Cudjo Say I Cry | Health and Justice

Cudjo Say I Cry | Health and Politics: An Introduction

The health of African Americans has always been intricately intertwined with, and severely compromised by, the racial and socioeconomic politics of American society.¹Learn more. These politics are apparent in the present-day disparities—laid bare by the current pandemic—between African Americans and white Americans in relation to health, income, and social status. At the root of these inequities is the perception of African peoples as essentially livestock. In erstwhile “slavocracies” such as Alabama, enslavers perceived the value of Black people only as units of labor and production, while simultaneously dismissing Black people’s social value. 

Africatown is a unique African American settlement built in the nineteenth century by formerly enslaved Africans. In 1927, Black author and anthropologist Zora Neale Hurston interviewed individuals in this community about the objective conditions of their lives. Hurston held discussions, in particular, with Africatown founder Cudjo Lewis, long thought to be the last Clotilda survivor.²Recent historical research suggests that a Clotilda woman named Redoshi, known as Sally Smith, outlived Cudjo Lewis. Learn more. Lewis spoke about his boyhood in Africa, subsequent capture, containment in the barracoon (the Portuguese term for slave barracks where African human cargo awaited transport as chattel), and arrival in Mobile. Hurston and Lewis talked about his enslavement, his emancipation, his purchase of land, and the founding of a settlement called Africatown. Published in 2018 as Barracoon: The Story of the Last “Black Cargo,” Hurston’s journals of these conversations with Lewis instantly became a “great reveal” of the mindset of a once-enslaved person. 

The process of social devaluation of Black people in America begins with their uprooting, their deracination from their motherland, Africa. The trauma and pain of this uprooting is poignantly expressed in the narrative of Lewis, whose African name was Kossola. When Hurston asked him about Africa, he said, “Excuse me I cry. Can’t help it when I hear de name call. Oh, Lor’. I no see Afficky soil no mo’!”⁶Zora Neale Hurston, Barracoon: The Story of the Last “Black Cargo” (New York: Amistad, 2018), 19. 

Kossola tried to reassure Hurston that she had not offended him in any way: “Excuse me. You didn’t do nothin’ to me. Cudjo feel so lonely, he can’t help he cry sometime.”⁷Zora Neale Hurston, Barracoon: The Story of the Last “Black Cargo” (New York: Amistad, 2018), 19. This statement implies that Kossola’s current tears spring from old wounds, traceable to his separation from his motherland. That separation, transmuted in the crucible of enslavement and Jim Crow segregation, generated an existential alienation and angst that Black Americans continue to experience within American society.

The loneliness of having lost his entire family in Africa was compounded by the macro- and micro-injustices Kossola experienced over time. He was denied reparations when, after five and a half years of illegal enslavement, his former “owner” Timothy Meaher denied him a “piece dis land so we kin buildee ourself a home,” forcing him to purchase the property instead.⁸Zora Neale Hurston, Barracoon: The Story of the Last “Black Cargo” (New York: Amistad, 2018), 67. He was denied social and economic justice when the L&N Railroad determined that it would “give him nothin’”⁹Zora Neale Hurston, Barracoon: The Story of the Last “Black Cargo” (New York: Amistad, 2018), 67. after an accident that caused him severe bodily injury and thus undermined his ability to provide for his family. The shooting death of his son Cudjo Lewis, Jr., by the local sheriff further hampered Kossola’s pursuit of happiness as a captive in a strange land.¹⁰Zora Neale Hurston, Barracoon: The Story of the Last “Black Cargo” (New York: Amistad, 2018), 75.

Stresses like those that attended Kossola’s life have haunted Black folk in Alabama and the nation across generations, adversely affecting their social and economic wellbeing to the present moment. Any approach to the amelioration of health conditions for African Americans in Alabama and across the nation must not only examine what sociologist Joy DeGruy has termed the “post-traumatic ‘slave’ syndrome”¹¹See source. experienced by African Americans, but also examine this syndrome in relationship with the one that birthed it: white supremacy. 

