White doctors are three times more likely to be picked for senior hospital jobs than doctors from ethnic minorities, an investigation has found.

UK: Ethnic doctors far less likely to reach senior posts in NHS - Health News - Health & Families - The Independent

From the article:

Health leaders called for an investigation into the figures, which the NHS Employers organisation said “added weight to concerns around discrimination” in the health service.

Black doctors were the least likely to secure consultant, specialist or trust doctor roles in 2012, according to the respected BMJ Careers journal, with a success rate of only 2.7 per cent. White candidates for the same jobs in 50 NHS trusts in England had success rates of nearly 14 per cent. Mixed ethnicity and Asian doctors were also much less likely to win senior positions than their white colleagues.

If a black woman and a white woman both need emergency obstetric care, a Brazilian doctor will assist the white woman because of the stereotype that black women are better at handling pain and are used to giving birth.

IPS – Brazil study: Racism Is Bad for Health | Inter Press Service

Read the rest of the study at the link, with details on how this racism in healthcare plays out.

About medical attention

iusedtoknowwhattosay replied to your quote: Doctors at the Odense University Hospital…

I am officially ashamed to be part of the human race today. Can I opt out and claim I am an alien from outer space and distance myself completely from those humans on this planet

I don’t think I ever told this story but here it goes.

It was 2001 or 2002 and my Dutch was not very good at the time (not that it is flawless now but it was even more precarious back then). I suffered from crippling abdominal pains from time to time. It would take almost ten years to figure out why (gallbladder, which I had removed at the end of 2010). But back around 2001, I was sometimes knocked down from pain in ways I had never experienced. We are talking “me curled up on the floor” levels of pain. I went to the doctor. He couldn’t figure out what it was through an external examination so he sent me for an endoscopy test (the one where they put a tube with a camera through your mouth up to your stomach).

I was told I shouldn’t eat 12 hours prior to the test. I am a grown up woman. I followed the instructions to the T. If I recall correctly, I even outdid the instructions by a few hours to be on the safe side (as in, I didn’t eat for 14 hours or so). The day of the test comes and here I am, surrounded by a doctor and three lab technicians. They were abrupt, but alas, I thought it’s part and parcel of the healthcare industry. They insert the tube down my throat. This was EXTREMELY painful. And I do not mean it lightly. The tube finds its way down my stomach and I vomited. I mean, it was as if I had eaten an hour before. A complete meal came out. Then, this doctor, had in him, while I have a tube down my throat and I am covered in my own vomit, unable to respond, to start shouting racist abuse at me: YOU FOREIGNERS ARE ALL THE SAME, IGNORANT ASSHOLES WHO CANNOT FOLLOW BASIC INSTRUCTIONS! and this went on for, at least, 10 minutes, while I wasn’t unable to say a word to defend myself. I was the “ignorant immigrant”, the “stupid foreigner”, the “reason why the medical industry was in shambles”, etc etc etc.

I was alone (my partner couldn’t come with me due to working hours). I don’t remember ever feeling so vulnerable and so mistreated before. I tried to explain I hadn’t eaten in my broken Dutch to no avail. I was told the test was useless and it was all my fault because IGNORANT FOREIGNER! I walked away crying and did not seek medical attention for YEARS as a result of this incident. YEARS. I didn’t even know there was a place I could complain about this or that what happened to me warranted an investigation and a sanction for the doctor and his assistants. Luckily for me, gallbladder problems are, for the most part, non life threatening. But I lived with the condition for years until I could muster the strength to seek help about it again.

For what it’s worth, my current doctor (and everyone who treated me in the hospital for surgery) were great and I have nothing but praise for them. However, I know all too well how certain people in the medical establishment treat those they deem as “inferior”.

Doctors at the Odense University Hospital refrained from operating a 65-year-old woman with pancreatic cancer, noting as a reason in her medical journal that she was ‘slightly retarded’.

Six months later, the woman was re-admitted to hospital in a serious condition, with her cancer having spread so much that it was not possible to operate. She died six months later.

Denmark: No op for retarded patient - Politiken.dk

I don’t think I can add anything articulate to this. Words fail me.

