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Gavin: Hello, welcome to the Lancet Voice, which is the Lancet's podcast on health stories from around the world. If you're not already subscribed, you can find the Lancet Voice on the podcast listening platform of your choice. I'm your cohost Gavin Cleaver.
Jessamy: And I'm Jessamy Baganon. This week marks a terrible milestone of 10 years since the start of conflict in Syria.
We wanted to take this opportunity to highlight the toll of the last decade on the health and well being of Syrians everywhere. Gavin and I spoke with two of the lead commissioners of the Lancet and American University of Beirut Commission on Syria, Samer Jabbour and Iman Nouahid, to hear their thoughts on the history of the conflict and the prospect for resolution for the people of Syria.
Gavin: Gentlemen, thank you both so much for joining me. We're talking today because it's ten years since the conflict in Syria began. Tell me some of your abiding memories and thoughts of the last ten years. And maybe Samer can go first.
Samer: Hello, thank you Gavin and Jessamy for hosting us for this podcast.
It really is a very painful memory to go back to consider and it is a Penfield anniversary to be at 10 years without a resolution in sight. When we did the collaboration with the Lancet on the photo essay I looked through tens of photos that that captured different milestones of the conflict.
And one striking aspect of what you can possibly call abiding memories is that One terrible memory comes to replace another terrible memory that has already replaced a previous terrible memory. If you all would remember, if your listeners would remember the picture of Aylan Kurdi, the child who, whose body was found on the beach in Turkey.
A Syrian refugee who fled with his family and died en route in the Mediterranean and his body washed up on the Mediterranean. That was a terrible defining image of the conflict, but then so many other terrible images came on top of that. That you almost have developed such a thick memory of of the suffering and of the atrocities that it's hard to know how to sort them out.
Iman: Yeah. Samer, it's amazing. The going back to the photo essays and it's just reminds us that how much an image can tell us. And because with the news of wars. One of the things that striking in this whole Syrian conflict is the fact that it started with such a hopeful, peaceful, uprising, people asking for basic needs, for their basic rights of self expression, and how it was turned into this ugly, protracted conflict.
With so many sort of foreign interventions, and so we kept seeing hospitals being destroyed, people being killed Syrians fleeing their own country, seeking refuge somewhere else risking their lives to, for for the hope of a better one. In another country. So it's but again, this is something that that summer and the commissioners always reflect on Is the role that many Syrians within the country and international, so the local leadership and the the Lincoln leadership in Dia, in the diaspora that that work together to try to to support the people in so many different things.
Samer: Thank you, Iman, for for going back to the days of, of hope to the days off when people saw the possibility of change. I think those remains with us, and I'm so glad you you you brought them up. But they're actually those are in my view, not just memories that actually continue to be a daily struggle.
They daily reality that many people inside and outside the country continue to have, which is that, you Those hopes for change are still possible. You see them in Myanmar, they reminds you of your own fate, and they you look at what's happening elsewhere, and you are reminded of your own fate and if you, and the fate of of those uprisings.
For all that purposes I really. see those early memories as being actually part of an ongoing struggle.
Gavin: I thank you both so much for sharing your thoughts and memories. It must be incredibly painful. The toll of the last 10 years is unimaginable. It's obviously been appalling.
What are some of the kind of lesser well known effects on Syria that have taken place over the last 10 years?
Iman: I spoke a bit about the images and the photo essays that to. And again, there are stories. Of people of individuals of families there. One of the things that and there are even hidden hidden facts and and hardships that are not to not even have the chance of being photographed, such as people that disappeared, those that are in prison and those that are have experienced acts of violence and torture.
And so I think it's important to realize that there are different levels of suffering that are taking place in the country through that some of it is obvious and you see it with the refugees and their inner stories and internal interactions and the dynamics of their lives. But there are people that we rarely hear about and they're reported here and there.
But. They're not really up there on our consciousness, and I think Samer can add to that.
Samer: Thank you, Iman. Yes, exactly. I'm going to build on what you said. You're right, Gavin. The toll has been appalling, and it's actually been unfolding in real time in front of our screens big and small.
What needs to be known about Syria is actually all out there to be to be seen and listened to. However, there are these less well known effect that are important for a health audience to consider. And our commission on Lancet AUB commission on Syria work. We point to some of those less well known dimensions of the health.
