To this evening. Panel discussion of medical racism, protecting ourselves, our families and our communities.
I'm Daphne Cunningham, co-chair with Alexander Gordon of the BMY Staff Network.
The network supports the global majority staff at the University of Oxford by fostering a diverse
community within a community and as a collective voice for racially minority staff within the university.
Membership is open and free for global majority staff members of the university.
The format of this evening is as follows.
The first four speakers will make a short presentation and the final panellists will be interviewed before questions and answers from the audience,
please type your question into the chat function provided and please indicate to whom you wish to address the question.
So with pleasure. May I now introduce you to two of the co-hosts for this evening's event from the University of Kent,
famed that network founder and co-chair Dave Thomas.
And Barbara at a gloomy. Thank you so much, Stephanie.
Now, the theme of the event this evening is medical racism, which is often an elephant in the room.
The racism is a public health crisis, and as Professor Sir Michael Marmot declared in the recent Marmot Review,
racism is a social determinants of health. So we believe solving racism is a public health concern and must start with naming it.
Professor Richard Williams proposed that entrenched systemic racism and the deliberate omission of word in patient
safety circles is a cause for astonishing levels of preventable harm and death amongst communities of colour.
And this has been devalued and discounted for more than 400 years.
Now, we've seen the covid-19 pandemic and how it has laid bare racial inequalities,
particularly in health care system and specifically for people from racially minorities background.
So this evening, throughout this discussion,
we will use the term medical racism and specifically we use this term to describe any measure that creates produce,
produces or sustains racial inequity between racial groups.
And this, we believe, may manifest in written or unwritten laws, rules, policies, procedures, practises, processes or regulations.
This evening, we're delighted to be in the presence of a group of esteemed scholars and professionals from the medical profession.
Now, it is with pleasure that I'll hand you back to my colleague Daphne, who will introduce our first speaker.
Thank you, Dave. When Dave and I were brainstorming participants for this event, Dr. Roberta Babb was first on the ticket list.
With 18 years of experience working and the public and private sector,
Dr. Babb is a registered clinical psychologist and a registered psychodynamic psychotherapist.
She is also an organisational consultant and entrepreneur.
Her specialist interests include mental health, wellbeing, forensic clinical psychology and psychotherapy,
race, gender equality, diversity, inclusion and anti-racism.
She is the co-founder of the Hanover Centre, a bespoke consulting partnership which draws on multidisciplinary expertise to offer distinct clinical,
organisational, educational training and media services.
I am delighted to welcome Dr. Bob. Thank you, Daphne, for that introduction.
Good evening. So this evening, I'm going to be talking about racism in health care, along with the other panel members,
I think the first thing that we have to do is to really think about the overview of the impact of racism on racial minorities,
individuals, but also think about some strategies that people can do to look after themselves when accessing health care services.
The first thing to do is to really think about actually the context. And I think to understand the complexity of racism, especially in health care,
is important to us to historical context as that mitigates what we call a collective amnesia that deny the existence of racism within health care.
I think it's important to think about within the U.K., the primary mode of health care is the NHS.
I suppose the UK health system was built on colonial resources.
The NHS was founded in nineteen forty eight and this was at the same time that the British Empire was
starting to dissolve and the resources needed to build and establish the NHS really relied on colonialism.
Have a 70 something. Years later, the NHS is still impacted by colonialism and institutionalised racism.
I suppose if you think about health care within the context of a colonial system,
you have to think about the fact that health care was primarily designed to keep the colonial population healthy, not necessarily in a thriving state.
We think about that colonialism is defined as a control of one power over dependent area of people and which occurs when one nation subjugate another,
conquering its population, exploiting it often while forcing upon its own language and cultural values upon people.
And in this sense, the white colonial is civilised ways of life when viewed as superior, morally correct.
And I do. And this really leads us to think about whiteness,
and this is so important because whiteness and the impact of colonialism is transparent
precisely because it's the institutionalised normative that dominates our culture.
It's a starting point. It's a benchmark. It's the norm. It's a structural advantage.
I suppose it's an unmarked and unknown feature of cultural practises,
which is rooted in an intrinsically linked to historic social, political and socially reproduced relations.
And that leads us to think about a weird sort of environment, one that's Western educated, industrialised, rich and democratic.
The hallmarks of racism really are anxiety, power, and we think about different forms of power,
biological or amputates, coercive, legal, economical material.
We're also thinking about interpersonal, social, ideological, informational and of course, medical, therapeutic.
We think of there's a denial of reality, oppression in terms of violence, cultural imperialism, marginalisation, powerlessness and exploitation.
And we also have to hold in mind how the idea of the nation state, capitalism, petro patriarchy,
science, epistemic violence all contribute to the persistence and existence of racism today.
So part of the difficulty when you think about racism is the fact that it does create
structural inequalities and definitely inequalities within racialized communities,
and this diagram really shows you the different levels that lead to the individual lifestyle factors,
the social and community networks, but also the living and working conditions.
And I think that then leads into inequality and discrimination. And the thing about inequality and discrimination is that it is actually stressful
because we are also thinking about racial trauma is a form of race based stress.
It refers really to individuals who are racialized their cumulative reactions to
racially dangerous events and real or perceived experiences of racial discrimination,
acute and cumulative. And the three classes which explain the emotional impact of racism, and the first one was hostile.
And this really includes experiences which are characterised by actions meant to communicate the
racialized individuals inferior status because of their memberships in minority racial group.
You also think about avoidant racism,
which involves experiences that are intended to maintain distance between a dominant and minority racial group and aversive hostile racism,
which involves experiences intended to create distance with strong hostile elements after racialized individual has gained entry into a space,
an institution or an organisation from which previously excluded.
And all of these are stressful situations. And we know that this is stress will have an impact on the body, it affects the brain,
the cardiovascular system, the skin, it also affects our immune systems.
And so you can really think about the fact that actually it has a huge impact because it
is a physiological and emotional demand placed upon the body when one must adapt or cope.
And racialise individuals through a number of socio political economic factors have
higher rates of death associated with disease and conditions such as hypertension,
stroke, cancer, diabetes, asthma, immune responses, elevated stress hormones, obesity.
And this one really shows that racism can impact a person's health pathway,
the fact that racial discrimination can lead to physical violence, psychological stress, the denial of goods, resources,
services, but also think about the impacts of living conditions, decrease quality of care,
but also psychological symptoms, negative coping behaviours and physiological stress responses.
And this can link to mental health difficulties and physical health difficulties.
And that's what we're really thinking about when we think about health care. So when we think about the impact of racism,
it's important to hold in mind that the majority of work in health care still reflects and serves the interests of privileged people in wage settings.
And the work is disproportionately informed by with health care research theory and practise.
And finally, in nineteen sixty one, really noted first hand how providing knowledge and practise in psychology and medicine,
they tend to reflect and serve the interests of the racist colonial domination as opposed to unchecked use of health care language,
hide structural violence and the neutral, an outcome informed with language and the health care system.
Institutions and systemic disadvantages really reproduce racialized people's lack of autonomy,
self determination which can fuel feelings of inadequacy,
helplessness, hopelessness and promote poor health outcomes, which further exacerbates racial inequality.
