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To this evening. Panel discussion of medical racism, protecting ourselves, our families and our communities.

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I'm Daphne Cunningham, co-chair with Alexander Gordon of the BMY Staff Network.

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The network supports the global majority staff at the University of Oxford by fostering a diverse

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community within a community and as a collective voice for racially minority staff within the university.

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Membership is open and free for global majority staff members of the university.

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The format of this evening is as follows.

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The first four speakers will make a short presentation and the final panellists will be interviewed before questions and answers from the audience,

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please type your question into the chat function provided and please indicate to whom you wish to address the question.

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So with pleasure. May I now introduce you to two of the co-hosts for this evening's event from the University of Kent,

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famed that network founder and co-chair Dave Thomas.

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And Barbara at a gloomy. Thank you so much, Stephanie.

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Now, the theme of the event this evening is medical racism, which is often an elephant in the room.

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The racism is a public health crisis, and as Professor Sir Michael Marmot declared in the recent Marmot Review,

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racism is a social determinants of health. So we believe solving racism is a public health concern and must start with naming it.

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Professor Richard Williams proposed that entrenched systemic racism and the deliberate omission of word in patient

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safety circles is a cause for astonishing levels of preventable harm and death amongst communities of colour.

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And this has been devalued and discounted for more than 400 years.

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Now, we've seen the covid-19 pandemic and how it has laid bare racial inequalities,

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particularly in health care system and specifically for people from racially minorities background.

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So this evening, throughout this discussion,

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we will use the term medical racism and specifically we use this term to describe any measure that creates produce,

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produces or sustains racial inequity between racial groups.

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And this, we believe, may manifest in written or unwritten laws, rules, policies, procedures, practises, processes or regulations.

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This evening, we're delighted to be in the presence of a group of esteemed scholars and professionals from the medical profession.

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Now, it is with pleasure that I'll hand you back to my colleague Daphne, who will introduce our first speaker.

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Thank you, Dave. When Dave and I were brainstorming participants for this event, Dr. Roberta Babb was first on the ticket list.

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With 18 years of experience working and the public and private sector,

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Dr. Babb is a registered clinical psychologist and a registered psychodynamic psychotherapist.

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She is also an organisational consultant and entrepreneur.

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Her specialist interests include mental health, wellbeing, forensic clinical psychology and psychotherapy,

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race, gender equality, diversity, inclusion and anti-racism.

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She is the co-founder of the Hanover Centre, a bespoke consulting partnership which draws on multidisciplinary expertise to offer distinct clinical,

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organisational, educational training and media services.

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I am delighted to welcome Dr. Bob. Thank you, Daphne, for that introduction.

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Good evening. So this evening, I'm going to be talking about racism in health care, along with the other panel members,

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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,

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individuals, but also think about some strategies that people can do to look after themselves when accessing health care services.

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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,

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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.

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I think it's important to think about within the U.K., the primary mode of health care is the NHS.

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I suppose the UK health system was built on colonial resources.

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The NHS was founded in nineteen forty eight and this was at the same time that the British Empire was

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starting to dissolve and the resources needed to build and establish the NHS really relied on colonialism.

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Have a 70 something. Years later, the NHS is still impacted by colonialism and institutionalised racism.

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I suppose if you think about health care within the context of a colonial system,

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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.

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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,

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conquering its population, exploiting it often while forcing upon its own language and cultural values upon people.

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And in this sense, the white colonial is civilised ways of life when viewed as superior, morally correct.

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And I do. And this really leads us to think about whiteness,

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and this is so important because whiteness and the impact of colonialism is transparent

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precisely because it's the institutionalised normative that dominates our culture.

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It's a starting point. It's a benchmark. It's the norm. It's a structural advantage.

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I suppose it's an unmarked and unknown feature of cultural practises,

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which is rooted in an intrinsically linked to historic social, political and socially reproduced relations.

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And that leads us to think about a weird sort of environment, one that's Western educated, industrialised, rich and democratic.

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The hallmarks of racism really are anxiety, power, and we think about different forms of power,

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biological or amputates, coercive, legal, economical material.

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We're also thinking about interpersonal, social, ideological, informational and of course, medical, therapeutic.

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We think of there's a denial of reality, oppression in terms of violence, cultural imperialism, marginalisation, powerlessness and exploitation.

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And we also have to hold in mind how the idea of the nation state, capitalism, petro patriarchy,

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science, epistemic violence all contribute to the persistence and existence of racism today.

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So part of the difficulty when you think about racism is the fact that it does create

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structural inequalities and definitely inequalities within racialized communities,

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and this diagram really shows you the different levels that lead to the individual lifestyle factors,

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the social and community networks, but also the living and working conditions.

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And I think that then leads into inequality and discrimination. And the thing about inequality and discrimination is that it is actually stressful

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because we are also thinking about racial trauma is a form of race based stress.

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It refers really to individuals who are racialized their cumulative reactions to

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racially dangerous events and real or perceived experiences of racial discrimination,

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acute and cumulative. And the three classes which explain the emotional impact of racism, and the first one was hostile.

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And this really includes experiences which are characterised by actions meant to communicate the

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racialized individuals inferior status because of their memberships in minority racial group.

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You also think about avoidant racism,

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which involves experiences that are intended to maintain distance between a dominant and minority racial group and aversive hostile racism,

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which involves experiences intended to create distance with strong hostile elements after racialized individual has gained entry into a space,

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an institution or an organisation from which previously excluded.

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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,

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the cardiovascular system, the skin, it also affects our immune systems.

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And so you can really think about the fact that actually it has a huge impact because it

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is a physiological and emotional demand placed upon the body when one must adapt or cope.

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And racialise individuals through a number of socio political economic factors have

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higher rates of death associated with disease and conditions such as hypertension,

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stroke, cancer, diabetes, asthma, immune responses, elevated stress hormones, obesity.

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And this one really shows that racism can impact a person's health pathway,

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the fact that racial discrimination can lead to physical violence, psychological stress, the denial of goods, resources,

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services, but also think about the impacts of living conditions, decrease quality of care,

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but also psychological symptoms, negative coping behaviours and physiological stress responses.

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And this can link to mental health difficulties and physical health difficulties.

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And that's what we're really thinking about when we think about health care. So when we think about the impact of racism,

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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.

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And the work is disproportionately informed by with health care research theory and practise.

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And finally, in nineteen sixty one, really noted first hand how providing knowledge and practise in psychology and medicine,

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they tend to reflect and serve the interests of the racist colonial domination as opposed to unchecked use of health care language,

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hide structural violence and the neutral, an outcome informed with language and the health care system.

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Institutions and systemic disadvantages really reproduce racialized people's lack of autonomy,

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self determination which can fuel feelings of inadequacy,

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helplessness, hopelessness and promote poor health outcomes, which further exacerbates racial inequality.

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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.

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And then we're finding that health care services are not adequately funded or resourced or understand or meet the needs of racialized communities.

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This is a racialized individual to have a negative experience of service provision.

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This then leads to increased medical mistrust and avoidance, but also the impact of worse mental health symptoms,

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but also physical symptoms and the issue about racial trauma and traumatisation.

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So we think about the impact of racism on the health care pathway. It really does cover a number of areas.

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We think about education and understanding. We think about how problems are even identified in the first place.

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Early identification is key, but it also affects racialized individuals entry into the system because it also met with racial,

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environmental and validations. The physicians, the practitioners don't necessarily represent the population that they serve,

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and this can lead to people experiencing racial inequities.

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There's also the social, cultural and political context which needs to be taken into consideration and the impact of racial race on diagnosis.

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We know that sometimes medical conditions and other biological issues will manifest differently depending on skin colour, but also racial factors.

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You think about the referral pathway, a therapeutic management and also aftercare community can follow up.

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So if we think about how we look after ourselves, it's really important to think about looking after ourselves in a holistic way.

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We think it's important to think about an investment in yourself.

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So I really like the social emotional well-being framework, which really promotes well-being in seven dimensions.

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You think about connexion to spirit, spirituality and ancestors.

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You're thinking about connexion to the body, connexion to the mind and emotions, connexion to family and kinship.

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Connexions a community connexion to culture and connexion to country. Because when we think about colonialism,

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these are the very things that have been disrupted and decentred by the historical and political context of colonialism.

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So just to finally kind of complete this, because I know we've only got a short time,

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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.

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Emotional, physical, social, spiritual and cultural self is an investment.

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We're also thinking about the possibility of personal therapy. Racism will have an impact.

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Racial trauma will have an impact. And part of our pathway forward is to learn to kill from these racist experiences.

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And that can happen through personal therapy. We'll also think about education.