For example, we point to to the experiences of suffering as being an important dimension that health researchers should consider and integrate in taking account of the toll of war. In health research, we typically focus on death, casualties, injuries health system effects perhaps a selected set of health conditions infectious disease epidemics and others.
But there are other dimensions the experiences of of, For loss and suffering is one of them. There are additional aspects that are even beyond our consideration. For example, what happens when you destroy key landmarks in a community? A market, a a mosque, a church, or when you destroy a historical object?
That have long been part of your life in a country such as Syria. The, for example, ISIS destructions of temples in Palmyra you lose your connection with your history, and that has profound, potentially profound mental health aspects. Our commission attempts to shed light on some of those relatively neglected topics in global health research on on conflict and health.
Gavin: We mentioned, of course, the work that the great work that your commission has done with the Lancet. In 2017, we published work on the weaponization of healthcare in Syria. That was a particular focus. Has anything changed about the weaponization of healthcare since then? Has it improved? Got worse?
Where are we now?
Samer: After 2017, we've expanded on the framework presented in the weaponization paper. So that we detail the additional dimensions not mentioned there. And this will be detailed in the commission report that's forthcoming with the Lancet. So I encourage your listeners to read that report when comes out.
Between 2017 and 2020, when the ceasefire came into effect in northern Idlib, attacks on health care, targeting of health workers, and other dimensions of weaponization of health care really were vicious. They have lessened since then, since the cease fire, but they have not disappeared. We continue to have occasional accounts of targeting of health workers, and this actually is not limited to the Syrian government, which has been the predominant perpetrator over this decade, but we see that actually in opposition areas, including by extremist groups who have infringed on the right to health and and harassed and arrested some of the health professionals as well.
To summarize, the levels have, has lessened but violations continue and we must expose them and fight them all the time.
Iman: Just to in parallel to all of this, the work since the the paper on weaponization of health care. There has been lots of efforts by the commission itself and by many partners globally, and and there have been developments either with a new resolution, security council resolutions.
The WHO actually initiating a surveillance system to to detect and monitor attacks on, on healthcare. So these are not to belittled although perhaps the attacks didn't stop, but I think there are, there's now a global commitment that this, something like this should not be tolerated, not in this conflict or any other conflict.
And I guess keeping the pressure. And shedding light on this issue should be always a priority for the Lancet, for the Commission and all health professionals.
Gavin: Samer, you mentioned the ceasefire in March 2020 there. Now, of course, in March 2020, a lot of the world's attention turned to the COVID 19 pandemic.
And so a lot less has been written about Syria since then. What has happened since the ceasefire that requires highlighting?
Samer: A lot. And thanks for asking this question because Syria, like many other crises around the world, has taken a backseat to COVID 19 for understandable reasons, but importantly Syrian conflict has not come to a resolution, and violent activities, including targeting civilians, continue on a regular basis in Syria.
We have noted in a forthcoming commentary quoting one of the human rights monitors in Syria the Syrian Network of Human Rights, that in 2020 alone over 1700 people died including over 300 children because of acts of violence. And this includes over 150 people dying by torture in prisons.
Violence continues and, but the violence is not the only cause of suffering in Syria. Syria has has, is now in free economic collapse. Essential food items have increased by 236 percent in price. Over this past year inflation is huge and there's widespread poverty right now inside Syria affecting over 80 percent of of people particularly the highly vulnerable groups, the the internally displaced people.
There are pockets inside Syria today that are what we can call pockets of hell on Earth. In in certain camp. Surrounded camps such as ban or, and Al Ho un agencies have documented terrible conditions. Obviously there are political issues around around addressing the situation in these camps.
But the situation is nonetheless no less deserving of. Of our attention the humanitarian needs are still not being met in in many parts in many parts of Syria particularly in addressing the IDPs the internally displaced people. So lots has happened in Syria.
Lots is continuing to happen in Syria. And we really need to continue the war
Iman: and we should keep in mind the refugees, the fact that the Syrian refugees, although they're outside the country, but they're also passing through many hardships because one, the support to the Syrian refugees have been has dwindled because of all the other competing humanitarian needs across the world and because of the COVID 19 Syrian refugees, for example, in Lebanon, Who are, of course, when they work, they're part of the informal sector, and this has been shut down throughout the COVID pandemic.
