interviews
Call It What It Is
by LaShyra Nolen
July 1, 2020
This interview with LaShyra Nolen, Harvard medical student, and the first Black woman to become class president, was conducted and condensed by franknews.
frank | You've written and spoken about your experience within a dual reality – of being both a medical student at Harvard, and a person committed to your own identity and equity.
LN | The dual reality is you're training at the best medical school in the world, but there is so much suffering going on in your community. And whatever knowledge you gain still isn't going to necessarily translate to the improvement of the condition of Black people. For example, I could go on to become the best surgeon in the world. I could save the life of a Black patient. But they can go outside, drive home, get stopped by a police officer, move too fast, and get killed.
That is the dual reality. You're learning, but you're not necessarily getting to the root cause of the suffering of your people.
You always have to think about it from both of those perspectives, that of a student and that of a Black person in America.
In addition, you go into class and you are expected to maintain professionalism. You are expected to just talk about the science and to talk about the assignment at hand – when that same morning you watched yet another police lynching of a Black man. You're trying to deal with those emotions, and you have no idea how it's going to be taken if you say, "Hey guys, I'm really not doing that well. Another Black man was killed. Racism is pervasive in our country and we're all complicit in it." It is a challenge that all Black professionals have. You have to walk in and put on this face, even though internally you are dealing with the turmoil and hurt of your community.
What does this moment feel like at Harvard, as a student?
As a medical student, I feel like I can speak out more than my mentors or faculty members who are more ingrained into the system of medicine. Academic medicine is very hierarchical. The higher up you go, the more you have your hands tied, and you can't speak as much truth because you're trying to move up to an associate professor position so that you can finally start to use your voice. I know that there's a risk that comes with speaking up, but I, personally, can no longer just pretend like everything's okay, and allow people to continue to suffer in silence. Even the most brilliant people have been complicit in racism, and some of them genuinely have never even thought about it.
They've grown up in a bubble, their entire lives, and all this is happening and they're just like,
"Oh my gosh, I'm a good person. I'm not racist." And you kind of have to be like, "No, but you really are though."
These brilliant people who are excellent in their field, are just now realizing they're complicit in this system.
Again, I am happy that's occurring, but I'm always just like, look how much it took for us to get here. NASCAR is just now removing the Confederate flag. Suddenly now I have Juneteenth popping up on my Google calendar. I'm like, what?
My classmates and professors have really been amazing actually. We are all from different backgrounds. Some are fourth-generation physicians, and some grew up on reservations and are bringing medicine to indigenous folks. All of them realize that the system needs to change, and they have been so supportive. Beyond just talking the talk and posting the black box on Instagram, they've been reaching out to me saying, “Here are the notes from class today. I got this recording for you because I know you've been putting in work on the advocacy front.” That's true allyship to me. I've really been pleasantly surprised and happy to see the support that I've gotten from my classmates.
There has been a widespread acknowledgment that COVID is affecting communities and people of color at much higher rates. I am curious if you think there has been an appropriate conversation around why that’s the case?
I think that in order to understand that we have to look at our history, and at policy. The original ill was, of course, chattel slavery. This country has not valued Black lives. The policy reflects that, and policy ties into our healthcare. That history of systemic discrimination is important to look at to examine the current landscape of COVID-19.
Redlining decided where people live in this country, and which communities our government and our local city councils were going to invest in. Black communities were not invested in. As a result, Black communities have not had access to the basic resources that they need to survive and thrive. They don't have access to healthy food. They don't have access to safe places to exercise. They are exposed to environmental pollution. They have less access to education. I mean, then you look at who is more likely to be an essential worker - Black people are overrepresented.
It doesn't end there. Once people get into the clinic, they have to deal with the biases and systemic racism in the hospital system. There are studies that have shown there are medical students and residents who still think that Black people have a higher pain tolerance.
We can take maternal mortality as an example of treatment differences. Black women, at all income levels, are dying disproportionately compared to white women. When they get to the hospital, doctors don’t believe their pain. I mean, it happened to Serena Williams. It is safer for Black women to not engage with the healthcare system because of the violence and harm it causes.
How do you think mistrust of the medical system compounded the COVID crisis?
I think it all comes back to this conversation of access, right? When COVID-19 first hit, the testing centers were predominantly located in affluent communities, and a lot of Black communities were left without access to testing. The lack of Black physicians and Black health care professionals means that when Black patients come in and say they have COVID-19 symptoms, they are less likely to get treatment compared to white people.
If you know there are no testing centers in your neighborhood, you know there is no representation in the hospital, and you know that you are going to be discriminated against once you walk in that door, you know your life is being devalued. That knowledge prevents Black people from seeking care from our healthcare system. With anecdotes of horror coming from your community, of course you are going to be nervous to trust the healthcare system.
