Racism in medicine | DW Documentary

Racism in medicine | DW Documentary

Dr bismar aori is busy the GP has been working in a medical practice in hanova for over a year since he arrived significantly more patients with a migrant background have been coming here word has gotten out that they’ll be well treated apparently that’s not the case Everywhere more than a quarter of the German population has a migrant background almost 24 million people but is everyone treated the same in the German healthc care [Laughter] System hello Hi how are you I’m fine yeah yeah so in Emmanuel’s case the doctor was able to intervene after a clinic turned him away yeah so I told the doctor he saved my life yeah you are welcome every time yeah today we’re going to check again

Your kidney yeah a year ago Dr orori diagnosed Emmanuel with third degree renal congestion the condition can quickly become dangerous he sent him to hospital for emergency surgery But when he arrived he was turned away at the reception desk even though he had all the necessary paperwork he had to make an appointment with the urology department he was told he had no choice but to Leave I meet him outside the clinic in Hanover where it happened I was shocked and then I I I stood for about 2 or 3 minutes I don’t have any possibility to go inside so what I have to do he saw your emergency paper he saw the and then the emergency

Paper so immediately I drove back to the doctor and tell him what has happened Dr aori tells me that he called the hospital to talk to the receptionist he said it was a misunderstanding standing and that a Manu should go back it can be so if a

White man it cannot be like that we just let him go but as a black sometimes there’s a um a lot of discrimination but sometime you have to forget and then Focus what we are Doing a urine blockage can result in kidney damage if he hadn’t gone back to Dr aori Emmanuel’s renal congestion could have been fatal I write to the hospital with questions about the case the answer as a general rule no one will be turned away someone with a medical emergency obviously isn’t

Expected to have an appointment and won’t be asked to return at a later date as I said also because was something I want to but the reality is often different says Dr aori yeah in four weeks when I want to admit a patient who doesn’t have a foreign background I

Rarely worry about them being turned away basically never but with someone with an African background when I fill out the referral form I make a mental note to follow up to call and ask if everything worked out okay it’s not the only example of racism in the German Health Care system will be

Coming across others of course most of us have had some bad experiences with doctors myself included however it happens significantly more often to people with a migratory background this is now backed up by the first comprehensive study on racism in the German Health Care System commissioned by the Federal Ministry for

Family Affairs and carried out by the center for integration and migration research the research team led by social scientist chian calulu evaluated more than 21,000 questionnaires and conducted additional interviews wherever we turned our Focus we saw problems in some cases is these were glaring for example in terms of

Getting help we also saw inequalities in terms of appointments we as a society should be alarmed about human rights issues in an area such as health and healthare where lives are at stake it’s a matter of life and death if certain groups are negatively affected then we as a society need to be

Concerned among the people affected in Germany are those who identify as black Asian or Muslim I think the healthare system is no different from other social institutions that are only adapting to new demographic and social realities very slowly in the areas We examined we see that there are still structures in place

That disadvantage certain groups we want to know how this impacts people’s everyday lives we journalists so we ask the public via Instagram within a day people are submitting detailed accounts of negative experiences very common the very fact that black people are spoken to in English or Muslim women are addressed in

A certain tone of voice it happens all the time when I arrived the emergency doctor took one look at me turned around and refused to touch me a Doctor Who’s taken the Hippocratic Oath would have let me die and it was because of the color of my

Skin in the ambulance the blue lights are switched off because Arabs always make a fuss about nothing my partner doesn’t speak German in doctor’s office offices he is often ignored by the staff for hours although the doctors themselves say on their websites that they speak English now we

Only go to the doctor together it’s doubly humiliating for him not to be able to go to a doctor’s office Alone while researching I came across the case of Ramia she had a problematic medical history but was fobbed off with painkillers again and again and not given a proper diagnosis I tell the head of the study about her I’m not surprised in fact we can also prove statistically that many

Muslim women are not taken Seriously more than 2third of Muslim women in the studies said that medical staff treat them unfairly or worse than others this has consequences 38.9% of Muslim women have changed doctors because they didn’t feel taken seriously among women who are not affected by racism the figure is 28.8% the research shows that there are certain prejudices regarding Muslim women that they’re passive emotional irrational there’s also the cliche that they’re very dramatic about pain a cliche often apply to people from Turkey especially women is that they exaggerate their pain symptoms or that they’re hyper sensitive we visit Remia in lower Saxony

She seems to have been a victim of exactly this kind of thinking her family documented her experience hello although she was seriously ill and spent weeks in hospital she wasn’t given an accurate diagnosis as a result she has lasting health issues all this has taken its