One must investigate, for example, the ideology and influence of Alabama’s once highly respected white scientist and physician Josiah Nott, a polygenetic¹²Polygenism is the now-discredited theory that the human races are of different origins. theorist who argued that Blacks were permanently inferior to whites, that the Black race was incapable of living with whites in a condition of freedom, and that Blacks were the lowest grade of humanity.¹³ Josiah Clark Nott, An Essay on the Natural History of Mankind, Viewed in Connection With Negro Slavery: Delivered Before the Southern Rights Association, 14th December, 1850 (Mobile: Dade, Thompson, 1851). See also: Reginald Horsman, Josiah Nott of Mobile: Southerner, Physician, and Racial Theorist (Baton Rouge: Louisiana State University Press, 1987), 233. Nott established a race-based approach to medical practice. Working in Alabama during the yellow fever epidemics of the latter part of the nineteenth century, he concluded that Black people were “much less susceptible to yellow fever than whites, and even the smallest drop of Negro blood diminished the susceptibility of whites to the disease.”¹⁴Reginald Horsman, Josiah Nott of Mobile: Southerner, Physician, and Racial Theorist (Baton Rouge: Louisiana State University Press, 1987), 233. He promulgated the notion that “there was reason to believe that the susceptibility of races to yellow fever is in direct ratio to the fairness of complexion.”¹⁵Reginald Horsman, Josiah Nott of Mobile: Southerner, Physician, and Racial Theorist (Baton Rouge: Louisiana State University Press, 1987), 233. In Types of Mankind (1854), Nott expounded on what he perceived as the unbridgeable gaps between races, sharing his conclusion that white supremacy and racial purity were the keys to civilization and future world progress. 

Do the attitudes held by Nott still color medical practice in Alabama? Do the diverging health outcomes he alluded to in 1854 mirror the disparities seen in the COVID-19 pandemic? —Deborah G. Plant

Post-Traumatic Slave Syndrome and the Pain of White Supremacy

Joy DeGruy’s post-traumatic slave syndrome theory acknowledges the impact of slavery on the physical and psychic health of Black people today.¹⁶See source.

In order to fully understand what is needed to improve health outcomes within the Black community, one must first acknowledge the full scope of the human damage caused by the brutality of a system that is at once traumatic, appalling, shocking, scandalous, disgusting, devastating, staggering, and wicked.

According to scholar Henry Louis Gates, 12.5 million Africans were kidnapped and shipped to the New World. Almost 11 million survived the dreaded Middle Passage, disembarking in North America, the Caribbean, and South America. Of this group, about 390,000 were brought to what is now the United States; of this number, 110 arrived on the Clotilda, and roughly 32 founded Africatown.¹⁷ See source.

Clinical psychologist Shari Renée Hicks suggests in her unpublished doctoral dissertation, “A Critical Analysis of Post Traumautic Slave Syndrome: A Multigenerational Legacy of Slavery,” that the 400-plus-year history of slavery in America can be broken into four phases of an African Holocaust that affected the mental, physical, spiritual, and economic health of enslaved Africans in America across multiple generations.¹⁸Shari Renée Hicks, “A Critical Analysis of Post Traumatic Slave Syndrome: A Multigenerational Legacy of Slavery” (PhD diss., California Institute of Integral Studies, 2015), 81-85. These phases are a useful schema to remind ourselves of the horror of this system and its legacies.

Phase I | The Acquisition Phase: 1442 to 1808
From 1442, when Europeans began establishing their conquest of Africa, to 1808, when the US deemed the international Atlantic slave trade illegal

This period is characterized by European raids on African villages and slavers capturing, trading, and buying people from some African kingdoms. This results in the decimation of lands and the killing of African customs, conventions, and ways of life. Africans are chained, caged, and shipped to the Americas for free labor. Millions drown during these transatlantic voyages.

Phase II | The Physical Enslavement Phase: 1619 to 1862
From Jamestown to the Emancipation Proclamation

During this stage, slavery is institutionalized in North American colonies and later the United States. The horrors of enslaved life—the separation of individuals from their families; the forced work on plantations for no wages; the physical, psychological, and sexual abuse—are manifold. While the international slave trade is abolished by the United States Congress in 1808, slavers continue to illegally traffic slaves to the United States until the Civil War. In 1860, the Clotilda Africans are brought to Mobile, Alabama.

