Medical Apartheid: The Foundation For Our Post-Colonized Healthcare System

by

Aryanna Cheeseboro

09/01/2025

For many Black women, seeking medical care means navigating a system where racial bias and unequal treatment persist—disparities that continue to undermine their health, safety, and trust in the very institutions meant to heal them. Medical apartheid, a term coined by Harriett A. Washington, refers to the systemic and historical mistreatment of Black Americans within the U.S. healthcare system, particularly through unethical medical experimentation, exclusion, and exploitation (2007). Recently, I was delighted to have the opportunity to speak with the immensely talented and skillful holistic doctor, Erica Steele, taking a deep dive into medical apartheid and dissecting the root of the problem.

Combahee River Collective

Dr. Steele educated me on the timeline leading to the cause of the broken system. From its creation in the 1940s, the U.S. healthcare system was built without Black Americans in mind, shaped by racism, exclusion, and a Westernized model that replaced indigenous healing practices. Rooted in neglect and inequality, the foundation for our post-colonized healthcare system laid the groundwork for the bias, structural barriers, and limited representation in research that continue to harm Black women and other marginalized groups today. Systemic bias, particularly in healthcare, has deadly consequences. In 2021, the CDC reported that Black women face a maternal mortality rate 2.6 times higher than that of White women. A survey completed by KFF, states that a majority, 54% of Black women, say they have experienced at least one form of discrimination in healthcare - a reality that reflects how little has changed since the system’s inception.

The long-standing pattern of neglect is evident in how the medical field has historically treated Black women as expendable subjects. As Dr. Steele explained, in the 19th century, the so-called father of gynecology, J. Marion Sims, performed repeated experimental surgeries on enslaved Black women such as Anarcha, Lucy, and Be

tsey, denying them anesthesia under the false belief that Black women did not feel pain. This exploitation continued on well into the 20th century. Henrietta Lacks, for example, had her cancer cells taken without her knowledge or consent, becoming the foundation of countless medical breakthroughs while her family remained in poverty. Activist Fannie Lou Hamer underwent surgery to remove a small tumor only to be forcibly sterilized without her consent, a practice so common it became known as the “Mississippi Appendectomy.” 

These stories expose how deeply the U.S. healthcare system was built on the exploitation, mistreatment, and inhumane experimentation of Black women, laying the foundation for the biases and disparities that persist today. 

A striking example of the continuation of the medical apartheid is the case of Adriana Smith, where medical professionals experimented on her body against her family’s wishes, without facing any consequences for such a clear violation of her dignity. This was made possible, in part, because the U.S. Constitution does not explicitly recognize human rights, but rather limits its protections to civil rights. This legal gap continues to leave room for exploitation. From past atrocities to present-day abuses, these practices expose how the post-colonized healthcare system still operates in ways that endanger, neglect, and exploit Black women.

Black women’s pain is often dismissed or underestimated by medical professionals, a bias that traces directly back to myths established during Sims’ era. Studies show that Black patients are systematically undertreated for pain, particularly in cases like sickle cell anemia, where women are frequently stereotyped as “drug-seeking” when they advocate for relief. Even medical equipment itself has been shown to fail Black patients. Such as pulse oximeters, which during the COVID-19 pandemic provided less accurate readings on darker skin, delaying treatment for many. These examples demonstrate that the mistreatment of Black women is not simply a relic of the past, but a living reality embedded in the very structure of healthcare.

While we can’t necessarily fix this broken healthcare system, it’s important to recognize that it was built on a foundation that systematically excluded Black people and marginalized communities, often failing to prioritize their health and well-being. This history of neglect and bias has had long-lasting effects, from unequal treatment in medical care to underrepresentation in research studies. Organizations like The Ruth Collective play a vital role in addressing these inequities by advocating for equitable healthcare, providing support to underserved populations, and raising awareness about systemic disparities.

I am grateful to Dr. Erica Steele for sharing such important insights, which I can now pass on to help highlight why the work of The Ruth Collective is so essential in supporting healthier, more just outcomes for all. 

Sources

Schumacher S, Hill L, Artiga S, Hamel L, Published IV. Five Facts About Black Women’s Experiences in Health Care. KFF. Published May 7, 2024. https://www.kff.org/racial-equity-and-health-policy/issue-brief/five-facts-about-black-womens-experiences-in-health-care/

Hoyert DL. Maternal Mortality Rates in the United States, 2021. Centers for Disease Control and Prevention. Published March 16, 2023. https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm

‌Washington, H. A. (2007). Medical apartheid: The dark history of medical experimentation on Black Americans from colonial times to the present. Doubleday.  https://books.google.com./medical_apartheid

Steele, Erica, DNM.  Personal Interview. (Aug 8 2025)