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By Tiffany Whitfield

COVID-19 and the state of public health have remained at the forefront globally the last of couple years and have highlighted disparities in health care access and outcomes. These disparities, though, are not new and have been revealed throughout history by other infectious diseases. Internationally recognized physician, scholar, and activist Dr. Vanessa Northington Gamble spoke to these disparities as the 2022 guest lecturer for the Daniel E. and Helen N. Sonenshine Endowed Lecture Series in Infectious Diseases, hosted by Old Dominion University's College of Sciences and the Department of Biological Sciences. Currently, Dr. Gamble serves as the University Professor of Medical Humanities, professor of health policy at the Milken Institute School of Public Health and professor of American studies at George Washington University. She is an expert on the history of American medicine, racial and ethnic disparities in health and health care, public health ethics, and bioethics.

On Thursday, March 31, she presented two in-depth talks to students, faculty, and the public ranging from health inequities during two epidemics to uncovering the life and breakthroughs of an African American female physician and activist in the mid-1900's.

The first lecture was titled "Exposing Pre-Existing Social Conditions: African Americans, the 1918 Influenza Epidemic, and COVID-19." Her talk centered on racial and social inequities on African Americans' experiences and responses to the 1918 influenza pandemic. Dr. Gamble provided historical context for understanding the "racial dimensions of the contemporary COVID-19 pandemic and its disproportionate impact on African Americans."

In her lecture she gave examples of how epidemics "continue to lay bare racial and social inequities in the United States." During the 1918 influenza epidemic, African Americans did not receive equal treatment in hospitals due to Jim Crow policies in which segregation was legalized and practiced outright. Black influenza patients and victims received care and burials in segregated facilities. During this timeframe white scientists and doctors "believed theories that African Americans were biologically, physiologically and morally inferior to whites." "The hospital was not the only Black institution in Baltimore, Maryland overwhelmed by the influenza pandemic," said Dr. Gamble. "At Mount Auburn cemetery, the largest Black burial ground, bodies arrived so quickly that gravediggers could not keep up, and by the end of October, the caskets of over 150 dead African Americans lay unburied, some for as long as three weeks." The crisis was resolved after the United States Army detailed approximately 370 Black soldiers to bury the dead in a mass grave. "These events in Baltimore underscore that the epidemic itself revealed the medical and political inequities African Americans faced as seen in Baltimore but repeated throughout the country," said Dr. Gamble. "The color line was so entrenched that African Americans assumed primary responsibilities for providing care to race members struck by the influenza epidemic."

Additionally, Dr. Gamble shared newspaper clippings and excerpts from books and papers from African American leaders such as sociologist and activist W.E.B. DuBois, practicing physician in Philadelphia Dr. Nathan Francis Mossell who was the first African American graduate of the University of Pennsylvania School of Medicine, and Richmond, Virginia physician Dr. William Henry Hughes who piloted Richmond's Black community through the 1918 global influenza pandemic. "African Americans lacked political and economic power and lived in the least desirable and most diseases ridden neighborhood, but despite their plights African Americans created separate hospitals and care facilities to take care of themselves," said Dr. Gamble. These leaders and other Black medical professionals and activists pulled resources so that Black patients were no longer given medical attention in basements, attics, or subpar facilities.

"Just as influenza revealed racial inequities in our society in 1918, COVID-19 does so today," said Dr. Gamble. "Statistics show that a disproportionate number of African Americans are sick and dying from coronavirus and many, many Black families are grieving." She noted a recent study in the revealed "the severity of COVID-19 among Black Americans was a predicted result of structural and society realities and not differences in genetic predispositions." "Systemic changes must address the separate and unequal health system that has been exposed by COVID-19," said Dr. Gamble.

