Fatima Hassan is a South African human rights lawyer and social justice activist and founder of the “Health Justice Initiative” in South Africa.

She won the Calgary Peace Prize in 2022 for her work in uncovering inequalities in the global distribution of COVID-19 vaccines, among other things.

Citation source: hil/aerzteblatt.de (19.09.23): ” High vaccine prices in South Africa: pharmaceutical companies and vaccine alliance criticized“

The coronavirus pandemic has once again highlighted the global inequalities in terms of medical care. Many countries in the Global North secured vaccine doses that far exceeded the size of their populations. Germany, for example, had 116.4 million Covid-19 vaccine doses in stock in February 2023, out of a population of 84 million. This vaccine nationalism (the tendency of wealthy countries to reserve vaccines for themselves) has led to shortages and higher prices on the international market. This made it difficult for poorer countries to gain access to affordable vaccines. In April 2020, the COVAX initiative was founded by several supranational institutions to coordinate global vaccine distribution. However, the UN Committee on Economic, Social and Cultural Rights criticized in April 2021 that COVAX cannot solve the problem of globally insufficient vaccine production. This would require technical support and, in particular, concessions in the area of intellectual property (patents). The Africa Coordinator of the People’s Vaccine Alliance Maaza Seyoum criticizes the system and speaks of “systemic racism” for the global community’s inadequate response to the COVID-19 pandemic in poorer countries(The Guardian, 26.08.2022).

*Edna Bonhomme (27.04.2022): Diseases of Relevance. London Review of Books.

*Fatima Hassan (23.05.2022): Vaccine apartheid is racist and wrong (PLOS Blogs Speaking of Medicine and Health)

Carl Gustav Jung (1875-1961) was a Swiss psychiatrist. In the 1920s, Jung made several long journeys to various parts of Africa, and also visited indigenous groups in North America. He is considered the founder of analytical psychology.

Fernando, Suman (2017). Racial thinking and racism are becoming the norm. In: Institutional racism in psychiatry and clinical psychology. Contemporary Black History. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-62728-1_3

Analytical psychology was developed in contrast to Freudian psychoanalysis. Jung was a student and friend of Freud from 1907 to 1913. Analytical psychology is mainly offered as individual therapy. Here client and therapist usually sit opposite each other. The aim is a dialog between the two as equal partners and a deep human encounter. However, the therapist is also seen as a teacher and “spiritual guide”.

Besides sickness in addition to the causes in the individual life story and in the social and cultural situation, there are also life conflicts that all people have to overcome: the so-called archetypal problems. His descriptions of these archetypes are based, among other things, on racist stereotypes that have found their way into European science through colonialism.

This is why, in analytical psychotherapy, the client is brought into contact with archetypal solutions, such as those presented in myths or fairy tales. This inevitably leads to the reproduction of racist and sexist stereotypes. The “cure” is to be achieved through individuation. Individuation occurs through the realization and integration of previously unconscious polar personality parts such as the so-called shadow as the negative or the animus or anima as the opposite-sex part.

Typology Triad Blog (2021): Jung and racism.

Interview partner:in Iman in an article by Alisha Qamar (2020). Alisha Qamar is a medical student in Bochum and an activist in the field of human rights, including with “The ONE Campaign”.

Thieme.de (Alisha Qamar), 12.08.2020:“Black Lives Matter – Racism in the healthcare sector“

Due to colonial continuities, Black people are still inadequately considered in medical care today and often receive poorer care.

At that time, terrible acts of enslavement were justified and justified by the fact that black skin was supposedly thicker and more resistant to pain than white skin. Medicine is still influenced by this idea today. The scientific journal “Proceedings of the National Academy of Sciences” from the USA published an article on the unequal treatment of black patients back in 2016, stating that the majority of doctors prescribe less pain medication to black patients than to white patients (57% to 74%). The study by Staton et al examined the different perceptions of pain among patients by doctors. In the study, the underestimation of pain felt by black patients was 47%, compared to 33.5% for white patients. On average, black patients wait longer in the emergency room and their concerns are not taken seriously. (Thieme 12.08.2020)

BIPOC are also exposed to stigmatizing diagnoses, such as the so-called Mongolian spot or Mediterranean disease. These stigmatizing diagnoses can sometimes have fatal or health-damaging consequences, as sometimes serious clinical pictures can be detected too late and preventive measures can only be taken inadequately(Ärztezeitung, 21.04.2015). This question of representation is closely linked to the fundamental issue of global inequality in the distribution of medical care, which has become particularly evident during the coronavirus pandemic.

