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PLOS BLOGS Speaking of Medicine and Health

Why I left my career in global health

By guest contributor Lazenya Weekes-Richemond

I entered the global health sector 14 years ago, a giddy 23-year-old ready to save the world. As a Black woman born and raised in the Caribbean, my mission to improve the health of Black and Brown people globally was personal and I was committed to make the greatest impact I could.

Little would I have known that 2020 – the year which exposed how race and privilege impacts global health – would be the year I temporarily hung up my hat and walked away from the sector.

My decision to leave wasn’t easy, but it was years in the making. I left at the height of my professional career as Deputy Director of a large health project across West Africa, telling myself and others I wanted a change. However stumbling across this saying on a poster in the aftermath of George Floyd’s murder, I’ve decided it is time to speak my truth.

SPEAK THE TRUTH EVEN IF YOUR VOICE SHAKES.

#BLM

I left the sector because it is racist and has a White saviour complex. I’ve sat in too many boardrooms where well-meaning White middle-class individuals draw up projects that White donors have deemed to be global health priorities and then dictate how Low- and Middle-Income Countries (LMICs) should execute the project with little regard for cultural sensitivities. The racist assumption that black and brown people do not have the solutions to their problems has resulted in White individuals from the Global North at the seat of power, making decisions and speaking on behalf of black and brown people. People from the Global North are often appointed as the global health experts occupying senior positions while the real experts – those affected by and more proximal to the health issues – are side-lined.

It is also bigoted and reeks of impunity. The sector will go to extraordinary lengths to protect its ‘charitable’ reputation. George Floyd’s murder led organisations to release a flurry of statements pledging to root out racism, diversify workforces and stand in solidarity with minoritized people. From my experience, organisations do not actually want full engagement from their Black and Brown staff. If we challenge the status quo, we are met with reprimand and eventual alienation. I’ve had initiatives shot down as Deputy Project Director while junior White staff can speak with abandon and test their much less thought through ideas. Bad behaviour is excused, and toxic work environments are tolerated to the detriment of minoritized staff.

It’s been nearly two years since I walked away from the sector and I’ve had time to reflect. Would I have left if I was a White woman? My honest answer is ‘unlikely’. White women are protected by the privilege of their skin. Would I return to a White supremacist, patriarchal sector that isn’t designed for me to thrive in? Honestly, I don’t know. If I do return, I need to see real change.

Specifically:

  1.  International organisations and ‘experts’ need to acknowledge and actively give up their privilege to create space for black and brown leadership. There needs to be more Global South based experts steering the ship as opposed to all white headquarter based senior leadership teams. If this means organisational restructuring to redistribute power to country and regional offices, then so be it.
  2. Senior leadership teams and line managers should be held accountable for toxic work cultures and tokenistic minority hires. Minoritized staff do not want to merely fill a quota; we want to fully engage, however we cannot thrive in stifling environments. Organisations should introduce comprehensive policies to ensure all staff feel comfortable speaking out against injustices they see or experience without fear of retaliation. No one should be above the law and HR departments should be given real power without leadership interference to weed out bullying, racist and bigoted behaviour right up to board levels. Organisations should consider recruiting Diversity Equality and Inclusion specialists with lived experience of marginalisation into their leadership teams to ensure anti-racist and inclusion work in embedded into workplace operations. The sector must be open to having uncomfortable discourses to disrupt favouritism and privilege, else it will continue to perpetuate inequalities.
  3. The role of international donors should be re-evaluated. Neo-colonialism is rife among donors and they are increasingly exerting their influence and dangling cheque books in the face of cash-strapped LMIC governments. The sector should push back against donors getting involved in setting the global health agenda. Instead, resource allocation should be equitable; based on health priorities identified by country governments. Tougher contract negotiation processes should be instituted to ensure donor rules and regulations are realistic and do not hinder programming in LMIC contexts.

The sector needs to urgently address its toxic, misogynistic and racist culture or it will continue to lose qualified minoritized professionals who bring unique perspectives, skillsets and most importantly proximity and understanding of the challenges and solutions needed to achieve the SDGs.

As for me, I remain on the side-lines, speaking my truth until I’m ready to re-engage and get back to my true passion of realising health as a fundamental human right for all.

Lazenya Weekes-Richemond worked in global health for 14 years managing large scale projects across Africa, the Caribbean, the Middle East, South and South-East Asia. As a black woman working on behalf of black and brown people in a predominantly white-led sector, Lazenya’s work now focuses on disrupting the status quo, calling out the white supremacist behaviours and neo-colonial practices within international development and offering solutions to redress power imbalances and inequities. She seizes every opportunity to bring attention to health disparities affecting black and brown populations.
 
Social media handles:
Twitter: @LazenyaR; @RethinkingGH

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