Later in the evening, she gave a second lecture, "A Pioneer of Racial Justice and Medicine: The Life and Career of Dr. Virginia M. Alexander," at the Lê Planetarium inside the New Chemistry Building. Dr. Gamble noted that she is in the midst of writing the biography of Dr. Alexander because of the similarities in their careers. Dr. Alexander was a groundbreaker in medicine, public health research, anti-racist activism, and religion. "I want to construct this pioneer to eliminate the substance and character of racist theories and show her as a complex human being with strengths, triumphs and accomplishments," said Dr. Gamble.

Dr. Gamble took the audience on a journey through the various phases of Dr. Alexander's life and career beginning with Dr. Alexander's time as a student at the University of Pennsylvania and the Woman's Medical College of Pennsylvania.

"After graduating from the University of Pennsylvania in only three years, Virginia left for Kansas City in 1925 to complete her hospital internship because no Philadelphia hospitals would accept her as an intern because of her race," said Dr. Gamble.

After completing her internship in the mid-west, Dr. Alexander returned to the east coast and converted part of her home in Brewerytown (North Philadelphia) into a six-bed clinic called the Aspiranto Health Home. Each phase of her professional career was met with hurdles and barriers, but she proved to be resilient.

Dr. Alexander had difficulty finding equal treatment for her patients from hospitals. "White hospitals would not accept her African American patients, and as a result, she was forced to bring patients she could not treat in her clinic to Mercy-Douglass Hospital, Philadelphia's black hospital at the time," said Dr. Gamble. Dr. Alexander did not implement these segregationist methods in her own practice and treated both African American and white patients during the late 1930s and 1940's.

Faith was essential to Dr. Alexander. When she was a freshman at the University of Pennsylvania in 1917, she attended her first Quaker meeting because it was closer than the Baptist church, she had grown up in. "From that very first meeting Virginia discovered spiritual connectedness and found that Quakerism suited her religious temperament," said Dr. Gamble.

Many of Dr. Alexander's white patients were members of the Society of Friends (Quakers). "She had close friends at Race and Arch Street (Quaker) monthly meetings, and she joined the Fireside Club, an interracial group of white Friends and African Americans dedicated to interracial understanding," said Dr. Gamble. Dr. Alexander became the first African American nominated to the Race Relations Committee of Philadelphia Yearly Meeting. "This was a committee that until then had remained entirely white due to the concerns of some of its white members," said Dr. Gamble. As a part of her efforts on the Race Relations Committee of Philadelphia Yearly Meeting, she worked to integrate Philadelphia Hospital. After some time, Dr. Alexander sought membership at Germantown Friends Monthly Meeting. "Despite her already respected status in the Quaker community, Friends were once again split in their support of her membership," said Dr. Gamble. "In 1931, over one year after she applied (and fourteen years after her first Quaker meeting), she was finally approved for membership and became the only African American (Quaker) member Germantown Friends Monthly Meeting."

Over the years Dr. Alexander fought to break down systemic barriers in the medical profession and advocated on behalf of her Black patients. She also did important research on the social, economic, and health problems of North Philadelphia yielding startling results about the health disparities affecting Black patients from high infant mortality rates and more deaths of Black tuberculosis patients compared to whites. In 1936, Dr. Alexander became the first Black student to attend Yale School of Public Health.

Dr. Alexander paved the way for other young physicians and for her colleague Dr. Helen Dickens, who happens to be Dr. Gamble's mentor. More details about Dr. Alexander's life intersected and resonated with Dr. Gamble and more will be revealed in her upcoming book.

Notably, Dr. Gamble has served on many boards and chaired the committee that took the lead role in the successful campaign to obtain an apology in 1997 from President Clinton for the United States Public Health Syphilis Study at Tuskegee. She is the author of several widely acclaimed publications on the history of race and racism in American medicine and bioethics, is a member of the National Academy of Medicine and National Academy of Sciences and is a Fellow of the Hastings Center. She believes public service is paramount.

The Daniel E. and Helen N. Sonenshine Endowed Lecture Series in Infectious Diseases was created so that current ºÚÁÏÕýÄÜÁ¿ students would be able to learn, listen and meet expert scientists in the hopes that they too would enter or contribute to the infectious diseases field.