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Divided: Racism, Medicine and Why We Need to Decolonise Healthcare

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A FINALIST FOR THE ORWELL PRIZE FOR POLITICAL WRITING 2023

'Important and ambitious' Observer, Book of the Day

'An illuminating and powerful intersectional analysis of health inequalities and racism' i-D Magazine

'A vital call to action' Leah Hazard, author of Womb

'Prepare to be blown away' Chikwe Ihekweazu, Assistant Director General at WHO

In the wake of the Covid-19 pandemic, we are all too aware of the urgent health inequalities that plague our world. But these inequalities have always been urgent: modern medicine has a colonial and racist history.

Here, in an essential and searingly truthful account, Annabel Sowemimo unravels the colonial roots of modern medicine. Tackling systemic racism, hidden histories and healthcare myths, Sowemimo recounts her own experiences as a doctor, patient and activist.

Divided exposes the racial biases of medicine that affect our everyday lives and provides an illuminating - and incredibly necessary - insight into how our world works, and who it works for.

This book will reshape how we see health and medicine - forever.

'Urgent examination of how modern medicine is intertwined with colonial histories and racist ideas ... compelling story-telling' Joanna Wolfarth, author of Milk

'Outstanding ... beautifully written and erudite, yet highly accessible ... should be mandatory reading for all medical practitioners' Jacqueline Roy, author of The Fat Lady Sings

'Necessary. In the right hands, this book will save lives' Nova Reid, author of The Good Ally

416 pages, Hardcover

First published April 6, 2023

72 people are currently reading
1587 people want to read

About the author

Annabel Sowemimo

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5 stars
186 (63%)
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82 (27%)
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Displaying 1 - 30 of 42 reviews
Profile Image for Kartik.
230 reviews139 followers
Want to read
October 10, 2024
I'm excited to read this because of the topic but good lord this cover is hideous 😥
Profile Image for Shannen.
35 reviews1 follower
November 4, 2023
"There are a few things that we can only start to understand by looking people in the eye, listening and sharing space with them. It is one of the important things that being a doctor has taught me."

After first starting this book in late April, stopping in June and then deciding to reread this book from the start a couple of weeks ago, this is my attempt to succinctly articulate my thoughts regarding this book.

Sowemimo holds nothing back, critically examining the state of healthcare and the dark foundations on which it has been built. Through meticulous research and evaluation, everyday medical practices that we have come to accept are turned on their head, preconceived notions shattered as she exposes the history of racism and colonisation that have worked to shape our contemporary methods. Her ability to present these arguments shines through, and makes this book a stellar read, not just for those directly involved with the healthcare system (e.g. medical students and professionals), but also for the wider public too, and in a field of work that constantly strives to unite people with the mesh that is medicalisation, it is clear that the world of medicine is becoming ever more divided.
Profile Image for Milo.
89 reviews90 followers
October 3, 2023
5 stars. A sensational and fantastic book! And if you read all of this review, I’ll send you a gold star sticker in the mail 🌟

To start, as the echoes of covid and all that the pandemic entails continues to reverberate globally, this book arrives as a crucial and timely piece of work. It doesn’t stop at just dissecting the systemic racism deeply ingrained in our healthcare and medicine and science here in the west, but also lays down the urgency of decolonisation, making it essential reading not only fr healthcare professionals but fr anyone concerned about the glaring disparities vulnerable and marginalised populations face.

Sowemimo’s eloquence in unravelling the complex historical roots of modern medicine is well-researched and accessible, and she confronts these uncomfortable truths head-on, forcing us to reevaluate our understanding of modern western healthcare’s colonial and racist past that’s still bleeding into the present. Overall, she presents us w a searingly truthful account that speaks to the heart of the matter.

Sowemimo’s lived experience in this book also really shines through, as a doctor, patient, activist, etc etc, that all infuse authenticity into her overarching narrative. Through her, I was able to further my knowledge and understanding of the stark realities of systemic racism, hidden histories, and healthcare myths that persist today, and her courage in sharing these experiences really underscore the urgency of this conversation.