So Syrian refugees are suffering also the multiple layers of of economic hardships. With education also, their access to online education is clearly less so than the host communities. So their their needs and their situation. are actually on, has, have deteriorated with the COVID 19.
Jessamy: Thanks both. It's harrowing to hear that. How do you think this is going to play out over the next year or two? And what do you think health advocates need to be doing? What would you like to see start happening?
Iman: One of them is this podcast. The fact that the fact that we need to keep the case.
And the the the stories of of the internally displaced Syrians, the Syrians inside Syria, the Syrians refugees, we need to keep it alive. And so I think health advocates, global health workers, health professionals, international agencies cannot turn their back. And and there's a need to to keep safe focus and make sure that light is always shed on the sufferings and the hardships that Syrians are going through.
So I think this is a minimum that that any of us can and should do. And I think documentation of what's happening, although this will not put food. on the table, but documenting what's happening and the suffering as is also an important commitment to this whole issue to the conflict and to the Syrians themselves.
And Samir, you can perhaps build on that and focus on even specific things. Yes,
Samer: I'm going to focus on specific health related actions that are really crucial for Syria. Now, I'll preface this by saying if we are to develop a laundry list of health asks for Syria. That list would be extensive.
There's much that needs to be done in Syria and for affected Syrian refugees and host communities, most importantly many of such communities being as poor as the refugees themselves. There's much to do to address the health and the health services needs of of these sets of communities, we perhaps can now address a few critical, let's call them critical asks for health that can be first steps.
The first is that we need continue to safeguard health health care workers. This is obviously a continuation of the weaponization subject we discussed. Even in the face of dire shortages of health workers and the COVID 19 pandemics, there are over 3, 300. Health workers that remain in detention or forcibly disappeared.
The majority of these, the vast majority, are by government forces and the government should release those workers immediately as all detainees. And and this is really the first step towards availing the health professionals needed to address The needs of the population in as much as it is also addressing the human rights of those detainees.
The second is to ensure humanitarian access. Today, Syria is one of four countries where Humanitarian access is considered to face extreme constraints according to international humanitarian monitors. And by the end of 2021, the situation could be much worse because the UN Security Council resolution that has authorized the extension of cross border humanitarian delivery to Syria can come to a halt, as has been threatened.
Already the cross border crossings have been reduced to one crossing, and with halting that, we are speaking about important risks that would befall the population there. The third critical dimension we feel is that we really do need to step up our response to COVID-19 pandemic in Syria, as in all other countries affected by these complex emergencies.
Some of our colleagues spoke have have spoken of. Many strategies that needs to be implemented and we endorse those providing protective equipment to health workers where there are critical shortages right now building up the infrastructure. There's not enough oxygen providing vaccines and supporting local innovations.
There is a lot of that. And the fourth dimension that we like to perhaps emphasize now is addressing the ripple health and humanitarian effects of of the economic sanctions imposed by the U. S. and the EU because they do affect the civilian population. And we must find ways of of addressing those those effects.
Gavin: So it was so moving to hear a summer and a man talk about that conflict, which they have personal experience of and to hear their memories and their kind of hopes for the future. It was very moving. I thought as well to hear, how it sprung from such a hopeful place and how it's ended up in, in the situation that it's in.
One thing we didn't cover in that interview was some of the kind of. For all statistics that really you really frame the conflict and show you how destructive it's been. There's a comment that we're publishing online on thelancet. com that you can read and it's written by Samer and Iman and the rest of the commissioners on our commission on Syria and it lays out some of the statistics and they're just so incredibly striking.
So I thought I'd put some of them here for context. So to start off, more than 585, 000 people have died in the Syrian conflict. It's one of the largest humanitarian crises since World War II. Life expectancy in Syria has dropped by 13 years. More than half of Syria's pre conflict population is displaced, which is 6.
2 million internally displaced people and 6. 7 million refugees. By 2017, in three Syrian cities alone, over 1. 2 million housing units were damaged and 400, 000 were destroyed. The Syrian Network for Human Rights Stats for 2020 say that there have been 1, 882 arbitrary arrests, 1, 734 civilian deaths, including 326 children, and 157 torture deaths.
Arrests and forced disappearances total 149, 000 people since the conflict began in 2011. I just think those statistics are so striking. It really emphasises. What an unbelievable toll this has taken as we heard from Summer and Iman.