What does a better understanding of investment into public health look like to you?
I think we need to turn all of the conversations that we've been having into public health initiatives. Racism was declared a public health emergency in Boston. That is the direction I think we should be moving in.
We need to move beyond equality to think about equity. We need to recognize that not everyone is on the same playing field. We need to truly make sure everyone's specific situation is taken into consideration. We do that by investing in those communities, and by looking at how we make sure they have access to good education, access to health care, access to housing, access to good food. Improving the conditions where people live, work, pray, play will improve their healthcare outcomes and our healthcare system.
Of course, we need things like the physical exam, but often patients go into that physical exam with preexisting chronic diseases caused by disparate suffering. Going as upstream as possible will lead to better healthcare outcomes and in the long run, improve healthcare costs. Even if investing in public health didn't improve healthcare costs, I still think that it's the moral thing to do. I think we're too driven by what's going to save money in our country. We need to do what's right.
Everyone deserves to have the basic resources they need, to live out a viable, joyous life. Right now we are doing nothing to guarantee that.
Someone said to me once, we’re too focused on raising the ceiling and not at all focused on raising the floor in the American healthcare system. Do you feel like this starts as a medical student?
I can definitely speak to that culture. As a medical student, I'm really passionate about community activism. I am passionate about making sure that everyone has access to healthcare, and ensuring that we're teaching medical students anti-racism so that they don't go out and further harm communities. I can spend two years doing that – serving on committees, writing up reports, and changing curriculum at my institution. But my peers who are spending the same time publishing papers on very specific proteins and disease processes might have a better chance at residency.
In medicine, you're not incentivized to do work that you don't get credit for. You always want to be able to publish, and activism isn't always publishable.
It has been the responsibility of Black students, students of color, and indigenous folks to improve their institution. They do the work so that they can thrive and survive, and so the next generation can do the same. But at the same time, they still have to do everything they have to do as a medical student to get to the next level. I'm literally trying to improve the very environment that I'm suffocating in, while also trying to handle everything else that medical students are expected to.
There was a letter early on from public health officials advocating for protest as it’s needed to fight racism within the healthcare system. Does that feel new or was it already a part of the conversation?
I think it's always been a part of the conversation for those who have been oppressed.
But that is what is special about this moment. We literally had a global pandemic that exposed the disparate suffering of Black people across the country, across the globe. And then on top of that, you have back to back to back killings of Black people. It's heartbreaking that it took this much for us to start having these conversations, but we are having them, and people can’t run away from them.
There are no distractions. We're not going to get anywhere if people don't name systemic racism for what it is.
We need to say Ahmaud Arbery. We need to say Breonna Taylor. We need to say their names, and we need to name the issue at large.
Big-name organizations are just finally starting to realize that this is something that they need to get on board with. It’s hard to know if it's really genuine or not. I think that people don't want to be on the wrong side of history. Regardless, learning is still happening. I'm very happy that anti-racism is becoming the status quo and that we are having these conversations. We need to continue to push the envelope to get people things they need to live a good life.
interviews
An Interview with Sasha Davis on the Economic Power of China
by Sasha Davis
April 9, 2018
This interview with Sasha Davis, a professor at University of Hawaii, Hilo, was conducted and condensed by Tatti Ribeiro for frank news.
Recently, the economic power of China in the region is influencing many Asia-Pacific locales to question hosting U.S. bases. People in places like Okinawa, Guam, Saipan, and Jeju Island, and South Korea more generally with the THAAD controversy, are concerned about how hosting U.S. military activities hurts their ability to attract Chinese tourists and investment.
OK. Yeah, I believe that one of the things influencing the way in which some of the places in the region are viewing American bases, and more American military operations and such, is the fact that China is becoming economically more powerful in the region. There are islands all around, like Okinawa, but also further out in the Pacific like Guam, Saipan, that are increasingly interested in attracting Chinese investment and Chinese tourists. And in the case of Japan, like overall last year, the figure I believe is around 6.5 million visits from Chinese tourists, and many of those to Okinawa. And so this has really become one of the major engines of the economy in some of these places. And so there's been a reluctance on the part of some of these countries to increase the militarization of the islands in a place like Okinawa, where the U.S. military is so prominent. I think there's a belief that some of the military landscapes being so close to some of the tourist oriented landscapes, can be a bit of a conflict for the industry.
What is the official U.S. military response to the pressures we’re facing from China?
