Innovation in Health Starts with African Leadership

The 25th of April marked the 4th Annual World Malaria day. Most of the articles I read discussing updates about malaria lacked the voices of African thinkers, researchers, and physicians. I began to reflect on this different kind of brain drain; what I call an ‘accidental’ brain drain where the critical thinking involved in medical research is conducted by foreigners and thus there is a reduction in the development of African lead research and professional development. Africans are merely assistants, translators, or technicians and therefore do not benefit from the processes of research that lead to innovation.

This ability to problem solve and develop things organically is crucial in general, but it is specifically the life blood of medical education and development. Medicine is a complex and scientific field that is constantly evolving. The answer to the most complex medical questions come from a combination of asking the right questions, having the correct support to answer those questions, then using the scientific method (trial and error) to figure out what works. Imagination, accidents, and exploration coupled with experience lead to many of the breakthroughs that have changed medical science.

I recently dialogued with a South African graduate student in microbiology. He was sent to study malaria but was not granted his own project. He was reduced to working as a lab technician for his European Primary Investigator (PI). In the US, all graduate students are given their own projects to work on from start to finish and the PI is there for assistance and guidance. This anecdote illustrates a structural problem for Africans that result in intellectually undernourished professionals that, in my experience, is very common.

Of course this is not the panacea and I am not implying that Africans need to ‘learn how to think’ as there are many amazing African intellectuals working every day on African problems in Africa.  Brain drain, lack of resources, and burn out due to an over burden on local professionals all take a huge toll on the health care profession. Neither am I saying that all foreigners should stay out of Africa. I am simply stating the grave importance of a paradigm shift regarding what role foreigners play in developing a plan of action for public health problems in Africa. This paradigm shift involves us as international assistants using our considerable resources to not merely advance our own careers, but to support African lead innovation (Studies detail triumphs, troubles of African innovators creating products for local health needs). This not only breeds larger and larger pools of innovators, but also gives African researchers and professionals the vital resource support they need to be advance their projects.

Walter Rooney discusses in the Underdevelopment of Africa, that the slow development of Africa is absolutely related to a racially motivated systematic exclusion of Africans from information about global discoveries.  As a result, there were not as many avenues for Africans to use that information and reformulate it to work in their own way. ‘Accidental’ brain drain risks continuing this underdevelopment by leaving the complex medical problem solving to foreigners. We ask foreign experts to answer the research questions that will change our models of medicine (Anti-Mosquito Drives Stumble at Final Ten Per Cent) , we ask foreign students to reap the benefits of problem solving in our African home communities (MIT class studies Kenyan slum’s clinic quandary ).

One of the goals discussed by the Roll Back Malaria Campaign on this World Malaria Day is to “develop endemic countries’ capacity to control malaria” (World Malaria day- A Day to Act). To achieve this goal it is important to not just partner them with local professionals in a symbolic way but to include them as leaders and partners in the plan. We should have those professionals think about and talk about malaria in their communities, not merely listen to lectures from ‘international experts’. We should support them in their ideas. They may fail a few times (and we should support them even when they do), but that is how technology and scientific discoveries happen worldwide and more importantly, it is how people develop as thinkers and innovators.

 

 

Merrian Brooks

Merrian is a medical resident studying the specialty of pediatrics in the USA. She was born and raised a Black American and feels proud to be the descendant of a group as a resilient and strong as those known as African slaves. She hopes to one day be a part of a movement to make medical systems work better for people of color in the US, and children and adolescents in sub-Saharan Africa.

2 Responses to Innovation in Health Starts with African Leadership

  1. Right on Merrian I cannot agree enough with your analysis…A lot of foreigners have made a lot of money in the name of developing Africa. Africans definitely continue to be “assistants, translators, or technicians” of Western scholars and practitioners. Some of the Western scholars and practitioners have become demigods influencing every step students from the African continent take. It is true that in the US PI are there to assist and provide guidance, but in some cases students from the continent do research in areas of PI interests because they provide funding for them. The structural problem is a killer as in many cases students who studied in the continent had to treat professors like some divine figure not to be questioned. In some cases that mentality surfaced even when we get in the West as thats how we have been educated from primary to tertiary institutions…Yes we need Western scholars & practitioners as we find solutions to our health care system. The funding being given every year for Africa Health Initiates does not measure in any way to the work done on the ground. I mean millions of dollars in Africa every year could do a lot but that money is spent on overhead cost as we depend heavily on foreign practitioners and consulting firms. Thus very little of that money end up spent on the real stuff. These foreign professionals do not even partner with the locals besides working as technicians and translators. You cannot tell me that is what is called partnership in the West. How can you diagnose Africas problems looking through Western lenses? We are definitely tired of those recycled lectures and presentations from the so called ‘international experts.’

  2. Thanks Merrian for this insightful article. I will be the first to admit that I am not very well versed in matters of health. Your article seems to feed quiet forcefully the broader African studies argument that part of solving developmental issues in Africa the first needs to be a fundamental “shifting [of] geography of reason” that must take place as termed by the Caribbean Philosophy Association. As people like Adebayo Olukoshi have made the argument that our imagination and therefore interventions in Africa can be accused of “focusing on “decoding” Africans for the rest of the world rather than serving to explain the African world to Africans” which has led to a “racialised division of labour in which blacks have experiences that whites interpret.” http://www.ru.ac.za/politics/thinkingafrica

    Last year the ruling party in South Africa introduced the national health insurance scheme in its party congress. This is the kind of monumental policy document similar to the Obama administration health reform project. It was with a lot of sadness that I witnessed how shallow the discussion was about the health insurance. There was very little media analysis on the suggested overhaul beyond the fact that there would be Cuban doctors sent to South Africa to help “save” our health care system. I thought to myself that surely the structural problems of our health system go even beyond the shortage of doctors. Surely the increase of Cuban doctors cannot be the only answer to the problem. I still wait to see the media consult our health practitioners to genuinely engage this monumental health reform policy. I do think that even our media’s ability to reduce the suggested reform to the role of Cuban doctors is telling of the deep- seated psychological belief that reform cannot come from the inside. Of course, we must need rescue from the Cubans or anywhere else before we look to ourselves for answers.

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