(H/T inessita)

Kwate’s study aims to address two unanswered questions confronting biomedical and behavioral researchers: What effect does racism have on the body, and what can society do about it?

“Most people don’t think of racism as a social construct that affects health,” says the trained clinical psychologist, who came to Rutgers last year from Columbia University. “They think of behaviors like diet, doctor visits, and the like, not so much about how the broader processes of inequality affect a person’s ability to engage in healthy behaviors.”

Health News - Rutgers Researcher Exploring Effects of Racism on Immune System

I don’t want to quote the entire article but it is well worth the read. An excerpt:

The summer of 2010 found Kwate and her team biking through central Harlem in Manhattan and Bedford-Stuyvesant in Brooklyn, shooting videos with cameras mounted on the handlebars to document signs of institutional racism. They are now coding the videos to identify such features as the retail environment and the proliferation of vacant lots.

The two predominantly African-American neighborhoods were chosen because they are similar in demographics and land-use characteristics. The researchers are interviewing a random sampling of 450 residents about their experiences with racism.

The study will measure the respondants’ immune system and metabolic function over two time points through physical tests.

se-smith

‘It’s all for a cause’ and ‘it’s for your own good’ are two claims that are often repeated to justify harmful actions. In ‘breast cancer awareness’ where such campaigns don’t appear to actively contribute to anything meaningful, it’s a slap in the face to people who dare to voice opposition to the framing or handling of such campaigns when they’re told that they should sit down and shut up. Despite valid concerns not just about how the campaigns are conducted, but what they actually do, they’re steamrollered by people who suggest they’re somehow pro-cancer if they have a problem with cause marketing and objectification that don’t appear, in any concrete way, to benefit the very cause under discussion. Does posting your bra colour contribute in some way to support for breast cancer prevention and treatment?

The US National Institute for Mental Health is sponsoring a research initiative on the state of “Mental Health” patients in the Global South. As you probably suspected, I had a few (well, more than a few) words about it:

However, notably absent from both the article and the organization’s website, is the question of the legacy of colonialism (past and present) in the Global South. Because, in case it is not obvious, we have an ongoing problem with definitions of what constitutes mental health, community responses to mental health issues and whose healthcare (and pharmacological) models are used to draft these definitions imposed on the Global South.

Read more here.

Weight and HFCS - a new study

Just came across this Study: HFCS Leads To Much More Weight Gain In Rats Than Sugar @ The Consumerist:

A study from Princeton published in the February issue of the journal Pharmacology, Biochemistry and Behavior (PDF) shows that high fructose corn syrup (HFCS), used as a cheap sweetener in everything from Coke to Progresso soup, is not the same as table sugar, namely for the way that it makes you gain 48% more weight.[…]

"Some people have claimed that high-fructose corn syrup is no different than other sweeteners when it comes to weight gain and obesity, but our results make it clear that this just isn’t true, at least under the conditions of our tests," said psychology professor Bart Hoebel. "When rats are drinking high-fructose corn syrup at levels well below those in soda pop, they’re becoming obese — every single one, across the board. Even when rats are fed a high-fat diet, you don’t see this; they don’t all gain extra weight."

Since HFCS was introduced into the American food supply as a cost-effective sweetener, the population’s obesity rate has shot up from 15% in 1970 to nearly 33% today.

I know many people have been suggesting this for years, but without the scientific proof, the health care establishment more or less refused to accept the premise. It seems that it is now confirmed. I only wonder for how long the subsidies will continue.

The price of preventing preterm labor is about to go through the roof. A drug for high-risk pregnant women has cost about $10 to $20 per injection. Next week, the price shoots up to $1,500 a dose, meaning the total cost during a pregnancy could be as much as $30,000. That’s because the drug, a form of progesterone given as a weekly shot, has been made cheaply for years, mixed in special pharmacies that custom-compound treatments that are not federally approved.

But recently, KV Pharmaceutical of suburban St.Louis won government approval to exclusively sell the drug, known as Makena (Mah-KEE’-Nah). The March of Dimes and many obstetricians supported that because it means quality will be more consistent and it will be easier to get.

