Discrimination in healthcare has major consequences for the quality of care and therefore for the health of patients. Sita Mohabir (28) gives experienced discrimination in healthcare a face and a voice. “It is about the impact of what I have experienced through their unconscious prejudices, formed on the basis of stereotypes in this society.”
Sita: “I’m in the hospital when a nurse comes to me. To hear my story, I understand from her questions. This happened the same week with another sister. They react with surprise when I tell them that I am an entrepreneur, saying ‘that’s great, how do you do that with all your limitations?’ If it turns out that I have studied: ‘I did not expect that’. And when it becomes clear that I have a boyfriend, I must be ‘really happy to have such a friend, who takes care of you’.”
A young woman of color
“Imagine, I have just had a very serious operation, I am sick in bed and receive these questions and reactions. Not because of caring for me, it’s not about me. But about me as a person and my identity. I am a young woman of color from a Dutch-Surinamese/ Hindustani culture with a chronic illness and a physical disability. Would I have gotten these questions and responses if I were an older white man? I don’t think so now.”
accumulation
“This is just one example of being approached and treated differently, and unfortunately won’t be the last. After my hip surgery, an assistant neurologist told me it could be another three years before I could walk again. I was alone and in tears at the time. The orthopedist reacted in disbelief when I told her: this should never have been said, because the neurological situation was not yet clear and certainly not by his assistant. I didn’t feel taken seriously by that neurologist at all.”
Because I am of color, I may be further away from him than a white man.
Sita
feeling (un)seen
“With the orthopedist, I do not experience any distance between patient and doctor/nurse. She takes me, my body and what I feel seriously. She asks what I think when the next checkup is in so many months, how I feel about it or what I think is best. We discuss the risks of whether or not to have another operation and really decide together. She approached the neurologist, who then apologized. I explained to him how sad and unseen I felt. Because I am of color, I may be further away from him than a white man. Yet he was negligent in this. I wanted to give him the opportunity to think about the impact and consequences of his unconscious prejudices.”
avoid care
“I notice that I prefer to avoid healthcare now, I am dreading another operation. Too much has happened in all those years, too often I didn’t get the right care and mistakes were made. Since I was 17 years old with cancer, I had the feeling that I was being treated differently. It’s not about the intention of health care providers, I don’t think they are always deliberately discriminating or racist. It is about the impact of what I have experienced through their unconscious prejudices, formed on the basis of stereotypes in this society. I don’t want to go to the hospital again unless it’s life-threatening.”
Research: Discrimination in healthcare
Discrimination damages people’s health and is a major cause of health inequalities. Experiences with discrimination in healthcare give the feeling that they are not seen and heard or are not taken seriously. As a result, people lose their trust in care organizations and start avoiding care. In addition, discrimination leads to unhealthy (chronic) stress, which can literally make people sick. Our research report offers stories of experience and useful tools to combat discrimination in healthcare.
Awareness and environment
“Now that I’ve read more studies about it, I know that’s how unconscious biases work. I recognize it faster now, but it still surprises me sometimes. I want to make people aware of this mechanism, so I share my experience and have made it my regular work. Hoping it gets better. That is why I also fill in feedback forms or send a letter of complaint, such as after my admission to the rehabilitation center. There they forgot to take medication and I got no help with dressing, for example, because she ‘first had to write a report’. While my white neighbor was helped a little later. Then you don’t feel important. Such a different treatment stings. Especially if you already feel so helpless, I sat there for a reason. But I wanted to get out of there as soon as possible.”
With an excuse and training, confidence is not restored. This will only grow if care providers practice conversation skills and reflect on their behaviour.
To reflect
“I understood from the black intern that they called me ‘the brown one with all those questions’. And she told how she herself was approached differently by white colleagues. And I saw how she was eventually sent away while her colleague, a white intern, continued to make mistakes and was not recognized by the same supervisors. The manager was understanding to my letter of complaint. The care manager promised to adjust the medication process. But yes, is that enough? I doubt it, especially as long as the staff doesn’t reflect the diversity of the clients. With an excuse and training, confidence is not restored. That only grows if caregivers practice conversation skills and reflect on their behaviour.”
Webinar: Discrimination in healthcare
On June 30, we will illustrate the impact of experienced discrimination on healthcare users and healthcare employees in a webinar. Together we will address unequal mechanisms that hinder the opportunities for equal care and a safe workplace. But we also reflect on the role of medical education and the organizational culture of healthcare institutions. We also share possible solutions, effective elements in the approach against discrimination and direction to make this theme a topic for discussion. Sign In!
A voice
“I have been ill for ten years and therefore have just as long experience in healthcare. As a result, I have become an empowered patient. It’s been years but now I speak up when I don’t feel treated well, badly or unequally. But there are a hundred thousand other patients in care in the Netherlands who are too ill and therefore leave it alone, who do not know how to put it into words or who think it should be. I speak out for all those people.”
Sita