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So educating yourself from reputable sources,

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but also connecting with the culture and finding other sources of information and also being aware of your health care options,

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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.

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I think in all of this is also important to think about consultation, preparation.

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Often we don't go see a health care provider.

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We're not really prepared to think about what we're going to discuss so you can have time to think about what

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you want to talk about and take time to actually communicate that that might require support and advocacy.

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But you can also think about the feedback and complaints system. You have an option.

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You have the right. You're entitled to make a complaint, to give feedback,

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because you think about the importance of utilising community resources and also developing trust,

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trust in yourself, because speed only happens at the speed of change, only happens at the speed of trust.

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So we think about this, like you said in the introduction, racism is a traumatic experience which has significant and long lasting implications.

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It is a public health issue and a structural, systemic,

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institutional and interpersonal and internalised racism exists within UK health care provision.

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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.

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There were some things that we can control and some things that we can't control.

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And I think the things that we can control is a fact that every thought, every feeling,

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every behaviour and interaction is an opportunity to do something different.

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I suppose this action demonstrates our commitment to racial equality within health care and other sectors because it really

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shows that racialized people are not overlooked and not dismissed or underserved simply because of their racial identity.

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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.

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And this is a Zimbabwean proverb from the Shona tribe,

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which means that a person who harms another will often forget, but the person who is harmed will always remember.

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I think from a racialized perspective, it's important to hold in mind that great opportunities lie in the midst of every crisis.

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There is hope. Together, we are going to make change happen and it's not going to stop us from achieving racial inequality.

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So cheapened racial equality and change.

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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.

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And thank you also for presenting the bio social strategy or set of strategies

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to really adopt a solution focussed approach to moving this agenda forward.

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Now, I would like to introduce our next speaker. With Dr. Mohammed Saikal.

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Described as an inspirational leader. Dr. Mohammed Sacro is a consultant neurorehabilitation physician and the director of research and innovation,

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and he's the lead at the East Kent University NHS Foundation Trust Hospitals.

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He's also the chair of the Brain Injury Forum and global ambassador for the Sir William Beveridge Foundation.

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If special interests are in motor neurone disease, head injury, brain injury, rehabilitation and multiple sclerosis, rehabilitation.

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The doctor say, thank you so much for joining us all the way from Zimbabwe, from Bangladesh, I might add.

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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.

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Thanks for organising this programme. I'll speak from multiple perspectives and real life experience as a medical doctor,

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as an NHS consultant, lead a BMY and occasional recipient of medical care.

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We've been given two questions to respond to questions. One was the impact of racism.

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Is clear. The impact is pernicious, severe and ongoing.

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American Medical Association has declared racism as a public health hazard.

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Various medical bodies in UK has a similar description.

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I'll ask the audience to read very succinct recent papers by Professor Patricia

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Greenhouse and Fiona Godlee from British Medical Journal on these issues.

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Systemic racism is alive and active in health service.

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The white supremacist element of the establishment. Sought to deliberately make effort to distract, divert, if not disrupt our yearning for justice,

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but amongst white people in the past, racism used to affect only black and brown people.

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Nowadays, the system is so integrated, so interconnected and interdependent on people that it affects everyone.

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Even if I am racially prosecuted as a consultant for 250 innocent white colleagues,

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doctors and nurses who suffer hundreds of innocent white patients will suffer.

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It is straightforward. I can cite dozens of examples of the impact lost impact of racism.

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And we all know that ethnic minority people are more likely to catch and die from it.

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We know that the CO2 measurement, oxygen saturation that has a racial element that underestimates have the mask

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that the research researchers have found will not fit on ethnic minority people.

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These are all designed for white people.

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As a doctor or a nurse or a physiotherapist, it's very unlikely that he will be promoted to a senior position.

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Those who do get to the senior position or work in various committees.

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Will soon find themselves to be constrained, if not disciplined, somehow, often with the trumped up charges of something to tow the line.

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And that's the modus operandi for hundreds of years to deliver the blow with a token dame in the board or somewhere.

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What I've said so far, these are not emotional outbursts.

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These are real life experience and data driven, evidence based, available in open, accessible applications that I would you to go to.

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In terms of the question to how do we address this racism, I think we need to act at all three levels micro racism,

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at individual level, at a community level like our community,

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the various barriers and a macro level of institutional racism to do the various structural and systemic processes that are built to nurture,

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to endure and to deliver the systemic racist abuse.

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I would make a few additional points on, in addition to what Dr. Bishop has already mentioned,

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we need to promote the notion that being nonracist is not good enough anymore.

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We need to promote the view that we all have to be actively, consciously being anti-racist and against all digitisers.

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We need to demand that antiracist training, anti-racist training be made mandatory in all institutions, public or private.

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And if we to increase the access, appeal or acceptance of a particular message to a particular community,

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perhaps we need to focus and try and improve the profile of the messenger.

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The fact that this is a prime example for this point,

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we need to encourage overall to the community of people to get into positions of influence, politics, business, leadership, etc.

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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.

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We must not allow that one of my colleagues, a consultant surgeon and eye doctor.

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He has done a large surgery study recently.

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More than a thousand doctors and nurses in NHS was asked recently about real life racism.

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And experience in Nelson is the result of a stark and surprising 80 percent of being.

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Doctors and nurses think racism exist and only 40 percent of white doctors and nurses think it exists.

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Two thirds of the doctors and nurses have witnessed or experienced racism.

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What is that trigger for white population? 17 percent and 30 percent?

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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,

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will not be served until those who are not affected feel as outraged by the people who are.

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Thanks for listening. Yeah, absolutely, yeah.

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Thank you so much. Thank you so much for that timely information on.

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I would like to introduce our next speaker. Um.

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That will be. Dr. Adulterating.

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Is a vaccinology with over 15 years of experience within both industry and academia.

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He's an active research fellow of the Future Vaccines manufacturing research hub, Backes Hub,

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which is involved in projects that address the challenges in vaccine supply and vaccine development for low and middle income countries.

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Infectious Disease Target. He's currently working with Professor Sarah Gilbert at the Jenner Institute at Oxford.

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Irrelevant to tonight's discussion or his knowledge of translational research on vaccine technology, from design through to production,

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in particular exploring vaccine platforms and production systems that can be transferred to low middle income countries?

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Before covid Adilman, I would occasionally run into each other and catch up on things because we work in the same building,

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so I am delighted to see him and to get to hear along with you more about his work.

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Welcome, Adam. Well, thank you very much, Stephanie. That's it.

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That was a very warm and welcoming introduction and I'm not actually going to be talking about my work,

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say, but the work of all scientists, let's say, who work in vaccine field.

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I've titled my talk because as trust me, because I think, you know,

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with with the theme of today's roundtable discussion on medical racism and impacts of that,

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one of the things that I felt this pandemic has really kind of borne out is this distrust,

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this erosion of trust of lots of different people from from scientific community, from government.

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And and I think that there are people more qualified in this panel to talk about this.

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So let's see if I can advance my slides. Fantastic.

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OK, so I start by just kind of reintroducing you to who I am.

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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,

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which is being in partnership with AstraZeneca and is being distributed across the world.

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But we're an academic unit and basically we study vaccines for various diseases.

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And so this is me. You can see me smiling because I'm outdoors.

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I've managed to escape the lab so it doesn't happen often. And, you know, we're passionate about vaccines.

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We can see first hand how, you know, when they work, how beneficial they are.

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There is over four billion vaccines administered annually and there that translates to around about two to three million lives saved each year.

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And this makes it really one of the greatest public health interventions helping to drive down that that disease burden,

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particularly in young children. But it serves the whole community.

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And it's just worth saying that today we are in the mode with modern production levels.

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We have actually safer vaccines than ever before.

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I mean, if you compare that to the when the inception of vaccines came out in sort of the 19th and early 20th century.

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And unless you've been remiss,

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you'll notice that we are living in the midst of a pandemic and this has had many different effects on different people.

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It's really sort of driven through the disparities and the experiences of people of colour or people of different economic status.

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So impoverished communities and the disadvantages disadvantaged and the societal and economic.

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Penalties really sort of brought out of us as a human human race, a collective desire to do something about it, and, you know,

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we have seen in recent times great collaboration and and coming together in order to try and solve this problem of covid.

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And vaccines are just one of the tools. But and I think what is.

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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.

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And and this is why we're sort of seeing any benefits that we are seeing in terms of turning around this pandemic.

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However, that speed also has led to some feelings of anxiety.

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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.

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And so there are many twists and turns on the on the process to making vaccines.

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And it is true. It is a very complex process with multiple stages.