*The New England Journal of Medicine (LaShyra Nolen), June 25, 2020:“How Medical Education Is Missing the Bull’s-eye“

Dorothea Buck (1917-2019) was a German author and sculptor. Under Nazi rule, she was classified as mentally ill and forcibly sterilized. She gave critical lectures, wrote essays and, among other things, a play about the hundreds of thousands of murders of mentally ill and disabled people during the Nazi era. In 1992, she founded the Bundesverband Psychiatrie-Erfahrener (Federal Association of People with Psychiatric Experiences) together with other people affected.

RBB, 27.05.2010:“Forgotten victims of National Socialism – Forcibly sterilized people fight for their rights“

During the Nazi regime, hundreds of thousands of people fell victim to human experimentation by doctors, as well as to inhumane medical treatment and the murder of the sick. The Nazis sought out their victims in psychiatric wards, concentration camps and prisoner-of-war camps. After the Nuremberg trials against the main war criminals, twelve follow-up trials were held between 1946 and 1949. In the doctors’ trial of 1946-1947, the American military court indicted 23 doctors, administrative staff and a lawyer on charges including Crimes against humanity. Seven of them were sentenced to death. The most famous war criminal, Joseph Mengele, camp doctor in Auschwitz 1943-1945, was never caught and died in a swimming accident in Brazil in 1979. For decades, victims of human concentration camp experiments on both sides of the Iron Curtain fought for compensation and recognition. Colonial injustices can also be identified here, as the Nazis saw their colonial project in Eastern Europe (Zimmerer 2003). After the war, Eastern European survivors were excluded from all benefits for a long time. “This only changed when international attention was drawn to the persecution of the group of Polish women who became known as the Ravensbrueck Lapins. Their case contributed significantly to the gradual softening of the radical exclusion of Eastern European victims of Nazi persecution” (Baumann 2009).

Picture: The bronze statue “Mother with Child” (Hamburg) created by Dorothea Buck.

*Stefanie Michaela Baumann 2009: Human Experiments and Reparation: The Long Dispute over Compensation and Recognition of the Victims of National Socialist Human Experiments. Berlin, Boston, Oldenbourg: De Gruyter.

*Jürgen Zimmerer, Holocaust and Colonialism. Beitrag zu einer Archäologie des genozidalen Gedankens, in: Zeitschrift für Geschichtswissenschaft 51/2003, pp. 1098-1119, here p. 1102. His contributions on the question of continuity were published once again as ders, Von Windhuk nach Auschwitz? Contributions on the relationship between colonialism and the Holocaust, Berlin 2011.

Peter Buxtun (born 1937) is an American social worker and former employee of the United States Public Health Service who became known as a whistleblower due to his publication of the Tuskegee Syphilis Study. The experiment was discontinued after it became public knowledge.

Der Spiegel (Johanna Lutteroth), 07.06.2012: “Medical scandal Tuskegee death study.”

In the 1930s, doctors began abusing poor black male farm workers suffering from syphilis in the so-called Tuskegee Study. They wanted to investigate how syphilis develops if it remains untreated. The study was conducted by the Public Health Service, an agency of the US Department of Health and Human Services. Almost 400 sick men in Tuskegee (Alabama) were deliberately deprived of effective treatment without their knowledge. It was forbidden to prescribe Penecellin to patients when it was discovered to be an effective drug against syphilis in 1943. The aim was to monitor the progression of the disease and its late effects. “The study had no scientific value at all. Because the gruesome consequences of syphilis had been known for centuries” (Berliner Zeitung, 19.05.2022). The study was only discontinued in 1972, after Peter Buxton had tried in vain for years to draw attention to the abuse. In the 1940s, the same group of researchers infected hundreds of people in Guatemala with the virus in order to research the disease (ibid.). Although the researchers described the Tuskegee study in 15 medical journals, there was never an outcry in the medical community (Martin J. Tobin 2022).

*Berliner Zeitung (Annett Stein), May 19, 2022):“Tuskegee experiment: Consequences of the cruel human experiments continue to this day.”
*Tobin (2022):“Uncovering the Tuskegee Syphilis Study: The Story and Timeless Lessons.”