Jessamy: Yeah and I think what was nice about the interview was it was very personal and I think it was very easy to understand just the sort of sheer desperation of seeing Your country decimated and a feeling that the way out and the way forward is so unclear, particularly now with COVID 19 with, the focus kind of being on that and having that double burden, but also just the, for me, I just felt that.
The lack of real hope for the future was very transparent.
Gavin: Yes, although it's not like a huge amount was solved in Syria when we had this kind of headline focus on the Syria conflict, but it's an even worse situation in terms of international attention now. And it's just so striking to hear from from summer and Iman.
We have a lot more Syria content out this week in the Lancet. If you go to the lancet.com, the homepage will display. At the top, we have a world report, which is our kind of journalistic look into the conflict in Syria recently, and the comment that I mentioned from Samer and Iman and the other commissioners as well, are well worth reading and extremely striking, and it's just something that it's a painful reminder, but it's something that we absolutely have to.
to keep in mind going forward, because it's as you said, Jessamy, it's far from a resolution.
Angela Saini's most recent book, Superior, The Return of Race Science, is a look at the history of racism, eugenics, and segregation in science. It's an analysis of how some of the factually incorrect ideas from that period are still used in modern day conversations about health. Jessamy and I spoke with Angela about this troubling past.
Jessamy: Might you be able to tell us about the evolution of race science, which your book Superior focuses on? And what happened after the Second World War? It's a fascinating
Angela: history. Surprisingly, there is overlap here between the science of sex differences and the science of race. Because when you look at the very birth of modern Western science and the ideas and assumptions that existed at the time, one of those assumptions was that women were not the intellectual equals of men, that they just weren't capable of.
having public lives and doing intellectual things in the way that men were, which is why within Western Europe, it was quite routine from the Enlightenment onwards to not have women in universities and to bar them from the scientific academies. Another assumption that was baked in from the beginning and this was partly because of the way that Western scientists started looking at human difference was that the human species was not one human species, perhaps, but that we could be divided up into subspecies or groups or breeds or even different races.
And what they did, what these early naturalists did was they looked at the world around us. So that other plants and animals could be perhaps subdivided or that certain subbreeds can breed with others and thought could it be the same for humans? And we know that there is cultural difference, obviously, between humans, wherever we live in the world.
But what they did was conflate that cultural and social and environmental difference with some kind of biological difference. As we know now, we are one human species. We are one of the most homogeneous species genetically on the planet. There are no natural dividing lines between us. So there are no genes that exist in all the members of one population and not in another.
There is nothing like that. Yet, because this idea has been with us for a few hundred years and it set the boundaries, really, for how the science of human difference happened in the same way that it also set the boundaries around the science of sex difference we find it very hard to let go. And that's why after the Second World War, even when the scientific facts became clear, and even when the moral case for continuing with race science or eugenics just wasn't there anymore.
People found it quite hard to let go. So there were those on the extreme, so at the very margins of the scientific establishment or way outside it, Nazi race scientists, hardcore eugenicists, hardcore scientific racists, who tried to keep the flame of those ideas alive. And to some extent they were successful with that because those ideas still exist in particularly far right circles and ethnic nationalist circles.
politically to this day, but I think more fundamentally, and I think what's more relevant, I hope, for the audience of this podcast is how it survived in mainstream science, how everyday scientists and doctors couldn't fully let go of these ideas because, like I said, they were so deep rooted in the way that they thought about human difference.
It was quite routine, for example, for American physicians in the 19th century. to explore the possibility that black people didn't experience pain in the same way as white people, or their bones were thicker or denser, or their skin was thicker. And there are many doctors, even to this day, who still believe those racial myths.
In fact, there was a study that was done a few years ago at the University of Virginia that showed that trainees, so these are people coming right through the bottom of the system, not near the end of their careers, that very young people who still believed at least one of these racial myths. It's
Jessamy: incredible.
And I was struck by how there's some very well known names that were involved in the early days of eugenics, which I wasn't aware of at all before I read your book. Did you find it surprising or was that something that you were already aware of when you started writing the book and it was a reason that you went down that road?
Angela: It was a history I did know a little bit already. I did know, for example, that eugenics was popular in the mainstream on the left and the right. It wasn't as though it was only a far right obsession. It was quite an everyday interest and quite mainstream within The Academy in the early 20th century.