Toll today Remia can hardly walk and is quickly exhausted she had to give up her job as a cleaner she doesn’t speak much German but understands everything we say play it all began with a sudden severe back pain in January 2021 she could hardly move and was wrecked by

Pain in the middle of the night her daughter called an ambulance Ramia was hospitalized for 10 days and diagnosed with nerve root compression syndrome what really upset me was that a nurse said to me there’s nothing wrong with you get up and then everyone was saying the

Results show you don’t have anything get up don’t make such a fuss my mother would call me at night during those 10 days and say they’re not doing anything I’m in so much pain that I wish I could die she was screaming in pain on the phone at night saying please

Tell me they’re doing something I don’t want to live I can’t take it anymore they treated me like that because I’m Turkish it wouldn’t have happened to a German woman the doctors failed to identify a lifethreatening heart valve inflammation her heart valve it was hanging by by a thread you

See severe back pain can indicate serious organ disease that’s why thorough Diagnostics are so Important I write to the hospital the family filed a written complaint the clinic is well aware of the case a spokesperson writes to me that there is no way of investigating how a nurse spoke to Ramia and that severe back pain is not associated with heart valve Inflammation but the renowned German Heart Center in Munich disagrees back pain might well be a symptom of heart valve inflammation another indication that Ramsey’s complaints were not taken seriously when her pain didn’t subside the family went back to her doctor to try and get a referral for another

Hospital my mother begged the doctor to admit her to another hospital the doctor got angry and said you’re not going to hospital there’s nothing wrong with you we were simply sent home selda kept all the paperwork she contacted the practice six more times stimes becoming increasingly desperate

By this point her mother had chills and fever you can’t keep fobbing off a patient saying they just have depression they’re menopausal I can understand that even as a general practitioner the first thing you do is look at test results from the hospital but if you see something is

Wrong you can say okay I don’t know I’m going to refer you to hospital that’s not what happened instead according to the family Ramia was told over the phone by the doctor’s assistant that she had depression and menopausal symptoms it was only at the point when

She could no longer eat and drink that she finally got a hospital referral from the Doctor this time she was admitted to a clinic in hanova 6 weeks after Ramia first complained of pain she finally got her diagnosis Advanced heart valve inflammation a doctor at this Hospital harun karakash who was indirectly involved with the case posted about it on Instagram a case of discrimination in

The Health Care system that almost cost a patient her life on unfortunately the hospital failed to carry out sufficient tests despite high levels of inflammation instead the patient was sent home with painkillers she saw several more doctors because she was still in severe pain despite taking painkillers she was told she was

Exaggerating the problem as foreigners Do eventually the family hired a lawyer they’re now demanding compensation from the doctor and the hospital but How likely are they to win their [Applause] case we have the possible treatment error during the hospital stay they should have investigate earlier and more thoroughly then there’s the doctor when

She heard there was a fever and chills she should have reacted immediately only about a third of all medical malpractice cases are successful in court racism really plays a role in these lawsuits from my perspective there are explicit racist cliches at play here people with a migration background

Supposedly exaggerate or even fake their pain but the fact is that racism and discrimination is very difficult to prove this it’s been proven that racism is an issue for people applying for apartments or jobs but racism in the German Health Care system has not been properly investigated even though it can be a

Matter of life and death so is it just a question of individuals who consciously or unconsciously behave in a racist way or is the problem systemic Dr oor’s practice in Hanover as a general practitioner he often uses a pulse oxymeter this measures a patient’s blood oxygen saturation based on light rays

That penetrate the skin however after years of experience he no longer trusts the device does the device work the same for every patient n no clearly not it’s often not accurate when measuring oxygen levels in people with darker skin tones I don’t always rely on it

100% would you use the pulse oxy metor for a black patient who’s short of breath no if a patient is short of breath I’d say based on these symptoms they need a hospital checkup doesn’t that bother you you have dark skin yourself what if the device doesn’t

Work you’re right at the end of the day it’s not optimal but if you know that the problem exists you can try to work around it and to do what you can so there aren’t any negative surprises a US study from 2020 showed that dangerously low oxygen levels are

Almost three times more likely to go undetected in Black patients than in white a serious problem that became especially accute during the global covid-19 pandemic the reason why the pulse oxymeter doesn’t always give reliable readings is because it was designed for white skin the supposed Norm a prime example of structural

Racism in medicine more on this later Dr bismar aori is aware of the obstacles his patient face and does his best to work around Them giving a patient the attention they need when there’s a language barrier for example is time consuming it can take longer than the 8 minutes a doctor spends on average with a patient in Germany good off yeah according to the professional code of conduct for physician all patients must be treated

