Health Care and Colonialism: A Sickness Unto Death

Nothing is immune from the stain of colonialism and its associated phenomena of racism. This includes the practice of medicine. Whether one is considering the inequality of medical care between the global north and south, the unevenness of medical care inside imperial nations stemming from those nations’ colonial history, or the racist attitudes still endemic in various applications of health care, the fact of white supremacy is present.  Sometimes it is intentional, while other times it is the result of an underlying legacy that society does not acknowledge.  That denial makes it easy to pretend it does not exist. Carrying on the pretense—which is something almost everyone does to some extent—ensures ongoing injustices against the formerly colonized peoples.

Some of these injustices might seem small to those not subject to them. They might also seem reasonable. They are often justified to society on the basis of cost. Other times, their justification relies on tropes that demean and stereotype present day members of once colonized or enslaved peoples. We are all familiar with such stereotypes and even non-critical eyes notice them being used in television shows, movies and other media. Even here, this use is not necessarily intentional, but is a result of the insidiousness of these stereotypes. It seems unnecessary to provide examples of these tropes here, since most people who live in North America are aware of them on some level, thanks to the work of anti-racist/anti-white supremacy advocates in the past and in the present.

This knowledge is of little use, though, if the injustices based on these stereotypes continue. This fact is one of the fundamental messages of Pediatric Emergency Physsician and Professor Samir Shaheen-Hussain’s new book, Fighting for a Hand to Hold: Confronting Medical Colonialism Against Indigenous Children in Canada. Shaheen-Hussain, who teaches at Montreal’s McGill University and is also a practicing physician, was one of the leaders of a campaign trying to end the practice of not allowing severely ill and injured children from the Inuit and Cree in Quebec to be accompanied by a caretaker when the care they required meant a plane flight to a hospital in Montreal or another Quebec metropolis. It was after some years of quietly accepting the practice that Shaheen-Hussain and others began a campaign to change the practice. His understanding that the policy itself—which was never actually encoded into law—was not just prejudicial to Indigenous peoples, but was a manifestation of Canada’s colonial history in their present day lives.

The campaign was called #Hand2Hold. It achieved its goals in terms of legislation but the practice itself rarely occurs. More importantly, the achievement of the campaign’s goal ended only one discriminatory manifestation of Canada’s colonialist legacy. Just like in the United States and other nations in the hemisphere whose existence is due to genocidal treatment of the original humans inhabiting their lands, there are many practices which need to be eliminated or reformed is social justice is to exist. Equally so, the attitudes and built-in prejudices of the non-indigenous population require a shift in consciousness.

Shaheen-Hussain’s text is an important part of this ongoing endeavor. As he details in his history of the #Hand2Hold movement, his work on the campaign provided him with an understanding of how deeply the legacy of colonialism informed Canadian culture, governance, education and politics. His story of the campaign evolves into an informed, detailed and comprehensive examination of how colonialism and its consequent racism imbues itself into the very fabric of a society. In fact, it is so woven into a society, most of that society is unaware of many of its manifestations—in their thinking and in the way their society is structured. This means that well-meaning members of a country and overt racists and white supremacists are subject to the phenomenon. Besides being an effort to end one aspect of this reality, the #Hand2Hold campaign becomes a metaphor for the foundation of colonialist racism that underlies Canadian (and other nations of the global north’s) society.

Fighting for a Hand to Hold is a multitude of approaches to the question of colonialism and its legacy. It is, as already mentioned, it is the story of a mostly successful campaign to allow minors to be accompanied by an adult caretaker when they are flown to an urban hospital far from their homes. It is also a history of the intentional separation of Indigenous children from their parents and their communities in so-called Indian schools, the abuse of those children and their families and a discussion of how this constitutes a form of genocide according to the United Nations Convention on Genocide. Furthermore, the text discusses the nature of medical care in capitalist economies—even those like Canada’s where medical care is publicly funded—and the effects these economics play on already marginalized communities. The picture painted herein is not necessarily unfamiliar, but its elucidation here is such that the specifics become a means of clarification of the greater fact. The second to last chapter is an argument for decolonizing health care drawn from the author’s experiences as a doctor, in the #Hand2Hold campaign and the research he did for this book.

Well-sourced and approachable, Shaheen-Hussain has written an engrossing and humane exploration of the legacy of European and American colonialism in the daily lives of those whose lands were stolen and culture denied. Academic in approach, yet written in a style that engages the interested reader not of the academy, Fighting for a Hand to Hold is an important and recommended addition to the ongoing discussion of health care in the twenty-first century.

Ron Jacobs is the author of Daydream Sunset: Sixties Counterculture in the Seventies published by CounterPunch Books. He has a new book, titled Nowhere Land: Journeys Through a Broken Nation coming out in Spring 2024.   He lives in Vermont. He can be reached at: