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    Racism & Bias Within The NHS During The Covid-19 Pandemic And Years Before

    Much of this ingrained bias within medicine can be traced back to slavery, when physicians would claim that black slaves could endure more pain than white people in order to facilitate further enslavement and torture. Enslaved people were often operated on for medical research purposes without anaesthetic and during World War II, these stereotypes justified the US military’s decision to test chemical weapons on black soldiers and even today, they still prevail. 

    “Until 1970s, they were still printing medical textbooks that said black people have a higher pain threshold,” says Dr Elfaki. “This translates into racial bias within pain management and general treatment of black patients.”

    There are more nuanced problems with the current medical syllabus, too. Mainly, that it is geared towards the treatment of white patients. “At university, the prototype in our anatomy textbooks was a white male,” says Dr Tosin Sotubo, GP and founder of Mind Body Doctor. “You’re not learning how to treat all people, you’re mainly learning how to treat white men.” Obvious problems occur as a result, namely that doctors are ill-equipped to treat Black and ethnic minority people.

    Take rashes as an example; rashes present differently on different skin colours. Only learning what they look like on white skin leaves doctors unable to recognise and diagnose potentially life-threatening illnesses like meningitis, measles and Lyme disease, on non-white patients as a result. “A more extreme example is Kawasaki’s disease, which although rare is the most common cause of heart disease in children” explains Dr Ifeoma Ejikeme, dermatologist. “The rash looks totally different on Black skin and with incorrect training could easily be dismissed for a simple viral rash, with dire consequences.”

    Dr Elfaki adds that these oversights have led to a level of distrust among communities: “Patients have become aware that doctors don’t understand or recognise their illness or their pain because of the way that they look, and there’s a huge amount of distrust from black and ethnic minority patients towards the NHS as a result.”

    As well as decolonising the curriculum and removing racial bias from medical training, important changes need to be made in terms of representation at a board level. “In London, almost half of NHS employees are black and ethnic minority, but 92% of NHS Trust Board members are white,” notes Dr Elfaki.

    It has been over ten years since the Department Of Health announced that they must “give even greater prominence to race equality,” with a “systematic action plan” to increase representation at the top tiers of the service to 30% BME. It’s clear the NHS and government has failed in this objective spectacularly – even by the their own admission.

    In the UK Parliament Human Rights Committee’s report published this week, it was noted that “the NHS acknowledge and regret this disparity [in maternal death rates between white and Black women] but have no target to end it.”

    Furthermore, a study by Roger Kline at Middlesex University in 2014 titled “The Snowy White Peaks of the NHS” found that there had been no significant change in the proportion of BAME Trust Board appointments in recent years, “continuing the pattern of under-representation compared to both the workforce and the local population.”

    It also found that BAME staff were twice as likely to enter the disciplinary process and BAME nurses take 50% longer to be promoted compared to white nurses. “You may see a lot of black and brown faces at the bottom, but you can’t let it lull you into a false sense of security because these people aren’t in positions where they can make changes or influence the system,” says Dr Elfaki. 

    In response, the NHS Workforce Race Equality Standard was set up in 2015, which is a live initiative that aims to implement a strategic approach to improve BAME representation at senior management and Board level and to help to provide a better working environment for the BAME workforce.

    For Abi, however, racism is still a reality of her everyday workplace – not just from patients, but from colleagues, too: “When the protests were taking place after the killing of George Floyd, a senior member of medical staff was leaving comments on Facebook that were anti-Black Lives Matter.” The comments included, “Can we just not have our street names changed to Mugabe Ave or Zambia Way. Thanks!” on a politician’s public page. “A number of us complained, but we were told there was nothing that could be done,” says Abi.

    UPI

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