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And it's worth noting that they are very tightly regulated, very specific tasks which are required in order to bring things forward.

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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.

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So this is just a graps from the European Medicines Agency website.

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But just looking at the different stages,

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and I think what I want to drive to you is just how tightly regulated this is and how much care and attention

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that goes into approving medicines and vaccines in particular because they're given to people before they're ill.

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And so the bar is very high for vaccines. The timeline of vaccines normally would be sequential, something like this.

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So you have one stage following from the other.

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And if you in this once you once things have been shown to be non-toxic, they can be administered to humans.

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And we do basically safety trials before progressing to ever larger trials.

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And as you go this way, the cost increases, I would say exponentially, but it increases a lot.

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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,

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there's a robust evaluation before authorisation.

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And then usually at that point, you put in the big money to to make large scale production.

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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.

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What was interesting is that they didn't skip any particular stage.

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This is not acceptable. You can't have a licenced product without doing all the stages.

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And instead what's happened is a collapsing and compression. And you see that they're overlapping activities.

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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,

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obviously we have you know, historically there's been some poor practises, but today it's very, you know, informed consent.

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Volunteers have to be aware of the risks and they're able to pull out.

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And on top of that, you know, we are so sorry.

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So we're dealing with the real. Progress in terms of the model of making vaccines, of taking things forward.

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So all I'd say is in terms of the concerns of the speed, there were no shortcuts taken.

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Everything was done properly.

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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.

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And this wasn't just Oxford. This was all all all vaccine producers.

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The other thing I wanted to sort of just note is that actually these trials have, due to the massive interest,

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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.

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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.

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And that that as well increases the confidence that these vaccines are going to work in a diverse population.

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And what's really gratifying is the fact that we see.

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The real world use the vaccines are helping to reverse a severe illness and stop hospitalisations,

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so there are people who are still concerned about the safe and we've all heard the stories of blood clotting.

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And I mean, I don't need to look at this just to see that basically we have the blue dots are

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are the harms that could come to you if you were if you were to succumb to covid.

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But vaccination stops that rescue. You do that. And on the right hand side is potential serious adverse effects.

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See the blood clots which have been reported and the risk of that is much lower.

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This is an extremely rare event that's not seen in the trials, even though tens of thousands of people were in the trials.

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It's only once you get into the population, you see millions of people that these very rare events become visible.

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But it's important to note that we would expect some adverse effects.

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However, they're not they're very rare.

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And usually the ones that we do see are very short lived. It is complicated.

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We have also the the variants which are circulating and this is a moving situation and we're moving arena.

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But so far, the vaccines have done a good job in controlling them.

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And that's why it's important really to sort of while you're ahead, kind of keep keep getting ahead.

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So we need as many people vaccinated as possible. There has been confusing messages, mixed messages.

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And, you know, this has been through the so the goldfish bowl, you know, that normally no one really cares about anything.

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I have to say, you know, science tests are boring folk. And, you know, if you if you like science, you love it.

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If you don't, then you stay clear of it.

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But we've had a lot of attention and this is kind of led to sort of armchair critics and running commentaries,

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you know, and really kind of we don't we don't no one pays attention to everything when everything's good.

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But when anything goes bad, it's really flagged up. And what this has given rise to is this sort of wave of misinformation,

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misrepresentation at best, and this sort of incident, which is kind of hitting the world.

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And I think maybe the panel would later on like to sort of discuss these these things.

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So I think I'm done. So I just wanted to say vaccines do work.

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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.

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And I'll stop there. Thank you very much. Thank you, Dr. Robbie, for that really insightful view about building trust amongst our community,

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and it's good to know that that the expansion of trials amongst the diverse groups is getting larger and larger.

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So hopefully that will also build trust amongst our community. So now on to our next speaker.

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So I'm very pleased to welcome Dr. Winston Morgan.

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He is the director of impact and innovation at the Research Institutes of Health, Sport and Bioscience at the University of East London.

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And he's working towards increasing the impact and visibility of knowledge, exchange and academic advances through his research.

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Dr. Morgan is also a soldier in clinical biochemistry and has published over 40 medical articles.

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He has an interest in the toxicity of amphetamine related compounds and is currently working on a

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project to understand the long term toxicity of highly active antiretroviral therapy in AIDS patients.

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Dr. Morgan is currently developing research on the role of race and ethnicity in medical research and medical outcomes.

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Apart from lavatory based research that is also involved in planning and teaching projects

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to improve the student experience and performance of widening participation students,

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particularly those from black and minority ethnic student cohorts.

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So we are extremely fortunate to have Dr. Rice to join us this evening, Dr. Winston Morgan.

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Dr. Winston Morgan, your mute.

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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.

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OK, I'm also waiting for Dr. Mongan Internet to recalibrate I.

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I would like to welcome our next speaker to the fore, Professor Dame Elisabeth.

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Onyango. Professor Dame Elizabeth Anion is a British nurse, health care administrator,

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lecturer and emeritus professor of nursing at the University of West London.

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In 1979, Professor Onyango became the United Kingdom's first sickle cell and thalassaemia nurse specialist.

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In 1998, by then a professor of nursing and the ANU created the Mariscal Centre for Nursing Practise at the University of West London.

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She was appointed a Dame Commander of the Order of the British Empire in 2017 for services to nursing and the Mary School Appeal.

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She holds a PhD and is a fellow of the Royal College of Nursing.

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Listed amongst the 100 great black Britons in Dr. Patrick Vernons recent publication,

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Professor Onyango has been awarded two honorary doctorate from the University of St.

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Andrews and Birmingham City University for her contribution to the nursing profession.

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And I could go on, I could go on and on.

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Professor on Aniello as as one of the biggest fans of yours.

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Thank you for accepting the invitation to present on this forum and I welcome you.

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Thank you very much. And as I've said before, if you are a real charmer, we love you.

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Please, please call me Elizabeth. I know. I know people are brought up to honour titles, and I appreciate that.

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But please call me Elizabeth. Thank you. Yes.

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I mean, in my culture, as a son of Jamaican soil, gratitude is a must, and we have to be kinder to our elders.

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So thank you for being here. So this presentation will take the form of an interview and I say interview very loosely.

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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,

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what it is and why it matters to the black community specifically.

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OK, thank you very much.

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For sickle cell anaemia is an inherited condition of the red blood cells that impacts the haemoglobin and excuse me, its origins.

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So those parts of the world where you find falciparum malaria and if you are a carrier or otherwise known as sickle cell trait,

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it's generally considered to be a healthy situation. However, if your partner also is a carrier, then every time you have children,

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there's a 25 percent chance or one in four chance that every child you have could have the condition.

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But, you know, when I was unretired, I must stress I'm retired from clinical practise, clinical genetic counselling and sickle cell.

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But I used to definitely emphasise with those that I was.

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Involved with that, this is a chance for each and every pregnancy so that you could have 10 children.

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All your children could have sickle cell anaemia. None of them could have it. People sometimes say it's like throwing the dice.

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So it is. And also the biggest myth is that sickle cell anaemia only affects black people, which, of course, is not true.

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When one looks back at the origins of falciparum malaria.

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It's found in various parts of the world's countries like Greece, Italy and the southern Mediterranean areas.

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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.

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However, when we look at the situation in this country, and this is linking to your point about the relevance to the black community,

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if one looks at the majority of people who are affected by the illness in this country,

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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.

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So that's why it is a significant condition in this country for the black community.

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But emphasising it's not just the black community. Brilliant.

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And it's really interesting how you you know, you make that juxtaposition between blonde hair,

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blue eyes and, you know, and people from African heritage.

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And I'd like to ask you to speak briefly about your childhood and your engagement with the health services,

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particularly while you were receiving care for your eczema.

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So I was my parents met at Cambridge University and my mother was of Irish heritage, born in this country.

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And my father was Nigerian and my mother got pregnant with me but never married.

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So there's a huge amount of shock, stigma, et cetera, et cetera. I'm 73, so go back to 1947.

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And I think everybody will understand why my mother, first of all, didn't tell her parents that she was pregnant.

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It was my grandmother, my maternal grandmother that discovered it, if you like.

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And then when she asked my mother if she was pregnant, my mother responded by saying yes.

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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.

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She resisted all pressure to have me. Oh, by the way, she she couldn't even reveal anything about the father.

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So it was when my grandparents, maternal grandparents came to see me in a maternity home run by Irish Catholic nuns.

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And one of the nuns said to my grandparents are to be sure, the baby is a little dark.

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Because everybody was expecting a white baby, and so this was this was my start.

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That was my journey. And I grew up in a children's home until I was nine, not because my mother rejected me.

