What is the Role of Religion and Culture in Global Health? An Informal Conversation with Dr. Ahmed Ragab

Informal Conversation with Dr. Ahmed Ragab group photoWhat has religion to do with global health? More than we might think, says Ahmed Ragab, MD, PhD, the Richard T. Watson Assistant Professor of Science and Religion at Harvard Divinity School, in a luncheon talk with faculty and students at the Harvard Global Health Institute (HGHI) on October 30, 2013. The event launched the Institute’s Fall 2013 "Informal Conversations" series, which explores cutting-edge cross-disciplinary issues, ideas, challenges, and opportunities that play a role in global health. Past speakers in the series have included Yale philosopher, Professor Thomas Pogge, and Dr. Peter Piot, former Under-Secretary General of the United Nations and UNAIDS. Invited faculty and students at the October lunch represented a wide range of disciplinary interests, including religion, public health, law, business, art, education, South Asian studies, and medicine.

A physician, historian, and scholar of the medieval and modern Middle East, Ragab began by framing "global health" within its broader history: interactions between the power-dominant rich regions of the "global north" (such as Western Europe and North America) and the historically lower- and middle-income regions of the "global south" (such as Africa and South America). A secular discourse has shaped these interactions, separating religion from health in much of the Western world since the sixteenth century. Both medical missions and colonial medicine have perpetuated power differentials, said Ragab. These effects continue to impact the lived experiences of many around the world for whom faith is one part (and often a very important part) of a complex set of beliefs that in turn affect health attitudes and behaviors.

Religion and culture are far more nuanced than they might appear to health workers. This means that global institutions like the World Health Organization, which team up with faith-based groups to promote local change, often find themselves in multilateral collaborations plagued by hidden agendas and unintended consequences. Monies and aid efforts from single-issue donors in the global north, for example, may (often inadvertently) "coerce" individuals and communities in the global south to focus on what gets funding, even when their real needs are quite different or extend beyond the external boundaries of the targeted health issue. Empowering religious leaders (in any culture) does not necessarily ensure mutual respect, agency, or even agreement with global partners on the health issues at stake. An "us-versus-them" mentality in our own culture further abets discrimination based on misperceptions about "religio-ethnicity," for example, when fellow nationals are mistreated or marginalized as "other" simply because of their appearance.

We learn what works best, Ragab said, from projects that are socially connected and locally related, those that depend on strong local support and that train and trust local practitioners. Such opportunities can couple with policy education, transforming leaders for the next generation. Ragab encouraged the lunch participants to pay attention to empowerment, authority, and resource distribution, to be mindful of the kinds of questions we ask as individuals within the academy, and to be thoughtful about the way we treat one another. Cultural difference is no excuse for "dumbing down" scientific facts, he said; rather, "There is a moral obligation to explain things because this is the only way to respect a person’s agency and ability to make choices—even if we disagree with their choices."

Ragab’s remarks sparked lively discussion and new questions. Looking ahead, "What would it be like if people here at Harvard wanted to learn more about health and religion?" asked Karen King, Hollis Professor of Divinity at HDS, as the audience began to explore opportunities for further discussion. "I didn’t even know how to think about religion and global health before your talk," said Dr. Suerie Moon, noting belief-related conflicts in the global polio eradication campaign; Moon is Research Director and Co-Chair of the Forum on Global Governance for Health at HGHI and Harvard School of Public Health (HSPH), and Co-Director of the Project on Innovation and Access to Technologies for Sustainable Development in the Sustainability Science Program at the Harvard Kennedy School of Government. Indeed, asked Tyler VanderWeele, HSPH Professor of Epidemiology, "What lessons can we take away from aid examples that have effectively helped to build long-term infrastructure?"

Harvard offers a range of opportunities to develop further cooperative networking and dialogue about religion, culture, and global health. Faculty, for example, may foster deliberative initiatives that include other schools and disciplines (such as the recent Harvard Kumbh Mela Project which included a health-related component), and can develop new courses, course materials, events, and related mentoring opportunities. At the Divinity School, for instance, Ragab directs the Science, Religion & Culture Program, which recently held its second annual "Ways of Knowing" graduate conference with presentations by more than 120 students.

Ragab encouraged students to initiate and develop their research interests creatively: "Form your own team of advisors; create your own research agenda; build your own program. Use events like this one to open up new questions."

Photo Courtesy of Christen Reardon