One thing I really appreciated in the book was her discussion on how we perceive the advancements in modern science and medicine. As she explains, it challenges the prevailing narrative that attributes these advancements solely to individual “geniuses”, who were more often then not privileged white European men, while overlooking, ignoring, and concealing the collective and more diverse contributions that have shaped modern medicine. Like modern medicine is a result of collective learning and collaboration across cultures, borrowed and sometimes appropriated frm different traditions, and this perspective forces us to acknowledge the rich tapestry of medical knowledge that existed long before the advent of “modern” medicine, often held by Indigenous cultures and other marginalised groups.

And by perpetuating this notion that modern medicine is primarily a product of white European male genius, we unintentionally (but also intentionally) erase the contributions of Indigenous and other historically marginalised communities. As Sowemimo explains, this erasure not only distorts the history of medicine but also reinforces harmful stereotypes and power imbalances. Likewise, the deliberate obscuring of the full history of medicine serves a colonial and white supremacist agenda, suggesting that Indigenous and enslaved people lacked the intellectual capacity to care fr themselves before European colonisation, and this viewpoint is not only entirely inaccurate but also incredibly harmful, as it dismisses the resilience, knowledge, and contributions of these communities. As she says, “We believe that Western medicine heralded progress, but the reality is that it could never have progressed were it not for colonial exposure to ‘traditional’ medicine practised in the Global South.”

Sowemimo also highlights a critical issue in the criminal legal system, in that her proposal to seek alternatives to incarceration challenges the conventional notion of retribution, drawn frm her experience as a doctor treating victims of sexual violence. She recognises that our current system in place in the west often fails to provide victims w the necessary tools, such as therapy and monetary reparations, to address the psychological traumas they endure after sexual violence, and this forces us to question the efficacy of punitive approaches, raising important questions about rehabilitation, healing, and addressing the root causes of criminal behaviour. As she says, we must envision a more compassionate and effective way of addressing crime and supporting those who have suffered its consequences, as the current system we have in place is very clearly not working.

I also found a lot of value in Sowemimo’s exploration of another critical issue in modern healthcare: the digital divide. In an age where technology is becoming increasingly integrated into healthcare services, there’s this steadily growing disparity between those who can easily access digital healthcare solutions and those who cannot. This divide disproportionately affects vulnerable populations, including the elderly, the homeless, the working class, and those w limited computer education. She explains that it’s evident that as healthcare services move online, those who are already at risk of poor health are further marginalised. As we continue to build internet-based healthcare solutions, we must ensure that we leave no one behind and work to create a healthcare system that serves all members of society, regardless of their digital capabilities or socioeconomic status.

All up, this book not only exposes the racial biases within medicine but also provides an illuminating perspective on how our world operates and, also importantly, who it serves. It’s a wake-up call that demands our attention, and it’s impossible to read it w/out being profoundly moved. ‘Divided’ has helped further reshape my perception of health and medicine, in a similar vein to ‘Inflamed’ by Rupa Marya and Raj Patel, and if you enjoyed that book you’ll undoubtedly appreciate this work as well. ‘Divided’ deserves nothing less than five stars fr its eloquence, urgency, and the profound impact it can make on our world. My gratitude to the author fr this monumental contribution to our understanding of healthcare, racism, and the pressing need fr decolonisation.
Profile Image for Morgan Blake.
18 reviews
November 28, 2024
An absolute must read for everyone and anyone (and even more so for anyone in healthcare). Terrifying and yet so empowering. Truly a journey of unlearning and learning.
Profile Image for Em Anderson-Wallace.
149 reviews4 followers
January 27, 2025
A super eloquent and interesting read which exposed and debunked a variety of topics such as race science, eugenics, health policy, medical metrics, the carceral system, psychiatry. I'd say this is super accessible for anyone interested in how race and healthcare intersect - think Invisible Women but instead of gender, it's race, and instead of data, it's healthcare.
Profile Image for Victoria Kinkaid.
97 reviews1 follower
June 1, 2023
This is a MUST read for any healthcare professional!
A deep dive into the systemic racism that forms the basis of our healthcare, from the attitudes of the scientists designing the studies that shape our current practice, to the inhumane clinical trials that have given us cures to diseases… this book explores the impact of colonialism and medicine and how the two are so closely linked