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She certainly didn't. She obstinately persisted in stating that she would never, ever give me up for adoption or long term fostering.

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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.

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Secondly.

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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.

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Because there was a nun who looked after my eczema in a very interesting way, other nuns, well, I don't think deliberately,

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but they would tear off the bandage and it would be very painful and it would tear off the cream that had been applied.

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It would bleed. It would be very, very sore. But this particular nun used distraction therapy and she used to use words like bottom,

390
00:47:04,280 --> 00:47:12,430
which to a small child growing up in a convent, which is very religious bottom I thought was the most.

391
00:47:12,430 --> 00:47:17,670
Terrible words, and none could say I burst out laughing, I have a huge sense of humour.

392
00:47:17,670 --> 00:47:23,220
I've always had it and that's when she would take advantage of me. And I thought she was absolutely wonderful person.

393
00:47:23,220 --> 00:47:28,470
And I associated with not ever receiving pain, getting pain.

394
00:47:28,470 --> 00:47:37,350
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,

395
00:47:37,350 --> 00:47:41,430
because I know you're going to ask me about health inequalities.

396
00:47:41,430 --> 00:47:48,630
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.

397
00:47:48,630 --> 00:47:55,930
I grew up with my mother, took me out of the children's home when I was nine.

398
00:47:55,930 --> 00:48:01,900
However, my stepfather was very.

399
00:48:01,900 --> 00:48:12,390
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.

400
00:48:12,390 --> 00:48:17,170
This is in the Midlands in the 1950s. And he started to physically abused me.

401
00:48:17,170 --> 00:48:19,990
I was rescued by my maternal grandparents.

402
00:48:19,990 --> 00:48:31,750
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,

403
00:48:31,750 --> 00:48:42,650
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.

404
00:48:42,650 --> 00:48:46,480
I realised that I've grown up being seen as other.

405
00:48:46,480 --> 00:48:51,550
You know where you come from, my dear Birmingham. No, no, no. Where do you really come from?

406
00:48:51,550 --> 00:48:53,230
So being seen as an outsider,

407
00:48:53,230 --> 00:49:05,470
other I was holding a belly full of anger and this drew me ultimately into getting involved with sickle cell and health inequalities.

408
00:49:05,470 --> 00:49:11,380
So there you go. Very neatly. If I'm helping you along, it's your next question.

409
00:49:11,380 --> 00:49:17,110
Sorry. Well, well, funny enough, I've now introduced a new question because you've evaded that word.

410
00:49:17,110 --> 00:49:26,350
Right. OK, so I want to really briefly speak about your your involvement in advocating for for

411
00:49:26,350 --> 00:49:32,280
more research sources to promote research into sickle cell anaemia in this country.

412
00:49:32,280 --> 00:49:37,720
I'm sort of the barriers that you faced in accessing that body of funding.

413
00:49:37,720 --> 00:49:43,500
So what has driven me is anger and my first.

414
00:49:43,500 --> 00:49:48,710
Memorable feeling of anger in terms of.

415
00:49:48,710 --> 00:49:58,790
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.

416
00:49:58,790 --> 00:50:03,710
That was in 1979. And that's I was also interested in genetics and genetic counselling.

417
00:50:03,710 --> 00:50:14,220
And I happened to read this paragraph in a classic nineteen seventy six seventy 76 textbook by two geneticists.

418
00:50:14,220 --> 00:50:18,600
I was interested to see if they would mention sickle cell anaemia. We had a paragraph.

419
00:50:18,600 --> 00:50:29,120
Listen to this paragraph. Sickle cell anaemia is not of great consequence to us in the context of genetic counselling in the United Kingdom.

420
00:50:29,120 --> 00:50:36,320
The cycling trade and sickle cell anaemia appear to be confined to people, people of African and Eastern origin.

421
00:50:36,320 --> 00:50:41,600
I mean, the ignorance of that statement, where were these genetic geneticists in this country?

422
00:50:41,600 --> 00:50:45,560
In other words, they totally overlooked the.

423
00:50:45,560 --> 00:50:50,750
So you can see I'm getting angry, just recalling it. This was 1976.

424
00:50:50,750 --> 00:50:54,860
So that was my first recognition. And I got involved.

425
00:50:54,860 --> 00:51:01,100
And I would like to bring it up right up to today, Dave, because sadly,

426
00:51:01,100 --> 00:51:13,050
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.

427
00:51:13,050 --> 00:51:21,300
Was actually the death was in twenty nineteen, it's because the coroner's inquest has just been made public twenty nineteen.

428
00:51:21,300 --> 00:51:34,050
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,

429
00:51:34,050 --> 00:51:42,210
where a young man with sickle cell anaemia had to die nine nine nine from his North London hospital bed to get oxygen.

430
00:51:42,210 --> 00:51:48,420
And this young man died. And it is in the media for those who want to look at it.

431
00:51:48,420 --> 00:52:01,170
So that was the first case. The second one was Richard who that was during those earlier this year who was shielding.

432
00:52:01,170 --> 00:52:08,730
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

433
00:52:08,730 --> 00:52:14,740
missing and the police and the mother told them that he had sickle cell anaemia.

434
00:52:14,740 --> 00:52:20,530
And the police first initial reaction was, well, if you can't find him, how do you expect us to find him?

435
00:52:20,530 --> 00:52:29,220
I'll give you those two examples to highlight how my anger and other people's anger.

436
00:52:29,220 --> 00:52:34,110
Why it's there and what I'm really sad at, to be very honest,

437
00:52:34,110 --> 00:52:43,800
is progress had been being made in respect to pushing sickle cell anaemia further up the NHS agenda.

438
00:52:43,800 --> 00:52:50,220
We hadn't got it up as far as we wanted, but it was much better than the 1970s.

439
00:52:50,220 --> 00:52:58,580
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,

440
00:52:58,580 --> 00:53:07,640
but we can put it within the context of stress cetera in the covid pandemic, which many people have experienced with long term conditions.

441
00:53:07,640 --> 00:53:20,350
But then the reaction, the negative reaction of the police just just just gives me yet more awareness of the low.

442
00:53:20,350 --> 00:53:25,360
Situation that Sickle-Cell that of those that mainly affects the black community

443
00:53:25,360 --> 00:53:31,880
in this country and that it is still not accorded the priority that it has,

444
00:53:31,880 --> 00:53:35,560
and if I can just give one final point.

445
00:53:35,560 --> 00:53:44,320
We know that there are many long term genetic conditions, the one that I compare sickle cell anaemia with cystic fibrosis,

446
00:53:44,320 --> 00:53:53,620
because that is a very serious genetic condition that mainly mainly affects northern European white communities.

447
00:53:53,620 --> 00:53:58,480
It does affect a small minority of the black population as well in this country.

448
00:53:58,480 --> 00:54:12,480
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.

449
00:54:12,480 --> 00:54:19,680
We think there is at least 15000 individuals affected by sickle cell disease in this country.

450
00:54:19,680 --> 00:54:27,750
So what I am looking for, what we should be looking for is equitable resources, priority given to these two conditions.

451
00:54:27,750 --> 00:54:31,200
Put them side by side when you look at it.

452
00:54:31,200 --> 00:54:41,220
You do not see equitable resources in terms of health service provision, research allocation, et cetera, et cetera.

453
00:54:41,220 --> 00:54:50,730
Thank you. Thank you so much, really heartbreaking stuff, but I want to move us forward and start back from the beginning.

454
00:54:50,730 --> 00:55:00,720
So, Dr. Bob, you know, very, very brilliantly and articulated a solution focussed approach and looking at this phenomenon in a biopsychosocial way.

455
00:55:00,720 --> 00:55:09,120
Right. So I want to highlight, first of all, your fantastic work with the Mariscal Foundation and really,

456
00:55:09,120 --> 00:55:17,730
really spotlight that because we need to leave on positives. And then secondly, I want to speak about, you know, yes.

457
00:55:17,730 --> 00:55:25,710
The acknowledgement of medical mistreatment and malpractice and how that has promoted mistrust amongst the minority ethnic communities.

458
00:55:25,710 --> 00:55:35,590
Well, very, very importantly, get your opinions on how our communities can protect themselves, their families and their communities,

459
00:55:35,590 --> 00:55:39,060
because I think it's important to leave with positive strategies,

460
00:55:39,060 --> 00:55:46,350
but also to celebrate the distance that we've travelled, notwithstanding the problems that we still have, by the way.

461
00:55:46,350 --> 00:55:51,180
Yes, well, I totally agree. And first of all, I think we have to collaborate.

462
00:55:51,180 --> 00:55:56,130
We have to work with like minded people. Nobody can do anything on their own.

