eugenic laws and practices (early/mid 1900s), and contemporary deportation. Analysis reveals that state-sponsored limitations on family privacy is a racial project that shapes the racial state. Performing an ideological genealogy with our cases, this article makes three contributions: it illustrates how the state leverages policies affecting families to define national belonging; it reveals how access to family privacy is patterned by race, ethnicity, gender, class, sexuality, and national origin; and it distills how Whiteness and a national racial hierarchy are socially constructed and maintained over time. With the racialization of privacy, we identify how the state seeks to reproduce institutionalized White supremacy and the effects this has on families. We argue that families are the linchpin in state-sponsored racial projects that construct the nation and that the racialization of privacy, as a form of inequality, is a defining characteristic of the color-line.

[A Study on Dispatched Nursing during the Japanese Colonial Era]

PURPOSE

This study aimed to explore the characteristics of dispatched nursing, a type of private nursing called Hasutsu, during the Japanese colonial period in Korea. This specialized and professional nursing was a form of a dispatched nursing service provided by nurses associations.

METHODS

This study reviewed a literature on visiting nursing, a literature on dispatched nursing, focusing on data collected during the Japanese colonial period from August 1910 to August 1945. Study design was a document research study of historical records.

RESULTS

The dispatched nursing service was established by the Japanese nurses in Korea. More than 60 nurses associations operated to meet the demands in the modern Korean nursing period. It was found that some associations tried to raise the nursing fees. Also, the practice of employing visiting nurses who did not have a license was criticized severely in the newspapers. Considering that the data was limited in this study, the existence of Korean nurses association employing Korean visiting nurses has not been specifically identified.

CONCLUSION

The findings reveal some aspects of dispatched nursing provided by the nurses associations in that era. The nurses associations developed their own specialized service independently by dispatching nurses to fulfill the needs of people not only with cheaper nursing fares than hospitals but with convenient nursing care services, including customized care for infectious diseases. A study of modern historical records of Korean nurses would facilitate deeper research into Korean nursing history.

[Prohibited Comparisons? Population Statistics and the Question of Comparability in the German Colonies (1885-1914)]

This article explores the relationship between statistical classifications and comparisons in German colonial statistics between 1885 and 1914. It questions the importance and the characteristics of comparison in terms of space and population in colonial statistics. The aim is to sharpen the view of statistical methods and categories in an imperial context. The results show that the statistical observation of colonies was based on a territorial distinction between metropole and colonies, which led to the use of different methods. I argue that this territorial and methodological distinction was interwoven with a fundamental incomparability between colonized populations and colonizers.

Auditory and spatial regimes of United States colonial rule in Baguio, Philippines

Control over geographic and sonic space was integral to the United States' imperial project in the Philippines. This article explores how the creation of the hill station of Baguio was achieved both spatially and sonically through the work of US urban designers such as Daniel H. Burnham. In the early twentieth century, Burnham's plans for Baguio (and Manila) inspired a model of auditory and spatial planning that colonial administrators hoped to replicate across the archipelago. In this context, I explore how the design and control of Baguio's auditory environment was part of a wider process to transforming the rural military outpost into a comfortable resort city for U.S. expatriates, members of the Filipino elite, and others to escape the noise, heat, disease and insurgency of Manila and the lowland areas. Furthermore, the article explores Baguio as an "auditory contact zone" where sound configured and framed the interactive dimensions of the imperial encounter between Filipinos and US expatriates. As I argue, the reengineering of urban spaces, such as Baguio, under the US colonial administration was integral in establishing sound as a material symbol of imperial power.

MEDICINE AND COLONIAL PATENT LAW IN INDIA: A Study of Patent Medicines and the Indian Patents and Designs Act, 1911 in Early- Twentieth-Century India

This paper investigates the history of drugs sold as "patent medicines" in India in the early twentieth century. The paper investigates their legitimacy as patenting of medicines was forbidden by the Indian Patents and Designs Act, 1911 (IPDA). The paper argues that the instrument of letters patents functioning as the prerogative of the Crown that gave monopolistic rights to grantees to sell any compound without having to disclose its constituents was the reason behind this seemingly conflicting historical relationship between the law and the market. Colonial law-making left sufficient space within the ambit of the IPDA for letters patents to have their ill effects. The colonial state made attempts to address this as a public health issue by incorporating concerns related to this class of medicines within regulations addressed to the drugs market in the 1930s. The currency of patent medicines in the market was further added to by Indian indigenous entrepreneurs fueled by cultural nationalism of Swadeshi ideology in Bengal in the early twentieth century. However, even such indigenous responses or attempts at hybridization of manufacturing and selling practices related to patent medicines were mostly informed by upper-caste/ upper-class interests and not so much by those of consumers of these medicines.

Bearding, Balding and Infertile: Polycystic Ovary Syndrome (PCOS) and Nationalist Discourse in India

This paper investigates the gendered and racialized discourse on Polycystic Ovary Syndrome (PCOS) in India. A complex metabolic, endocrinal and reproductive disorder, PCOS is one of the most common endocrinopathies in women of reproductive age today. Due to an unclear etiology, there is no single clinical definition for PCOS, contributing to a sense of confusion around the syndrome. India has one of the highest rates of PCOS in the world. Medical and social discourses on PCOS suggest the high rates are due to the failures of Westernized lifestyle and diet in women from developing countries. Taking the example of India, I argue that the lack of a clear etiology creates a discursive vacuum and that PCOS in itself is not a gendered and racialized syndrome, but the discourse on it is. Through the figure of the "new Indian woman," I address the socio-political anxieties of nationalism projected onto the female body and suggest that the discourse on PCOS in India is in reaction to a rising nationalist rhetoric. As a syndrome that presents through "masculine" symptoms, PCOS acts a unique entryway into the intersectional issues of gender, race, sexuality, class and national identities. An analysis of the Indian setting might shed light on PCOS discourses that are increasingly relevant globally.