Oh that's a good question. You know, I think that the U.S. military response has been a little more focused on what the Chinese military has been doing, as opposed to some of the investments and economic pressures. Things such as the way the U.S. has been doing the freedom of navigation exercises in the South China Sea, or the recent visit by the USS Carl Vinson I believe to Vietnam, as a way of sort of shoring up security relations with Vietnam. Kind of to show some solidarity against the Chinese there. But I haven't seen as much in terms of U.S. military pushback against the economic influences of China in some of these places. And I think part of that is that it's not necessarily read as a security threat. But I’m sure it's on the minds of military planners and people in the Department of Defense in Washington D.C. I'm just not sure if I've seen much of a military response to that Chinese economic influence.
Should there be a military response?
Well I'm not sure if the response is necessarily a military one as much as a political and potentially economic one. I think that it comes down to a little more with the U.S. you know, thinking about how it shores up its security relationships in the region. I think it needs to think about the fact that from the perspective of these islands, they have to look at the financial opportunities the United States might be bringing. And I'm not sure if that's today, quite as obvious as the potential positives of Chinese investments, or Chinese tourist spending in that part of Asia and the Pacific. And I think one thing that needs to be done is there probably needs to be more coordinated efforts with the State Department and the Department of Interior for places like Micronesia that fall under those parts of the U.S. federal government. Things like trying to cut aid to those countries, or having any kind of restrictions about migration abilities from places like Micronesia. It's something that isn't going to attract or keep those countries kind of oriented towards the United States.
How do you compare potential economic opportunity from China to say, security from the U.S?
Yeah it's interesting because I was just reading, and I think it was in some of the press coverage of the of the U.S. aircraft carrier visiting Vietnam, where there was a quote by somebody in Vietnam that says, you know, everybody likes the Chinese money but nobody trusts the Chinese. And of course maybe that's a little bit of a hyperbole saying everybody wants the money, and everybody doesn't trust them. But I think that is definitely an attitude I've seen across the region where a lot of the countries are very interested in the economic development, but they are wary of what the ulterior motives might be of that investment in places like in Micronesia, or Guam, or Saipan. There are real concerns over, is the Chinese government trying to buy influence? Or potentially through these large infrastructure projects, potentially putting military assets in there later. That comes up both locally and in U.S. concerns for the region.
Do you have any particular fears about what those consequences might be?
Yeah, I think some of the perspective I try to take from doing research in the region is to take the view of trying to kind of stand on the islands in the region and look outward, and look at what are the things that say the Chinese offer or what are the pressures coming from China, or the influences. And then looking at the United States and saying, what are the pressures or influences coming from the United States? And I think the islands that are there in the middle have to kind of try and navigate their own path through this larger context. And I think that there's been a pretty big concern about the consequences of American military activities in places like Guam, in places like Okinawa, and also in places like the Marshall Islands.
I think traditionally there has been some opposition that has kind of arisen in these islands because of the negative environmental and social consequences of that militarization. And so this is where a lot of the people, that are like the independence movement, say that more sovereignty movements in the region are usually kind of against U.S. political power or what have you. But now China is kind of entering the scene and there are a lot of concerns about if the islands in the region cozy up to China. Is this sort of changing one kind of imperial power for another? You know, is one more dangerous than the other, and this sort of thing, or destabilizing. On the other hand it also presents some opportunities now for governments in the region to kind of play one power off of the other. For things like getting investment, or aid, or just like you know, political attention.
I think China has been doing a pretty effective job of sort of doing a charm offensive if you will, in places like Micronesia. They'll have the head of Micronesia come to China and roll out the red carpet, and the fans, and promise aid and all the stuff.
And in terms of the fears for the region I think mine sort of center on obviously hoping that there are still peaceful relationships that are maintained between the U.S. and China. Partially because if you look at most of the military strategies that involved military or military conflict, they involve those battles happening over those islands, that use them as bases and as battle spaces. Particularly around Okinawa, the East and South China Sea. But also further back with places like Guam, which would obviously be targeted. So I think from the perspective of those islands, they would want to make sure that those relationships between the big powers don't really sour.
Do you think economic pressure from China could change the dynamic between the U.S. and South Korea?
I think that there could be some. You know I certainly don't see the South Korean government abandoning their military alliance with the United States as long as there is a North Korea that is threatening. I can't imagine that that would be seen as kind of politically palatable. But yeah, the rising economic influence of China does mean that South Korea has to think more about kind of watching their steps in a sense. In terms of the way in which U.S. militarization in South Korea is perceived as being a threat to China. I think the THAAD controversy is a great example of this, where the South Korean economy, particularly the tourist economy, but also some of their exports and some of their companies that operate in China, were absolutely hammered by what is essentially a Chinese boycott of South Korea after they agreed to allow U.S. missile defense to come into South Korea. Because China looked at it as being aimed towards them, or as kind of destabilizing the deterrence that Chinese missiles could play in Asia. And so I think that South Korea has to be conscious of that.