So if you think about how people enter the health care system, you have a number of factors that lead to the presence of health symptoms.
And then we're finding that health care services are not adequately funded or resourced or understand or meet the needs of racialized communities.
This is a racialized individual to have a negative experience of service provision.
This then leads to increased medical mistrust and avoidance, but also the impact of worse mental health symptoms,
but also physical symptoms and the issue about racial trauma and traumatisation.
So we think about the impact of racism on the health care pathway. It really does cover a number of areas.
We think about education and understanding. We think about how problems are even identified in the first place.
Early identification is key, but it also affects racialized individuals entry into the system because it also met with racial,
environmental and validations. The physicians, the practitioners don't necessarily represent the population that they serve,
and this can lead to people experiencing racial inequities.
There's also the social, cultural and political context which needs to be taken into consideration and the impact of racial race on diagnosis.
We know that sometimes medical conditions and other biological issues will manifest differently depending on skin colour, but also racial factors.
You think about the referral pathway, a therapeutic management and also aftercare community can follow up.
So if we think about how we look after ourselves, it's really important to think about looking after ourselves in a holistic way.
We think it's important to think about an investment in yourself.
So I really like the social emotional well-being framework, which really promotes well-being in seven dimensions.
You think about connexion to spirit, spirituality and ancestors.
You're thinking about connexion to the body, connexion to the mind and emotions, connexion to family and kinship.
Connexions a community connexion to culture and connexion to country. Because when we think about colonialism,
these are the very things that have been disrupted and decentred by the historical and political context of colonialism.
So just to finally kind of complete this, because I know we've only got a short time,
if we think about the strategies that help look after ourselves, I think we think the first thing would be to think about making time for health.
Emotional, physical, social, spiritual and cultural self is an investment.
We're also thinking about the possibility of personal therapy. Racism will have an impact.
Racial trauma will have an impact. And part of our pathway forward is to learn to kill from these racist experiences.
And that can happen through personal therapy. We'll also think about education.
So educating yourself from reputable sources,
but also connecting with the culture and finding other sources of information and also being aware of your health care options,
if you think about trauma, is characterised by lack of choice. And so you need to have an awareness of the best options and best practise.
I think in all of this is also important to think about consultation, preparation.
Often we don't go see a health care provider.
We're not really prepared to think about what we're going to discuss so you can have time to think about what
you want to talk about and take time to actually communicate that that might require support and advocacy.
But you can also think about the feedback and complaints system. You have an option.
You have the right. You're entitled to make a complaint, to give feedback,
because you think about the importance of utilising community resources and also developing trust,
trust in yourself, because speed only happens at the speed of change, only happens at the speed of trust.
So we think about this, like you said in the introduction, racism is a traumatic experience which has significant and long lasting implications.
It is a public health issue and a structural, systemic,
institutional and interpersonal and internalised racism exists within UK health care provision.
The socio economic factors impact health care, they really need to be addressed and they also need to be thought about at this moment in time.
There were some things that we can control and some things that we can't control.
And I think the things that we can control is a fact that every thought, every feeling,
every behaviour and interaction is an opportunity to do something different.
I suppose this action demonstrates our commitment to racial equality within health care and other sectors because it really
shows that racialized people are not overlooked and not dismissed or underserved simply because of their racial identity.
So inclusion, I think. So in conclusion, I think it's really important to think about the fact that the ex forgets, but the tree remembers.
And this is a Zimbabwean proverb from the Shona tribe,
which means that a person who harms another will often forget, but the person who is harmed will always remember.
I think from a racialized perspective, it's important to hold in mind that great opportunities lie in the midst of every crisis.
There is hope. Together, we are going to make change happen and it's not going to stop us from achieving racial inequality.
So cheapened racial equality and change.
Thank you so much, Dr. Bob, for a very, very insightful presentation and really taking a deep dive into what is really a complicated subject.
And thank you also for presenting the bio social strategy or set of strategies
to really adopt a solution focussed approach to moving this agenda forward.
Now, I would like to introduce our next speaker. With Dr. Mohammed Saikal.
Described as an inspirational leader. Dr. Mohammed Sacro is a consultant neurorehabilitation physician and the director of research and innovation,
and he's the lead at the East Kent University NHS Foundation Trust Hospitals.
He's also the chair of the Brain Injury Forum and global ambassador for the Sir William Beveridge Foundation.
If special interests are in motor neurone disease, head injury, brain injury, rehabilitation and multiple sclerosis, rehabilitation.
The doctor say, thank you so much for joining us all the way from Zimbabwe, from Bangladesh, I might add.
Thank you so much. Thanks for your kind words, yeah, I'm stuck in a lockdown with people with severe second week in the middle of this.
Thanks for organising this programme. I'll speak from multiple perspectives and real life experience as a medical doctor,
as an NHS consultant, lead a BMY and occasional recipient of medical care.
We've been given two questions to respond to questions. One was the impact of racism.
Is clear. The impact is pernicious, severe and ongoing.
American Medical Association has declared racism as a public health hazard.
Various medical bodies in UK has a similar description.
I'll ask the audience to read very succinct recent papers by Professor Patricia
Greenhouse and Fiona Godlee from British Medical Journal on these issues.
Systemic racism is alive and active in health service.
The white supremacist element of the establishment. Sought to deliberately make effort to distract, divert, if not disrupt our yearning for justice,
but amongst white people in the past, racism used to affect only black and brown people.
Nowadays, the system is so integrated, so interconnected and interdependent on people that it affects everyone.
Even if I am racially prosecuted as a consultant for 250 innocent white colleagues,
doctors and nurses who suffer hundreds of innocent white patients will suffer.
It is straightforward. I can cite dozens of examples of the impact lost impact of racism.
And we all know that ethnic minority people are more likely to catch and die from it.
We know that the CO2 measurement, oxygen saturation that has a racial element that underestimates have the mask
that the research researchers have found will not fit on ethnic minority people.
These are all designed for white people.
As a doctor or a nurse or a physiotherapist, it's very unlikely that he will be promoted to a senior position.
Those who do get to the senior position or work in various committees.
Will soon find themselves to be constrained, if not disciplined, somehow, often with the trumped up charges of something to tow the line.
And that's the modus operandi for hundreds of years to deliver the blow with a token dame in the board or somewhere.
What I've said so far, these are not emotional outbursts.
These are real life experience and data driven, evidence based, available in open, accessible applications that I would you to go to.
In terms of the question to how do we address this racism, I think we need to act at all three levels micro racism,
at individual level, at a community level like our community,
the various barriers and a macro level of institutional racism to do the various structural and systemic processes that are built to nurture,
to endure and to deliver the systemic racist abuse.
I would make a few additional points on, in addition to what Dr. Bishop has already mentioned,
we need to promote the notion that being nonracist is not good enough anymore.
We need to promote the view that we all have to be actively, consciously being anti-racist and against all digitisers.
We need to demand that antiracist training, anti-racist training be made mandatory in all institutions, public or private.