What did surprise me was how people still clung to these ideas, even after the second world war. So even after it was clear that what the Nazis had done was take this idea and stretch it to its limit and applied it in its program of racial hygiene, even when it became clear that the science couldn't support this ideology.
Even then there were people who, after the 1950s, still attached themselves to it and tried to resurrect it. There were British scientists who in the decades after the second world war tried to rehabilitate eugenics and present it in a way that might be palatable again to people. They were really committed to what in effect was a social ideology that said that some people shouldn't be allowed to breed and some people should.
Jessamy: And I suppose, we as you say, we do see that even now, there's stories of enforced sterilization and things like, even now in the States, so much of it is also to do with class as well as race. Do you think that's become
Angela: more extreme recently? The British eugenics movement in its, at the start, was really all to do with, about class and disability.
It was very much looking at the lowest socioeconomic groups in society. And this is why it appealed to progressives at the time, because they were thinking, how can we solve the problem of poverty? And for them, for some of them, the eugenicists at least, they thought If the reason that people are poor is some kind of genetic failing in themselves, that they are passing down traits like criminality.
And of course, this emerged out of genetics. People looked at Darwin's theory of evolution. They looked at Herbert Spencer and this kind of social Darwinism and try to apply it to ourselves. That's really where eugenics, the seeds of eugenics started. So when Francis Galton, Darwin's cousin, looked at human beings and said maybe the reason that.
I'm as brilliant as I am because it's because my family are all brilliant and they've been brilliant for generations. They've passed down these traits to each other. And the reason that people are poor and aren't doing so well in other parts of society might be because they're passing down, mental feebleness as it was described or criminality or other genes that make them weaker over generations.
So why should we encourage them to have more children? and not encourage the brighter, more beautiful people to have more children. And it's a kind of infantile logic when you think about it. And also it was never going to work because of course, as we know, genetics doesn't work that way. It's not necessarily the case that brilliant, beautiful people have brilliant, beautiful kids, but that's beside the point.
The point is that for them, it felt like a progressive way of solving. poverty. And that's the way it really became presented. And that's part of the reason it became so popular because it was about improving the health and wealth of the nation by weeding out the weaker elements. It's ruthless in that way.
And of course when the Nazis carried out their program of racial hygiene, you just saw just how ruthless it could be. So
Jessamy: Moving forward and to the context of now, you discuss the difficulties of talking about biological differences and the sort of. how they then can be used to extend racism in the sort of modern context.
How do you think scientists and journals like the Lancet should be talking about these differences in health outcomes between groups so that we can avoid that as much as possible?
Angela: It's very tricky. And in fact, I wrote an essay for The Lancet last summer because I was concerned about the way that medical professionals and physicians were talking about race with regard to COVID 19.
There was a lot of speculation, you might remember in March and April, that the reason that we were seeing these ethnic minority disparities in outcomes. During the pandemic in the UK and in the U. S. might be down to genetics. And of course that flies in the face of everything we know about the genetics of race because these categories, these racial categories, are not biological or genetic categories.
They are social categories. They were defined socially at the time in quite an arbitrary way by these naturalists, like I said, during the Enlightenment. And if you want to understand how arbitrary they are. Just think about where we draw the lines. We draw them around skin color. That's how we use race in the modern day.
First of all, that is not how people have always thought about human difference. That was an invention of the Enlightenment period in Western Europe. And secondly, You can have black skin and be Aboriginal Australian, West African, South Indian. You can be from so many parts of the world. You can have white skin and be East Asian, Western European, South American.
You can be from almost anywhere, again. So it is as vague a way of dividing people as anything else. They could have chosen anything. They could have even chosen harder biological boundaries like height, because at least you can put a number to that. Or they could have chosen eye colour. They could have chosen anything.
The fact that they landed on skin colour reflected the politics of the time in some ways, because it mapped onto the way that colonial powers were treating the rest of the world. But more importantly, it was fully Nonsensical even then, there were huge debates even then about how to divide up the human species.
The fact that they landed on skin color is not because it was more scientifically salient, it's just because that's where they landed. That was, it was a kind of broad, arbitrary In some ways, biologically meaningless, but socially meaningful way of dividing up the world. And we shouldn't persist with those kind of biological, treating those categories, those social categories, which do define how we live now, because they define how we're treated by society.