But in terms of like, the base in Pyeongtaek and that sort of thing, you know, there are other domestic concerns in South Korea from people that want less dependence on U.S. military, or chafe at the local effects of militarization, of the operation of the bases, and the way the land was taken around Pyeongtaek, and then some of the environmental and social problems with the exercises.
But I think overall, that South Korea maybe now, sort of has to think about playing both sides a little more than they may have been in recent decades, and I think maybe a model for this would be like the Philippines. The Philippines was once, even a few years ago, very staunchly pro U.S, very anti China. The stuff from the South China Sea was really reaching a fever pitch and then politically things shifted. Where now you've got the Philippines really playing both sides and looking for Chinese investment. They're kind of putting the U.S. at more of an arms length, at least rhetorically. But yet they also are still certainly keeping those military connections in place in the Philippines, and don't want to alienate the U.S. so much that they feel like they might be at the mercy of Chinese power in the South China Sea. So I could see South Korea kind of taking a similar tact. But you know, the South Korean leadership is a little more reasonable than the Philippine leadership right now. But I think their context is somewhat similar.
That’s really interesting.
Yeah. I mean one thing that I think is important to kind of reiterate, is one of the things that I think is an under-appreciated aspect of the US's ability to maintain security relationships in these places, like South Korea, or Okinawa, or Guam, or other areas in the Pacific. I think that Americans need to understand that being next to these large military installations is seen as a sacrifice, as a burden. You know, there are major environmental and social consequences of doing that, and Americans shouldn't take this for granted. That these will always be there, and they can operate however they want to without having to care what people in Okinawa or Guam or South Korea think. Because many bases and training ranges have been negatively impacted by people in these places having opposition to the bases. So I think it's important that Americans recognize that more complex terrain these bases are in.
I agree we just take it as it is. It’s important to think critically about it, which obviously you do as a profession. But for everybody else to look at it through that lens.
Another key thing like said, I don't know if Americans appreciate, is even if there's an agreement between say the U.S. and Japanese government, if enough people in Okinawa don't want that base to be there, then it will get worse. It doesn't get built, or gets delayed for years, and years, and years, and so there really needs to be, I think more engagement at the local levels and recognition that things have to be done differently. I think to kind of respect local wishes in some of these areas.
What about in other regions? How is China’s presence in Africa affecting U.S. presence there?
Well I don't have a lot of on the ground knowledge of what's going on other than I know the different U.S. military installations and operations that have been going on across the Sahel, and also in the Horn of Africa, and how China is increasing both military presence in those areas side by side with their investments. And you look at the whole, One Belt One Road project, of China developing the infrastructure to connect China to Africa, particularly to East Africa. And they are having more economic, political, and military operations and focus on that region. And it's also a region that now the U.S. is paying a little more attention to as well. Partially because of the existence of the different kind of fundamentalist Islam groups in the area and their connections to terrorism in Africa. So I think there are some similarities there with Africa as well as in the Pacific. I think that they operate in those regions where, it's sort of between the empires if you will.
You have these larger powers like China or like the United States, or you know even large countries like India, that are kind of trying to project their ability to facilitate their security projects in those areas. And when you look at places like Africa, or even the Western Pacific, they're on the edges, and the contact zone between these larger powers, and they’re borders of a kind. And so I think that it's because those areas are unstable, and because it's not necessarily clear, kind of, who's sphere of influence they may be under, it's a place where there's potential for conflict or at least for competition between the different great powers. And so because of that it can definitely cause destabilization both in Africa or in the Indian Ocean, or even out in the Pacific.
Does it seem like a play for hegemony on China’s part?
Absolutely it is.
You know it's interesting because as you know, some of the literature on China's traditional conceptualizations of hegemony, and what they politically strive for — a lot of their political tactics and strategies have been about preventing US hegemony. Not so much necessarily to produce their own. Because there's actually a lot of concern that what comes with being a global hegemon in terms of you know, all that you've got to do to back it up militarily. It costs a lot of money. Chinese strategies that I read about, tend to imagine their preference as sort of a multipolar world where Chinese interests are kind of not hemmed in as much by a U.S. kind of hegemony. But that's not necessarily replacing it. But certainly they want more wiggle room. And I think some of their moves towards the west, towards Africa, into places like Central Asia, come from a concern with U.S. power in the western Pacific
Chinese military and political strategists read the U.S. strategies of what war in the Pacific might look like. And most of the U.S. strategies are centered around being able to blockade China's east coast, not let trade in or out, and keep them hemmed in.
I think that plays into their strategies of aiming towards Central Asia and towards Africa. It is also about kind of having an escape route I guess from an American power that's amassed in the western Pacific.
Right. That makes sense. Well, thank you again for your time.
Sure! No problem.