463
00:55:56,130 --> 00:56:05,040
And the example I would give is the Mariscal statue appeal that raised three quarters of a million pounds in 13 years to

464
00:56:05,040 --> 00:56:16,410
have that statue erected in June 2016 in the grounds of St. Thomas Hospital of a Jamaican Scottish nurse entrepreneur.

465
00:56:16,410 --> 00:56:22,530
Will all sorts of things. We can call her doctor. Yes, that was Mary Jane Siecle.

466
00:56:22,530 --> 00:56:26,790
And so that, I think, is a classic example of what you're talking about,

467
00:56:26,790 --> 00:56:33,270
that whilst we can get really depressed about the lack of women statues of of of statues,

468
00:56:33,270 --> 00:56:42,360
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.

469
00:56:42,360 --> 00:56:45,660
You find that actually a lot of people support these sort of causes.

470
00:56:45,660 --> 00:56:51,120
It comes from deep, deep within because we want our children and our grandchildren.

471
00:56:51,120 --> 00:56:57,180
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,

472
00:56:57,180 --> 00:57:04,980
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.

473
00:57:04,980 --> 00:57:14,490
So I think that is a very positive story and it's certainly provided and still provides huge, huge joy that that was achieved.

474
00:57:14,490 --> 00:57:21,210
So I agree. We must in fact, I think I am a person that is more positive than negative.

475
00:57:21,210 --> 00:57:26,090
So I totally agree with the approach that you're alluding to.

476
00:57:26,090 --> 00:57:32,160
Now, you must know something about how do we protect ourselves, our families and our communities?

477
00:57:32,160 --> 00:57:34,980
Because I think leaving, you know, really,

478
00:57:34,980 --> 00:57:42,450
really practical strategies for or for delegates who have attended this evening really to get that insight quick wins.

479
00:57:42,450 --> 00:57:48,450
How can we protect ourselves, our communities and our families in the light of these inequalities?

480
00:57:48,450 --> 00:57:53,830
Well, I just think we cannot be isolated. I think that things can overwhelm us so much.

481
00:57:53,830 --> 00:57:59,380
I think I, I, I explained that I have this virtual toolbox.

482
00:57:59,380 --> 00:58:09,540
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.

483
00:58:09,540 --> 00:58:18,020
But we could share the sort of two boxes we have because first of all, if we are mentally depressed.

484
00:58:18,020 --> 00:58:21,530
As individuals and as groups.

485
00:58:21,530 --> 00:58:34,180
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?

486
00:58:34,180 --> 00:58:39,650
You know, why should we have been on tenterhooks as to whether. Shervin would be found guilty.

487
00:58:39,650 --> 00:58:47,830
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,

488
00:58:47,830 --> 00:58:52,180
but it also explains why some of us feel more vulnerable than others.

489
00:58:52,180 --> 00:59:01,750
So we have to be linked in with like minded people, not necessarily all from our own ethnic, you know, gender, whatever group.

490
00:59:01,750 --> 00:59:09,280
I think we have to be prepared to collaborate a lot more because in numbers is strength and we all need strength.

491
00:59:09,280 --> 00:59:16,480
So it might seem quite common sense approaches, but I have found I'm not I'm not an incredibly theoretical person.

492
00:59:16,480 --> 00:59:20,710
I have to be honest. I am a more common sense approach.

493
00:59:20,710 --> 00:59:31,150
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.

494
00:59:31,150 --> 00:59:37,330
How have they overcome it? It's obviously having some sort of belief system in yourself.

495
00:59:37,330 --> 00:59:42,260
And in fact, actually, you know something? It's having confidence in yourself.

496
00:59:42,260 --> 00:59:45,920
And as brown skinned, black skinned individuals,

497
00:59:45,920 --> 00:59:56,740
we have to engender self-confidence within ourselves and our families and our friends and our colleagues.

498
00:59:56,740 --> 01:00:06,040
Through support, through action, so that's that's really what I'm going to say, because that's helped me enormously.

499
01:00:06,040 --> 01:00:13,210
Thank you so much and giving honour to or you know or people who have done this work,

500
01:00:13,210 --> 01:00:19,810
have done this work tirelessly, are doing this work and will do this work on the shoulders upon which we stand.

501
01:00:19,810 --> 01:00:28,510
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.

502
01:00:28,510 --> 01:00:36,230
Just tell us about that. So in September. Dave, thank you. In September, Dave, my my memoirs are coming out through a publisher.

503
01:00:36,230 --> 01:00:41,840
This time it will be called Dreams from My Mother.

504
01:00:41,840 --> 01:00:47,870
OK, thank you so much. Thank you so much. Fascinating conversation and I really appreciate it.

505
01:00:47,870 --> 01:00:51,980
Thank you so much for joining us. Thank you. I'd like to know.

506
01:00:51,980 --> 01:00:57,830
Welcome back. My colleague, Dr. Barbara, a woman who will introduce our next speaker,

507
01:00:57,830 --> 01:01:03,590
if I think to say that Dr. Ruth Morgan is able to connect with us this evening.

508
01:01:03,590 --> 01:01:07,340
So please take the stage. Thank you.

509
01:01:07,340 --> 01:01:11,110
First of all, can you hear me? Good.

510
01:01:11,110 --> 01:01:20,540
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.

511
01:01:20,540 --> 01:01:24,590
I'm having some trouble because I've used up so much time,

512
01:01:24,590 --> 01:01:30,930
so what I'm going to do is just taking you through a small piece and someone in the audience

513
01:01:30,930 --> 01:01:35,310
I was looking at the comment of someone in the audience asked about racism and what it is.

514
01:01:35,310 --> 01:01:41,270
So I'm going to start there and just just throw some quotes in, because some of my colleagues,

515
01:01:41,270 --> 01:01:45,260
as I explained to you, have actually covered a lot of things that I would have liked and said.

516
01:01:45,260 --> 01:01:50,780
So it doesn't really matter. So anyway, we must talk about racism and the thing about racism.

517
01:01:50,780 --> 01:01:58,160
And we're not talking about racism where we never talk about racism before, since the pandemic and also since the summer of George,

518
01:01:58,160 --> 01:02:04,400
Florida Black Lives Matter, so many people conveniently forget that racism existed before the covid-19.

519
01:02:04,400 --> 01:02:11,300
And because it was structural, structural, we were able to live with it.

520
01:02:11,300 --> 01:02:17,610
So we were living with racism. Why structural racism? But, you know, we pretend it wasn't there.

521
01:02:17,610 --> 01:02:25,820
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.

522
01:02:25,820 --> 01:02:31,950
And at the same time, many people who are held back by racism are embarrassed or fearful to talk about it.

523
01:02:31,950 --> 01:02:37,310
So we've got this thing. People who are advantaged, I want to talk about it, people who are disadvantaged.

524
01:02:37,310 --> 01:02:44,840
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?

525
01:02:44,840 --> 01:02:50,540
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.

526
01:02:50,540 --> 01:02:57,170
So racism stems from the belief that certain human phenotypic characteristics and we're talking about facial features,

527
01:02:57,170 --> 01:03:02,770
skin colour allows us to place people in distinct groups or races.

528
01:03:02,770 --> 01:03:11,750
OK, we then assert that all members of that group designated group have similar abilities and qualities,

529
01:03:11,750 --> 01:03:17,690
which makes them either superior or inferior, and then they are treated accordingly and are treated accordingly.

530
01:03:17,690 --> 01:03:25,880
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.

531
01:03:25,880 --> 01:03:33,170
OK, so you also they are also allocated or denied privileges based on this superiority or inferiority.

532
01:03:33,170 --> 01:03:39,920
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.

533
01:03:39,920 --> 01:03:44,900
So that's what we're talking about, racist people who adhere to this view of how we see the world.

534
01:03:44,900 --> 01:03:51,770
OK, so now structural racism is something that's built on that sort of structural racism is observed when discriminatory or

535
01:03:51,770 --> 01:04:00,440
racist ideas about certain groups are allowed to permeate the culture practises and policies of our major institutions.

536
01:04:00,440 --> 01:04:07,490
That's what institutional racism is or why society, which it's more structural,

537
01:04:07,490 --> 01:04:12,170
it enables acts of discrimination to become normalised to the extent that almost

538
01:04:12,170 --> 01:04:18,020
everyone in that organisation or society are able to navigate their way around racism.

539
01:04:18,020 --> 01:04:23,060
So you pretend it's not there without acknowledging, without having to acknowledge that it's there.

540
01:04:23,060 --> 01:04:28,860
That's what normally happens in our society until something like something like covid-19 comes along where you have to acknowledge it.