Phase III | The Post-Enslavement Phase: 1865 to 1954
From the end of the Civil War and the passage of the Thirteenth Amendment in 1865 to the beginning of the Civil Rights Era

In the years following the Civil War, the de jure abolishment of slavery is quickly replaced with de facto re-enslavement through Jim Crow. This phase saw sustained attempts by white Southern culture—often enforced by physical violence—to deem Blacks as inferior and hinder their access to education and entrepreneurial activity. It is in these years that the Clotilda Africans buy their own land from plantation slaveholder Meaher and found their own schools, churches, and cemetery.

Phase IV | Black Appeal to Government For Justice Phase: 1954 to 1995 and beyond
From Brown vs Board of Education to the present

Blacks rally for government support following years of violence, from the terror of KKK lynchings to unethical medical research such as the Tuskegee syphilis experiment in Alabama (1934–1971) to insidious, racist economic policies like redlining. Communities protest against segregation and “separate but equal” paradigms in public education, transportation, and housing and press for fairness and voting rights. The Civil Rights and Black Power movements gain momentum; achievements such as the desegregation of public accommodations and the integration of schools take place. Leaders like Malcolm X and Martin Luther King (both assassinated as a means to shock African Americans back into submission) manifest hope, self-love, and cultural identity, demanding fairness for the Black community. In this period of mostly peaceful, nonviolent protest, Black communities continue to suffer from violence such as the gruesome bombings of the 16th Street Baptist Church in Birmingham. Africatown survives as a community, but faces industrial encroachment, entrenched poverty, and government neglect.

All these incidents, events, and blood memories constitute what scholar and policymaker Daniel Dawes calls the political determinants of health¹⁹See source. and cultural studies theorist Shehla Burney refers to as “the material and psychological consequences of living under the power of Euro-centric control.”²⁰Shehla Burney, Pedagogy of the Other: Edward Said, Postcolonial Theory, and Strategies for Critique (New York: Peter Lang, 2012), 143-172. In a review of Dawes’ The Political Determinants of Health, former US Surgeon General Regina Benjamin writes: “The current state of the nation’s health did not happen by chance, but on purpose. It will force you to rethink the role social, environmental, economic, and other factors play in influencing how long we will live.”²¹See source. 

Greater-Than-Normal Incidence of Disease and Adverse Health Conditions

The Gulf States Health Policy Center, a think tank founded by Benjamin, conducts policy research and builds community coalitions to improve the health rankings of the Gulf States. During an April 2020 event focused on COVID-19 in Alabama, Benjamin asked a pointed question: Why are under-resourced communities more affected by COVID-19? “Why do African-Americans make up 25 percent of the state population but account for 45 percent of the COVID-19 deaths in the state of Alabama? African Americans are more prone to hypertension, heart disease and diabetes, poor food, poor fitness—lack of affordable healthcare, which abrogates early disease examinations,” said Benjamin. “We come into the hospital much sicker, die much faster, and die more often, and so that is very concerning.”²²See source.

Data collected from the Centers for Disease Control’s 500 Cities Project bear witness to the dire health of Black communities. This set of data shows us the greater-than-normal incidences of disease and adverse health conditions in Africatown compared to both greater Mobile and Alabama. For example, in Africatown:

• 51 percent of residents 18 and older record high blood pressure (41 percent in Mobile, 37 percent in Alabama),
• 49 percent of Africatown residents 18 and older are obese (39 percent in Mobile, 40 percent Alabama),
• 9 percent of Africatown residents suffer from coronary heart disease (8 percent in both Mobile and Alabama),
• 7 percent of Africatown residents have had a stroke (4.5 percent in Mobile, 4 percent in Alabama),
• 21 percent of Africatown residents 18 and older do not report good physical health for the past 14 recent days (16 percent in Mobile, 14 percent in Alabama), and
• 19 percent of Africatown residents 18 and older claim poor mental health for the past 14 days (15 percent in Mobile, 14.5 percent in Alabama).

Public Health and the Political Domain | Black Lives Matter

We must also consider how social and economic systems inflected by racism continue to shape outcomes in Black communities if we are to tackle any of these health disparities. The deaths of Black individuals at the hands of police are just one example. While many law enforcement officers are committed to fairness, the violence inflicted by some police on private citizens must be assessed against the backdrop of larger social and economic structures that threaten the health of brown and Black males, in particular. Police brutality is a public health issue.²⁵Learn more. 

