While I usually prefer to write blog posts in the third person, I’ve decided that, given the immense relevance of this post’s topic to my life, it would be best to convey my thoughts directly through my voice. I was similarly intrigued by the epilogue of Harriet Washington’s Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present and Irmgard Bauer’s article “More harm than good? The questionable ethics of medical volunteering and international student placements.” My personal interest in these texts was due to my intention of enlisting in Doctors Without Borders after graduating from medical school. This has been a dream of mine since transitioning from an adolescent education major to premed about two years ago. Even prior to beginning on the premed track, I aspired to work in the international aid/development sector, most likely for the United States Agency for International Development. However, after reading the epilogue Medical Apartheid, I no longer have any desire to work for a government that permits research firms and pharmaceutical companies to exploit Africans as test subjects. Despite assertions of philanthropy from research and medical-volunteering corporations, the texts indicate that these companies are capitalistic and commercialized. Thus, Washington and Bauer provide insight on the condemnable activities of avaricious companies that profit off citizens of the developing world with immunity from U.S. governmental intervention.
In the epilogue of Medical Apartheid, Washington elucidates how in contemporary times, American researchers have replaced African Americans with Africans as an expendable source of experimental test subjects. Africans suffering from epidemics and desperate for medical care are provided with experimental medications from U.S. pharmaceutical corporations that describe the distribution of the drug as a humanitarian gesture. However, the lethality of the experimental drugs and failure to obtain informed consent reveals the profit-oriented and racist beliefs of the researchers. For instance, Washington explained, “During the height of a 1996 meningococcal meningitis epidemic, for example, scientists offered Pfizer’s experimental drug Trovan (floxacin) to terrified parents in Kano, Nigeria…By the time the experiment ended, two hundred children were left severely disabled and eleven were dead.” In response to any experimenter’s hypothetical assertion that the Trovan incident was a rare exception, rather than the norm, statistics on American medical research in Africa on a continent-wide scale refute any humanitarian motives of the pharmaceutical companies. For example, Washington stated, “Seventy billion dollars is spent each year on medical research, but only 10 percent is devoted to diseases that cause 90% of the global health burden.” Therefore, researchers employed by large corporations dehumanize Africans as guinea pigs. This is done to extract as much research progress from Africa as possible that can be translated into higher profits by selling products in the United States.
Similar to Washington’s argument concerning the profit-oriented motives of U.S. researchers in Africa, Bauer’s article explores how the massive financial resources of American non-governmental organizations (NGOs) are used to benefit volunteers and the NGOs over the people they ostensibly aim to help in developing countries. I personally am guilty of contributing to this type of system, yet it was an education-based program rather than a medical one. During my senior year of high school, I fundraised for the construction of a primary school in Nicaragua and traveled there for a week and a half to assist with some of the construction. At the time I believed I was making a difference. Yet after reading Bauer’s article, I now understand that the money I spent on plane tickets as well as my transportation and housing costs while I was in Nicaragua would have had a far greater impact on the community where the school was built if I had donated it instead. For example, Bauer explained, “Since poor health is predominantly a consequence of poverty, and the many millions spent in the medical volunteering industry seem, at times, grossly wasted, a more thoughtful use of the clearly available funds has been called for.” Thus, there is a striking parallel between the commercialized nature of medical volunteer agencies discussed in Bauer’s article and the profit-oriented practices of pharmaceutical corporations operating in Africa. Analogous to the American researchers in Africa who Washington criticized, Bauer demonstrates how the financial motives of NGOs are present behind their altruistic facades. For instance, Bauer contends, “Increasingly, NGOs are forced to commercialise in the highly competitive international volunteering market to the point, as one example from Guatemala shows, that an NGO which pays northern doctors US$ 500 per surgery is so popular that it needs to search the country for patients to meet the interest.” Hence, Washington’s book and Bauer’s article similarly convey the capitalist structures of pharmaceutical companies and the medical volunteer industry, respectively, that have contributed to the suffering of countless people in the developing world.
I have always had a passion for aspiring to help economically disadvantaged communities and believed that the best way to do so would be to participate in NGO programs, whether in Nicaragua building schools or as a physician in Doctors without Borders. However, the epilogue of Medical Apartheid and Bauer’s article suggest that even seemingly philanthropic organizations are corrupted by commercialism. Given the capitalist nature of the global economy, to have the most meaningful impact on the lives of others, I should strive to become wealthy myself and donate all my monetary resources to impoverished communities to use as they see fit.