Over the last few days, physicians and nurses across the country have taken a knee, galvanized by the recent death of George Floyd, as well as the disproportionate effect of the coronavirus pandemic on African-American families. The White Coats for Black Lives movement firmly identifies racism as a public health issue and calls on everyone in the health care system to take action.
As physicians, we can see what role we have in fighting this injustice; however, as South Asians, we know that awareness within our communities is still lacking. The goal to be the “model minority” often overshadows outward displays of camaraderie. Some of this may be secondary to focusing efforts in fighting their own other battles (such as Islamophobia) and against hate crimes directed towards their own communities. However, racism within the South Asian community against African Americans is not uncommon, and many of us have bore witness to overt racism growing up. The silence has not gone unnoticed – in fact, in the past few days, South Asian or Bollywood celebrities have been called out on their colorism campaigns and misappropriation of black culture.
The role and duty of South Asian physicians
Our generation of South Asian professionals in North America will need not just to express gratitude for the activism that has reduced racist structures (or at least deferred their attention from us), but also to acknowledge the privilege afforded to us by education and profession. Indian, Pakistani and other South Asian physicians must lead that charge.
Asian physicians make up the second-largest majority of the medical profession within the United States — Asian doctors are anywhere from 11 to 15 percent in fact. Of these, for example, greater than 60,000 physicians and approximately 10 to 12 percent of entering medical students are estimated to be of Indian heritage in this country. For context, approximately 13.4 percent of the total population identifies as black or African American, thereby accounting for a large part of our patient population who we have a duty to care and advocate for.
Like many of our second-generation colleagues, our parents were primarily part of a migration from India, Pakistan, and Sri Lanka most prominently. It began around 1965 and exponentially increased through 1990, thanks to relaxed immigration legislation and increased employment opportunities, many brought about by the Civil Rights Act of 1964, the Voting Rights Act of 1965, and The Fair Housing Act of 1968. The large number of South Asian immigrants who arrived during those years did so as either university graduates, or with the funds to obtain an education here on U.S. soil. As a result, South Asian immigrants overall have been prominent in fields that require extensive and often expensive training, such as medicine and technology.
We children, grandchildren, and great-grandchildren of these immigrants can use our position to advocate for change. The first thing to do is speak out against racism within our own communities. Despite our different families and upbringings, both of us authors have bore witness growing up to elderly community members, outwardly spewing racist propaganda – particularly condemning engaging in romantic relationships with black women or men. Being taught however, to be good Indian or Pakistani girls and to “respect our elders” we kept our mouths shut against these acts, and today feel embarrassed by that complacency.
But we are no longer those young girls, and today we advocate that South Asians voicing their support for black lives must be followed by action.
South Asian physicians, in particular, must be part of solutions to tackle health inequities for our black patients. Health disparities in medicine are prevalent in all fields of medical practice. Coronavirus is claiming the lives of African Americans at an alarming rate, almost 2.5 times greater than Whites or Asians. Black men continue to have a substantially lower life expectancy. The medical community should have as a primary aim going forward to help narrow the disproportionate gap in African-Americans’ death from coronary artery disease, stroke, and cancer.
Furthermore, South Asian physicians should organize around the development of programming that creates equity not only for black patients, but for our black colleagues as well, who are considerably underrepresented in health care (which in turn adversely impacts black patients). If nothing else, we should take our good fortune and funds to contribute to organizations that will abolish health inequities that we see daily in our line of work.
To be sure, South Asians have endured discrimination. We have seen the look of disappointment on patients’ faces when a brown doctor walks into the room. We continue to endure microaggressions aimed at our origins. However, of the utmost importance now is that we take the immense burden of fighting for persons of color away from our black colleagues and patients and allow them to rest — they have been fighting just to matter for long enough. Now we must fight for them.
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