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Ageism, racism and paternalism are baked into our imperfect healthcare system

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Lwando Xaso is an attorney, writer and speaker . She is the founder of Including Society. She is also the author of the book, ‘Made in South Africa, A Black Woman’s Stories of Rage, Resistance and Progress’. Follow her at @includingsociety.

Our healthcare system has its fair share of racist healthcare providers to whom the health of our parents is entrusted. These healthcare providers are the ones who are paternalistic in their approach, undermining and mistreating our parents because of their race and age.

First published in the Daily Maverick 168 weekly newspaper.

Most children are used to being dismissed, overlooked and ignored. By virtue of their age, children are often infantilised, and their interests ignored. Black people are also used to being dismissed and overlooked. Historically, we were infantilised too because of our race. Black women were infantilised because of their race and gender, and at some point in our legal history we were considered perpetual minors. So, it is remarkable that my mother is an example of a woman who breathes fire against disrespect and inconsideration. I cannot tell you the number of times I have watched her go toe-to-toe with a white manager at a store or restaurant, scorching them with the heat of her words during a time when white people had legal licence to deny us access. Whatever parts of me thought that white people could not be challenged, an outing with my mom reminded me otherwise. She helped me disbelieve any power that I was conditioned to believe whiteness held.

Like children, black women like my mom were not supposed to question or talk back, let alone be difficult. My mom did all those things. She does not reserve her full might for just our home. She takes it to work and to every other public space. In the midst of testy exchanges between her and a white manager, I admired her ability to be agile, disruptive and cutting, but also steady with her words. I can honestly say I have never watched my mom being disrespected with impunity. She has never allowed me to be disrespected with impunity. I recall a time when my mom showed up at my white school to advocate on my behalf against an antagonistic white teacher. My mom takes up every slight, no matter how small it may seem to others. It is a matter of principle. And today I can say I am my mother’s daughter.

Many of my peers describe their black mothers the way I describe mine. Our mothers are the daughters of Winnie Mandela. The black women whose ferocity moved boulders and crossed rivers. These black women, although now advancing in age, remain no-nonsense and fierce. However, during this pandemic I have realised that as fierce as these black women are, they need reinforcements. They need their daughters.

I was dismayed by the experience my mom has had with a number of white doctors over the past few years. It is unsurprising how rife racial bias is in our healthcare system. A lot of the hospitals that our parents are referred to are guilty of racist and ageist attitudes. I, like so many others, am grateful for our hard-working healthcare providers who have served as a formidable last line of defence between us and death.

But like many sectors, our healthcare system has its fair share of racist healthcare providers to whom the health of our parents is entrusted. These healthcare providers are the ones who are paternalistic in their approach, undermining and mistreating our parents because of their race and age. Like so many other parts of the world, racism is embedded in the South African health system. Every time my parents have had to interact with white healthcare professionals without me, I often wonder if they were heard and seen, and treated with respect.

They have had a few incidents that left me infuriated. When our parents are not feeling well, they are at their most vulnerable and if they feel unseen and unheard, this can exacerbate their symptoms.

As much as I know my mom can stand up for herself, black women should not have to fight an uphill battle to be treated with decency in the healthcare system.

In her paper “Medical Mistrust and Enduring Racism in South Africa”, Tessa Moll explores how institutional racism affects interactions and communications between patients and healthcare providers. She writes that race is a category that drives all manner and measure of interactions and decisions between healthcare providers and patients.

And in SA the racial bias of the healthcare system has, and will continue to have, deadly consequences. Inasmuch as our parents advocated for us, it’s our turn to have their backs. The medical world can be intimidating, and even more so for our parents, who are not as physically strong as they used to be. The stakes are too high for them to be left to navigate this system alone. I shudder at the thought of how in the past year the disregard for ageing black lives has caused deaths that could have been prevented. DM168

This story first appeared in our weekly Daily Maverick 168 newspaper which is available for R25 at Pick n Pay, Exclusive Books and airport bookstores. For your nearest stockist, please click here.

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  • Jamie WHITELAW says:

    Another attorney who is obviously greatly impressed by the actions of the late Winnie Mandela. With that background is she able to properly judge anyone? What are the real complaints regarding the “white doctors”? She makes no mention of black nurses, and sisters who are sometimes found to have treated their
    own people dreadfully. One could write reams regarding some black doctors and their association with the medical aid companies……but that would be racist!!! She is her mother’s daughter, with a great log on her shoulder.

  • Peter Oosthuizen says:

    As a white person I have no conception of the hurt and anger that the past has caused our black compatriots and I regret it deeply. However an oped like this, written in broad generalities with no specific references is unhelpful. One has to ask when black people will take responsibility for themselves and stop feeling that they are forced to see white medical practitioners. I have the good fortune to have a very competent black specialist where I live while one of our children has come back to SA from abroad to work as a doctor in a state hospital. Neither of these people shows the slightest hint of prejudice. Perhaps the problem is not with the doctors.

  • Miles Japhet says:

    If you look through a particular lens then you will always find what you want to see. I suggest that if racism is so rife amongst white medical professionals, that your parents choose only to deal with non-white ones.

  • Chris Lane says:

    Talk about spewing venom. Without supporting facts.

  • Leonie Pentz says:

    I must agree that researched and factual pieces vs making general assumptions based on personal experiences makes for better (or hopefully, actual) journalism. At the same time, my personal subjective experience at my local (private) hospital was the same – just different. Older white people (yes mostly rich Afrikaans ones) treat the coloured and specifically African nurses with disdain and utter rudeness. I was amazed – these are the people caring for you while you are at your most vulnerable, yet, you see it fit to be racist towards them?? And the same carers and nurses stayed friendly and helpful…
    I have also been at Grote Schuur with my teenage son years ago in the trauma unit and saw how old white patients in dire need were being ignored while African immigrants were attended to…
    Moral of the story? Don’t throw the baby out with the bathwater…this one at least is not a ‘medical system’ issue. People can be asses everywhere.

  • Stephen T says:

    Bell Pottinger would have been proud of this article.

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