Whose Health Matters: Trust and Mistrust in Humanitarian Crisis and Global Health Interventions

Abstract

Trust and mistrust are often highlighted when explaining skepticism and resistance to humanitarian health interventions. Mistrust, as manifested through rumors, resistance, or violence against health workers, is often explained as a lack of knowledge and reason, which is countered through education campaigns or marginalization of traditional healing methods. By analyzing three case studies of global humanitarian health interventions – the cholera epidemic in post-earthquake Haiti, the Ebola epidemic in West Africa and in the Democratic Republic of Congo, as well as the Covid-19 pandemic – we argue, however, that political-economic origins, postcolonial continuities, and neocolonial practices are strong determinants that coin the relationships in global health interventions. By looking at historical, political, economic, and social aspects, we seek to explain that mistrust can also be interpreted as an experienced-based rational reaction shaped by previous atrocities. Normatively framing mistrust in humanitarian encounters as inhibiting the success of interventions avoids addressing more relevant issues able to explain multilevel and multidimensional mistrust as rooted in power asymmetries.