541
01:04:28,860 --> 01:04:32,630
But before we get to that, so we structural racism exists,

542
01:04:32,630 --> 01:04:40,700
discriminatory actions are routinely implemented as part of our day to day behaviours without fear or challenge.

543
01:04:40,700 --> 01:04:46,370
So that's what you see in the NHS all the time, day to day people doing discrimination actions.

544
01:04:46,370 --> 01:04:51,210
No one's challenging it because it's structural. You don't have to.

545
01:04:51,210 --> 01:05:01,550
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.

546
01:05:01,550 --> 01:05:05,090
So if someone you where is the evidence of structural racism?

547
01:05:05,090 --> 01:05:13,100
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.

548
01:05:13,100 --> 01:05:14,990
That is structural racism.

549
01:05:14,990 --> 01:05:26,300
So the widely accepted idea of a social determinants of health also help to disguise racism because all because all known or unknown,

550
01:05:26,300 --> 01:05:29,630
that poor medical outcomes in education.

551
01:05:29,630 --> 01:05:38,450
So we all know that poor medical outcomes and things like poor medical care is linked to education, employment, housing, geography.

552
01:05:38,450 --> 01:05:44,720
So way of passing, living, criminal justice, political power and economic resources,

553
01:05:44,720 --> 01:05:50,510
they're all linked to something they're willing to health outcomes. So you can say it's because of that.

554
01:05:50,510 --> 01:05:53,750
What people tend not to say is that all of these things that I've just mentioned,

555
01:05:53,750 --> 01:05:58,550
poor medical education, employment, housing, they're the result of racism.

556
01:05:58,550 --> 01:06:05,420
And what we see is that white people from lower socioeconomic classes will also have disproportionately poor Americans.

557
01:06:05,420 --> 01:06:10,040
And that and so they can say, right, it's got nothing to do with race because it happens to white people as well.

558
01:06:10,040 --> 01:06:19,610
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.

559
01:06:19,610 --> 01:06:26,510
Black people, we just say it's the social determinants of how to simplify and then deny any form of structural racism,

560
01:06:26,510 --> 01:06:34,160
as we saw with the civil report. So if you can say it's the social determinants of health, it's not racism.

561
01:06:34,160 --> 01:06:38,100
But what happens is we have covid and this is really important.

562
01:06:38,100 --> 01:06:47,240
So then along comes covid-19 like luminal and UV light in the hands of a forensic scientist to reveal the hidden blood spatter,

563
01:06:47,240 --> 01:06:55,010
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,

564
01:06:55,010 --> 01:06:59,540
walks into the room with a forensic scientist, walks into the room, there's no evidence of any crime.

565
01:06:59,540 --> 01:07:05,600
Then they add some luminol and they shone the UV light and suddenly the blood splatter is everywhere and everything is revealed.

566
01:07:05,600 --> 01:07:10,940
And that's what happened with Kobe. Our society, if you like, very sanitised.

567
01:07:10,940 --> 01:07:14,330
Everything was happies, multicultural, multiracial, everything was happy.

568
01:07:14,330 --> 01:07:19,850
Then Kobe comes along and actually reveals, like you like all the inequality.

569
01:07:19,850 --> 01:07:25,220
So the data shows that injury and death covid-19 remains significantly worse.

570
01:07:25,220 --> 01:07:31,290
People racialise black when we take into control social determinants of health.

571
01:07:31,290 --> 01:07:35,420
So when we take into consideration consideration all of those things that I've mentioned where you live,

572
01:07:35,420 --> 01:07:39,590
how you live, etc., you are still likely to die if you're black.

573
01:07:39,590 --> 01:07:42,530
This leaves genetics and racism.

574
01:07:42,530 --> 01:07:50,690
Now, science says, and I'm a scientist, says there is no gene linked to race, which makes you more susceptible to covid-19.

575
01:07:50,690 --> 01:07:55,880
So we have to say, must be racism. But that's what people don't have access.

576
01:07:55,880 --> 01:08:00,780
So poor access to medical medical services is racism in action.

577
01:08:00,780 --> 01:08:06,260
Whenever someone asks me, just point to that. The idea of treating people differently, that's how you get there.

578
01:08:06,260 --> 01:08:15,320
So as long as racism is a viable political idea, then we will see things like poor medical outcomes for people racialized as black.

579
01:08:15,320 --> 01:08:20,720
Finally, racism feeds on itself and becomes self-perpetuating.

580
01:08:20,720 --> 01:08:27,840
So not allowing people access to proper education means there are fewer individuals for those groups.

581
01:08:27,840 --> 01:08:36,650
And free spirited video from those groups who have been affected to be able to explain and identify problems

582
01:08:36,650 --> 01:08:42,070
like covid-19 in a way that people want it to be explained to them in a way that people can trust.

583
01:08:42,070 --> 01:08:50,640
And with that, I'm going to stop. And.

584
01:08:50,640 --> 01:08:59,660
Presentation. I think I think I'm good, so sorry about that.

585
01:08:59,660 --> 01:09:04,520
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.

586
01:09:04,520 --> 01:09:13,510
I know we want to have some discussion. So I hope I've added something to the mix that we can talk about.

587
01:09:13,510 --> 01:09:18,610
OK, Mr. Morgan, that was that was quite informative,

588
01:09:18,610 --> 01:09:30,370
so thank you very much for being able to connect such an account of what's going on in, you know, institutional racism.

589
01:09:30,370 --> 01:09:36,200
OK, so we are now going to move on to some questions and answers.

590
01:09:36,200 --> 01:09:44,530
So please put your cameras on and your audio and.

591
01:09:44,530 --> 01:09:49,240
See how that works. OK.

592
01:09:49,240 --> 01:09:58,080
OK, ready for perhaps the first question? Yes, I do have the first question and it goes to Dr. Winston.

593
01:09:58,080 --> 01:10:05,180
OK, I know that, but go for it.

594
01:10:05,180 --> 01:10:09,170
OK. OK,

595
01:10:09,170 --> 01:10:17,990
the first question is how much has been written about the outcomes for black and minority ethnic staff and students

596
01:10:17,990 --> 01:10:27,280
in academia for advice for those of us in academia and how we can influence change at the institutional level?

597
01:10:27,280 --> 01:10:29,200
Well, that's a really big and tough question.

598
01:10:29,200 --> 01:10:35,410
You're right, how can you influence change at the institutional level, particularly in higher education institutions?

599
01:10:35,410 --> 01:10:43,810
Unfortunately, you have to stand up and call out whether it's micro aggressions or of overt racism.

600
01:10:43,810 --> 01:10:49,450
The system allows relies on people not to say anything.

601
01:10:49,450 --> 01:10:52,540
When, when when you see discrimination, that's what normally happens.

602
01:10:52,540 --> 01:10:59,350
So you have to, as an individual, also try and get yourself allies and accomplices.

603
01:10:59,350 --> 01:11:06,160
That is people from a variety of backgrounds, including your white colleagues, to actually take on some of the burden.

604
01:11:06,160 --> 01:11:11,830
Do not take it on yourself and on your own. Some allies, but call it out.

605
01:11:11,830 --> 01:11:16,160
Don't be afraid to do that and also use allies from outside your institution.

606
01:11:16,160 --> 01:11:23,750
So if you feel you are alone in your institution, there are networks of other people who might be the same kind of situation,

607
01:11:23,750 --> 01:11:30,340
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.

608
01:11:30,340 --> 01:11:32,920
So you can organise, for example, a presentation,

609
01:11:32,920 --> 01:11:38,380
but rather than you do it yourself and you bring someone from outside so you don't get some of that flack.

610
01:11:38,380 --> 01:11:44,950
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.

611
01:11:44,950 --> 01:11:53,750
But that's a starting point. Stand up to it. But get allies and accomplices to help you do to fight.

612
01:11:53,750 --> 01:12:05,580
That's great. Thank you very much for that, handsome. If I could add something to this,

613
01:12:05,580 --> 01:12:19,830
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,

614
01:12:19,830 --> 01:12:26,130
devastated, because remember, at the end of the day, there's only one person who is in charge.

615
01:12:26,130 --> 01:12:30,930
Less racist can make you feel guilty.

616
01:12:30,930 --> 01:12:34,810
And it's important not to provoke and and react.

617
01:12:34,810 --> 01:12:39,360
There are a lot of institutional organisational bodies, say, for example,

618
01:12:39,360 --> 01:12:45,480
in the hospitals, there is a freedom to speak Gurdon's where they can talk anonymously.

619
01:12:45,480 --> 01:12:50,970
Being committees are very importantly within a hospital context.