Robert Koch (1843-1910) was a German microbiologist and is considered one of the pioneers of bacteriological research. He achieved worldwide fame through his discoveries of pathogens, including the tuberculosis bacterium (Mycobacterium tuberculosis) and the cholera pathogen (Vibrio cholerae), which earned him the Nobel Prize in Physiology or Medicine in 1905.

Robert Koch (1904):“On sleeping sickness (letter to the Minister of Spiritual, Educational and Medical Affairs)“

Medical research played a key role in colonialism. According to the former director of the Institute for the History and Ethics of Medicine (University of Heidelberg), Africa could never have been colonized in this way without the progress made in the fight against malaria and other diseases (SRF, 04.02.2021). From 1906 to 1906, Robert Koch experimented with the arsenical agent Atoxyl in what is now Uganda. He was aware that Atoxyl is dangerous in high doses. Koch injected the drug at intervals of seven to ten days, accepting pain, blindness and the death of thousands of people (ibid.). The sick were held in so-called concentration camps. Koch took the concept of the concentration camp from the British colonizers of South Africa, who imprisoned political opponents in these camps (Bauche 2006). The camps served as a place of isolation for the sick to prevent the spread of disease, but also as a research facility where people were forced to undergo medical experiments “Since precise observation over a longer period of time is possible in the concentration camps, it is here that the most recommendable mode of atoxyl treatment can be found and, for example, a staged therapy can be tested” (Robert Koch quoted from Bauche 2006).

*Manuela Bauche 2006: Robert Koch, sleeping sickness and human experiments in colonial East Africa. In: Freiburg Postcolonial/Orte

Konrad von Megenberg (1309-1374) was a clergyman and author. The quote comes from his book “The Book of Nature”. It is expressly written for laypersons and not for experts.

Bernd Schneidmüller (2012): Catastrophic memory: Great plague and Jewish pogroms 1348 to 1352. Volume 2, p. 399

During the so-called burning of the Jews in the middle of the 14th century, many thousands of Jews were persecuted, expelled and murdered. The pogroms were not only a consequence of the raging plague at the time, as the pogroms often preceded the plague. Jewish communities were accused of poisoning wells and thus causing the plague. Mergenberg represents one of the few critical voices of the time, writing that Jewish people died equally from the plague. Some rulers, such as Emperor Charles IV (1316-1378), guaranteed the perpetrators impunity (document of June 25, 1349, see Schneidmüller 2012: 399): “The plague thus not only seized people’s bodies, but also their minds (…) People, mortally threatened by microorganisms in their own bodies, sought their salvation in the eradication of the seemingly alien from their habitat” (ibid. 400).

*Ruth Kinet (2020): With the Plague Came the Progoms (from the podcast “From the Jewish World”)

*František Graus (2002): Jewish progroms in the 14th century: The Black Death

*Haverkamp, Alfred (1981): The persecution of Jews at the time of the Black Death in the social fabric of German cities

Joseph-Achille Mbembe (born 1957) is a Cameroonian historian and political scientist. He is a professor at Witwatersrand University in Johannesburg, South Africa.

The University of Chicago Press Journal (Achille Mbembe), 13.04.2020:“The Universal Right To Breathe.”

In his article, Mbembe draws attention to the general destruction of the foundations of all life on our planet. “In Africa in particular, but also in many places in the global South, energy-intensive mining, the expansion of agriculture, predatory land sales and the destruction of forests will continue unabated. The power supply and cooling of computer chips and supercomputers depend on it. […] If COVID-19 is indeed the spectacular expression of the planetary impasse in which humanity finds itself today, then it is about nothing less than rebuilding a habitable Earth to give us all the breath of life. We need to reclaim the lungs of our world in order to break new ground. Humans and the biosphere are one. Humanity has no future on its own.”

The Centers for Disease Control and Prevention is an agency of the US Department of Health and Human Services. The CDC was originally founded in 1946 to ensure the control of malaria in the post-war period. The agency maintains field offices in 49 states. The director from 1983 to 1989 was James O. Mason.

Current Trends Prevention of Acquired Immune Deficiency Syndrome (AIDS): Report of Inter-Agency Recommendations

Other epidemics have also resulted in BIPoC or people from the Global South being stigmatized. As HIV/AIDS spread in the early 1980s, the Centers for Disease Control and Prevention, under Director James O. Mason, issued a statement classifying Haitians as a high-risk group for HIV/AIDS. The claim was later withdrawn, but the consequences were fatal. The origins of this can be traced back to erroneous scientific assumptions. In 1992, the CDC again issued a warning that Haitian refugees could pose an “unjustifiable threat to the health of the United States”(Washington Post, August 7, 1992). In 2007, another study was published linking HIV to Haiti, stating that “subtype B probably migrated from Africa to Haiti around 1966” and then on to the United States. They base this hypothesis on virus sequences from only five (!) Haitian Americans who contracted AIDS in 1981 and who came to the United States “after 1975”. This stigmatization has had far-reaching effects, including social isolation, discrimination in health care and everyday life, and a negative impact on the entire Haitian community in the United States.

