The murders of George Floyd, Breonna Taylor, Ahmaud Arbery, and other Black Americans—on top of generations of systemic oppression and trauma in the US—are unacceptable. They should not and cannot be normal. My colleagues at IntraHealth International and I are outraged and anguished. Most of all, we are determined to act.

So we’re taking a good, hard look at ourselves. We’re an organization that’s committed to equality, equity, justice, and respect. We staunchly oppose racism. But we’re seeing that we have a long way to go toward becoming the antiracist organization we strive to be.

A stronger, more antiracist organization

Here are some steps we’re taking:

• Right now, IntraHealth’s executive team and board of directors do not include any Black members. In fact, when I came onboard as president and CEO in March, I made IntraHealth’s leadership whiter. This must change. As we compile a list of candidates who might fill the two vacant seats on our board, we’re making racial diversity a critical element of our search, because we know diversity drives innovation and leads to stronger organizations.
• We’re investing in educating our staff. As a start, we’re buying copies of How to Be an Anti-Racist by Ibram X. Kendi for all US-based staff members. Over the longer term, we’ll be bringing in guest experts to train US staff on antiracism and improve our cultural competencies. And we’ll be having uncomfortable conversations as we delve into the areas where we’ve fallen short.
• For the first time, we’re adding Juneteenth as an official holiday for all US staff this year. We’ll be spending June 19 honoring Black Americans, educating ourselves, and reflecting on how we can do more and better.
• We’re using science-based metrics to overhaul our policies, processes, and systems across the organization to ensure greater equity, diversity, and inclusion across all our practices, including recruitment and hiring.
• Through our payroll department, we’re making it easier for staff to donate to the racial justice efforts that are most important to them.
• We’re rethinking the way we cultivate and describe our workplace culture so we can attract and retain talented, diverse new employees who share our values.
• And I’m urging all managers to be flexible and accommodate their team members who need to take time off to tend to their mental health and wellness. I’m encouraging staff to use sick leave for this purpose.

These are only a start.

A legacy of racism in public health

Too often, Black Americans’ rights to high-quality health care are not honored. The ideals of public health have not served them as they have white Americans. For example:

• We know that, in the US, coronavirus is affecting Black Americans disproportionately. And yet Black patients who sought medical treatment this spring for a fever and cough were less likely to be tested for COVID-19 than white patients who were having the same symptoms.
• Medical language has long been weaponized to misguide the public and misrepresent the causes of death for Black Americans killed by the police—we saw this in the case of George Floyd’s initially skewed autopsy results. And this on top of our medical establishment’s legacy of covert experimentation on and hostility toward Black Americans, including through the Tuskegee Study of Untreated Syphilis in the Negro Male, the story of Henrietta Lacks, and eugenics and forced sterilization right here in North Carolina.
• Black women are over three times more likely to die from pregnancy-related causes than white women in the US. And Black Americans are systematically undertreated for pain compared to white Americans.
• And consider the comments of Ohio state senator Stephen Huffman—an elected official and a physician—as he speculated on why Black Americans are harder hit by the COVID-19 crisis than white Americans: “Could it just be that African-Americans or the colored population do not wash their hands as well as other groups or wear a mask or do not socially distance themselves? Could that be the explanation of why the higher incidence?” He said these things during a hearing last week on whether to declare racism a public health crisis.

This is a loathsome betrayal of the trust we put into our health policymakers and systems. The effects of racism on public health have never been clearer.

We have to actively fight against systemic racism to be truly antiracist.

Many of our issues with racism in the US are unique to our country, shaped by over 400 years of slavery, Jim Crow laws, mass incarceration, and more. But racism is a global system that affects all fields, including international development. US-based global health organizations like IntraHealth risk exporting our racism overseas with every flight we take and inflicting it on our partners and stakeholders—the very people we are meant to serve.

As a US-based organization that works primarily in African countries, we cannot ignore the inherent issues of race, power, and imperialism in the work we do every day. We have to be part of decolonizing global health and demand that our funders do the same.

My kids grew up in Africa. They went to diverse international schools. They are half Moroccan Berber. So when we first started talking about the news and the protests a few weeks ago, they were shocked. They thought there was no way they could be part of the systemic racism that has existed in the US for generations.

But the more we talk about overt and covert racism, and the history of our country, the more they realize it’s not enough to not contribute to the problem. We have to actively fight against systemic racism to be truly antiracist.

This is what we’re working toward at IntraHealth. If we’re going to make our vision a reality—and ensure that everyone everywhere has the health care they need to thrive—we cannot be silent. We need to act.