620
01:12:50,970 --> 01:13:01,560
It important, not to mention. Talk with external conditions, I think minor independent counsel, for example,

621
01:13:01,560 --> 01:13:10,660
we have in captivity that kind of what is so that the backlash doesn't happen.

622
01:13:10,660 --> 01:13:15,010
Thank you, Dr. Sacro. I mean, you you you pre-empted the question I was going to ask you,

623
01:13:15,010 --> 01:13:22,450
because that question was specifically posed to you from one of four or delegates would have replaced that with another question to you.

624
01:13:22,450 --> 01:13:33,430
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.

625
01:13:33,430 --> 01:13:42,980
Specifically, I want you to speak to that in relation to persons from racial minorities backgrounds and just shed some light on that.

626
01:13:42,980 --> 01:13:47,680
What are the implications of long covid neurologically on people from minority

627
01:13:47,680 --> 01:13:54,880
backgrounds and how can we protect ourselves and our families and our communities?

628
01:13:54,880 --> 01:14:03,820
Right. I mean, this is going to be a very tough question, which we'll be talking about for the next several years.

629
01:14:03,820 --> 01:14:13,180
The biggest problem for a lot of it will be believing in the believing in the existence of it.

630
01:14:13,180 --> 01:14:23,890
You know, covid is a predominantly male disease, along with the youngest symptoms are also report fatigue,

631
01:14:23,890 --> 01:14:33,430
sleeplessness, depressions, all these things, all these are symptoms, report and characteristically symptoms fluctuate.

632
01:14:33,430 --> 01:14:45,520
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.

633
01:14:45,520 --> 01:14:59,990
And in terms of. Minority issues, I mean, we have just completed a study in Bangladesh, UK, US, Canada.

634
01:14:59,990 --> 01:15:12,020
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.

635
01:15:12,020 --> 01:15:24,890
I think the main problem will be not just finding a solution, but delivering and accessing care, accessing care for these kind of issues.

636
01:15:24,890 --> 01:15:36,650
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.

637
01:15:36,650 --> 01:15:41,600
So that will be an issue, but I think it will unfold.

638
01:15:41,600 --> 01:15:45,620
With time. Thank you. Thank you so much.

639
01:15:45,620 --> 01:15:50,360
They make the comment that was a very important question.

640
01:15:50,360 --> 01:15:54,100
Well, then and then it disappeared in action.

641
01:15:54,100 --> 01:16:03,050
The very important point that someone raised and felt provoked by the statistics that I.

642
01:16:03,050 --> 01:16:10,880
Provided tough times to be that 80 percent of the medical and people in the region believe

643
01:16:10,880 --> 01:16:17,190
racism exist and 40 percent of political people and white people believe it exists.

644
01:16:17,190 --> 01:16:21,470
I intend to of the reality is the truth.

645
01:16:21,470 --> 01:16:30,200
And you can take a positive out of 40 percent of white people believing in the distance.

646
01:16:30,200 --> 01:16:35,090
That gives rise to the real thing, which is what we need, what Elizabeth said.

647
01:16:35,090 --> 01:16:40,610
We need a collaboration of the Like-Minded people.

648
01:16:40,610 --> 01:16:48,400
This kind of this discussion on this empty racist movement requires polite people, not all white people.

649
01:16:48,400 --> 01:16:53,330
A lot of white people are actually fighting for anti-racism.

650
01:16:53,330 --> 01:17:03,920
So somehow we need to make that the like minded people and not denigrate everyone, white people, as that itself is racist.

651
01:17:03,920 --> 01:17:11,300
So we need to have that provoked and very passionate things.

652
01:17:11,300 --> 01:17:18,470
We need to be it to contain control of mindset and create a strategy how we can handle.

653
01:17:18,470 --> 01:17:28,850
And instead of getting into this debate, the terminology of being minority opinion is the focus on the on the issues in

654
01:17:28,850 --> 01:17:38,720
terms of injustice and actually ask for anti-racism training to be mended,

655
01:17:38,720 --> 01:17:43,790
if possible, unconscious bias training positions. But it has its merits.

656
01:17:43,790 --> 01:17:50,660
But what is necessary is everyone to raise the voice we need and do whatever we want.

657
01:17:50,660 --> 01:17:57,280
That doesn't mean everyone is racist. We need anti-racist.

658
01:17:57,280 --> 01:18:02,620
I wonder. Thank you. Thank you so much.

659
01:18:02,620 --> 01:18:10,570
We have another question in the chat, it's a monster question on Mike one, and it's for Professor Dame Elizabeth.

660
01:18:10,570 --> 01:18:18,490
Can you speak to the bone marrow transplant and the ways in which this sometimes is utilised,

661
01:18:18,490 --> 01:18:34,170
the way in which this sometimes utilises treatment available for sickle cell and how it is affected by racism and disparity?

662
01:18:34,170 --> 01:18:45,950
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.

663
01:18:45,950 --> 01:18:51,590
The way we talk about the actual I don't really want to get into the nitty gritty because I'm not

664
01:18:51,590 --> 01:18:57,620
up to date with it and I refuse to ever discuss stuff that I'm not up to date with point one.

665
01:18:57,620 --> 01:19:09,180
Secondly, though, I would I would sort of give the comparison in this country with historically what went on with blood.

666
01:19:09,180 --> 01:19:18,380
The the perception going back to the 1970s when I was in practise in the 80s,

667
01:19:18,380 --> 01:19:33,840
that black people were very reluctant to come forward to donate their blood without people actually aware of how institutionally.

668
01:19:33,840 --> 01:19:37,470
And the National Front, by the way, took place up.

669
01:19:37,470 --> 01:19:48,000
That black people's blood was supposed to be inferior and carried infections and that attitude, rather than looking at the facts very simplistically,

670
01:19:48,000 --> 01:19:57,960
I have to admit here that we know there are various blood types, but there are subgroup types within those blood groups.

671
01:19:57,960 --> 01:20:06,810
And the more people from diverse communities that we can have that could come forward to donate blood,

672
01:20:06,810 --> 01:20:14,550
the the higher the chance to get the appropriate matches for people from different diverse backgrounds.

673
01:20:14,550 --> 01:20:18,810
And I think because this wasn't really explained clearly.

674
01:20:18,810 --> 01:20:28,440
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.

675
01:20:28,440 --> 01:20:33,600
And I think this is a similar issue, possibly, as I've said, I'm not totally up to date with this,

676
01:20:33,600 --> 01:20:41,550
but with the efforts that people are trying to have to get HLA matches and to encourage donors, et cetera.

677
01:20:41,550 --> 01:20:48,540
But of course, the other issue with bone marrow transplantation and sickle cell disease,

678
01:20:48,540 --> 01:20:55,320
which is not quite the same as bone marrow transplant and for for beta thalassaemia,

679
01:20:55,320 --> 01:20:59,340
major, which I'm sure most people will know,

680
01:20:59,340 --> 01:21:07,950
those individuals with that condition require blood transfusions every four to six weeks to survive from childhood into adulthood,

681
01:21:07,950 --> 01:21:17,880
whereas with sickle cell disease very complex, a proportion of individuals require blood donations, but not all,

682
01:21:17,880 --> 01:21:24,420
and also some require very intermittently, etc. They don't require it generally, but a small proportion.

683
01:21:24,420 --> 01:21:34,560
So what I was I'm aware of in respect to the perceptions and attitudes and issues surrounding bone marrow

684
01:21:34,560 --> 01:21:44,880
transplantation for sickle cell disorders is an ethical and cultural and religious sometimes attitude.

685
01:21:44,880 --> 01:21:51,330
Well, hold on. If there was better treatment for sickle cell disease, do we need bone marrow transplantation?

686
01:21:51,330 --> 01:21:56,760
Because bone marrow transplantation very dangerous, even if you got the match.

687
01:21:56,760 --> 01:22:07,320
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,

688
01:22:07,320 --> 01:22:11,440
parents, adults is is is actually very complex.

689
01:22:11,440 --> 01:22:17,050
On the other hand, there are historically there was a perception that.

690
01:22:17,050 --> 01:22:24,490
Bone bone marrow transplant patients weren't actually talked about as much for sickle cell disease as for other conditions.

691
01:22:24,490 --> 01:22:36,970
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.

692
01:22:36,970 --> 01:22:45,750
And we see that with covid-19 and vaccinations. Do you trust the system?

693
01:22:45,750 --> 01:22:50,890
Do you really trust the system? That that vaccination is OK.

694
01:22:50,890 --> 01:22:56,910
We all have our role to play. I've had my two vaccinations. I just put that on the table.

695
01:22:56,910 --> 01:23:07,170
But those of us interested in the history of medicine and racism totally understand where this lack of trust is coming from.