Equally but are they a doctor might tell a patient to come back with an interpreter even though most doctors speak English and this can affect Diagnostics yes the diagnosis and how the condition develops it gets much worse as a result in the waiting room we ask patients about their

Experiences when you’re alone with the doctor they talk to you weirdly like you’re a foreigner are you taken seriously here yes I’m taken seriously that’s why I feel more comfortable here he will understand more part of our problems than the others he can explain much in

English or my Tre language also he also understand that’s why I want to go to the recent study clearly shows the effects of racism among black patients 62.8% feel they are treated worse than others I think that we humans all have the right to be treated well by other

People we all need to be aware that we don’t benefit from treating other people worse it doesn’t make us better it doesn’t make us stronger it doesn’t make us smarter it just harms other people why does the Health Care system fail to reflect our diverse Society even medical equipment appears

To be biased and people with acute health problems are being sent home a system that’s supposed to help everyone equally is actually putting many at risk it’s a problem that needs to be addressed at its roots gaps in the system start with gaps in education here in rostock a group of

Medical students want to change this ban asked us not to use his last name he fears the far right might Target him the problem he says starts with medical literature off we learn about Dermatology and how disease patterns look exclusively in terms of white skin not all patients are going to be white

This means we can Overlook diseases misdiagnose and in the worst case let people die is there a disease where this is particularly noticeable it’s issue with Lyme disease and also with anemia some symptoms are detected using a Visual Diagnosis but these will look different on black skin

How they look on different skin colors is something you have to learn how do you incorporate this knowledge you have to look for the teaching materials research online students have to make an extra effort and if you don’t have the time and energy you don’t learn it an educational Gap that’s

Unacceptable ignorance can be dangerous take a rash that could indicate a dangerous disease like shingles or measles if we Overlook people we Overlook their problems their needs but Healthcare is a basic right we’ve made this our mission at least in Germany so far only one medical school has

Adapted its teaching in Germany most course loads for medicine are considered too heavy already that argument doesn’t hold up the Federal Association of medical students has taken a clear position we want racism to be addressed in teaching ban belongs to the student initiative critical medicine rostock they want to see the topic of

Racism in medicine addressed in present day not just historically in the Nazi era the initiative has organized a workshop on discrimination in medicine this is the first time that the topic counts towards their degree everyone here says they’ve encountered incidents of everyday racism in hospitals there’s this term for itan or

Mediterranean disease it was used in front of me in front of the nursing staff someone said of a patient who didn’t speak German who looked foreign oh they’re faking it they’re exaggerating I had no idea how to respond did it mean I couldn’t treat that patient what was I supposed to do with

That this was a person who was in pain Mediterranean disease a discriminatory and racist term that’s still banded around doctors often pre-select patients on the basis of foreign names the idea is I don’t want to treat that patient because they probably don’t speak German but names don’t say anything

About what language a patient speaks attitudes in medicine are only gradually starting to change mostly due to Grassroots pressure medicine is an old discipline an elitist discipline a white discipline the wheels turn very slowly but racism is sometimes very overt we have to ask why is change taking so Long there is no excuse for racism in today’s society that’s one reason it’s so hard for many to admit that it exists while making this documentary we often encountered closed doors when we raised the issue of racism including at this midwives Congress in Berlin the Press Department doesn’t want us at a

Discussion about racism once it’s over we talk to participant Reena Zuri hello hi I’m Johanna Le Zuri tells us racism in delivery rooms isn’t widely recognized as a problem she hopes to change that I think the word racism makes it hard if we used the term Prejudice it

Would be easier to talk about racism is such a taboo topic we think of right-wing extremists neonazis and violence but there are more subtle forms all of these midwives have witnessed racism in maternity Wards it’s a place that can be highly stressful and staff have to cope with a lot people under stress are more likely to react in a way that’s racist reacting in a sensitive way is not your pay grade you’re paid to look after five women at

Once your first reaction is always oh I wasn’t being racist not me but then when you dig deeper you realize that you do have certain thought patterns instilled in you and you start to wonder I’d say there are colleagues who have been in the profession for a long time who don’t have that

Self-awareness they can be very defensive if you talk to them point it out to them they’ll say I didn’t mean it like that I think it’s good if clinics offer regular training courses again it’s a question of time and money and ultimately Hospital’s will to Change Ria’s life hasn’t been the same since her heart valve infection she tells me today she has a mechanical heart valve the inflammation had become so bad that antibiotics didn’t Work after a highrisk operation an artery in her leg burst and she had to have emergency surgery since then her right leg has been numb she has to be careful not to strain it that’s one of the reasons why she had to give up workee I feel empty inside useless I have