And if we to increase the access, appeal or acceptance of a particular message to a particular community,
perhaps we need to focus and try and improve the profile of the messenger.
The fact that this is a prime example for this point,
we need to encourage overall to the community of people to get into positions of influence, politics, business, leadership, etc.
I will cite on this occasion Professor Muldrow, who said the civil report, the that risk turning the clock back on the fight against racism.
We must not allow that one of my colleagues, a consultant surgeon and eye doctor.
He has done a large surgery study recently.
More than a thousand doctors and nurses in NHS was asked recently about real life racism.
And experience in Nelson is the result of a stark and surprising 80 percent of being.
Doctors and nurses think racism exist and only 40 percent of white doctors and nurses think it exists.
Two thirds of the doctors and nurses have witnessed or experienced racism.
What is that trigger for white population? 17 percent and 30 percent?
It seems like we are living in two parallel universes within the same health service that are considered by saying justice will not be hard,
will not be served until those who are not affected feel as outraged by the people who are.
Thanks for listening. Yeah, absolutely, yeah.
Thank you so much. Thank you so much for that timely information on.
I would like to introduce our next speaker. Um.
That will be. Dr. Adulterating.
Is a vaccinology with over 15 years of experience within both industry and academia.
He's an active research fellow of the Future Vaccines manufacturing research hub, Backes Hub,
which is involved in projects that address the challenges in vaccine supply and vaccine development for low and middle income countries.
Infectious Disease Target. He's currently working with Professor Sarah Gilbert at the Jenner Institute at Oxford.
Irrelevant to tonight's discussion or his knowledge of translational research on vaccine technology, from design through to production,
in particular exploring vaccine platforms and production systems that can be transferred to low middle income countries?
Before covid Adilman, I would occasionally run into each other and catch up on things because we work in the same building,
so I am delighted to see him and to get to hear along with you more about his work.
Welcome, Adam. Well, thank you very much, Stephanie. That's it.
That was a very warm and welcoming introduction and I'm not actually going to be talking about my work,
say, but the work of all scientists, let's say, who work in vaccine field.
I've titled my talk because as trust me, because I think, you know,
with with the theme of today's roundtable discussion on medical racism and impacts of that,
one of the things that I felt this pandemic has really kind of borne out is this distrust,
this erosion of trust of lots of different people from from scientific community, from government.
And and I think that there are people more qualified in this panel to talk about this.
So let's see if I can advance my slides. Fantastic.
OK, so I start by just kind of reintroducing you to who I am.
So obviously, I work in the University of Oxford and the Jenner Institute, which is now world famous for making one of the leading covid vaccines,
which is being in partnership with AstraZeneca and is being distributed across the world.
But we're an academic unit and basically we study vaccines for various diseases.
And so this is me. You can see me smiling because I'm outdoors.
I've managed to escape the lab so it doesn't happen often. And, you know, we're passionate about vaccines.
We can see first hand how, you know, when they work, how beneficial they are.
There is over four billion vaccines administered annually and there that translates to around about two to three million lives saved each year.
And this makes it really one of the greatest public health interventions helping to drive down that that disease burden,
particularly in young children. But it serves the whole community.
And it's just worth saying that today we are in the mode with modern production levels.
We have actually safer vaccines than ever before.
I mean, if you compare that to the when the inception of vaccines came out in sort of the 19th and early 20th century.
And unless you've been remiss,
you'll notice that we are living in the midst of a pandemic and this has had many different effects on different people.
It's really sort of driven through the disparities and the experiences of people of colour or people of different economic status.
So impoverished communities and the disadvantages disadvantaged and the societal and economic.
Penalties really sort of brought out of us as a human human race, a collective desire to do something about it, and, you know,
we have seen in recent times great collaboration and and coming together in order to try and solve this problem of covid.
And vaccines are just one of the tools. But and I think what is.
You know, important to realise is that this isn't just one group or one, you know, it's pretty much everybody everybody's all in.
And and this is why we're sort of seeing any benefits that we are seeing in terms of turning around this pandemic.
However, that speed also has led to some feelings of anxiety.
And, you know, when especially when you hear experts saying, no, no, no, you can't possibly make a vaccine in less than a year.
And so there are many twists and turns on the on the process to making vaccines.
And it is true. It is a very complex process with multiple stages.
And it's worth noting that they are very tightly regulated, very specific tasks which are required in order to bring things forward.
And I think if you were to look at from the invention all the way through to licensure, typically you would be looking at multiple stages.
So this is just a graps from the European Medicines Agency website.
But just looking at the different stages,
and I think what I want to drive to you is just how tightly regulated this is and how much care and attention
that goes into approving medicines and vaccines in particular because they're given to people before they're ill.
And so the bar is very high for vaccines. The timeline of vaccines normally would be sequential, something like this.
So you have one stage following from the other.
And if you in this once you once things have been shown to be non-toxic, they can be administered to humans.
And we do basically safety trials before progressing to ever larger trials.
And as you go this way, the cost increases, I would say exponentially, but it increases a lot.
And then it's at this stage, once you've shown that it's safe and it works and it does what it's supposed to do in the target audience,
there's a robust evaluation before authorisation.
And then usually at that point, you put in the big money to to make large scale production.
But in the pandemic, there's no time for that. We saw people, vulnerable people dying very, very quickly and we needed to do something about it.
What was interesting is that they didn't skip any particular stage.
This is not acceptable. You can't have a licenced product without doing all the stages.
And instead what's happened is a collapsing and compression. And you see that they're overlapping activities.
And, you know, the other thing to note is that we have very you know, the way the clinical trials are are designed is, you know,
obviously we have you know, historically there's been some poor practises, but today it's very, you know, informed consent.
Volunteers have to be aware of the risks and they're able to pull out.
And on top of that, you know, we are so sorry.
So we're dealing with the real. Progress in terms of the model of making vaccines, of taking things forward.
So all I'd say is in terms of the concerns of the speed, there were no shortcuts taken.
Everything was done properly.
And the only risk that was taken was a financial one, i.e. before we knew stage one was was successful, we'd already invested in stage two and three.
And this wasn't just Oxford. This was all all all vaccine producers.
The other thing I wanted to sort of just note is that actually these trials have, due to the massive interest,
have actually recruited very fast and that's increased the proportion of ethnic minorities who are partaking and want to be seen to be involved.
And that that's that's really good news. And the other thing is also we're having trials in different parts of the world.
And that that as well increases the confidence that these vaccines are going to work in a diverse population.
And what's really gratifying is the fact that we see.
The real world use the vaccines are helping to reverse a severe illness and stop hospitalisations,
so there are people who are still concerned about the safe and we've all heard the stories of blood clotting.
And I mean, I don't need to look at this just to see that basically we have the blue dots are
are the harms that could come to you if you were if you were to succumb to covid.
But vaccination stops that rescue. You do that. And on the right hand side is potential serious adverse effects.
See the blood clots which have been reported and the risk of that is much lower.
This is an extremely rare event that's not seen in the trials, even though tens of thousands of people were in the trials.
It's only once you get into the population, you see millions of people that these very rare events become visible.