And despite the heaviness of the topic at hand, Annabel has written it in a way which allows you to understand, digest and feel empowered to create change! A very compelling read

This book has completely changed my practice for the better!
Profile Image for Tara Jones.
108 reviews18 followers
August 15, 2023
Amazing book. I feel I should buy a copy for everyone else I know.
Profile Image for Esme Kemp.
377 reviews22 followers
July 13, 2024
Just will the fallout from millennia of colonialism ever end!!!?? So so depressingly depressing how rotten the root of everything is. Found myself struggling to read the chapters that were based in the modern day world and ‘enjoying’ the historical chapters more which is definitely because it’s a bitter pill to swallow to know that scientific racism is still living and breathing in our healthcare, science classrooms and uni halls TODAY as of THIRTEENTH JULY 2024. Throw out the whole damn system, I can’t.
Profile Image for zenni.
39 reviews
June 19, 2025
3.5
i feel like this book wasn’t written in its entirety for the audience that is discussed the most and will most likely pick up the book, a few too many explanations of things that if you’re Black you’re just going to know (med and non med)

i did learn quite a bit, it is lovely to read something from someone who went to the same med school so reading about cruci and particular seminars and structures unique to ucl i felt #represented, was very cool to read names of people who i speak with irl, and she literally has the job that i want in the future so big up

idk i feel like it was lots of mini books in one book and i think some of the topics discussed deserved something more fleshed out so a couple of chapters could have been sacrificed to delve deeper and give space to others
2 reviews
March 4, 2025
Really well written and informative, impressive for such a young author and researched during the constraints of the pandemic
73 reviews1 follower
May 3, 2023
Aside from being a clear, factual call for action, this book is deeply personalised and beautifully written. Sowemimo covers so many healthcare aspects that many people overlook and consistently demonstrates the dire need for change. Her writing is immersive and clear even when the topics are deeply saddening and rage-inducing. She does not shy away from the truth of imperialism and white supremacy, making her argument for change all the more distinct in every sentence. I highly recommend that anyone interested in medicine and equality read this book as so much information is given and each chapter perfectly explains the issues. This is definitely a book I will refer back to! 10/10
Profile Image for Nyasha Tarlia.
218 reviews4 followers
October 26, 2023
“We never discuss how health institutions have been shaped by imperialism. Nobody challenged these narratives.” (P.g. 3)

It’s no secret that there are racial disparities in the health care system. However there is not much research into where these racial tensions have derived from. Dr Annabel Sowemimo looks into the history of the healthcare system, and where medical practices and knowledge have come from.

Dr Annabel Sowemimo looks into the origins and the creation of healthcare and how a lot of medicines and healthcare practices were created under the pretense of scientific racism, which ultimately still impacts our healthcare system and how black people and minorities are treated in the healthcare system till today. “Understanding the legacy of scientific racism is crucial to deciphering how our medical interventions are still affected by colonialism today.” (P.g. 27)

One of the most stand-out topics discussed is how black people have been used as social experiment to understand different sicknesses; for scientific research; and to create medicines “Africa and other former European colonies, have historically been seen as a playground for those who wish to test a scientific hypothesis or be fine medical skills.” (P.g. 60)

The racial divisions in health care is a majorly under-discussed topic. This was an extremely informative and well written book that I would advise to anyone working in healthcare or anyone who has interest in the origins and development of the healthcare system

