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12 June 2020

Blog by By Dr Bina Rawal

Have you ever been winded by a punch to the solar plexus? I have. I remember not being able to breathe temporarily as I keeled over, while two boys called me offensive names and told me to ‘go home.’ It wasn’t something I could compute, especially as I was on my way home from primary school. This only ever happened once – the sight of my four big brothers accompanying me to and from school the following week must have sent some kind of signal to the perpetrators. Micro-aggressions however are harder to deal with. These range from the way someone looks (or doesn’t look) at you to the politely delivered reasons as to why you are not suitable for something – a much slower form of suffocation.

When my family arrived in the UK in the 1960’s, racism was overt and signs outside guesthouses saying ‘No Blacks, No Irish and No Dogs’ were not unusual. As a new arrival, having served ‘under’ the British in Kenya, my father accepted that he was lower in the pecking order for jobs, but he swallowed his pride (to the detriment of his mental and physical health) in order to improve his children’s prospects. Since then, many laws have been introduced and much rhetoric delivered, yet gaps in opportunities, attainment, pay and health outcomes remain, lying on top of a mountain of research on the socioeconomic determinants of health and wellbeing. Training for staff on unconscious bias helps, but why aren’t names routinely removed from CVs before being passed to a hiring manager for shortlisting? I’m told that some online recruitment platforms ‘can’t’ remove names from CVs. Yes, they can. If people invest in making this happen. The NHS is doing this in part.

A recent PHE report (1) shows a gap in terms of outcomes from COVID-19. After accounting for the effect of sex, age, deprivation and region, people of Bangladeshi ethnicity had around twice the risk of death than people of White British ethnicity. Other minority ethnicities had between 10 and 50% higher risk of death when compared to White British. The OpenSAFELY report (2) which examined the linked electronic health records of over 17 million adult NHS patients found that ‘people from Asian and black groups are at markedly increased risk of in-hospital death from COVID-19, and contrary to some prior speculation this is only partially attributable to pre-existing clinical risk factors or deprivation.’ So what exactly are we doing about this? I haven’t heard of any specific recommendations for BAME workers with the highest risk of death from COVID-19, even though I know people in the frontline at such high risk. Use PPE, keep calm and carry on seems to be the message coming through.   

Race has become a subject that we’re trained to tip-toe around – but this must suit those who came up with this particular social construct. Just as history is written by the victors, social constructs can be created by the privileged to retain a certain position in society. It’s convenient to hush it up by making the aggrieved party fear that they will come across as shrill, difficult or as a loose cannon. The history I learnt in school in the UK about the British Empire is not the same history I heard my parents and grandparents talk about amongst themselves. I was in a minority both in number and in opinion, so found it difficult to have an open dialogue about race at school.

Dialogue isn’t easy for both sides, white and non-white. From my personal perspective, it’s really hard to articulate the impact of years of subtle micro-incidents that leave a seed of doubt each time as to whether you ‘just imagined’ an element of racial discrimination. I was lucky because I got a helping hand from kind teachers, I kept my head down and I worked very hard to achieve personal success, which paradoxically has made it harder to speak up, because that success became ‘proof’ that there couldn’t have been racial discrimination. Another reason not to speak out is that one doesn’t wish to embarrass one’s white colleagues and friends, because after all, they have let you into their circle, (a very comfortable place to be) and they are not the ones who are personally liable for the injustices out there. I cannot speak for Afro-Caribbean colleagues, but imagine all this applies and much more. In recent days, black and white people have been protesting together, demanding that we fast track change so that our children “will not be judged by the color of their skin, but by the content of their character.”

Yuval Noah Harari postulates in his book ‘Sapiens’ that the success of our species is built on cooperation, collaboration and organisation on a massive scale around shared fictions such as money and religion. So, in the midst of this success to forget morality, decency and fairness would surely lead to self-destruction and a legacy that befits homo ‘stultus’.

Recently, every time I hear the question, “How many times must a black man die in police custody due to the use of overwhelming force?” I am reminded of the Bob Dylan lyric, “The answer, my friend, is blowin’ in the wind.” We just need to grasp it.

 

Dr Bina Rawal is a Non-Executive Director of the Innovation Agency and Senior Specialist, Corporate Partnerships at Cancer Research UK (CRUK)


References:

(1) Disparities in the risk and outcomes of COVID-19

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/890258/disparities_review.pdf

(2) OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. (Pre-peer review report)

https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1

 

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