But it's important to note that we would expect some adverse effects.
However, they're not they're very rare.
And usually the ones that we do see are very short lived. It is complicated.
We have also the the variants which are circulating and this is a moving situation and we're moving arena.
But so far, the vaccines have done a good job in controlling them.
And that's why it's important really to sort of while you're ahead, kind of keep keep getting ahead.
So we need as many people vaccinated as possible. There has been confusing messages, mixed messages.
And, you know, this has been through the so the goldfish bowl, you know, that normally no one really cares about anything.
I have to say, you know, science tests are boring folk. And, you know, if you if you like science, you love it.
If you don't, then you stay clear of it.
But we've had a lot of attention and this is kind of led to sort of armchair critics and running commentaries,
you know, and really kind of we don't we don't no one pays attention to everything when everything's good.
But when anything goes bad, it's really flagged up. And what this has given rise to is this sort of wave of misinformation,
misrepresentation at best, and this sort of incident, which is kind of hitting the world.
And I think maybe the panel would later on like to sort of discuss these these things.
So I think I'm done. So I just wanted to say vaccines do work.
And please, if you are eligible and offered a vaccine and it's and you're happy to take some, you should take any vaccine that's offered.
And I'll stop there. Thank you very much. Thank you, Dr. Robbie, for that really insightful view about building trust amongst our community,
and it's good to know that that the expansion of trials amongst the diverse groups is getting larger and larger.
So hopefully that will also build trust amongst our community. So now on to our next speaker.
So I'm very pleased to welcome Dr. Winston Morgan.
He is the director of impact and innovation at the Research Institutes of Health, Sport and Bioscience at the University of East London.
And he's working towards increasing the impact and visibility of knowledge, exchange and academic advances through his research.
Dr. Morgan is also a soldier in clinical biochemistry and has published over 40 medical articles.
He has an interest in the toxicity of amphetamine related compounds and is currently working on a
project to understand the long term toxicity of highly active antiretroviral therapy in AIDS patients.
Dr. Morgan is currently developing research on the role of race and ethnicity in medical research and medical outcomes.
Apart from lavatory based research that is also involved in planning and teaching projects
to improve the student experience and performance of widening participation students,
particularly those from black and minority ethnic student cohorts.
So we are extremely fortunate to have Dr. Rice to join us this evening, Dr. Winston Morgan.
Dr. Winston Morgan, your mute.
OK, I think we may have lost the Internet with Dr. Winston, so we might have to to move on to our next speaker and see if we can get them back.
OK, I'm also waiting for Dr. Mongan Internet to recalibrate I.
I would like to welcome our next speaker to the fore, Professor Dame Elisabeth.
Onyango. Professor Dame Elizabeth Anion is a British nurse, health care administrator,
lecturer and emeritus professor of nursing at the University of West London.
In 1979, Professor Onyango became the United Kingdom's first sickle cell and thalassaemia nurse specialist.
In 1998, by then a professor of nursing and the ANU created the Mariscal Centre for Nursing Practise at the University of West London.
She was appointed a Dame Commander of the Order of the British Empire in 2017 for services to nursing and the Mary School Appeal.
She holds a PhD and is a fellow of the Royal College of Nursing.
Listed amongst the 100 great black Britons in Dr. Patrick Vernons recent publication,
Professor Onyango has been awarded two honorary doctorate from the University of St.
Andrews and Birmingham City University for her contribution to the nursing profession.
And I could go on, I could go on and on.
Professor on Aniello as as one of the biggest fans of yours.
Thank you for accepting the invitation to present on this forum and I welcome you.
Thank you very much. And as I've said before, if you are a real charmer, we love you.
Please, please call me Elizabeth. I know. I know people are brought up to honour titles, and I appreciate that.
But please call me Elizabeth. Thank you. Yes.
I mean, in my culture, as a son of Jamaican soil, gratitude is a must, and we have to be kinder to our elders.
So thank you for being here. So this presentation will take the form of an interview and I say interview very loosely.
Right. So the first thing I would like to begin our conversation by asking you to tell us a little bit about sickle cell anaemia,
what it is and why it matters to the black community specifically.
OK, thank you very much.
For sickle cell anaemia is an inherited condition of the red blood cells that impacts the haemoglobin and excuse me, its origins.
So those parts of the world where you find falciparum malaria and if you are a carrier or otherwise known as sickle cell trait,
it's generally considered to be a healthy situation. However, if your partner also is a carrier, then every time you have children,
there's a 25 percent chance or one in four chance that every child you have could have the condition.
But, you know, when I was unretired, I must stress I'm retired from clinical practise, clinical genetic counselling and sickle cell.
But I used to definitely emphasise with those that I was.
Involved with that, this is a chance for each and every pregnancy so that you could have 10 children.
All your children could have sickle cell anaemia. None of them could have it. People sometimes say it's like throwing the dice.
So it is. And also the biggest myth is that sickle cell anaemia only affects black people, which, of course, is not true.
When one looks back at the origins of falciparum malaria.
It's found in various parts of the world's countries like Greece, Italy and the southern Mediterranean areas.
And so, excuse me, it is possible to be blue eyed, blonde haired, white pink skin and have sickle cell anaemia or type of sickle cell disorder.
However, when we look at the situation in this country, and this is linking to your point about the relevance to the black community,
if one looks at the majority of people who are affected by the illness in this country,
it is those of African, African, Caribbean heritage, as well as a smaller group from other parts whose heritage is from other parts of the world.
So that's why it is a significant condition in this country for the black community.
But emphasising it's not just the black community. Brilliant.
And it's really interesting how you you know, you make that juxtaposition between blonde hair,
blue eyes and, you know, and people from African heritage.
And I'd like to ask you to speak briefly about your childhood and your engagement with the health services,
particularly while you were receiving care for your eczema.
So I was my parents met at Cambridge University and my mother was of Irish heritage, born in this country.
And my father was Nigerian and my mother got pregnant with me but never married.
So there's a huge amount of shock, stigma, et cetera, et cetera. I'm 73, so go back to 1947.
And I think everybody will understand why my mother, first of all, didn't tell her parents that she was pregnant.
It was my grandmother, my maternal grandmother that discovered it, if you like.
And then when she asked my mother if she was pregnant, my mother responded by saying yes.
Why hadn't you told us? Well, I was going to jump off a bridge so that that's, you know, the stage state my mother was in.
She resisted all pressure to have me. Oh, by the way, she she couldn't even reveal anything about the father.
So it was when my grandparents, maternal grandparents came to see me in a maternity home run by Irish Catholic nuns.
And one of the nuns said to my grandparents are to be sure, the baby is a little dark.
Because everybody was expecting a white baby, and so this was this was my start.
That was my journey. And I grew up in a children's home until I was nine, not because my mother rejected me.
She certainly didn't. She obstinately persisted in stating that she would never, ever give me up for adoption or long term fostering.
And so I think that's one of the elements that has made me fairly stable in life that I never had any sense of rejection.
Secondly.
Well, there were various factors going back, I did live in the children's home till I was nine, and that's why I decided I wanted to be a nurse.