“we need to address the racial inequalities in medicine. Only then we can help to build a system that is more equitable for everybody.” (P.g. 6)
Profile Image for Michaela Salmon.
158 reviews3 followers
December 10, 2023
I read this book after watching a video of Annabel talking about it and wanting to learn more. It’s really well written and easy to read. It explores the colonial history of medicine and I learnt about how ideas about race used to justify the slave trade still have an impact on modern medicine and on people today. For example there is a false idea that black people can withstand more pain leading to them receiving less pain medication still today. This idea was first devised and used to justify the inhumane slave trade. This may also be carried forward in the design of AI systems. Diagnostic systems are also often based on a default white man and don’t recognise diversity therefore contribute to health inequities. For example I was shocked to discover that there is still a lack of photos of the presentation of various health conditions on black and brown skin for doctors to use in diagnosis leading to under diagnosis for black people. There is also a lack of recognition within medicine of the social determinants of health including the effects of racism. It is not enough to be neutral - Annabel quotes Archbishop Desmond Tutu in terms of being neutral in situations of injustice meaning you have chosen the side of the oppressor: “if an elephant has its foot on the tail of a mouse and you say you are neutral, the mouse will not appreciate your neutrality”.
Profile Image for Michele.
123 reviews
October 11, 2024
An essential read, that should be required reading for every healthcare professional.

Dr Annabel Sowemimo is a sexual health consultant, working in South London, funnily enough in the same trust I am currently working in. This book is an extremely ambitious, vast and meticulously researched, focusing on the racist origins of Western medicine, the real life consequences of this on patient care and how we can and must be better.

Many doctors, because of their social background, are often reticent to be political, shying away from discussions of race, politics and social injustice. Dr Sowemimo presents an accessible yet affronting examination of how racism has affected every corner of medicine and I think is an important stepping stone for healthcare professionals to critically think about tools and ideas we use in everyday clinical practice such as spirometry, hypertension guidelines and eGFR, which have race stratification elements but no clear research as to why.

Furthermore, I really enjoyed how Dr Sowemimo offered realistic solutions which went beyond just diversifying the workforce. She really grapples with the frustrations, uncertainty and difficulty of addressing health care inequalities in a over-burdened, under-staffed and under-funded healthcare system.
Profile Image for Tony.
1,003 reviews21 followers
August 11, 2023
This is a book well-worth reading. Especially when you hear the usual suspect wanking on about 'wokeness'. The way medicine and healthcare have been built means that a lot of issues facing BAME communities are handled badly, overlooked, or misunderstood.

Annabel Sowemimo does an excellent job of taking us through the way racism and colonialism have impacted medicine and healthcare for centuries and then looks and how it continues to do so. The way people are filtered by the colour of their skin as a key factor in their healthcare, how black people were seen to feel less pain, how Doctor's exploited non-white men and women as test subjects and how colonies were exploited are all at the core of this book.

Perhaps also the idea that perhaps social/economic conditions are a better guide to healthcare outcomes than simple race.

As a white bloke it is astonishing to learn so much that I didn't know. Not just about the history but the way racist/colonial approaches still impact healthcare today.

Well worth reading. And it is full of facts. Which will also annoy the usual suspects.
Profile Image for Scott.
67 reviews1 follower
February 21, 2024
DOI: Annabel Sowemimo, the author of this book used to be a colleague of mine. Of all of our cohort of junior doctors, she was the most likely to change the world.

It looks like shes doing just that.

Her passion and energy shine through this important book about how racism is embedded within the practice of medicine and how that is so damaging.

Covering a broad range of topics from gynaecology and the prison system to education and AI inputs, the book skilfully weaves the underlying narrative with some powerful personal insights.

