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Put the Black in BAME: the change that needs to happen in pharmacy


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By Mohammed Hussain

22 Jun 2020

By Mohammed Hussain, RPS Fellow, former GPhC council member, current NHS Trust non-executive director, senior clinical lead in health technology

The coronavirus has spread out of control, in every continent and every country in the whole world. The fact is, we have to find a new way to live with the coronavirus until we find a vaccine or achieve herd immunity.

Racism is similar. It is a pandemic. It has spread everywhere, and there is no way to put it back. Racism also kills, and inhibits people’s lives. It creates social distancing and furloughs careers (though without the government support). Unlike the coronavirus, there is no likelihood of a vaccine for racism.

Racism is not just the knee of a policeman on your neck: it is the knee on your career; your ambitions; your dreams; your aspirations. The knee on the neck is also subtle. It is the microaggressions in everyday life that, although they do not kill, like a thousand cuts, they will bring you down and limit your life chances.

Like all people of colour, I have experienced acts of racism, small and large, my whole life. My earliest memory is of a racist attack on myself and my brothers by a group of bigger white boys. By age 8, I had my arm broken by another white boy, shouting ‘Paki’. From age 11 to 16, we were abused every single day on the way to secondary school. I’ve been spat at, punched, kicked, egged and shot by air gun pellets. This is the life of a brown or black person.

My name is not the name I grew up with. During summer pharmacy placements, and then on to my pre-reg at Boots, I was racially harassed by the other team members, who mocked my name and decided to call me ‘Fred’ and ‘Mike’. When I complained to the store manager, he told me this was just work banter and that I needed to ‘lighten up’. The abuse continued for the whole year. This is why I now use Mohammed as an easy to pronounce name that is still true to my identity, but this is not the name I grew up with.

‘I relentlessly pushed equality, diversity and inclusion’

Whilst I have successfully worked in many roles, in community pharmacy, as the pharmacist, I have generally been afforded greater respect. However, on almost every occasion that something has gone wrong and the white customer has become angry (and whether it was the pharmacy’s failure or not) I have been called ‘Paki’. I have been racially assaulted and physically attacked twice in pharmacy by a white male (it always seems to be the men). The issue of race and my brownness appears to offend most greatly when things go wrong; otherwise we are tolerated. It is not just patients. I have encountered acts of racism, small and large, from colleagues and managers.

At what I thought was the pinnacle of my professional career on the GPhC Council, at a formal dinner an existing white Council member brazenly told me I had only got the role because I ticked a box. The shock at the audacity of this comment at first stopped me in my tracks, but then I responded, ‘I don’t care what you think, I don’t care what the panel that appointed me thinks. I am here now and by the time I leave I will have made a difference’. I believe I did just that. I relentlessly pushed equality, diversity and inclusion. I focussed in on systems, processes and data. That is how change happens – change the machinery and the hearts and minds can follow or not. That is my philosophy.

I pushed for the reporting on ethnicity pass rates on the pre-reg exam that highlighted that Black students have a 50% pass rate, compared to over 90% for some other groups. I pushed for equality impact assessments and challenged on changes to accommodate Ramadan. The latter led me into a conflict with two white academics in Birmingham, who subsequently lodged multiple complaints over a number of years to the GPhC.

I have been attacked outside of work, and managed to secure a conviction for racially aggravated assault in 2015. This racism is easy to identify. The more insidious racism is the structural, systematic bias that pervades everything about us. Like the coronavirus it gets everywhere. It was the bias in Fitness to Practise cases and sanctions that drove me to join the RPSGB, and then the GPhC.

‘We have a long way to travel for equity’

Bias is often masked as insight. I had senior white pharmacists tell me that the reason why BAME pre-regs were not more represented in hospitals was because ‘they’ preferred retail environments. This is an unconscious bias masquerading as insight. It is dangerous in that it denies there is a problem. I knew this to be wrong. Almost every BAME pre-reg I knew applied to hospital, but they didn’t get in (myself included). The BAME pharmacists end up in retail because they have to work somewhere, and that’s where the barriers to entry are less discriminating. The position is now improving with the Oriel system reducing organisational and interviewer bias.

The RPS is another example of an organisation that has long been in denial about racial disparity. Even today the RPS does not know the ethnic make-up of its members and how that compares to the registrant population. I had to call out the RPS for two years’ running for organising the annual Fellows dinner in Ramadan – inviting Muslim Fellows to dinner, when we can not eat. These are small acts, but they demonstrate that we have a long way to travel for equity.

‘We need to put the Black back into BAME, and address issues specific to this cohort’

In addressing racial disparity, we need to look with a critical eye, and recognise that BAME is an umbrella term masking a heterogenous group. The pharmacy profession has work to do: South Asians (primarily Indian) are better represented in pharmacy, but the Black and other minority representation is very poor. We need to put the Black back into BAME, and address issues specific to this cohort. As allies, Asians need to recognise that although we share common experiences the barriers we face and are structurally different. Allies need to create the space for black voices and not fill the space as a representative for all of BAME.

The burden of fixing these issues falls disproportionately on BAME people. We have not created the problem and, therefore, we should not have the sole burden of fixing it. Our white colleagues need to educate themselves and join us to make this a priority. Together we can make a difference.

The racial disparities in our profession reflect wider society. We cannot fix everything, but we can make our little piece of the world a fairer more just place. The best time to address inequality was generations ago, the second-best time is now.


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