In a world where healthcare is often seen as a bastion of objectivity and science, Dr. Annabel Sowemimo has exposed the deeply ingrained racial biases that permeate the field. Her book, “Divided,” is a revelation, shedding light on the systemic racism and colonialism that shape our healthcare experiences and outcomes. Speaking to The Trouble Club at the AllBright venue in London, Dr. Sowemimo’s experiences as a doctor, patient, and activist have provided her with a unique perspective, making her book a vital addition to the conversation about health, medicine, and equity.

Who is Dr Annabel Sowemimo and what is her book about?

Dr. Annabel Sowemimo is a dedicated Sexual & Reproductive Health (SRH) registrar, scholar, activist, and accomplished writer. She is also the co-founder and director of the Reproductive Justice Initiative (RJI), a charitable organisation committed to addressing health disparities and racial inequalities in sexual and reproductive healthcare. Dr. Sowemimo advocates for enhanced accessibility to SRH services for marginalised communities and the eradication of gender-based violence. Her writing portfolio includes contributions to esteemed publications such as The Independent and gal-dem.

Dr. Sowemimo's research is centered on the experiences of Black women in the United Kingdom concerning fertility control methods. Her debut book, "Divided: Racism, Medicine, and the Urgent Need for Healthcare Decolonization," was released in April 2023. In this illuminating work, she delves into the profound influence of racism and historical colonial legacies on the British healthcare system and its repercussions on the health of Black women.

Racial biases in healthcare

“I began receiving messages from young black women, particularly, who wrote, that they had never heard people speak about racism shaping their experiences of health care,” Dr. Sowemimo recalls. “I knew our work was important, I knew it was helping people. But every now and then I would speak to a medical colleague and they would say something demeaning. My work was considered a little project. Colleagues would tell me it was edgy, not academically vigorous. It was clear that this work wasn’t a prior to them, and in some people’s mind it was even a complete waste of time.”

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Despite the challenges and dismissals she faced, Dr. Sowemimo remained steadfast in her commitment to improving sexual reproductive health and addressing the racial inequalities embedded within the healthcare system. The events of 2020, with the onset of the COVID-19 pandemic, only underscored the urgency of her mission.

“In the throes of lockdown,” she continues, “I felt it was the right time to start writing my decolonising healthcare column. In my first column, I wrote about my experience of encountering a young woman who needed emergency dialysis due to her fears about deportation. She hadn’t sought medical help until she had kidney failure. The article resonated with many. I received direct messages from people sharing their experience of similar issues.”

Not all the responses were supportive. Dr. Sowemimo faced criticism from some quarters, but it was the messages from young medical students that had the most profound impact on her. “My inbox is flooded with messages from students across the UK asking how they might spark similar conversations about the role of colonialism, race within healthcare at their medical school,” she says.

The intersection of racism and medicine

Driven by a desire to make a more significant impact and untangle the complex web of health inequalities, Dr. Sowemimo realised that she needed to write “Divided.” She urgently needed to address the history of healthcare, rooted in colonialism and race science, that continues to perpetuate health inequalities. The COVID-19 pandemic brought the role of healthcare institutions and the power of medical professionals into stark focus, making it impossible to deny the existence of health and racial inequalities.

“Divided” is the culmination of years of learning and unlearning. Dr. Sowemimo had to confront and dispel the deeply entrenched race science and colonialism that underlie the field of medicine. “Race science, the pseudoscientific belief that empirical evidence exists to justify racism, continues to be part of healthcare every day,” she asserts. “Our understanding of health has been shaped by European colonisation and race science. We have to unravel this through conversations with academics, activists, and other health professionals, as well as my own experience.”

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She is on a mission to examine the story of race and health worldwide, highlighting how race science has been used to justify racism in different contexts, including in the United States, which exerts considerable scientific and pharmaceutical influence globally. Dr. Sowemimo challenges the notion that science is entirely objective, emphasising how social context can influence scientific understanding, particularly in a racist and colonial context.

Dr. Sowemimo and her work challenge the conventional wisdom that medicine is neutral and that science is devoid of politics. “That’s incredibly naive to even think from the beginning,” the Trouble Club host Eleanor Newton agreed.

Health inequalities beyond medicine

Dr. Sowemimo delves into the history of racial classification in the book, exposing how early Enlightenment thinkers like Carl Linnaeus laid the foundation for racial categorisation. Linnaeus, initially a botanist, extended his classification system from plants to humankind. His work classified different groups of people and ascribed defined characteristics to them, which became deeply entrenched in scientific thought and fuelled the subjugation of various communities.

Dr. Sowemimo’s book also explores the challenges of racial and ethnic identity in healthcare. She showcased the inadequacy of simplistic categories and the complexity of individual experiences. She notes how people of mixed heritage often struggle to fit within narrow definitions of ethnicity provided on medical forms, emphasising the importance of understanding the multifaceted nature of identity.

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The issue of pain is another key aspect of Dr. Sowemimo’s work. She sheds light on how pain is not universally understood or treated within the healthcare system. Factors such as race, gender, and socioeconomic status can profoundly influence how a patient’s pain is perceived and managed. Dr. Sowemimo recounts an experience in pediatric A&E where she challenged a senior triage nurse’s assessment, ultimately saving a child’s life. This experience exposed how biases can affect medical decision-making and reiterating the importance of addressing disparities in pain management.

Dr. Sowemimo also discusses the role of prisons in perpetuating health inequalities. She reveals shocking statistics, such as the fact that the risk of women dying after leaving prison is 40 times higher than the rest of the population. This disturbing disparity underscores the need to reform the criminal justice system and prioritise rehabilitation over incarceration.

Hence, in “Divided,” Dr. Annabel Sowemimo shares her powerful and thought-provoking insights challenging the status quo in healthcare and demanding a reevaluation of deeply ingrained biases and inequalities. Her work serves as a call to action, urging us to confront the uncomfortable truths about race, health, and medicine and work towards a more equitable and just healthcare system. As she eloquently states, “We need to address the racial inequalities in medicine, and only then can we hope to build a system that is more equitable for everyone.”