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Expert Q&A

From Words to Action: How to Begin to Dismantle Racism in Global Health and Development

Vital Strategies

Q&A with Angela Bruce-Raeburn

Amid the global uprisings against racism, many organizations have been reckoning with their own complicity in perpetuating inequities. In the international development sector, this includes evaluating what leadership looks like and how notions of expertise are conceived, reflecting on how programs ignore or recreate colonialist histories, and looking at ways in which organizational storytelling sustains these harmful narratives. Angela Bruce-Raeburn wants people to know that the success of these undertakings hinges on going beyond words or phrases—it is going to require a lot of work. 

Angela is currently the Regional Advocacy Director for Africa at the Global Health Advocacy Incubator. She is also the founding principal of DiverseDEV, an organization dedicated to starting the conversation about diversity and inclusion in the development sector. Angela was previously Senior Policy Advisor for Oxfam America where she led the development of the  advocacy strategy in response to the 2010 earthquake in Haiti. It was from that work she realized development work will fail if organizations continue to ignore and overlook the way that racism and colonialism are embedded in prevailing structures. Angela began to speak out to urge organizations to do better. She published the piece “But Wait Until They See Your Black Face” in 2018, and has since become a frequent contributor on the subject, which she approaches through the lens of a Black immigrant woman. Angela was born and raised in Trinidad and Tobago and later moved to New York with her family where they lived undocumented. Her interest in equity, social justice and racial identity are driven by these experiences, and was shaped further during her years at Lincoln University, a Historically Black College and University (HBCU). 

We sat down with Angela, who recently joined us as a guest speaker, to learn more about her experience drawing attention to structural racism and inequities in the international development sector and advocating for more successful and equitable health outcomes. 

“We are going to have marginal outcomes if we continue to do development as if nothing happened before development even started and as if local people are not experts in their own lives.”    

From your experience, can you please tell us how systemic racism in global health and development hinders desired outcomes?

How development started and how it has been structured over the last 50 to 75 years is at the core of the problem. It was created for geopolitical reasons so that the U.S. and other high-income countries could create pockets of allies. The whole notion of why we’re helping poor, mostly black and brown people, came from us wanting to have strategic advantages over other countries. The structure in and of itself was never really designed for the people in those countries. The racial aspect of it cannot be overlooked. Where are these places in the world? Where a lot of white people do not live.


For years, we never talked about the racial aspects of development and only talked about it in a benevolent way. People who work in development were there to “save the lives of vulnerable people.” But we say that as though people’s lives became vulnerable out of the blue; that one day they woke up and were poor. No, we had a whole system of colonialism and neocolonialism where wealthier countries sucked the life out of other countries. If we act as though all these things never happened, then we’re going to fail.


If you go to Haiti right now and ask any Haitian person that was alive in 2010 during the earthquake, “what did the response of the international community do to help your country?” You’ll find that there won’t be a lot of people who said we did a good job. We did a terrible job for a lot of reasons and those reasons were rooted in racism. I watched as international aid workers descended to fix problems they did not understand. There was little consultation of Haitians as experts in their own lives and countries. Many foreign aid workers did not even know the basics of the history of Haiti, including the history of the war of liberation fought against the captured Africans enslaved on the island of Hispaniola. They don’t even realize that Haiti was the first Black country to throw off the yoke of slavery and fight against the French.


We are going to have marginal outcomes if we continue to do development as if nothing happened before development even started and as if local people are not experts in their own lives.

Why is it so important for international development and health organizations to acknowledge and confront biases rooted in colonialist and racist thinking both within the organization and in the work that they do?

It’s important because without out it we are going to continue to fail. If you meet an organization that says proudly, “we’ve been working here for 50 years,” think about what that means. It means that you have not left anything sustainable that would allow you to leave. If you can’t leave, then you’re failing.


While we are encouraged to talk openly about diversity, equity and inclusion, if we dig deeper, we realize that diversity and inclusion do not speak to the entrenched racialized power imbalances that define those who receive aid and those who deliver it. By continuing to work within those structures that are donor-led rather than people-led, we are not going to be effective and frankly, what we are doing is not humanitarian work.

“I always say that ‘rising tides do not lift all boats equally,’ and Black women have not risen with that tide.” 

You’ve said that you think people are more comfortable talking about gender than race. Why is it important to move past comfortable conversations? And do you think it’s possible to have both discussions at the same time?

I do think people are more comfortable talking about gender. Race brings up a violent past that is difficult to handle—slavery, colonialism, discrimination, hate. Americans say things like, “slavery, it happened so long ago,” while the British and French don’t want to talk about their colonialist past; that they have wrecked Africa! If we do speak about race then we do so at an individual-level but don’t address the structures embedded in our society that allow us to continue to engage in discriminatory and racist practices.


