Diasporic Guilt and the Limitations of Western Healthcare

A banquet of song and dance, Ibrahim Jabbar-Beik (1923-2002).

There’s an unspoken guilt that has been looming over my family since the internal conflict began in Iran. My mother was one of the lucky people in her family that fled Iran before the oppressive powers became unbearable, and it is a source of pride for her. Leaving her third-world country to build a new, more accomplished life in Canada. She hasn’t spared me a day without reminding me of the sacrifices she made to provide a safe and comfortable life for me. And why wouldn’t she? It is something to be immensely proud of.

What she doesn’t tell me is how much guilt she feels for leaving. As she moved forwards, her country moved backwards. As much as she likes to disassociate herself from Iran and her status as an immigrant, there will always remain an inherent part of her body that is perpetually worried. It lives in her body and never fully settles. Each mention of Iran builds this worry in her shoulders and her jaw. She carries it with herself quietly, as if naming it would make it heavier.

Since the internet blackout and protests began earlier this year in Iran, her avoidant way of going about everyday life is becoming harder to maintain. The distinct separation of her Iranian and Canadian identities is no longer holding. Her quiet worry and observance of the slow deterioration of Iran as an outsider can no longer be something she does passively; it has become a sort of psychological torture. The worry has mutated into an incessant hypervigilance; monitoring Telegram and WhatsApp Iranian news channels with a compulsive urgency, as if constant attention might offer some form of protection. Her evident change in behaviour since the internet blackout has made it clear that connectivity to one’s country and family, particularly for diaspora, is an essential part of our well-being.

Western frameworks of health do not yet understand nor recognize this diasporic guilt that plagues immigrants with family from countries facing conflict. The West recognizes social determinants of health as related to issues with income, employment, education, and other individualized matters [1]. It does not include the necessary component of connectivity, which is especially important digitally for diaspora from countries with conflict. 

Digital platforms have become lifelines for diaspora, allowing families to remain connected and emotionally present despite geographic separation. When access to these platforms is deliberately restricted, this essential component of connection is weaponized. The resulting psychological toll perpetuates a shared distress and helplessness beyond those physically present in the country. Western healthcare systems understand this sort of psychological distress as the aftermath of a discrete traumatic event; something that happens to an individual, at a specific moment in time. Diasporic grief cannot be traced to a single moment; it is the culmination of generations of unrest and unresolved loss in the homeland. Without acknowledging this broader context, Western healthcare is likely to mischaracterize diasporic grief as pathological rather than a rational response to gradual disconnection from their culture and homeland. 

As a mixed Iranian-Canadian, it is hard to stay connected to the Iranian side of my heritage. I could never fully claim either side; there’s always been an in-betweenness. My mother’s reluctance to acknowledge and connect to her Iranian heritage as an effort to assimilate into Canadian culture does little to mitigate this reality and instead worsens this diasporic grief rooted in cultural erasure during a time of political violence. Connectivity, especially digitally, is essential for the preservation of culture among diaspora. This need is increasingly important in times of distress, as it can reduce the psychological toll of diasporic guilt and the constant feeling of powerlessness that accompanies watching your homeland deteriorate from afar. Western healthcare models must acknowledge diasporic grief as a consequence of displacement and create cultural support systems that promote connection rather than detach and individualize grief. This recognition by Western healthcare has the potential to not only ease suffering, but help preserve culture across generations.

References

1. Government of Canada. Social determinants of health and health inequalities [Internet]. Government of Canada. 2024. Available from: https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html

   
   

   ‌