Nothing to do no work work was my second home now it’s gone today she’s at a checkup appointment in the same hospital where she had heart surgery Yeah to be honest she doesn’t have hope she says she thinks things won’t get better she says if they had recognized her heart problem earlier her leg would be okay this way please you can put your things there animal tissue was inserted in Remy’s ruptured leg artery the doctor checks

That blood is circulating properly looks good it’s turned out well I’m so glad I can’t believe there’s positive news you can see the blood circulation is fine when you press here great good news thank you very much but the trauma runs deep the family hopes their lawyer will make sure R is

Compensated for her suffering all the money in the world won’t bring back my mother’s heart valve for us it’s about these people being penalized but they might not get what they want lawyer Maha zili tells me that doctors are unlikely to apologize for medical malpractice out of court because if they

Did their liability insurance might refuse to cover the Costs this means that they usually refrain from comment and don’t apologize in the sense of admitting responsibility This is why patients often end up taking their cases to Court many clients wouldn’t take legal action if doctors admitted responsibility so it’s about medical malpractice but it’s also about this ignorance this lack of sensitivity on the part of medical personnel Ramia for example lost all faith in her doctor that lack of trust is reflected in the german-wide study which shows

That 12.8% of Muslim women avoid or delay seeing a doctor for fear of not being taken seriously the figure is 6.3% for women who are not affected by racism we see especially in the health sector that when someone experiences discrimination and racism their trust disappears we’re losing these people

They’re turning away from the Health Care System that’s supposed to protect them hello hi Miran man did get an apology for what happened to her in December 2021 she went to a hospital in Frankfurt with severe stomach pain a senior doctor saw her he just didn’t take me seriously I

Told him how I was feeling I had the impression that he wasn’t taking it seriously I kept insisting the pain wasn’t normal and he said well be glad you’re here because with your ailments you’d be dead by now if you were in Africa I was upset by the idea that I should be

Grateful I’m allowed to be here she grew up in Germany but knows all too well what it’s like to be perceived as different I knew it was serious because I was in so much pain and then he said your German is really good it was like he hadn’t listened to anything I said

All he noticed was how I spoke German and that’s the problem a local politician man was so shocked that she posted a video on Instagram from the hospital I asked him is the pain normal and he said pain is never normal but your compatriots can put up with it

Better than other people it’s terrible to be at the mercy of these people they don’t see you as a human being the video got hundreds of thousands of views and a barage of hateful comments the doctor should put you down you monkey you look like a prehistoric African with that

Face are you walking upright yet or on all fours like a primate man also received hundreds of messages from other people who’d experienced racism in the Health Care system if it happened to me today i’ do it again drawing attention to the problem is the only weapon we have against

Racism trust that others will empathize story took an unexpected turn the doctor apologized man is convinced that this only happened because she’s a politician she also managed to get the hospital to organize anti-racism workshops for its staff I see my task as pointing out what happens on an individual level between

People when this is unacceptable and ignorant but the problem is also structural it’s institutional it’s the universities it’s the hospitals black bodies have been dehumanized by colonialism in spite of scientific progress medicine seems in many ways to be stuck in the 19 1960s its Norms no longer reflect our diverse

Society but where do the strict hierarchies that make change so difficult come From some of the Contemporary Health Care Systems inqu equities have Deep Roots as medical historian Philip Austin explains science can advance very quickly once there’s new research but it can take a long time for structural change to happen in Germany until the end of the

1960s only a few people had the say in hospitals they had unlimited power they made all the decisions that changed in the late 60s but it takes generations to change structures and of course a system in which people are earning very well is going to be very hierarchical at the medical history

Museum in Hamburg Philip Austin sheds light on murky chapters in the history of German medicine for example the history of racial Prejudice even icons of German science contributed to racist views of black people take renowned German physician and microbiologist Robert C he conducted drug trials in a former British colony in East Africa many people here suffered from sleeping sickness Co experimented on them using a remedy containing arsenic his goal to gather data for the German pharmaceutical industry Robert cooch’s experiments with sleeping sickness patients led to blindness the trials took place in what he called concentration camps patients were crammed together and treated until they

No longer showed symptoms of the disease people tried to escape they were held by force massive Force C tested his remedy on more than a thousand people a day many died in the process the precise figures are unknown these experiments play a very important role in the history of the

