My experience working in the NHS gave me an understanding and respect for mainstream healthcare to some extent. I have been able to translate medical insights into the knowledge gaps within the NHS directly into my work with Centric. More importantly, I have been able to do this via our Health Activism project. We have been investigating Health Activism alongside Dr Caitjin Gainty from King's College London and Dr Agnes Forster-Arnold from the London School of Tropical Medicine. We have uncovered systematic exclusion of underserved communities not designed to be seen on a critical level. Unfortunately, we tend to only be seen as a statistic.
Seeing as off-stage communities are misunderstood, these same people have continued to feel disconnected from health institutions. This oversight is not just limited to health institutions; this has extended to education and policing in the community and reflects Brixton’s positionality as a home to counter-public spheres due to the distrust expressed in the above areas.
The work that we have become focused on doing with health activism has given people in the local community a chance to have their voices amplified where they were once ignored. During one-to-one interviews with members of our communities, they have given us their own compelling individual stories and perspectives concerning how they have maintained their lifestyles. Our interviewees made it a point to really focus on their own preventative methods via the assistance of local independent health outlets in the community.
We realised that it was not the pandemic that encouraged the heavy usage of ethnomedicine in the community, as it may have initially been assumed. It actually appears that for most of our participants, they had carried forward a multitude of holistic remedies passed down to them from their family members back in their countries of origin. This knowledge of self, and experiential knowledge, has empowered people in the locale to take care of themselves. Alternately, there is also a palpable distrust of mainstream healthcare and media that motivates health activism.
As a black woman in the community who looks for natural solutions for health, I was very familiar with the remedies pulled out from our findings. The holistic knowledge that the community holds empowers and even helps administer this support to people in their neighbourhood and the wider community.
The emerging trend of health activism and medical pluralism also encouraged a power shift, as individuals did not feel that there was an equitable relationship with mainstream healthcare. Especially for older individuals of BAME backgrounds, people in white coats were to be merely heard and obeyed with no critical interaction. Some of the individuals in our study mentioned that they felt there was a superiority complex from GPs and specialist doctors in the community, hence making people more reluctant to engage with the services presented to them. Conversely, relationships with ethnomedical and alternative health modalities were regarded as more democratic, more interactional, more discursive and generally a more liberating exchange. These dynamics are critical especially when people are seeking good health, wellbeing and an element of solace in health without feeling berated, denigrated or disregarded by public health professionals and clinicians.
Health activism is not limited to looking for preventative measures to avoid illness. Still, it has also included a level of people understanding the importance of managing their already existing conditions without the inclusion of mainstream healthcare. These conditions have ranged from HIV/AIDS to diabetes and other diseases prevalent within the BAME community.
The power shift in the communities also reflect increased economic empowerment that has been boosted since 2020. As black-owned health outlets became more popular during the pandemic, the black community became more familiar with these stores to support their health and way of living. An ecology of opportunity and services for previously unsatisfied needs is a positive step for a community learning self-sufficiency at the medical level.
It is important to note that ethnomedicine and mainstream healthcare, where possible and feasible, should be combined. The people we interviewed recognised there must be a rigorous, evidence-based standard in ethnomedicine. Yet, there appears to be a distinct knowledge-gap among public health professionals and clinicians when it comes to both the popularity and efficacy, in cases of ethnomedicine and complementary therapies. At the very least, healthcare professionals within the urban space need to be acquainted with what the communities whom they serve and interact with are doing to maintain their health.
As medicine becomes more digitised, it is important communities are not left behind. Holistic health activism has been practised for generations within communities and there is no indication this will decrease, the contrary in fact. In light of this, tech innovations may also have to take this into consideration as local support initiatives may be able to utilise digital solutions which contribute to improved wellbeing and health outcomes for those black communities who are most disenfranchised from mainstream healthcare.
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