Understanding The Legacy Of Colonialism On Morocco’s Public Health Landscape – Analysis
When analyzing the global public health sphere, many are quick to point out the inequities in access, delivery and quality of care, and socioeconomic status. To most holistically understand the cause of these modern day disparities that plague the wellbeing of communities, dialogues about historical colonialism and oppression must be held. This acknowledgment is pertinent in countries such as Morocco, where a deep power imbalance rooted in French colonization is a significant socio-structural determinant of health.
Stanford defines colonialism as a practice of domination, which involves the subjugation of one people to another. From 1912-1955, French colonial rule in Morocco consisted of the establishment of a protectorate which politically, economically, and infrastructurally took control of the country. In terms of the public health sector, encounters between the Islamic sultanate and Republic of France brought forth clashing between Islamic conceptions of the body and health and colonial medicinal practices and methodologies. With colonialism designed to support the interests of Europe, French colonization neglected the fundamental right to self-determination with forced inequities impacting the health, wellbeing, and lived experience of the Moroccan people.
Colonial racism and perception of Islamic society
As colonial domination in Morocco began, the French assumed a position of moral superiority over non-European indigenous people, viewing themselves as rational, scientific, and progressive. French physicians used colonial medicinal approaches to reinforce the notion that Moroccan society was unsophisticated and underdeveloped, labeling Islamic belief as, “a pathology of mind and society”.
Bigotry and religious persecution against Islam was incorporated into the production of French biomedical exploration. In the 1900s, physician Georges Lacapère began a medical campaign in Fès rooted in the belief that Muslims were culturally, socially, and biologically inferior to Europeans. Using inaccurate biomedical research, Lacapère framed his patient’s ways of praying, working, eating, relaxing, and dedication to Islam as a cause for the expression and transmission of the disease he called, “Arab syphilis”. His work to delineate “Arab syphilis” was an attempt at moral conquest over Islam, illustrating how the perpetuation of racism and religious discrimination was the basis for colonial expansion in the public health sector. The inaccuracies of his work further marginalized Moroccan society, threatening Islamic practices and legitimate health care for Moroccans.
Health and socioeconomic disparities
As the protectorate progressed, the French encountered a struggle against typhoid, a fatal disease caused by poor hygiene, inadequate sanitation, and contaminated drinking water. In an effort to combat typhoid, the French began to regulate the water supply in towns such as Fès, neglecting the sophisticated water system already established by Moroccans. Consistent with the subjugation caused by colonization, the French were more concerned with protecting their own interests than the health of Morrocans. They redesigned and segregated Fès water systems to favor European communities, subsequently improving the health of French colonists and leaving Moroccans at a disadvantage. The French continued to maintain dominance over water governance, prioritizing irrigation schemes that supported European farmers and increased disparities for rural Moroccan farmers.
Socioeconomic consequences increased as French industrial development uprooted and forced rural Moroccans and nomads into slum housing known as bidonvilles. Diseases such as tuberculosis spread rampantly in these environments afflicted by overcrowding, unsanitary conditions, and unclean air. While the French established sanatoriums, patient isolation, and health campaigns, colonial administration tended to prioritize the wellbeing of European settlers, neglecting health care for the rural Moroccans in bidonvilles. Post-independence, more inclusive national tuberculosis control programs were established, but the ingrained lack of health care access and socioeconomic disparities persist in modern day tuberculosis incidence.
Gender-based discrimination
The French protectorate continued to change Moroccan society through gendered and religious discrimination that denigrated Moroccan women. Traditionally, Moroccan female medical authorities (‘arifa) and midwives (qablat) were considered experts in the fields of reproductive health, gynecology, and childbirth. Although men were typically banned from these specializations in Moroccan Muslim society, French male doctors intervened, labeling the Muslim qabla as an “abortionist, sorceress, adviser, weaver of spells”, and villainized their practices as medical quackery.
Wives of colonial officers and French female physicians were employed to observe Muslim females and report on their medical practices. The role of French women assisted the male-dominated protectorate in ridding of traditionally female healing practices and attempting to delegitimize Islam’s significance in health, childbirth, and the body. French colonial intervention in Morocco’s public health sector was therefore patriarchal as well as oppressive.
Decolonizing the public health sector
After Morocco’s independence in 1956, the country began to gradually improve health care service and quality through public policy, programs, and health education reform. Today, Morocco’s public health landscape is enveloped by medical pluralism, balancing European biomedical practices with traditional Islamic-inspired biological, mental, and spiritual healing. Despite this modern day coexistence, inequities still persist due to the deep-rooted legacy of colonialism.
Considering decolonization within the public health sector does not mean a return to pre-colonial conditions. It calls for an analysis of power dynamics, alternative concepts, and the return of autonomy to those hit the hardest by health, socioeconomic, and gender inequality – specifically rural Moroccan communities and women.
Programs and workshops by organizations such as the High Atlas Foundation (HAF) reflect these efforts, reaching rural women through the intersection of Islamic teachings and empowerment. In their empowerment methodology, HAF embraces spirituality and the Holy Qur’an, incorporating Islamic teachings about the body, health, and sexuality as they engage with rural women.
While inequities from the attempted erasure of the role of Moroccan women in the health sector are lasting, programs like these are an effort to strengthen the pre-colonial presence Islam held in Morocco’s public health sector. This intentional fusion of cultural and religious heritage with women’s health is key in rethinking and restructuring how Morocco’s most marginalized communities can heal from decades of inequality, colonial dependency, and oppression.
While the colonial era left an aftermath of discrimination, socioeconomic disparity, and an attempted reform of society, Morocco demonstrates a continual resilience and commitment to decolonizing its public health system through these pluralistic approaches. The coexistence of modern medicine and traditional Islamic practice is a strong reminder that health care cannot be grasped through or restricted to a singular perspective. Rather, it is multifaceted and its diversity is a testament to the commitment of Moroccan society to reclaim its healthcare narrative and build a healthier future.
Rachel Bartkowski is an Intern at the High Atlas Foundation in Marrakech and an undergraduate student at Northeastern University studying Biology, Human Services, and American Sign Language.