German pharmaceutical industry it was a precursor to antibiotics an active ingredient is still in use today a Nobel Prize winner Robert C conducted research that treated black patients as Subhuman there is early evidence of this idea that black people are insensitive to pain it was a factor in the debate about the legitimacy of slavery the idea was widespread at the time that black people were insensitive to pain it was used to justify physically aring them there were already scientific

Arguments against that idea that said people’s sensitivities are all the same but these ideas persisted unine and they remain damaging as illustrated by Miran man’s case the problem of racism in the German Health Care system has come to the attention of the Hamburg chamber of Physicians president pedram Emami says

It’s starting to be Discussed I think that in the healthc care system as a whole we often have difficulty embracing change but to a certain extent we’re a mirror of society in society as a whole we don’t always find it easy to deal with painful questions this means that we need perseverance for the

Future it certainly won’t be easy the organization now has an anti-racism Counseling Center cases of discrimination are reported from all over Germany in particular by doctors with problems at work Dr amami favors a gentle approach I think it’s very difficult not only for those affected but also for

Those who act in racist ways knowingly or not it’s not always easy to be confronted with it that’s exactly why I think we need to be careful with our criticism we need to strike the right tone so we don’t alienate people otherwise nothing will change people will become increasingly polar For Ramsey’s family any change is already too late the damage caused is irreversible it’s still not clear whether she’ll ever get the apology she Wants people should be listened to no matter where they come from no one should be pushed aside all I want is my health only her faith in Germany’s Health Care system has been shaken for good

More than a quarter of the population of Germany has a migrant background. Many report that they have received substandard care from doctors and hospitals. Is the healthcare system afflicted by racism?

This documentary hears from people who’ve been turned away or received inadequate care in a medical emergency; from midwives who report on racism in the delivery room; from students who criticize teaching according to white norms; as well as from doctors who reflect on the problem.

The film shows just how dangerous conscious or unconscious racism in the healthcare sector can be. Its findings are based on the results of the first representative study on the issue in Germany, published in November 2023 by the German Centre for Integration and Migration Research.

The fact is: Even today, the term ‘Morbus Mediterraneus’ still circulates in the healthcare sector, which is intended to describe “exaggerated suffering in southerners”. Standard medical equipment doesn’t always function reliably when used on dark-skinned patients. And many doctors have never learned that some diseases can be diagnosed differently depending on whether the person is Black or White. The medical norm, even in textbooks, is still the white, western European patient. This can result in misdiagnosis and the serious worsening of symptoms.

Take the case of Remziye T. from Lower Saxony: Her infected heart valve went undiscovered for a long time because doctors didn’t take her pain seriously enough. When the problem was eventually correctly diagnosed, it was too late for medical treatment. Now Remziye T. has to live with a mechanical heart valve: the operation has left her unable to walk properly and she is no longer able to work.

Dr. Bismarck Ofori allowed the camera team to film in his Hanover surgery. Many of the patients who attend the Black doctor’s practice have a migrant background. They tell him they’ve not been taken seriously in other surgeries; some of them were even brusquely turned away. In Ofori’s treatment room, it’s evident that careful diagnosis and overcoming language barriers in the process costs time and money. Not that language is the only obstacle to making a correct diagnosis. The pulse oximeter, for example, a device used to measure the blood’s oxygen content, can be less accurate when used on patients with darker skin. But this is not systematically taught at medical school.

The healthcare system is only just beginning to unpack the issue of racism and its impact. But many doctors, medical students, midwives and a medical historian have spoken out – addressing a problem that, in the worst-case scenario, can have fatal consequences.

#documentary #dwdocumentary
______

DW Documentary gives you knowledge beyond the headlines. Watch top documentaries from German broadcasters and international production companies. Meet intriguing people, travel to distant lands, get a look behind the complexities of daily life and build a deeper understanding of current affairs and global events. Subscribe and explore the world around you with DW Documentary.

Subscribe to:
⮞ DW Documentary (English): https://www.youtube.com/dwdocumentary
⮞ DW Documental (Spanish): https://www.youtube.com/dwdocumental
⮞ DW Documentary وثائقية دي دبليو (Arabic): https://www.youtube.com/dwdocarabia
⮞ DW Doku (German): https://www.youtube.com/dwdoku
⮞ DW Documentary हिन्दी (Hindi): https://www.youtube.com/dwdochindi

For more visit: http://www.dw.com/en/tv/docfilm/s-3610
Follow DW Documentary on Instagram: https://www.instagram.com/dwdocumentary/
Follow DW Documental on Facebook: https://www.facebook.com/dwdocumental

We kindly ask viewers to read and stick to the DW netiquette policy on our channel: https://p.dw.com/p/MF1G