A definite must for anyone interested in making healthcare better for the future. Despite a lot of righteous anger, the book ends on a positive note, letting us know that if we do the work, we can change the basis of our system.
Profile Image for Ivy.
42 reviews
December 1, 2024
Firstly wow. Easily 5/5. This book should be an essential read for anyone working or studying in healthcare truly! I’ve had this on my list for a year now and so glad I finally read it. Annabel Sowemimo does not hold back, she provides an unfiltered perspective on the ways in which racism is interwoven into healthcare, and as a black woman within the healthcare field, I found reading the depths of our reality rough (hence why it took me so long to finish, I was mad as hell lol) but very important! I’m probably going to have to read it again. It’s also written in a way that’s very easy way to read. Everyone stand up immediately!!!!
13 reviews
January 19, 2025
Genuinely the most interesting thing i’ve read omg. Completely blew my mind. Essentially this book explores the colonial history of modern medicine and how so much of healthcare practises today are shaped by larger sociocultural forces. The “the psychology of oppression” chapter was my personal favourite. I loved how accessible the writing was while also demonstrating insane amounts of attention and research. I need to revisit this book stat because i literally have no words for how mind blowing some of the stuff in here is. Much to think about truely, should be required reading for like every healthcare course.
Profile Image for Joanna.
146 reviews
October 13, 2025
A fascinating and very readable book, which explains, clearly and lucidly, why the development of medicine has been racially biased and why that is damaging, both to communities of colour, patients of colour, white patients and medical professionals. It is very clear on highlighting the connections between historical developments of (e.g.) diagnostic criteria differentiated by race, and how that leads to distrust among (particularly) black communities in the UK and USA. Its scope is very wide.
I would recommend reading this alongside Unwell Women, which covers much the same ground, but considering the medical issues for biological women.
30 reviews2 followers
January 16, 2024
Highly recommend to all! This book taught me so much about the racist basis of so many aspects of medicine - as a psychiatry doctor and someone who went through the medical training system, even I was unaware of so much of this, so I can imagine the average non medical layperson will know even less. Highlights some very important concepts, including the whitewashing of medical discoveries and the racial discrimination within medical training itself. A must read for all.
Profile Image for becca barry.
90 reviews
October 11, 2024
This is an incredible book that documents the racial inequities within healthcare and medicine. It outlines the colonial history of medicine and explores how medicine itself is not objective - it is influenced by the sociopolitical context in which it develops. These evolving attitudes and perspectives are then traced to modern day practice, and the author evaluates how the current western healthcare system is impacted by these legacies.
Profile Image for Priya Birdi.
145 reviews
February 7, 2024
An important read, made me very angry in parts. It’s one of the few I’ve read where I hadn’t heard many of the points they made, found it very concerning yet informative. The first half was more intriguing than the second half. The epilogue was very moving and personal, the author writes with so much passion throughout.
Profile Image for Shalini.
433 reviews
July 27, 2024
This is a must read for all those who practice medicine, and is exactly what the cover says: a call to action to decolonisation healthcare. As much as I thought I was familiar with most of the issues raised, I learnt much about the history and data. I hope this is the beginning of the conversation that brings about active change.
Profile Image for Paul.
1,015 reviews24 followers
September 29, 2023
The concept of decolonising healthcare was new to me, and the historical perspectives given in the book made me look at our health systems and assessments anew. Fascinating book, and should be widely read.
Profile Image for Hattie.
148 reviews
January 13, 2024
this was a fantastic book, so moving. sowemimo has such a brilliant way of writing and her research is so diligent and in-depth. recommend this to everyone who feels frustrated with medicine and public health, or the legacy of colonialism in this country
Profile Image for Anita.
976 reviews
December 8, 2024
Lowkey annoyed that it took me this long to read this! What a superbly thought-provoking and important read. I’m so impressed by this author. Huge thank you to the publisher for sending me this quite a while ago, such an important read.
Profile Image for N E E K S.
32 reviews
January 10, 2025
Definitely a must read!
I learnt so many things I didn’t know about the foundations of medical field. If the system doesn’t want to educate itself the least we can do is read books like this so that we - also parts of our systems are educated on these terrible realities.
Profile Image for Jo.
178 reviews4 followers
June 17, 2023
A good starter on institutional racism.
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