They define the boundaries. of racism, discrimination, of the structural reasons why the world looks the way it does, but really have no tangibility, or next to no tangibility in biology. We shouldn't be treating them as though they're real and that they in themselves can have an impact on health. And yet, Early last year, that's exactly how medical researchers were behaving, as though that were a possibility.
In the months that followed, of course, that's increasingly been shown to be nonsense. But what worried me at the time was how quickly they turned to that. Turn to genetics. Where if you know that black Americans die of almost everything at greater rates than white Americans, and that to be a black American is socially defined, not just because all races are socially defined, but also because Many, if not most black Americans are of mixed ancestry, they are not, you can, because of that racist one drop rule that existed in America, it meant that you could have one black grandparent, as long as you present socially as black to the world, you're still considered black.
So it is socially defined in, in every possible way. How plausible is it? To assume that there could be genetic differences between these social, socially defined groups that are so profound that group will die of almost everything at greater rates than everybody else, that their life expectancy will be lower than everybody else.
That just doesn't make any sense. We really do have to extricate the biological idea. of race from medicine and what I worry about, and this is something I wrote about in my essay, is that we're just not doing that. We're just, we're still so wedded to it.
Jessamy: And, obviously there is the need to be able to talk about it because from the sort of social determinants of health and the structural reasons why ethnic minorities have worse health outcomes.
How should we be talking about that? I guess that's the what do we need to move
Angela: towards? We should be talking about it in the same way that we talk about class. So when we see class differences in health, we don't biologise that. We don't assume that there are some genetic reasons that these poorer families are doing worse than everybody else.
And that's exactly what we should think when we look at racial categories. We should accept that they are socially defined and they socially determine health outcomes. In this country, in the UK, we also have a life expectancy gap, but it's between the rich and the poor. And in fact, that gap has been getting bigger over the last 10 years.
The fact that in its latest list of groups that should be prioritized for the vaccine, the government has included social deprivation. is a perfect example of why that really matters. Your social status does have an effect on your health. The fact that they also included ethnic minorities in that group.
So the fact that you're from an ethnic minority background in that group, I think we should see as a tacit admission from the government, that structural racism must also matter because why else would you do that? There is no other reason for doing that.
Jessamy: Certainly, and I think that the, the inequalities that we see in terms of access to healthcare in the UK and in the US is so striking that it's hard to see how we can move forward from that without having a really honest and big discussion about it, that, that will change this sort of, The way we view race, what do you see for the next couple of years after COVID 19 of these discussions, where do you see them moving?
Angela: This debate has already been happening in the U. S. for quite a while, so there are some very good scholars there, like Dorothy Roberts, for instance, who wrote Fatal Invention and Killing the Black Body who've been writing about this for a very long time. There are a lot of academics Historians, critical race theorists, and people within medicine in the US who have been trying to shift the narrative around race and health to focus on the social determinants of health.
And they've done that very well. For example, Mary Bassett, the New York City Health Commissioner. This has been a big issue for her for a very long time, and she's been very successful there. Around the end of 2019, I went to give a talk at the National Institutes of Health in the US. And I was expecting a little bit of pushback there when I started talking about race being a social construct.
And in fact, I didn't have any at all. It is already where they're moving. And it really was heartening to see that research in the US led by a few particular individuals, for example, Francis Collins, who's really led on this to reframe the way. We think about social difference and health has really moved this debate along.
And that is why some of the mistakes that we saw happening here last year, when we talk about the pandemic haven't happened so much in the U S there's been a reluctance to. adopt those same narratives there. So I think the UK in that sense needs to catch up to the narrative that's already happening in other countries.
And we need more research on the social determinants of health. We need to look at diet more carefully. We need to look at socioeconomic status more carefully. We need to look at immigrant status, stress. All these different things that we know have an impact on people's health outcomes. We need to look at overcrowding, toxic environments.
There was that case just recently of the girl who died as a result of living too close to a road or the pollution was so bad where she lived. Also has an outcome and it disproportionately affects certain communities more than others. So once we can unpick all these little things, I think then we'll get a more reliable picture of what really, what society can do to make people healthier.