Because there was a nun who looked after my eczema in a very interesting way, other nuns, well, I don't think deliberately,
but they would tear off the bandage and it would be very painful and it would tear off the cream that had been applied.
It would bleed. It would be very, very sore. But this particular nun used distraction therapy and she used to use words like bottom,
which to a small child growing up in a convent, which is very religious bottom I thought was the most.
Terrible words, and none could say I burst out laughing, I have a huge sense of humour.
I've always had it and that's when she would take advantage of me. And I thought she was absolutely wonderful person.
And I associated with not ever receiving pain, getting pain.
And then I discovered she was lost. So to cut a long story short, that's why I decided to do nothing but to just go on a little bit further,
because I know you're going to ask me about health inequalities.
And in the next question, which I would like to relate to sickle cell, if you don't mind, and I'll partly answer this now.
I grew up with my mother, took me out of the children's home when I was nine.
However, my stepfather was very.
I don't know what the word is, angry, shocked at the reaction he got from his mates, that there was, as was called, a half kaschalk me in the home.
This is in the Midlands in the 1950s. And he started to physically abused me.
I was rescued by my maternal grandparents.
And really I'm saying this because it was when I read the light bulb moment came for me very many years on when I read President Obama's first memoir,
Dreams from My Father, and he he gradually realised the issue of race and racism and also that he held a lot of deep seated anger.
I realised that I've grown up being seen as other.
You know where you come from, my dear Birmingham. No, no, no. Where do you really come from?
So being seen as an outsider,
other I was holding a belly full of anger and this drew me ultimately into getting involved with sickle cell and health inequalities.
So there you go. Very neatly. If I'm helping you along, it's your next question.
Sorry. Well, well, funny enough, I've now introduced a new question because you've evaded that word.
Right. OK, so I want to really briefly speak about your your involvement in advocating for for
more research sources to promote research into sickle cell anaemia in this country.
I'm sort of the barriers that you faced in accessing that body of funding.
So what has driven me is anger and my first.
Memorable feeling of anger in terms of.
Sickle cell anaemia, as it was perceived in terms of priorities in this country, was in 1976 before I actually became a sickle cell counsellor.
That was in 1979. And that's I was also interested in genetics and genetic counselling.
And I happened to read this paragraph in a classic nineteen seventy six seventy 76 textbook by two geneticists.
I was interested to see if they would mention sickle cell anaemia. We had a paragraph.
Listen to this paragraph. Sickle cell anaemia is not of great consequence to us in the context of genetic counselling in the United Kingdom.
The cycling trade and sickle cell anaemia appear to be confined to people, people of African and Eastern origin.
I mean, the ignorance of that statement, where were these genetic geneticists in this country?
In other words, they totally overlooked the.
So you can see I'm getting angry, just recalling it. This was 1976.
So that was my first recognition. And I got involved.
And I would like to bring it up right up to today, Dave, because sadly,
this year we have heard in the media about two tragic deaths of young adult males in their 20s with sickle cell anaemia, not the first one.
Was actually the death was in twenty nineteen, it's because the coroner's inquest has just been made public twenty nineteen.
So this this was not on. Those who want to look at excuses, God forbid, one can't blame covid-19 pandemic, this was pre Ripponden,
where a young man with sickle cell anaemia had to die nine nine nine from his North London hospital bed to get oxygen.
And this young man died. And it is in the media for those who want to look at it.
So that was the first case. The second one was Richard who that was during those earlier this year who was shielding.
And we don't know all the information at the moment, but we know that he he left home and his mother tried to report it to the police as
missing and the police and the mother told them that he had sickle cell anaemia.
And the police first initial reaction was, well, if you can't find him, how do you expect us to find him?
I'll give you those two examples to highlight how my anger and other people's anger.
Why it's there and what I'm really sad at, to be very honest,
is progress had been being made in respect to pushing sickle cell anaemia further up the NHS agenda.
We hadn't got it up as far as we wanted, but it was much better than the 1970s.
And yet we have gone totally backwards. One case, nothing to do with covid, another one, I wouldn't say it was to do with covid,
but we can put it within the context of stress cetera in the covid pandemic, which many people have experienced with long term conditions.
But then the reaction, the negative reaction of the police just just just gives me yet more awareness of the low.
Situation that Sickle-Cell that of those that mainly affects the black community
in this country and that it is still not accorded the priority that it has,
and if I can just give one final point.
We know that there are many long term genetic conditions, the one that I compare sickle cell anaemia with cystic fibrosis,
because that is a very serious genetic condition that mainly mainly affects northern European white communities.
It does affect a small minority of the black population as well in this country.
Just to just to sort of close on this example. There are ten thousand six hundred individuals affected by cystic fibrosis, a serious genetic disorder.
We think there is at least 15000 individuals affected by sickle cell disease in this country.
So what I am looking for, what we should be looking for is equitable resources, priority given to these two conditions.
Put them side by side when you look at it.
You do not see equitable resources in terms of health service provision, research allocation, et cetera, et cetera.
Thank you. Thank you so much, really heartbreaking stuff, but I want to move us forward and start back from the beginning.
So, Dr. Bob, you know, very, very brilliantly and articulated a solution focussed approach and looking at this phenomenon in a biopsychosocial way.
Right. So I want to highlight, first of all, your fantastic work with the Mariscal Foundation and really,
really spotlight that because we need to leave on positives. And then secondly, I want to speak about, you know, yes.
The acknowledgement of medical mistreatment and malpractice and how that has promoted mistrust amongst the minority ethnic communities.
Well, very, very importantly, get your opinions on how our communities can protect themselves, their families and their communities,
because I think it's important to leave with positive strategies,
but also to celebrate the distance that we've travelled, notwithstanding the problems that we still have, by the way.
Yes, well, I totally agree. And first of all, I think we have to collaborate.
We have to work with like minded people. Nobody can do anything on their own.
And the example I would give is the Mariscal statue appeal that raised three quarters of a million pounds in 13 years to
have that statue erected in June 2016 in the grounds of St. Thomas Hospital of a Jamaican Scottish nurse entrepreneur.
Will all sorts of things. We can call her doctor. Yes, that was Mary Jane Siecle.
And so that, I think, is a classic example of what you're talking about,
that whilst we can get really depressed about the lack of women statues of of of statues,
of people of colour, which is still the case, we've got examples now, few, but we've started to get examples when people come together.
You find that actually a lot of people support these sort of causes.
It comes from deep, deep within because we want our children and our grandchildren.
You know, for those of us who do like statues and I know there's a whole debate about statues, not for Apple, but for those of us,
you know, who say, well, we're going to have such as we need to have the more representative for our children and our grandchildren.
So I think that is a very positive story and it's certainly provided and still provides huge, huge joy that that was achieved.
So I agree. We must in fact, I think I am a person that is more positive than negative.
So I totally agree with the approach that you're alluding to.
Now, you must know something about how do we protect ourselves, our families and our communities?
Because I think leaving, you know, really,
really practical strategies for or for delegates who have attended this evening really to get that insight quick wins.
