(De)Racializing Refugee Medicine

Abstract

Based on ethnographic research within refugee-serving institutions in Philadelphia, Pennsylvania (USA), this paper examines the relationship between physicians and the knowledge they produce and consume about caring for refugees from around the world. I explore the “seething presence” of race in refugee medicine, a domain of medical practice whose entanglement with racial ideology and practice has been underexamined. I consider how knowledge about refugees from different groups—whether racially laden designations like “Asian” or “African” or national markers like Congolese or Burmese—circulates in clinical spaces as health-care teams diagnose and treat refugees using standards of “evidence-based” medicine. Assessing the primary literatures that refugee health-care providers use to justify varying care plans, I argue that race, while often unmentioned, structures the practice of refugee medicine. Additionally, the implicit use of race as an analytic, not racism or economic injustice, often disguises the impact of structural racism and inequality in refugee health disparities. I end with some reflections on how we might conduct a more just practice of refugee health care—and by extension, health care more generally—by shifting our gaze from the particularities of seemingly obvious cultural difference to social structure.