Gavin: Yes, I was just going to ask Angela, it has been interesting, hasn't it, to see the UK government's kind of rejection of critical race theory. Over the last few months. Where do you stand on that? Why do you think they've come out specifically against critical race theory?
Angela: We see similar things happening in other countries.
So for example I remember being in budapest around the end of 2019 When the government had recently banned gender studies in that country or effectively banned gender studies in that country And the reason they did that was because it didn't fit in with their policy or their ideology of traditional families, that they felt that gender scholars were undermining the idea of the traditional family.
And reluctantly, I think it's a shame it's happened this way, but I think this government also has certain axes to grind when it comes to how academics are now. At last talking about race and gender and all these other forms of inequality and how they're rooted in society. There are still people I think out there, including within this government possibly, who feel that society is not to blame.
for these problems, that there is something deep down. And I think it comes back to, like I said, this eugenic style ideology that says that people's problems are their own fault. They're rooted in themselves. This idea that it's not the state's job or society's job to fix inequality, that the impetus should come from these communities themselves because they are to blame for the problems that they have.
And that is a line that has been adopted. on both sides of political spectrum over many years. But I think with this government in particular, it has almost whipped up an artificial culture war. It's a culture war that doesn't exist in academia because people accept that we need this information. We need more data on all these different things.
We need to understand the world in its complexity, not just in a kind of narrow way from just a single set of. Perspectives. And the government on the one hand, when it talks about freedom of speech, it's just appointed a freedom of speech champion for universities. It says that's what it also wants.
But then on the other hand, it doesn't want critical race theorists. It doesn't want me. There's a round table happening just today as we're speaking with 25 museums and heritage bodies where the government is saying, we don't want you to do Britain down effectively. We don't want you to present a version of Britishness that.
Focuses too heavily on empire or slavery or all these other things. You can't really have it both ways. Either we get the data and the facts in their entirety, and we build an honest and true picture of human difference and how society works. Or we just have a form of propaganda.
Gavin: Yes, it's a bit like them having an open conversation, but only on their terms, isn't it?
Angela: And you have to ask you, this academic freedom debate has been bubbling for many years now. It's only relatively recently that the government has got involved. But you have to wonder, the people who are shouting loudest for freedom of speech, whose freedom of speech are they shouting for? Because we've long had a problem in universities of, a certain set of people.
pass through the system much faster than others. They become professors much faster than others. And that has implicitly meant that many voices weren't heard for many years. And yet I don't hear those freedom of speech activists shouting for them. I don't see them asking for more diversity in academia or more inclusion in academia, or for voices from ethnic minorities or working class people to be heard more.
Jessamy: It was great to speak to Angela. And I think one of the reasons that we wanted to, is that Race and ethnicity have been such a sort of defining feature of the COVID 19 pandemic and the, the disproportionate impact that it has had that at the same time, when I was reading this book, I was thinking, what's the best way that you can discuss these things without them being misinterpreted?
Because as Angela says, When you talk about race and health, there's the possibility for people on the far right or for, racists or people who would like to believe that there are some genetic differences to use that, when in fact we're saying, the social determinants of health, the way our society is geared with its sort of infrastructure and bias towards these people means that they are disproportionately impacted.
It's not because they have some genetic thing that makes them potentially more susceptible to COVID 19. It's the societies that we've constructed. And how do we communicate that best? And I think that was interesting talking to Angela about that.
Gavin: Yeah, I think it was a really great reminder of how it's important to make sure that these sweeping conclusions based on race aren't drawn because they're not valid conclusions.
They have this sort of unscientific basis to them.
Jessamy: Yeah, and I think also, the way the book is written and what I found particularly shocking is just how recent some of these things are in terms of race science and belief in sorts of differences and where they stem from and also even, you know post second world war how People tried to, carry on using them and then slightly changed it to culture that, Oh people are culturally different.
And that's that. And that all became very confused and people that we know well in history, Darwin, his cousin, Golton, Mary Stokes, all of these different people having these sorts of very strong and what seems now extraordinary beliefs about race. I think Highlight some of the reasons why we are in the situation where we are today,
Gavin: thank you for listening to this episode of The Lancet Voice. You can find The Lancet Voice wherever you usually get your podcasts, and we're always open to your feedback. You can reach Gavin on podcasts at lancet. com. We look forward to seeing you again next time.