How can we protect ourselves, our communities and our families in the light of these inequalities?
Well, I just think we cannot be isolated. I think that things can overwhelm us so much.
I think I, I, I explained that I have this virtual toolbox.
I think we all need to know, have we got our two boxes, those two boxes for when we feel down, when we feel depressed now we all have to generate.
But we could share the sort of two boxes we have because first of all, if we are mentally depressed.
As individuals and as groups.
And we've seen I think so many of us have watched the George the trial of Derek, Shervin, et cetera, and how many of us were on tenterhooks as that?
You know, why should we have been on tenterhooks as to whether. Shervin would be found guilty.
That tells you everything. I just give that because it's recent and I think a lot of us can relate from all sorts of backgrounds,
but it also explains why some of us feel more vulnerable than others.
So we have to be linked in with like minded people, not necessarily all from our own ethnic, you know, gender, whatever group.
I think we have to be prepared to collaborate a lot more because in numbers is strength and we all need strength.
So it might seem quite common sense approaches, but I have found I'm not I'm not an incredibly theoretical person.
I have to be honest. I am a more common sense approach.
And I like to observe how did Nelson Mandela survive? I like to look at the lives of people who had actually worse situations than I've had.
How have they overcome it? It's obviously having some sort of belief system in yourself.
And in fact, actually, you know something? It's having confidence in yourself.
And as brown skinned, black skinned individuals,
we have to engender self-confidence within ourselves and our families and our friends and our colleagues.
Through support, through action, so that's that's really what I'm going to say, because that's helped me enormously.
Thank you so much and giving honour to or you know or people who have done this work,
have done this work tirelessly, are doing this work and will do this work on the shoulders upon which we stand.
I give honour to you and I just want to close by asking you to speak about your upcoming publication literally in a minute or so.
Just tell us about that. So in September. Dave, thank you. In September, Dave, my my memoirs are coming out through a publisher.
This time it will be called Dreams from My Mother.
OK, thank you so much. Thank you so much. Fascinating conversation and I really appreciate it.
Thank you so much for joining us. Thank you. I'd like to know.
Welcome back. My colleague, Dr. Barbara, a woman who will introduce our next speaker,
if I think to say that Dr. Ruth Morgan is able to connect with us this evening.
So please take the stage. Thank you.
First of all, can you hear me? Good.
I'm going to share my screen, I'm going to do the full thing because I think it's unfair on everyone else because I.
I'm having some trouble because I've used up so much time,
so what I'm going to do is just taking you through a small piece and someone in the audience
I was looking at the comment of someone in the audience asked about racism and what it is.
So I'm going to start there and just just throw some quotes in, because some of my colleagues,
as I explained to you, have actually covered a lot of things that I would have liked and said.
So it doesn't really matter. So anyway, we must talk about racism and the thing about racism.
And we're not talking about racism where we never talk about racism before, since the pandemic and also since the summer of George,
Florida Black Lives Matter, so many people conveniently forget that racism existed before the covid-19.
And because it was structural, structural, we were able to live with it.
So we were living with racism. Why structural racism? But, you know, we pretend it wasn't there.
Those who are advantaged by racism want to protect their dirty secret because they don't want people to know that they're advantaged by racism.
And at the same time, many people who are held back by racism are embarrassed or fearful to talk about it.
So we've got this thing. People who are advantaged, I want to talk about it, people who are disadvantaged.
There are lots of reasons why they might feel they can't or won't talk about it. OK, so but what do we mean by structural racism?
It's really important because, again, a lot of people talk about these things, but we don't define clearly and I want to define it from my viewpoint.
So racism stems from the belief that certain human phenotypic characteristics and we're talking about facial features,
skin colour allows us to place people in distinct groups or races.
OK, we then assert that all members of that group designated group have similar abilities and qualities,
which makes them either superior or inferior, and then they are treated accordingly and are treated accordingly.
That's important. So if you think someone is inferior, you will treat them less. And that's where a lot of these inequalities develop from.
OK, so you also they are also allocated or denied privileges based on this superiority or inferiority.
And there's a long story that we can go into. So individuals who had had this view of the world can be considered racist.
So that's what we're talking about, racist people who adhere to this view of how we see the world.
OK, so now structural racism is something that's built on that sort of structural racism is observed when discriminatory or
racist ideas about certain groups are allowed to permeate the culture practises and policies of our major institutions.
That's what institutional racism is or why society, which it's more structural,
it enables acts of discrimination to become normalised to the extent that almost
everyone in that organisation or society are able to navigate their way around racism.
So you pretend it's not there without acknowledging, without having to acknowledge that it's there.
That's what normally happens in our society until something like something like covid-19 comes along where you have to acknowledge it.
But before we get to that, so we structural racism exists,
discriminatory actions are routinely implemented as part of our day to day behaviours without fear or challenge.
So that's what you see in the NHS all the time, day to day people doing discrimination actions.
No one's challenging it because it's structural. You don't have to.
So and what we see is a differential access to medical services and poor medical outcomes is one of the key ways structural racism is evident.
So if someone you where is the evidence of structural racism?
You point to the differential medical outcomes, you point to the fact that more black people died from covid than any other group, for example.
That is structural racism.
So the widely accepted idea of a social determinants of health also help to disguise racism because all because all known or unknown,
that poor medical outcomes in education.
So we all know that poor medical outcomes and things like poor medical care is linked to education, employment, housing, geography.
So way of passing, living, criminal justice, political power and economic resources,
they're all linked to something they're willing to health outcomes. So you can say it's because of that.
What people tend not to say is that all of these things that I've just mentioned,
poor medical education, employment, housing, they're the result of racism.
And what we see is that white people from lower socioeconomic classes will also have disproportionately poor Americans.
And that and so they can say, right, it's got nothing to do with race because it happens to white people as well.
But it's not as simple as that, because what we know is that, first of all, this allows us to blame poor medical outcomes for racialized impact.
Black people, we just say it's the social determinants of how to simplify and then deny any form of structural racism,
as we saw with the civil report. So if you can say it's the social determinants of health, it's not racism.
But what happens is we have covid and this is really important.
So then along comes covid-19 like luminal and UV light in the hands of a forensic scientist to reveal the hidden blood spatter,
confirming the crime was committed in a room that has been sanitised. So that if you've seen those detective shows where you walk into the detective,
walks into the room with a forensic scientist, walks into the room, there's no evidence of any crime.
Then they add some luminol and they shone the UV light and suddenly the blood splatter is everywhere and everything is revealed.
And that's what happened with Kobe. Our society, if you like, very sanitised.
Everything was happies, multicultural, multiracial, everything was happy.
Then Kobe comes along and actually reveals, like you like all the inequality.
So the data shows that injury and death covid-19 remains significantly worse.
People racialise black when we take into control social determinants of health.
So when we take into consideration consideration all of those things that I've mentioned where you live,
how you live, etc., you are still likely to die if you're black.
This leaves genetics and racism.
Now, science says, and I'm a scientist, says there is no gene linked to race, which makes you more susceptible to covid-19.
So we have to say, must be racism. But that's what people don't have access.