According to health equity expert Dr. Camara Jones, police violence is a striking reflection of the American legacy of racism, which has created a system that assigns value and structures opportunity while concurrently—and unfairly—advantaging some and disadvantaging others based on skin color. 

This, says Jones, saps the strength of the whole society through the waste of human resources.²⁶See source. When it comes to institutional racism, we are all in this together. No one in America can escape this particular pandemic. 

Ridding society of institutional racism will require definitive steps towards comprehensive healing. It requires acknowledgment, validation, apology with direct-targeted action, acceptance of the apology, and the seeking of forgiveness, according to DeGruy. However, she suggests that the United States hasn’t even moved out of the acknowledgment phase.²⁷Alicia St. Andrews, “Post Traumatic Slave Syndrome and the Invisible Wounds of Trauma,” San Francisco County ACEs Connection (CA), accessed April 28, 2021.

Africatown as Patient | Can the Doctor be Trusted?

Africatown~CHESS, a local environmental justice group, is one of the most trusted community development corporations in the area. It operates on the premise that all are deserving of a Clean, Healthy, Educated, Safe, and Sustainable Africatown. 

It is critical to acknowledge the trust placed in organizations like CHESS, because many African Americans do not trust government public health initiatives to this day because of medical experiments perpetrated on Blacks, compounding the blood memory of traumatic experiences on slave ships. They have not forgotten surgeon J. Marion Sims and his “research.” Sims, considered the father of modern gynecology, conducted a series of experimental operations between 1845 and 1849; most of his test subjects for non-voluntary sterilization and hysterectomies were enslaved Black women. They remember the Alabama “public health” disaster of the Tuskegee Experiment, which began in 1932 under the guise of free medical care for Black men. Some 600 people were enrolled as guinea pigs … to test their medical response to the purposeful infection of syphilis. And they recall the Mississippi Appendectomy, in which involuntary sterilizations were performed on poor Black women without consent and for no valid medical reason, simply because white male medical doctors deemed them unfit to reproduce. 

This history of medical abuse, informed by notions of white supremacy, must be a part of public health consciousness. Confronting it and regaining the trust of the Black community is crucial for any progress to be made.²⁸In addition to Joy DeGruy’s Post Traumatic Slave Syndrome: America’s Legacy of Enduring Injury and Healing, the authors recommend the following books on public health and Black communities: Nell Irvin Painter’s, The History of White People; David Livingstone Smith’s Less Than Human: Why We Demean, Enslave, and Exterminate Others; Dorothy Roberts’ Killing the Black Body: Race, Reproduction, and the Meaning of Liberty; and Harriet A. Washington’s Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present.

We Cannot Preserve the Town If We Cannot Preserve the People | Africatown’s Public Health Gaps

Descendants and residents believe that great harm has been done to this community’s health during the 160 years since Africatown’s founding. It is the job of elected officials to protect the people, and simple morality would suggest the same for industry leaders. Yet many in the community feel that those who should have done so failed at their jobs. Now is the opportunity for a second chance.³⁰Learn more about race and equity in Mobile in the film Mobile in Black and White, a multifaceted film project exploring race relations in the twenty-first century. 

In conclusion, city, state, and federal government, along with private development interests, must base future public health actions in Africatown on: 

• the acknowledgment of the Four Stages of the African Holocaust that have caused Africatown descendants generations of physical, mental, and spiritual anguish,
• the acknowledgment of racism as a disease that has produced post-traumatic slave syndrome,
• the development of a citywide Truth and Reconciliation Commission to explore the impact of slavery on mental and physical health and that will search for, fund, and apply solutions,
• an assessment of industrial pollution and its impact on health, and the commensurate funding for care, compensation, and remediation, 
• the development of health definitions and statistics to quantify the impact of acute concerns such as COVID-19 and cancer caused by pollution on the community, 
• the provision of affordable health care for physical, mental, and spiritual disease for the Africatown community and Clotilda descendants, 
• and the leveraging of the Clotilda and new development and investment to promote clean neighborhoods, clean sites, clean industry, and clean health.