Pre-Colonial Health Systems

• Multiple systems operated simultaneously, each rooted in land, body, and community
  • Indigenous nations: ecologically grounded plant knowledge, ceremony, relational healing
  • West and Central African healing traditions: communal health, herbalism
  • Midwifery and neighborhood healers among immigrant communities
• All systems shared a core feature: accountability
  • Community councils, restorative practices, mutual obligation
  • Health was communal, not individual
• Biodiversity analogy: heterogeneous ecosystems flourish; monocultures collapse
  • Same principle applies to health systems

Epistemicide as Colonial Method

• Disease was a genocidal tool, but also carried an epistemological framework
  • Indigenous and African ways of knowing classified as inferior, pagan, or dangerous
  • Healers criminalized; midwives called witches
• Epistemicide was not a side effect of colonization: it was a method
  • Devaluation created a vacuum for Western institutions to fill
• Knowledge survived through individuals and elders passing it down
  • Still present in doula practice, ceremony, and individual reclamation work today

The 1913 Turning Point

• Early formal public health (mid-19th century) was bold and coalition-based
  • Physicians, housing reformers, poverty advocates, civil engineers
  • Focused on environment: housing, water quality, food, urban conditions
• Herbert Winslow Hill’s 1913 book argued the 19th-century approach was wrong
  • Central claim: infectious disease has one source, a germ in an infected person
  • Argued chasing “bad surroundings” was inefficient vs. finding and isolating the infected individual
• This shifted public health from treating the environment to treating the individual
  • The sick body was isolated from community, land, and ancestral knowledge
  • Built in a Euro-Western assumption: people stand apart from nature
• COVID as a modern echo: contact tracing prioritized over lived conditions

What Was Lost and Why It Matters

• Three things got “filed away” as irrelevant:
  • Communal and ancestral knowledge (labeled superstition)
  • The environment around the sick person
  • The community that knew and sustained the person
• Public health became reducible to individual behavior and individual choice
• Communities are not accessing or trusting health systems now
  • Rooted in this historical undermining
  • Current “community engagement” efforts often lack authentic co-creation with communities as experts

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The story we've been told is that professional health and justice systems arrived and improved on messy, informal community care. That story has cause and effect backwards. Before professionalization, communities in the US had sophisticated, relational, place-based systems for health and accountability. They were displaced deliberately, over roughly 150 years, because they threatened the financial and political interests of people building institutions around different values.

This episode introduces the term the series returns to in every era: epistemicide. The systematic destruction of community knowledge systems. It sets up the pattern the next five episodes will trace, era by era, and names the contradiction at the center of the present moment — institutions investing in "community engagement" while keeping community wisdom routed through their own gatekeepers.

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I sat down with Malka — educator, community herbalist, organizer, and co-founder of the DC Mutual Aid Apothecary — to talk about honoring endings, beginnings, in-between moments, mergers, sunsets. All the transitions that, when witnessed well, can turn into wisdom instead of just abrupt, unmarked closings.

Malka spent over a year researching the closure of Movement Ground Farm, a decade-long land-based nonprofit that attempted to shift into a worker-led model and eventually decided to sunset. She wove the story of that organization into a virtual interactive timeline, drawing on 20-plus interviews (some of them four hours long with former staff). Her research has become a case study for anyone moving toward collective land-based work, especially the people asking what we can learn from projects that have shut their doors.

We talk about why so many of us leave organizations carrying rage, distrust, and shame. Why the nonprofit form so often turns into a machine for sustaining itself. What happens when a founder can't let go of power, and what shifted for the Movement Ground Farm ED once he had a year of reflection and an outside witness to help him make sense of what happened. Malka also shares where she is right now with the DC Mutual Aid Apothecary, six years in, exploring what a soft ending can look like when a project has grown so entangled with its community that ending it isn't even fully in her hands anymore.

If you've ever left a project feeling like it went up in flames, or watched one dissolve without acknowledgment, this one's for you.

In this episode:

• Why unmarked endings get carried into the next role as rage, cynicism, or a quiet loss of faith
• What happens when the nonprofit's real job becomes sustaining the nonprofit
• Movement Ground Farm as a case study, and Malka's process of interviewing people from every side of a decade-long story
• The founder's paralysis, and what shifted when he could finally make sense of what happened
• Two very different kinds of endings: organizations imposed on a community versus ones that grew out of it
• Why some things can't fully be ended, because they no longer belong to their founders
• What a "soft ending" can look like (Plant Fest, and giving away thousands of seedlings, is a good example)
• The elements Malka names for holding a closure well: an outside witness, space for community to honor the work, not hoarding what you've built, and telling the story with nuance
• The offering an ending organization can make to the rest of us as a case study, mistakes on display, humbly

Resources mentioned:

• Movement Ground Farm — harvestingforseed.com
• The DC Mutual Aid Apothecary

Connect with Malka:

• LinkedIn: Malka Roth
• Instagram: @malkaeve
• Email: malkae.roth@gmail.com

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🔗 Stay Connected

Take the Quiz → Discover where your organization most needs storytelling

Let's connect on LinkedIn

Lean more about how we can work together at https://madisonmurphybarney.com/entangled-health

Reach out with questions and inquiries at mbarney@entangledhealth.com