So poor access to medical medical services is racism in action.
Whenever someone asks me, just point to that. The idea of treating people differently, that's how you get there.
So as long as racism is a viable political idea, then we will see things like poor medical outcomes for people racialized as black.
Finally, racism feeds on itself and becomes self-perpetuating.
So not allowing people access to proper education means there are fewer individuals for those groups.
And free spirited video from those groups who have been affected to be able to explain and identify problems
like covid-19 in a way that people want it to be explained to them in a way that people can trust.
And with that, I'm going to stop. And.
Presentation. I think I think I'm good, so sorry about that.
It's a big rush to be confused, but as I said, because I lost some time, I didn't want to take up everyone else's time.
I know we want to have some discussion. So I hope I've added something to the mix that we can talk about.
OK, Mr. Morgan, that was that was quite informative,
so thank you very much for being able to connect such an account of what's going on in, you know, institutional racism.
OK, so we are now going to move on to some questions and answers.
So please put your cameras on and your audio and.
See how that works. OK.
OK, ready for perhaps the first question? Yes, I do have the first question and it goes to Dr. Winston.
OK, I know that, but go for it.
OK. OK,
the first question is how much has been written about the outcomes for black and minority ethnic staff and students
in academia for advice for those of us in academia and how we can influence change at the institutional level?
Well, that's a really big and tough question.
You're right, how can you influence change at the institutional level, particularly in higher education institutions?
Unfortunately, you have to stand up and call out whether it's micro aggressions or of overt racism.
The system allows relies on people not to say anything.
When, when when you see discrimination, that's what normally happens.
So you have to, as an individual, also try and get yourself allies and accomplices.
That is people from a variety of backgrounds, including your white colleagues, to actually take on some of the burden.
Do not take it on yourself and on your own. Some allies, but call it out.
Don't be afraid to do that and also use allies from outside your institution.
So if you feel you are alone in your institution, there are networks of other people who might be the same kind of situation,
are there to support you, who have experienced it, who are happy to come along and talk to your colleagues, and that might even be better.
So you can organise, for example, a presentation,
but rather than you do it yourself and you bring someone from outside so you don't get some of that flack.
And it will also show that you have support. So I don't know. That's one of the things there's so many, so many answers I could give.
But that's a starting point. Stand up to it. But get allies and accomplices to help you do to fight.
That's great. Thank you very much for that, handsome. If I could add something to this,
that's precisely what I want to put do on top of that first thing is not to feel provoked and to react and feel bad or destroyed,
devastated, because remember, at the end of the day, there's only one person who is in charge.
Less racist can make you feel guilty.
And it's important not to provoke and and react.
There are a lot of institutional organisational bodies, say, for example,
in the hospitals, there is a freedom to speak Gurdon's where they can talk anonymously.
Being committees are very importantly within a hospital context.
It important, not to mention. Talk with external conditions, I think minor independent counsel, for example,
we have in captivity that kind of what is so that the backlash doesn't happen.
Thank you, Dr. Sacro. I mean, you you you pre-empted the question I was going to ask you,
because that question was specifically posed to you from one of four or delegates would have replaced that with another question to you.
You're not going to escape this one. I know you're doing some work around the impact of long covid from a neurological perspective.
Specifically, I want you to speak to that in relation to persons from racial minorities backgrounds and just shed some light on that.
What are the implications of long covid neurologically on people from minority
backgrounds and how can we protect ourselves and our families and our communities?
Right. I mean, this is going to be a very tough question, which we'll be talking about for the next several years.
The biggest problem for a lot of it will be believing in the believing in the existence of it.
You know, covid is a predominantly male disease, along with the youngest symptoms are also report fatigue,
sleeplessness, depressions, all these things, all these are symptoms, report and characteristically symptoms fluctuate.
Let's just imagine with someone. Yeah, you can see what I'm getting at, a lot of family members and medical bills and they're not dealing with this.
And in terms of. Minority issues, I mean, we have just completed a study in Bangladesh, UK, US, Canada.
It looks like there's a bigger proportion of people will develop long unconvicted in the UK, about 10 percent in addition to people, 16 percent.
I think the main problem will be not just finding a solution, but delivering and accessing care, accessing care for these kind of issues.
Sometimes the minority people may feel that this is not a legitimate, valid medical things to go and seek support from the GP and things like that.
So that will be an issue, but I think it will unfold.
With time. Thank you. Thank you so much.
They make the comment that was a very important question.
Well, then and then it disappeared in action.
The very important point that someone raised and felt provoked by the statistics that I.
Provided tough times to be that 80 percent of the medical and people in the region believe
racism exist and 40 percent of political people and white people believe it exists.
I intend to of the reality is the truth.
And you can take a positive out of 40 percent of white people believing in the distance.
That gives rise to the real thing, which is what we need, what Elizabeth said.
We need a collaboration of the Like-Minded people.
This kind of this discussion on this empty racist movement requires polite people, not all white people.
A lot of white people are actually fighting for anti-racism.
So somehow we need to make that the like minded people and not denigrate everyone, white people, as that itself is racist.
So we need to have that provoked and very passionate things.
We need to be it to contain control of mindset and create a strategy how we can handle.
And instead of getting into this debate, the terminology of being minority opinion is the focus on the on the issues in
terms of injustice and actually ask for anti-racism training to be mended,
if possible, unconscious bias training positions. But it has its merits.
But what is necessary is everyone to raise the voice we need and do whatever we want.
That doesn't mean everyone is racist. We need anti-racist.
I wonder. Thank you. Thank you so much.
We have another question in the chat, it's a monster question on Mike one, and it's for Professor Dame Elizabeth.
Can you speak to the bone marrow transplant and the ways in which this sometimes is utilised,
the way in which this sometimes utilises treatment available for sickle cell and how it is affected by racism and disparity?
I think it is actually quite a complex question, and I think the the person posting it is quite likely alluding to the fact that.
The way we talk about the actual I don't really want to get into the nitty gritty because I'm not
up to date with it and I refuse to ever discuss stuff that I'm not up to date with point one.
Secondly, though, I would I would sort of give the comparison in this country with historically what went on with blood.
The the perception going back to the 1970s when I was in practise in the 80s,
that black people were very reluctant to come forward to donate their blood without people actually aware of how institutionally.
And the National Front, by the way, took place up.
That black people's blood was supposed to be inferior and carried infections and that attitude, rather than looking at the facts very simplistically,
I have to admit here that we know there are various blood types, but there are subgroup types within those blood groups.
And the more people from diverse communities that we can have that could come forward to donate blood,
the the higher the chance to get the appropriate matches for people from different diverse backgrounds.
And I think because this wasn't really explained clearly.
So we do need people who are able to communicate technical issues in a way that do not appear to be racist or to denigrate certain groups.
And I think this is a similar issue, possibly, as I've said, I'm not totally up to date with this,
but with the efforts that people are trying to have to get HLA matches and to encourage donors, et cetera.