None of them anticipated the dramatic price hike, though — especially since most of the cost for development and research was shouldered by others in the past.

Premature labor drug spikes from $10 to $1,500 - Health - Pregnancy - msnbc.com

Also from the article:

Doctors say the price hike may deter low-income women from getting the drug, leading to more premature births. And it will certainly be a huge financial burden for health insurance companies and government programs that have been paying for it.

Two issues come to mind: 1) the talks about potentially criminalizing miscarriages - what happens when a woman who cannot afford this drug miscarries the fetus? and 2) we read about the case a few days ago, when a woman was forcefully hospitalized to carry a fetus to term - what would happen when a hypothetical woman is forced to undergo treatment with this drug and she either has to incur in long term debt or risk legal consequences for not taking the treatment?

The increase in price of this drug alone is reason enough to be concerned for the welfare of pregnant women. However, the increase in price combined with the systematic attack on reproductive rights is just terrifying.

Beauty is not only in the eye

I just spent the last two hours making myself “presentable” in view of the fact that I am scheduled for surgery tomorrow at 7AM. I have taken a long bath, removed unpleasant body hair, scrubbed my skin to make it softer, gave myself a pedicure, trimmed my nails, waxed my facial hair. As I was doing this with a considerable effort (since I cannot eat much these days, everything I do is like climbing a mountain), I reassured myself that it was OK to do this. That even though I don’t give a damn about beauty standards, it was OK to be scared of the possibility that my surgeon, anesthetist, nurse or assistant could potentially be one of those Daily Mail (or Men’s Health or Maxim) commenters that believe that women who do not groom according to their expectations do not deserve to live, do not deserve to be loved or cared for. Because you know, those commenters on websites are real people. And they could, potentially, have your life in their hands. And I also realized how fucked up it is that beauty standards might come to that.

Sickness and the other

Lately I’ve been quite sick. Not just sick as in suffering from a cold but crippling pain of the kind that keeps me up all night. As I type this, I am dizzy, nauseous and just pretty much unable to move. Also, I am exhausted because I get very little sleep at night. I have a strong suspicion my gall bladder needs to be surgically removed. Genetics from both sides (maternal and paternal) lead me to believe that I, too, have a pretty sick gall bladder. Either that, or I have something way more serious which I don’t even want to think about.

Still, even though I am dealing with this pain for a good month or so, I do not want to go to the doctor. I am, indeed, terrified of doing so. My past experiences have been so traumatic and dehumanizing that I am, at the moment, dealing with pain that in fact paralyzes me, rather than put myself through the grief of dealing with a health care professional. And I consider myself one of the lucky ones. My friend’s sister is dealing with what could very well be an extremely aggressive form of cancer and her experiences, which she is documenting in her blog in detail are heart breaking and illuminating. I cannot, in good faith compare anything I’ve gone through to her ordeal, because the severity of her sickness does not compare to anything I ever suffered since I live here. However, there are many themes that run across her accounts that are common not only to situations I’ve been in, but to those many other foreigners face on a daily basis when seeking treatments.

The Dutch healthcare system is very different than anything I’ve encountered before. Not worse, not better, just very different in approach. First of all, pain control medication is pretty much frowned upon. I suspect that this is part of the Calvinist heritage and an approach to “toughen it up” (i.e. “deal with it” or “endure it”). During delivery women are systematically discouraged from seeking pain relief (like epidurals) and pain endurance is more or less celebrated/ encouraged by health care professionals. I have no supporting data for this, but I would venture the theory that this is also driven by a desire to keep health care costs down (as medication is covered by health insurance and in the case of epidurals, an anesthesiologist would need to be present). In the past, when enduring some form of pain (say due to a twisted ankle), I have offered to pay for pain relief medication out of pocket and I was told that it was simply not possible. I had to toughen it up.

