Over the past few weeks, I have been coming to terms with the fact that I, a doctor, may become seriously unwell with Covid-19. And I am seriously concerned that as an African-British woman I may have less chance of surviving.
Due to the infectious nature of the disease, most hospitals have stopped or reduced visitors. This would mean I would have no one to advocate on my behalf, so if the severity of the disease doesn’t kill me, I could still be at risk by not receiving the same level of care as my Caucasian counterparts.
Racism in medicine has always been an issue but it is back on the agenda during this global pandemic. I have witnessed Black, Asian and ethnic minority (BAME) colleagues face racism from patients and their colleagues, as well as being on the receiving end myself. I have seen patients insist they do not want to be treated by BAME doctors and threatening to submit complaints. In response to this, I’ve witnessed other staff saying nothing and seemingly trying their best to accommodate these wishes to avoid, at all costs, said complaint. It is important that the public and those in the NHS know the fears that a BAME doctor might have about how they might be treated as a patient, especially during this unprecedented time.
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As an NHS doctor working in maternity and armed with the facts that black women are five times more likely to die from pregnancy-related issues, I am no stranger to contemplating health inequalities based on race. We are now learning that Covid-19 disproportionally affects those from a BAME background. Yet, we are simultaneously being told that this viral infection is “a great leveller” that does not discriminate.
Every death is a tragedy, but as Dr Chaand Nagpaul, chair of the Council of the British Medical Association, said, the number of BAME individuals who have died cannot be “random” when you consider that BAME staff make up less than half of the NHS workforce. At the time of writing, out of the 45 NHS staff who have died of coronavirus, at least 32 appear to have been BAME.
I recognise as a female African-British doctor I am still in a relatively privileged position but that does not mean I am immune to the systemic discrimination BAME individuals may face should I contract Covid-19.
BAME doctors might find it harder to complain about inadequate levels of personal protective equipment (PPE) and so might inadvertently place themselves at a greater risk of catching the virus, according to Dr Nagpaul.
I recognise, in many ways, I am in a relatively privileged position. But that does not mean I would be immune to the systemic discrimination BAME individuals may face should I contract Covid-19 and become unwell enough to require hospital care. My profession and status would not protect me then. Sadly, we know subconscious bias contributes to how easily healthcare is accessed and how that care is received.
I recognise that the reasons for the deaths we are seeing in the BAME community will be complex and varied. But some reasons may be unsettling. According to research by The King’s Fund, the variations in experience in health services and health outcomes are not only down to genetics, as is so often touted, but also racism, or, “cultural insensitivity”.
Very little progress has been made when it comes to reducing discrimination against BAME NHS staff. We can only hope that research into the tragic deaths of my fellow BAME colleagues during this epidemic will be prioritised. This may help inform how we as a profession can tackle and change a problem that goes against the core values the NHS — that we love and work for — holds dear.
At this country’s time of need, each and every member of the NHS is selflessly placing themselves in the line of fire.
But we must acknowledge the BAME NHS staff potentially putting themselves at disproportionate risk for a system that does not value them equally.
The author of this article is a doctor specialising in obstetrics and gynaecology in England and has asked not to be identified.