I always say that “rising tides do not lift all boats equally,” and Black women have not risen with that tide. We need to understand intersectionality and that there is no monolithic “women.”  When we say, let’s elect more women to congress, or get a woman CEO, we need to ask ourselves what kind of women we are talking about. The #MeToo movement allowed us to bring the violence of rape and sexual violence against women out into the public space. But it didn’t do that with race; race was not part of the conversation. Black women had to force this conversation. Myself and other Black women followed people who were writing and would comment to say what we need to say. I felt like the conversation could pass us and leave us behind, as it has many times before. I resent that people used to say things like “rising tides lift all boats.” I look back and see that that was never true. No matter how much you did what you were told to do, it’s always a moving goal post. If it were true we would have way more Black women running these international organizations.


The #MeToo movement then gave birth to the #AidToo movement, in response to sexual misconduct scandals at various organizations and the subsequent mishandling of allegations. Rather than doing the work to dismantle the core root structures of racism and sexism inherent in aid delivery systems, organizations began to advance standards of safeguarding, often without the input of local aid workers. But why would those aid workers then trust a system that was developed for them but without them? Unless we begin to really acknowledge the power differentials embedded in development work, we will continue to be covering deep wounds with Band-Aids.

As someone who has been working for years on drawing attention to structural inequities within global health, what changes have you observed and where do you see the need for advocacy in the future?

I think COVID-19 has changed a lot of the landscape. It has made people and organizations that have generally regarded themselves as experts realize that perhaps they are not the experts on everything—that people in-country have a lot of expertise. I think the fact that the U.S. is doing such a terrible job in response to COVID-19 while in other parts of the world, especially in Africa, people are doing and responding better, is something we need to pay attention to. As an organization, if I were to be making decisions about leadership, I would look at what people in-country are able to do without our “expertise.” Development organizations can do better in the future by downplaying their own expertise and advocating for local expertise.

“Organizations need to reach a consensus about what they are trying to change. Often times this whole question of ‘dismantling racism’ is a slogan. But in reality, it’s a lot of work.”

What are some key steps organizations can take internally to address such longstanding, systemic issues?

We need to look at boards of organizations and make a concerted, intentional plan to get different kinds of expertise, especially from outside of the U.S. We need to open ourselves up to the fact that this is a big world and there are a lot of ideas that we do not have. This filters down into: What does leadership look like? What do partnerships look like? When you tell me that you have partnerships in that country, is it a real partner? Or do you have a top-down relationship? Who controls the purse strings? These are areas that you really need to look at if you want to make intentional changes and begin to dismantle racism within the organization and in the work you do. If you don’t want to talk about it, then you can hire a token Black woman and put her in a place where she doesn’t have decision-making power. When looking for expertise in the organization, develop and showcase expertise from other parts of the organization, including people on the lower rungs.


In a previous position, I would brief my boss with my expertise on Haiti while he went to Capitol Hill to talk about my expertise. Look at how you can rework those kinds of relationships. Organizations need to be intentional about this paradigm shift. It can’t be a one-off, “let’s talk about diversity, equity and inclusion (DEI) today.” DEI in a vacuum doesn’t change anything.  Organizations need to reach a consensus about what they are trying to change. Often times this whole question of “dismantling racism” is a slogan. But in reality, it’s a lot of work. Most organizations aren’t up to the task. White people in these jobs aren’t giving up their privilege.


When I get invited to go on panels, I look to see who else is on the panel. You see panels that are all white men or I’ve seen a panel with four white women executives discussing extreme poverty. The reason that happened was because the chief of staff wasn’t someone like me. If they were, they would have said “who else can we put on this panel to discuss extreme poverty?” When your chief of staff is someone just like you, your experiences are not varied enough to allow you to understand that this is a moment for you to step back and give up some of your privilege. Organizations need to do this intentional work internally if they want to start to redress the relationship with the communities and people they work with.


Read more from Angela on how organizations can begin to address and dismantle racist practices.


“Organizations need to build bridges and develop a true ethic of care in the work they do. This bridge does not have to run north to south; it can start in the south and go north.” 

How can we rework and reimagine the relationship between international development organizations and the countries and communities that we work in?

Organizations need to build bridges and develop a true ethic of care in the work they do. This bridge does not have to run north to south; it can start in the south and go north. We expect people we work with in-country to be within our schedule and subscribe to all of the professional norms that were developed in white places. During my meetings, especially with my African teams, I ask people about what is happening in their lives; how their son or daughter is. “Can I get the comms report?” is not the way that people do business everywhere. When George Floyd was killed, the people on some of my calls wanted to talk about it. We have to give people time to process and ask questions. I wanted to make sure that the conversation was not us acting business as usual. We need to have respect for these things.


It’s important for us to build humanity into our work, especially if we call ourselves humanitarians. We have calls where we don’t care at all about what’s happening or the people on the other side. It matters to me that some of the people I’m having calls with have to take three modes of transportation to get to work, so I might move back my meeting. It’s me trying to meet you where you are. You may think it’s a small thing but it has a huge impact when you work in a global space. We need to ask ourselves: what do they do there that we can do here? I want to be engaged not only in the work but in the process of the work. We can advocate for equal pay, or that our colleagues in-country get the same perks like “rest and relaxation.” These are ways that we can build bridges to the workers and the people that we say we want to serve.