imageHowever, this is not the dehumanizing part of dealing with the healthcare system. The dehumanization comes from an assumption that I have had to deal with on way too many occasions: the presumption that I do not know what I speak about because I am a foreigner and, as such, I am ignorant. The worst of these situations happened around seven years ago during an endoscopy procedure. I had similar symptoms to what I am experiencing right now (strong abdominal pain after eating, usually lasting for many hours). At first they thought I had an ulcer and I was prescribed medication accordingly. When this medication did not have the desired effect, I was sent for an endoscopy study. This required that I do not eat for 12 hours. Needless to say, terrified by the prospect of the procedure, I complied. As the endoscopy took place, I ended up vomiting all over the place. I know this is probably very gross and I apologize for my graphic depictions but they are pretty instrumental to what followed. As I vomited all over myself and my surroundings, with a tube shoved down my throat, what came out was what looked like recently ingested food. Chunks of what I had had eaten 14 hours or so before. It looked as if I had just had a very hearty breakfast or a complete meal right before undergoing the endoscopy. The doctor in charge of the procedure started shouting abuse at me. Not just complaining or expressing annoyance. Just shouting plain abuse. The peak of the abuse came when he shouted ”You ignorant foreigners do not know how to follow instructions! You were clearly told you couldn’t eat for 12 hours”. As I sat there, with a tube shoved down my throat, covered in vomit, I had to hear that the reason for the indignity was not that I was sick and could not digest food. Clearly, the reason for my situation was that I was an “ignorant foreigner who could not follow instructions”. With tears streaming down my face, unable to respond (tube down my throat made it difficult to defend myself), I never felt more humiliated and belittled in my life. Being sick was not enough. I was obviously an ignorant foreigner who could not follow medical procedures. When he removed the tube, with my throat still sore and in excruciating pain, I tried to explain that I hadn’t eaten in 14 hours, that obviously, that vomit right there was proof that something was very wrong with my digestive system. He would have none of that. He refused to believe me. He wrote down that he could not perform the study due to my non compliance with the instructions. I was sent back home. To this day, I do not know what caused the pain. In fact, the symptoms disappeared once I stopped eating meat. That was until a month or so ago.

Now I am faced with the situation of enduring a system that constantly uses my condition as “the other” to mask its institutionalized bigotry. A couple of weeks ago, I learned that I am not alone in this perception. A group of healthcare professionals of Turkish heritage is opening the first clinic to target the immigrant population of Amsterdam. This is what the founder of the clinic had to say on the subject:

Genco said efforts to encourage general hospitals to take the different backgrounds of patients into account were sometimes rebuffed. For example, leaflets in Turkish about healthcare problems were returned to him with a note reading ‘we speak Dutch here’.

Even though I am not Turkish and have no affiliation to the Turkish community (at least not further than friendships and acquaintances), I wonder if I can wait until this new clinic is operating because, quite honestly, I don’t want to have to shout back with a tube shoved down my throat.

Anti-leprosy laws must be repealed, say UN human rights experts

Anti-leprosy laws must be repealed, say UN human rights experts

13 August 2010 – United Nations independent human rights experts have urged  the repeal of all laws discriminating against people affected by leprosy, which has been eliminated as a public health problem in most countries but still carries a strong social stigma.

The Human Rights Council Advisory Committee, composed of 18 independent experts serving as a think tank for the Council, have drafted a set of principles and guidelines also recommending that States enact laws to ensure that those affected by leprosy and their family members do not suffer discrimination in employment, health, marriage, and the use of public utilities and places.

The disease, one of the oldest known to mankind, is curable if diagnosed in time and disabilities caused by it can be prevented.

However, historically, people with the condition and their families have been despised and abandoned.

“Only after the elimination of social discrimination can the international community say that leprosy has truly vanished,” said Advisory Committee member Shigeki Sakamoto.
Those who have the disease and their families have been systematically isolated for years by States and communities which believe leprosy can spread and are afraid of the deformities it could cause.

The UN World Health Organization (WHO) estimates that in just a quarter century, more than 15 million cases of leprosy – which affects the poorest and most disadvantaged members of society – have been cured.

But despite this extraordinary progress, thousands of people still suffer from the neglected disease, and in many places, they still suffer discrimination.