But of course, the other issue with bone marrow transplantation and sickle cell disease,
which is not quite the same as bone marrow transplant and for for beta thalassaemia,
major, which I'm sure most people will know,
those individuals with that condition require blood transfusions every four to six weeks to survive from childhood into adulthood,
whereas with sickle cell disease very complex, a proportion of individuals require blood donations, but not all,
and also some require very intermittently, etc. They don't require it generally, but a small proportion.
So what I was I'm aware of in respect to the perceptions and attitudes and issues surrounding bone marrow
transplantation for sickle cell disorders is an ethical and cultural and religious sometimes attitude.
Well, hold on. If there was better treatment for sickle cell disease, do we need bone marrow transplantation?
Because bone marrow transplantation very dangerous, even if you got the match.
So I think the whole HLA issue is sorry, the whole issue of bone marrow transplantation and it's perception's by those with sickle cell disease,
parents, adults is is is actually very complex.
On the other hand, there are historically there was a perception that.
Bone bone marrow transplant patients weren't actually talked about as much for sickle cell disease as for other conditions.
So it's it is. It is. We are going back and I'll finish on this to Winston's and others on the issue of trust, the trust, trust or lack of trust.
And we see that with covid-19 and vaccinations. Do you trust the system?
Do you really trust the system? That that vaccination is OK.
We all have our role to play. I've had my two vaccinations. I just put that on the table.
But those of us interested in the history of medicine and racism totally understand where this lack of trust is coming from.
But we're also very concerned. That there should be benefits of scientific advances that we do trust.
Thank you much. I have a question for Dr. Bob.
I'm going to be this person because it's me,
I'm the first person I don't want to be the one to exhaustively help white people ask the right questions to break structural racism.
But I know they need help due to fear of reproach in parentheses, revealing their racism or appearing racist.
How do I balance the two to get my organisation to be more aware and I would add.
How does the system protect herself from the damage of doing this work?
Think that's a really good question, and I think like I said in my presentation, I think the first thing you have to do is look after yourself.
You are your work. You are your people, you are your connexion. And without you, this can't go forward.
The first thing is to look after yourself and to think you have a choice.
I think sometimes it's about not always bringing the content to conversations because I think we're
having to experience an opportunity or a time where our private pain becomes public property.
And so I think part of it is maybe being curious about the absence of what's happening with Saddam Hussein,
to have allies, to connect with people, to go forward. But you thinking about how do I look after myself?
And actually sometimes you have to think about is now the right time? We think often we have to do it right then and there.
But it may be too emotionally difficult to emotionally traumatising, too emotionally stressful.
So we have to think about how we engage with these, I suppose, challenges in a way that allows us not only to survive, but thrive.
And that takes time. Like I say, change only happens at the speed of trust and having to really invest in yourself differently.
But think about being so focussed rather than selfish and actually thinking about doing that.
Thank you so much. And on the point of trust, I'd just like to instigate some comments here from or initiate some comments, rather,
from Dr. al-Turabi here around, you know, who's who's doing the research and who is the research for and who is the research community.
So what I'm saying here, Dr. al-Turabi, is to what extent can we motivate more of your colleagues to get involved in this research process in order?
To develop that level of trust within the community, what are your perspectives on that?
Because if we see more people from. Diverse backgrounds, you know, getting involved in the research process, for example, yourself,
you know, how what are the implications of that on the greater sort of trust within the community?
I mean, I think that's a good question in the sense that we tend to trust people who, you know,
are like us, you know, whether you're from the north or from the, you know, whatever your background is.
And people kind of flock together.
And when I was you know, when I was growing up, I just had to look to my father, who really, you know, he was my kind of role model.
And I follow in his footsteps and and I have an Oxford Daphne.
You know, we kind of have these discussions all the time.
Who is there, you know, pushing a path for us and, you know, and showing showing an example of of,
you know, engaging with academia or doing the kind of work.
So but the question on trust is, you know, I always say it's all about credibility of expertise.
And if the environment is such that we don't feel comfortable to go into those areas,
then then you have this this deficit and then there's the sort of the progression kind of deficit as well.
You know, I think Winston talks about this and others.
But what I what I kind of want to come back to is this idea of the social contract, right, which is, you know,
vaccines, for example, they they have a benefit for the user, but actually the benefits to the greater society.
You know, I am protecting me, but actually also protecting you.
So why would if I don't feel that the society is looking out for my best interest, why would I why would I do that?
And the point that Elizabeth made was I dropped the dame there was that, you know,
if the individuals have who who kind of partook in the in the in the research are not representative of you.
I mean, how how how much are you going to really say?
I always used to be massively underweight, apparently, but I'm telling you, for a young Sudanese boy, I was perfect.
You know, that's that's so so there is sort of, you know, medical idiosyncrasies,
which we sort of push us to to kind of be easy to to reject any kind of thing put to us.
Trust. However, the credibility of the information is key for me. You know, I'm a scientist.
We kind of look to the data and but then it's sort of listening to, you know,
having someone who's going to come to you, sit with you and explain it to you.
And you don't feel patronised. You not feel, you know, maybe to get rid of some of the jargon.
I hate jargon like I'm sorry if I've used it today, but, you know, it just we need to we need to simplify things.
And that to me, that to me was.
Do you want to come in on that? Sorry. No, but I want you to finish and then I'll come in.
Sorry, I just I was just indicating that I'd like to add something to you.
I think I think that was it's after 7:00 now. I'm sorry, but oh, we'll have to try this.
So I apologise. To apologise.
To apologise. Thank you. Could you please.
Unfortunately has nominated me to be the the bad guy.
So thank you. But thank you so much for a fascinating discussion to all our panellists.
And I thank you so much for accepting our invitation in the first instance and for partaking in such
a timely and important conversation or chat suggests that we probably need to consider a part two,
but we don't have that discussion of share with my colleagues. So thank you so much for your contribution.
We really, really appreciate it.
And on behalf of the University of Canberra and my staff at work, I would also like to thank some of our sponsors who supported this event.
For example, the Canteen Medical and Midway Medical School, specifically their firm, their common commitment and, you know, to promote equality,
diversity and inclusion, and specifically to situate racial justice as a fundamental aspect of their pedagogy, research and practise.
So we thank the cantered Medway Medical School and we hope that we can continue this collaborative relationship.
Barbara. And some thoughts about losing the votes of thanks to the sponsorship of student success we have of great
supportive the is wonderful in supporting this collaborative events and also with student success,
also with the School of Social Policy, Sociology and Research.
Thank you. On behalf of the BME staff network here at Oxford, I would also like to thank the following for their support or sponsorship of this event,
the Oxford Biomedical Research Centre, Green Templeton College,
and most particularly event organiser Hayley Pugh University College Union, Oxford Equality and Diversity Unit,
Oxford, Rio Blanco and Tahj Perry Paria, Shayler Kamilla Compassionate Kova Alexander Gordon Victoria Swarmy.
And last but not least, Dave Thomas and Barbara tonight with the Baim Staff Network of the University of Kent.
I want to say thank you and good evening. There will be a recording and you will get an email to Eventbrite when it's ready.
Thank you. Thank you. Thank you. Thank you. Thank you.
Thank you. Bye bye. Thank you very much, everybody.