"Othering" and Global Health

The act of "othering" involves identifying an individual or group of individuals as different from oneself or from the mainstream. Discourse on othering is ubiquitous in global health, as international health efforts (by definition) involve communication and cooperation among different cultural groups. Othering becomes problematic in any context (especially health) when it leads to the marginilization of any particular group through the introduction of a power dynamic. In other words, when people who are "othered" become inferior to those who are othering, disasterous outcomes can occur.

In their book, Stories in the Time of Cholera: Racial Profiling During a Medical Nightmare, Charles Briggs and Clara Mantini-Briggs discuss how othering facilitated a cholera epidemic among people living in the Orinoco Delta in eastern Venezuela. While the authors present examples of blatant racism and the exertion of power and superiority over people living in this region, the accounts of othering by well-intending public health officials and aid workers are particularly startling. Without being completely conscious of the outcomes of their words or actions, many people who were fully dedicated to assuaging the epidemic actually facilitated it by connecting cholera to culture. In doing so, they shifted the blame from factors such as lack of access to care and inadequate plumbing systems to the people who contracted the disease themselves.

Briggs and Mantini-Briggs present a strong case for the significance of critical thought and consideration of the outcomes of othering when working with people different than ourselves. As the late Dr. Edward Said described in his concept of Orientalism, people often other automatically, making it easy to introduce a power dynamic in the process.

While it might not be beneficial (or even possible) to eliminate othering, it is essential for people providing services to be aware of any power dynamic introduced during the process of othering. As Briggs, Mantini-Briggs, and Said describe, doing otherwise could lead to marginalizing people, even where explicitly unintended.