696
01:23:07,170 --> 01:23:17,680
But we're also very concerned. That there should be benefits of scientific advances that we do trust.

697
01:23:17,680 --> 01:23:24,100
Thank you much. I have a question for Dr. Bob.

698
01:23:24,100 --> 01:23:26,320
I'm going to be this person because it's me,

699
01:23:26,320 --> 01:23:35,260
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.

700
01:23:35,260 --> 01:23:44,800
But I know they need help due to fear of reproach in parentheses, revealing their racism or appearing racist.

701
01:23:44,800 --> 01:23:50,890
How do I balance the two to get my organisation to be more aware and I would add.

702
01:23:50,890 --> 01:23:55,400
How does the system protect herself from the damage of doing this work?

703
01:23:55,400 --> 01:24:01,450
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.

704
01:24:01,450 --> 01:24:07,030
You are your work. You are your people, you are your connexion. And without you, this can't go forward.

705
01:24:07,030 --> 01:24:10,660
The first thing is to look after yourself and to think you have a choice.

706
01:24:10,660 --> 01:24:15,670
I think sometimes it's about not always bringing the content to conversations because I think we're

707
01:24:15,670 --> 01:24:21,280
having to experience an opportunity or a time where our private pain becomes public property.

708
01:24:21,280 --> 01:24:26,590
And so I think part of it is maybe being curious about the absence of what's happening with Saddam Hussein,

709
01:24:26,590 --> 01:24:32,590
to have allies, to connect with people, to go forward. But you thinking about how do I look after myself?

710
01:24:32,590 --> 01:24:38,170
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.

711
01:24:38,170 --> 01:24:43,150
But it may be too emotionally difficult to emotionally traumatising, too emotionally stressful.

712
01:24:43,150 --> 01:24:50,050
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.

713
01:24:50,050 --> 01:24:57,160
And that takes time. Like I say, change only happens at the speed of trust and having to really invest in yourself differently.

714
01:24:57,160 --> 01:25:04,060
But think about being so focussed rather than selfish and actually thinking about doing that.

715
01:25:04,060 --> 01:25:13,300
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,

716
01:25:13,300 --> 01:25:26,950
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.

717
01:25:26,950 --> 01:25:39,400
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?

718
01:25:39,400 --> 01:25:43,030
To develop that level of trust within the community, what are your perspectives on that?

719
01:25:43,030 --> 01:25:52,170
Because if we see more people from. Diverse backgrounds, you know, getting involved in the research process, for example, yourself,

720
01:25:52,170 --> 01:26:00,690
you know, how what are the implications of that on the greater sort of trust within the community?

721
01:26:00,690 --> 01:26:07,140
I mean, I think that's a good question in the sense that we tend to trust people who, you know,

722
01:26:07,140 --> 01:26:12,480
are like us, you know, whether you're from the north or from the, you know, whatever your background is.

723
01:26:12,480 --> 01:26:14,060
And people kind of flock together.

724
01:26:14,060 --> 01:26:21,360
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.

725
01:26:21,360 --> 01:26:26,290
And I follow in his footsteps and and I have an Oxford Daphne.

726
01:26:26,290 --> 01:26:29,200
You know, we kind of have these discussions all the time.

727
01:26:29,200 --> 01:26:39,510
Who is there, you know, pushing a path for us and, you know, and showing showing an example of of,

728
01:26:39,510 --> 01:26:42,990
you know, engaging with academia or doing the kind of work.

729
01:26:42,990 --> 01:26:50,940
So but the question on trust is, you know, I always say it's all about credibility of expertise.

730
01:26:50,940 --> 01:26:57,660
And if the environment is such that we don't feel comfortable to go into those areas,

731
01:26:57,660 --> 01:27:03,630
then then you have this this deficit and then there's the sort of the progression kind of deficit as well.

732
01:27:03,630 --> 01:27:07,290
You know, I think Winston talks about this and others.

733
01:27:07,290 --> 01:27:14,820
But what I what I kind of want to come back to is this idea of the social contract, right, which is, you know,

734
01:27:14,820 --> 01:27:21,360
vaccines, for example, they they have a benefit for the user, but actually the benefits to the greater society.

735
01:27:21,360 --> 01:27:24,780
You know, I am protecting me, but actually also protecting you.

736
01:27:24,780 --> 01:27:33,210
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?

737
01:27:33,210 --> 01:27:41,670
And the point that Elizabeth made was I dropped the dame there was that, you know,

738
01:27:41,670 --> 01:27:52,850
if the individuals have who who kind of partook in the in the in the research are not representative of you.

739
01:27:52,850 --> 01:27:56,600
I mean, how how how much are you going to really say?

740
01:27:56,600 --> 01:28:03,910
I always used to be massively underweight, apparently, but I'm telling you, for a young Sudanese boy, I was perfect.

741
01:28:03,910 --> 01:28:10,730
You know, that's that's so so there is sort of, you know, medical idiosyncrasies,

742
01:28:10,730 --> 01:28:19,970
which we sort of push us to to kind of be easy to to reject any kind of thing put to us.

743
01:28:19,970 --> 01:28:23,810
Trust. However, the credibility of the information is key for me. You know, I'm a scientist.

744
01:28:23,810 --> 01:28:30,020
We kind of look to the data and but then it's sort of listening to, you know,

745
01:28:30,020 --> 01:28:34,040
having someone who's going to come to you, sit with you and explain it to you.

746
01:28:34,040 --> 01:28:38,690
And you don't feel patronised. You not feel, you know, maybe to get rid of some of the jargon.

747
01:28:38,690 --> 01:28:46,670
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.

748
01:28:46,670 --> 01:28:50,460
And that to me, that to me was.

749
01:28:50,460 --> 01:28:54,890
Do you want to come in on that? Sorry. No, but I want you to finish and then I'll come in.

750
01:28:54,890 --> 01:28:58,400
Sorry, I just I was just indicating that I'd like to add something to you.

751
01:28:58,400 --> 01:29:04,730
I think I think that was it's after 7:00 now. I'm sorry, but oh, we'll have to try this.

752
01:29:04,730 --> 01:29:08,650
So I apologise. To apologise.

753
01:29:08,650 --> 01:29:14,300
To apologise. Thank you. Could you please.

754
01:29:14,300 --> 01:29:18,290
Unfortunately has nominated me to be the the bad guy.

755
01:29:18,290 --> 01:29:25,940
So thank you. But thank you so much for a fascinating discussion to all our panellists.

756
01:29:25,940 --> 01:29:33,470
And I thank you so much for accepting our invitation in the first instance and for partaking in such

757
01:29:33,470 --> 01:29:42,110
a timely and important conversation or chat suggests that we probably need to consider a part two,

758
01:29:42,110 --> 01:29:47,150
but we don't have that discussion of share with my colleagues. So thank you so much for your contribution.

759
01:29:47,150 --> 01:29:49,310
We really, really appreciate it.

760
01:29:49,310 --> 01:30:01,010
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.

761
01:30:01,010 --> 01:30:11,780
For example, the Canteen Medical and Midway Medical School, specifically their firm, their common commitment and, you know, to promote equality,

762
01:30:11,780 --> 01:30:21,230
diversity and inclusion, and specifically to situate racial justice as a fundamental aspect of their pedagogy, research and practise.

763
01:30:21,230 --> 01:30:30,140
So we thank the cantered Medway Medical School and we hope that we can continue this collaborative relationship.

764
01:30:30,140 --> 01:30:40,460
Barbara. And some thoughts about losing the votes of thanks to the sponsorship of student success we have of great

765
01:30:40,460 --> 01:30:48,830
supportive the is wonderful in supporting this collaborative events and also with student success,

766
01:30:48,830 --> 01:30:55,460
also with the School of Social Policy, Sociology and Research.

767
01:30:55,460 --> 01:31:06,290
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,

768
01:31:06,290 --> 01:31:10,840
the Oxford Biomedical Research Centre, Green Templeton College,

769
01:31:10,840 --> 01:31:19,600
and most particularly event organiser Hayley Pugh University College Union, Oxford Equality and Diversity Unit,

770
01:31:19,600 --> 01:31:30,460
Oxford, Rio Blanco and Tahj Perry Paria, Shayler Kamilla Compassionate Kova Alexander Gordon Victoria Swarmy.

771
01:31:30,460 --> 01:31:41,060
And last but not least, Dave Thomas and Barbara tonight with the Baim Staff Network of the University of Kent.

772
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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.

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Thank you. Thank you. Thank you. Thank you. Thank you.

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Thank you. Bye bye. Thank you very much, everybody.