Medical Mistrust and Enduring Racism in South Africa (original) (raw)
Related papers
The issue of race and ethnicity within obstetrics and gynecology has come to the forefront in the current social and political climate. Understanding the ill effects of racism within the clinical space requires an acknowledgment of both the ongoing problem and current limitations in the state of knowledge and praxis among clinicians, trainees, and educators alike. In this commentary, the issue of race and racism within obstetrics and gynecology is discussed through a case of discrimination experienced by an intern working in an urban, academic hospital. By attending to the different layers of hierarchy within medical education and care as well as the multitude of silences from potential allies, we demonstrate a critical need to understand racism and inequality in the clinical and educational space. We deconstruct the issue of race and racism by contextualizing it with ongoing discussions in the social sciences and public health as well as wider discussions of the relationship of race with professional training and employment in biomedical fields. Finally, we offer both action items and calls for future educational and practice-based solutions to affect change in the way obstetrics and gynecology is taught and practiced.
Racism in a Medically Segregated World
The article posits a preliminary critical examination of issues tied to racism within the field of medicine and medical school education. The discussion notes that manner in which the economy commingles historically to produce long term and persistent practices of racialization, which result in a pernicious system of medical apartheid. The discussion concludes with a call toward an ethics of liberation, which calls for expanding the ethics of medicine, in ways that integrate values that support doctors in honoring all life, reinserts the notion of community care, and speaks truth to power.
Social Science Medicine, 2010
This commentary briefly explores the conceptual issues that underlie studies of race and racism in health care. First, what do we mean by racism in the contemporary medical context? Second, is there a model of racism that can encompass the range of what is referred to as racism? That is, is it possible to conceptualise everything that is meant by racism, from features of interpersonal communication to population-level inequalities, in a single model? Monica Peek and colleagues (2010) explore how patients' perceptions of race may influence decision-making in a medical context. A model of shared decision-making ('Information-sharing, Deliberation or Physician recommendation and Decision-making') is posited as an intervention capable of reducing disparities in disease outcome. Racialised inequalities in rates of diabetes diagnosis, complication, disease management and quality of outcome are well documented and require urgent remedial attention. Previous research has shown that methods of shared decisionmaking do not work as well with minority ethnic patients as with majority ethnic patients. Peek and colleagues explore how Black people with diabetes view the role of race in decision-making about medical care with their doctors, using a combination of in-depth interviews and focus groups.
Palgrave Communications, 2019
Relying on the experiences of migrant patients, research on migration and health in South Africa has documented a particular concern with public health care providers as indiscriminately practicing 'medical xenophobia'. This article argues that there is more complexity, ambivalence, and a range of possible experiences of non-nationals in South Africa's public health care system than the current extant literature on 'medical xenophobia' has suggested. Based upon in-depth interviews with frontline health care providers and participant observation at a public health care clinic in Musina sub-District, this article demonstrates how discretion may play a crucial role in inclusive health care delivery to migrants in a country marred by high xenophobic sentiment. It finds that in spite of several institutional and policy-related challenges, frontline health care providers in Musina provided public health care services and HIV treatment to black African migrants who are often at the receiving end of xenophobic sentiment and violence. The article concludes that citizenship, nationality or legal status alone do not appear to tell us much as 'bureaucratic incorporation' and 'therapeutic citizenship' are some of the modalities through which migrants are constantly being (re)defined by some of South Africa's health care providers.
Race trouble: experiences of Black medical specialist trainees in South Africa
Background: This research aimed to identify and explore the experiences of Black registrars in their training in the Western Cape’s academic hospitals in order to identify structures, practices, attitudes and ideologies that may promote or impede the advancement of Black doctors into specialist medicine. This is justified by the requirement for universities to work towards monitoring and evaluating efforts to create non-discriminatory and inclusive training environments. Methods: This study employed qualitative research methods. Ten Black African medical specialists were interviewed about their training experiences in two university training hospitals in the Western Cape Province, South Africa. Interview data was collected using open-ended questions and coded and analysed using thematic and critical discursive analysis techniques. Results: Four experiential themes emerged from the interview data, they included: 1) experiences of everyday racism during work hours, 2) the physical and psychological effects of tokenism and an increased need to perform, 3) institutional racism as a result of inconsistent and unclear methods of promotion and clinical competence building, and 4) an organisational culture that was experienced as having a race and gender bias. Conclusion: This is a pilot study and there are limits on the generalizability of the data due to the small sample. What is clear from our participants, though, is the strong experiential component of finding it challenging to be a Black trainee in a White-dominated profession. We are undertaking further research to explore the issues raised in more detail.
Racism in healthcare: a scoping review
BMC Public Health
Background Racism constitutes a barrier towards achieving equitable healthcare as documented in research showing unequal processes of delivering, accessing, and receiving healthcare across countries and healthcare indicators. This review summarizes studies examining how racism is discussed and produced in the process of delivering, accessing and receiving healthcare across various national contexts. Method The PRISMA guidelines for scoping reviews were followed and databases were searched for peer reviewed empirical articles in English across national contexts. No starting date limitation was applied for this review. The end date was December 1, 2020. The review scoped 213 articles. The results were summarized, coded and thematically categorized in regards to the aim. Results The review yielded the following categories: healthcare users’ experiences of racism in healthcare; healthcare staff’s experiences of racism; healthcare staff’s racial attitudes and beliefs; effects of racism i...
Racism and Healthcare: Representations of the ‘Other’ in Health Services
2018
In countries where immigration is seen as important, health and social-medical services recruit staff member’s that support this image of society. Immigration rates of those originating from the southern hemisphere are already elevated in many northern countries, but in France, the metropolitan territory also includes nationals of overseas territories and departments (in particular the French Caribbean), whom are heavily recruited in public services, and by extension, hospitals, beginning in the 1960s-70s. [6] The white majority of patients within these services do not always perceive this phenomenon in the best light.
Race and Health: Dilemmas of the South African health researcher
Fault Lines: A primer on race, science and society, 2020
Concepts related to race Two concepts related to race that are regularly conflated with race in the health literature deserve special mention: ethnicity and ancestry. 4 Ethnicity is often used interchangeably or in combination with race (as race/ethnicity). Ethnic categories are used to group people according to their shared cultural heritage, language, social practice, traditions, and geopolitical considerations. As with race, there is no universal
The Racism That Undergirds Global Public Health
CounterPunch, 2021
With Epidemic Illusions: On the Coloniality of Global Public Health, Eugene Richardson takes to task the discipline of epidemiology, and with it, global public health. Utilizing the West Africa Ebola epidemic of 2013-2016 as his canvas, Richardson paints a picture that highlights the racism that undergirds the conventional medical and public health perspectives. As Black Lives Matter is to white supremacy, Epidemic Illusions is to epidemiology. It shows us how global public health is itself fraught with white supremacy and colonial assumptions. It is a book for our times.