*The Guardian (Edna Bonhomme), 22.02.2021:“From HIV to Covid, pandemics show us fear of disease is colored by prejudice“

Ludwig Külz (1875-1938) was a doctor and from 1902 head of the Nachtigal Hospital in Togo. The indigenous population was denied access and treatment there. He was also a government doctor in other German colonies. From 1920 onwards he trained so-called emigrants as a professor at the Hamburg Tropical Hygiene Institute. In the quote, Külz referred to the prevailing “motto”, “Black hands, white heads”, which was first postulated by Friedrich Wulffert in a lecture.

Quoted by Wolfgang U. Eckart (1997): Medizin und Kolonialimperialismus Deutschland 1884-1945, S. 59. Original Source: Ludwig Külz (1911): Grundzüge der kolonialen Eingeborenenhygiene, in: Beihefte z. Arch. f. Schiffs- u.Trophyg. 15 (1911) 3, 386-475; Wesen und Ziele (1910).

In the collective memory, German colonial medicine is often associated with “adventure”, dangerous tsetse flies or the self-sacrificing efforts of German doctors “far from home”. At the latest with the “colonial entry” of the German Empire in 1884, many (especially young) doctors took advantage of their assignment in the colonies to advance their medical careers. In this context, they developed dangerous drugs that they tested on the colonized population. This happened primarily in the sleeping sickness concentration camps and leprosy homes in Togo, Cameroon and “German East Africa”. From 1907 onwards there was to be a more “social” colonial policy, based on “humanity, justice and charity”. However, here too, the “effective exploitation of the land and people” – such as the “arms” of the colonized mentioned in the quote, i.e. the labor of the colonized – to maintain and improve the German colonial economy was the actual goal. Ludwig Külz called for a “colonial human economy” that should implement acculturation and the implementation of “colonial racial hygiene” as “sanitary pedagogy”. The task of the “tropical hygienist” is to strengthen the weakening German colonial economy by preserving “valuable” life within the colonized population (e.g. “strong men”). At the same time, it was Külz’s central concern to avoid “bad” or “inferior” lives, especially in the sense of a so-called “mixed-race population”.

*Wolfgang U. Eckart (1997): Medizin und Kolonialimperialismus Deutschland 1884-1945. Verlag Ferdinand Schöningh: Paderborn.

Dr Nise da Silveira, born on 15 February 1905 in Maceió; died on 30 October 1999 in Rio de Janeiro, was one of Brazil’s most important scientists*, psychiatrist, alchemist of the psyche and Marxist, who resolutely defined new paths through the fields of medicine, philosophy and art. Her work was characterised by her rejection of the invasive methods of psychiatry that were common at the time. She was the only female graduate alongside 157 men. Nise da Silveira completed her specialist training as a psychiatrist at the Antonio Austregésilo Neurological Clinic and in the same year won a national competition for a post in psychopathology and mental health care at Praia Vermelha Hospital.
When she was employed at the Pedro II Psychiatric Centre in Engenho de Dentro, Nise da Silveira rejected the practices of lobotomy, insulin shock or cardiazole shock therapy and was then transferred to the occupational therapy department. There she enabled her patients to develop personally and artistically. In particular, she led art therapy sessions, through which, according to her understanding, subconscious states of the psyche became accessible. Nise da Silveira, the “psiquiatra rebelde”, revolutionised the history of psychiatry beyond the borders of her country and was a forerunner in the worldwide movements of psychiatric forms in Brazil, England, Italy and Germany between the 1960s and 1980s. She advocated the humanisation of treatment methods for chronically mentally ill patients and created the “Museu de Imagens do Inconsciente”, which was also her study and research centre. After her death, her private archive was included in UNESCO’s “Memory of the World” programme as a heritage of humanity, a digital collection of historical documents of exceptional value to human history.

