Who Lives, Who Dies, Who Cares? Reimagining Global Health (Gen Ed 1093)





How can health care systems be restructured to provide high quality care even to the poorest and most vulnerable people on our planet?

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Arthur Kleinman, Anne Becker, and Salmaan Keshavjee

If you are sick or hurt, whether you live or die depends not only on biological factors, but social ones: who you are and where you are, what sort of healthcare system is available to help you survive, and what kind of care is available to help you recover, if society believes you deserve it. The global coronavirus pandemic illustrates with dramatic urgency the role social forces play in patterning health inequities and determining individual fates. The vulnerabilties of those most likely to get sick and die from COVID-19 stem from the ongoing effects of systemic racism on racialized subjects, the devaluation of eldercare and precarity of low-paid work under neoliberal forms of governance, and material effects of colonial-era power structures that render health care systems dangerously weak or inaccessible for many communities. Now, as ever, it is imperative to develop frameworks and methodologies to identify and to intervene effectively in harmful social configurations that cause illness and suffering.

Most medical research narrowly focuses on the biological basis of disease, but this course takes a novel biosocial approach to reveal how governments, institutions, and histories shape health and well-being, how poverty and racism get into someone’s lymph nodes, how cost- saving measures manifest as tuberculosis in someone’s lungs. In doing so, the course challenges the conventional assumptions within the field of global health—examining how interventions influence what happens after a catastrophe in unexpected ways, how the persistence of health inequalities over centuries can be explained, how the structures of powerful institutions influence the policies they develop, how the poor deserve not only health care but high quality health care, and how caregiving and global health are urgent moral practices.

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