How the corona crisis reveals the balance of power in medicine

Tine Hanrieder heads the research group "Global Humanitarian Medicine" at the WZB Berlin Social Science Center, which investigates expert hierarchies in the field of global health. Her project "Medical Internationalisms and the Making of Global Public Health (Dr.GLOBAL)" is funded by the Volkswagen Foundation in the frame of a Freigeist Fellowship. It examines the internationalization of the medical professions in France, Cuba and the USA and while focusing on how care models from the Global South are applied and reinterpreted by professional groups in the Global North.

Dr. Hanrieder, how strongly does the coronavirus pandemic affect your research?

Well, otherwise I would be visiting archives and attending conferences in the USA. This kind of research, though, has no longer been possible for 2 months or so. Instead, there are currently many webinars and online forums and meetings where the various expert communities and professional groups come together. 
On the positive side, the topic of "global health policy" is suddenly on everyone’s lips – but this window of opportunity will soon close again.

Portrait, Tine Hanrieder sits on stairs in Schloss Herrenhausen
(Foto: Martin Bühler for VolkswagenStiftung)

Does this mean that the corona crisis has given rise to some positive inputs and new research questions?

My research group is concerned with the question of how care models are transported from the Global South to the Global North, for example in the humanitarian field or through models built on so-called "community health workers". This model is currently being heavily promoted. Health professionals with experience of working in developing countries are now making proposals to train a "reserve army" of ordinary health workers in countries of the Global North, for example in Great Britain or the USA.

The question of who should actually be allowed to set the agenda is currently being re-evaluated: The scientific institutions? The political level? Or the health workers themselves, the front line level? We are seeing more and more protest actions and trade union awareness in occupational groups that are traditionally first and foremost defined by their altruism and therefore – despite all their systemic relevance – feel uncomfortable when it comes to standing up for their rights. But for all that, currently a number of fundamental questions are indeed now coming in for scrutiny worldwide: Where should we set priorities? Who gets a say? What’s in the interest of the country? What’s in the interest of socially disadvantaged groups?
I’m watching all this very closely, and I’m curious to see where it all ends. 

Does the pandemic also have any direct impact on your Freigeist project?

Some of the developments surrounding this crisis seem to confirm some of our earlier project findings. These include the fact that political imports from the Global South tend to reflect inherently colonial attitudes. In one US state, for instance, an internationally active NGO has launched a large-scale community health worker program to ensure contact tracing and broader social support on a wide scale. This NGO initially designed its program in complete absence of consultation with the existing professional association for community health workers on the spot. Although the cosmopolitan and academic elites who set up such programs celebrate the achievements of community health workers – who are mostly precariously employed, mostly female and mostly belong to ethnic minorities – they fail to draw on the expertise these helpers have built up over the years. The local people on the front line have to fight for every ounce of recognition.

Videointerview: Tine Hanrieder talks about her Freigeist Project (in German)

Interview with Tine Hanrieder in the TV program "alpha-demokratie" on the topic: "The World Health Organization".
 

Tine Hanrieders publication "How Do Professions Globalize? Lessons from the Global South in US Medical Education" was released in "International Political Sociology".