Image/source: Arquivo Nise da Silveira, https://revistacult.uol.com.br

Livro –MELLO, L.. Encontros. Nise da Silveira. São Paulo: Azougue Editorial, 2009. Entrevistas e depoimentos que Nise da Silveira concedeu entre 1976 e 1997

In the wake of the Communist uprising in 1935, da Silveira founded the organisation “Uniao Feminina do Brasil” (UFB) together with intellectual and feminist activists. The women demanded legal changes that would grant women custody of their children after a divorce, equal pay with men and the right to maternity leave. These demands brought the UFB close to left-wing organisations, which in turn were linked to the Communist Party. On 19 July 1935, the ruling dictator President Getúlio Vargas signed Decree 246, which immediately ordered the closure of the UFB as an illegal organisation – less than two months after it was founded. A year later, Nise da Silveira was denounced by a nurse who had discovered Marxist literature in da Silveira’s locker. This was followed by 18 months in prison and a ban on practising her profession. In 1944, with the end of the dictatorship of President Getúlio Vargas after 15 years, democratic processes gained the political upper hand and the emancipation of society through education and art became a political concern.

Nise da Silveira was granted amnesty and transferred back to her previous position at the Pedro II Psychiatric Centre in Engenho de Dentro, Rio de Janeiro. She was deeply shocked by the invasive and, for her, brutal treatment methods that had become the norm in international psychiatry: Insulin shock therapy, electroshock, lobotomy (a neurosurgical operation in which steel needles are driven deep into the patient’s brain to sever the neural pathways between the thalamus and frontal lobe and parts of the grey matter). The Portuguese doctor António Egas Moniz (1874 – 1955) was awarded the Nobel Prize for Medicine in 1949 for the development of lobotomy. When Nise da Silveira was asked to apply these therapies herself, she flatly refused – which earned her the title “psiquiatra rebelde” from that moment on. For her, these methods were risky, aggressive and ineffective, akin to torture. She was convinced that “all these techniques […] represent an attack on the integrity of man in the noblest of his organs”. Sensitised to a life in captivity by her own imprisonment, she was equally horrified by the housing of the 1,500 or so schizophrenic patients at the time in closed rooms and walled courtyards.

In order to keep her job, the only solution offered to her was to be transferred to the neglected occupational therapy department. Even though the job had previously only consisted of cleaning and maintenance work, Nise da Silveira accepted the offer. She took over an unused administrative area of the hospital complex and founded the Secao de Terapeutica Ocupacional e Reabilitacao, the Occupational Therapy and Rehabilitation Section, on 9 September 1946, and from then on began her ground-breaking work. Nise da Silveira developed a clinical method based on affection and respect for the dignity of each person.

Nise da Silveira became known worldwide for the avant-garde idea of using affection as a scientific method in the treatment of mental illness. Empathy, commitment and charity overcame hospital walls, prejudice and abuse of patients. In 1956, Nise da Silveira founded the Casa das Palmeiras, the first Brazilian clinic for psychiatric treatment in the form of a day school.

Nise Da Silveira – Uma Psiquiatra Rebelde (Em Portuguese do Brasil), 1. Januar 2000
https://www.fembio.org/biographie.php/frau/biographie/nise-da-silveira/
Museu virtual – Ocupação Nise da Silveira – Itaú Cultural
Livro –MELLO, L.. Encontros. Nise da Silveira. São Paulo: Azougue Editorial, 2009. Entrevistas e depoimentos que Nise da Silveira concedeu entre 1976 e 1997

Memória do Mundo da UNESCO: Arquivo Pessoal de Nise da Silveira
https://www.youtube.com/watch?v=AtUhmbHqeXM&embeds_referring_euri=https%3A%2F%2Frevistacult.uol.com.br%2F&source_ve_path=MjM4NTE&feature=emb_title
Nise, el corazón de la locura.. (subtitulada)
https://www.youtube.com/watch?v=mcLpV3a_hZ4&t=2953s
Nise da Silveira – Posfácio: Imagens do Inconsciente
https://www.youtube.com/watch?v=EDg0zjMe4nA
Leon Hirszman, Imagens do Inconsciente
https://www.youtube.com/watch?v=FxYx4obbARE
https://www.youtube.com/watch?v=9-uN1lsWFjM&t=4322s
https://www.youtube.com/watch?v=fgong5EYqUE&t=3585s
Robert Berliner, Nise – O Coracao da Loucura (Nise – in the Heart of Madness)QUEM É NISE DA SILVEIRA
https://www.youtube.com/watch?v=LbWP3JEUV1s