News – March 2021

World Day Against Racism

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++ English version below ++

Trigger warning: description of structural racism in health care, racism as social determinant of health, description of white privilege, reference to Hanau

In the following text we will try to outline the connections between racism and multiple discrimination as a social determinant and thus the need for intersectionality in health care. There is no claim to completeness.

Access to health professions and university education, and especially access to restricted fields of study such as psychology and medicine, is significantly more difficult for many BIPoC than for white people due to institutional racism in schools and universities. This composition is also reflected in our white policy group, for example. What this means for an intersectional approach to modern health care quickly becomes clear: currently, important perspectives and impulses are missing, and the health care system is just one of many examples, showing that postcolonial continuities have inscribed themselves in the world that surrounds us. We are aware that we as a group are still in the beginning stages of our critical and intersectional examination of racism.

Being affected by racism, sexism, classism, rejectionism and other mechanisms of exclusion can be the cause of mental illness such as anxiety disorders or depression and post-traumatic stress. In this context, experiences of racism and microaggressions in everyday life, flight and other existential emergencies affect BIPoC to a high degree and increase the likelihood of becoming ill. The aforementioned mechanisms can be understood as social determinants of health that have a significant negative impact on access to health care. In addition, external circumstances that cause illness also often act as barriers to addressing illness and beginning a healing process. For example, Serpil Temiz Unvar, the mother of Ferhat Unvar, who was a victim of the racist right-wing terrorist attack in Hanau on February 19, 2020, said:

"What good is a therapist to me as long as this danger is there?"

Therapeutic work with trauma sequelae can usually only begin properly when external circumstances permit and there is no acute threat, perpetrator contact, or current reference to the trauma event. Other circumstances that negatively influence a healing process are racist police violence and racial profiling, failures of security authorities, accusations by trafficked persons or severely protracted, bureaucratized asylum procedures that often have no prospect of success.

Thus, there are more difficult access opportunities to health professions for BIPoC as well as external circumstances that hinder a healing process in case of (mental) illness. In addition, groups outside the(white) dominant society are often also significantly disadvantaged in (mental) health care. For example, it is significantly more difficult for Black people to find and keep a place in therapy.

In addition, there are far too few anti-racist trained professionals with power-critical and trauma-sensitive approaches and there is a shortage of therapists, doctors and psychologists of color, especially in Saxony. This results, for example, in the problem that BIPoC have to explain their own affectedness in a therapy setting when they work with untrained professionals. Under certain circumstances, this can also have a retraumatizing effect.

Medical research and literature is oriented toward white cis-male bodies, which can sometimes have deadly consequences for Black people if, for example, their skin color is not taken into account when making diagnoses. Many diseases, e.g. meningitis, manifest as a reddish rash on the skin on white bodies. Symtomatics on black bodies, on the other hand, look significantly different. FLINTA* or people with disabilities, are also structurally disadvantaged by the centering on white, cis-male bodies in medical research and literature.

Another social determinant is the intertwining of the issues of work and health. Migrant* women, people with migrant histories, people with disabilities, and FLINTA* are disproportionately employed in precarious, low-wage jobs with increased risk of infection. In particular, during the Covid 19 pandemic, they are at significantly increased risk of contracting the disease. A study from the Robert Koch Institute (3/16/2021) shows that Covid 19 deaths were significantly higher in socially disadvantaged regions of Germany than in less disadvantaged parts.

Even without Corona, the aforementioned groups work in conditions that cause illness, while health care tends to be denied to them as a social resource.

The Covid-19 pandemic has also continued to reinforce or make visible certain racisms, such as anti-Asian racism or racism against Sinti*zze and Roma*nja. Here, in public discourses, racist ascriptions of others are associated with supposed events that trigger infection (the market in China, asparagus pickers, etc.) and fuel racist resentment and violence.

Therefore our demands are

  1. (Post-) colonial and (post-) national socialist crimes and their effects on our coexistence today must be collectively recognized.

  2. Responsibility in racist, sexist, ableist, classist, queer- and trans-hostile, fatshamist, ageist and other contexts must be taken consequently and lead to a self-critical confrontation. We are all perpetrators.

  3. Medical and psychosocial health care must be accessible to all people.

  4. From the asylum procedure to physiotherapy: medical and psychosocial professionals must be trained to be critical of power, anti-racist and sensitive to trauma.

  5. Professional literature and medical research must reflect diversity and not assume only cis-male, white bodies.

  6. Interdisciplinary and intersectional collaboration at the community level must be encouraged.

  7. Access to health professions should be designed to map societal diversity.

  8. Working conditions should be safe for all people not only on paper but in reality.

  9. We hope that this text will lower the hurdle to contact us with a concern and to take advantage of our counseling services. We know that this is an enormous leap of faith! All the conditions described cannot remain as they are and we must work together to change them.

Glossary:

  • BIPoC: Black, Indigenous, People of Color.

  • FLINTA*: Female, Lesbian, Intersexual, Non-Binary, Transsexual, Asexual,*.

  • cis-gender: gender identity corresponds to the sex assigned at birth

Sources and opportunities for continuing education:

Books

Individual publications

Podcasts

  • Advieh Podcast - Pajam (Spotify)

  • Public Health Podcast (episode 25) - Racism as a social determinant.

  • Somali Vendetta - Intersectional Feminism (speaking out for feminist women's struggle day on March 8).

Podium

Projects/ Associations

Studies

English version

Trigger warning: Description of structural racism in health care, racism as a social determinant, description of white privilege, relation to Hanau

In the following text we will try to outline the connections between racism and multiple discrimination as a social determinant and thus the need for intersectionality in health care. There is no claim to completeness.

Access to health professions and university education, and especially to restricted-access fields of study such as psychology and medicine, is significantly more difficult for many BIPoC than for white people due to institutional racism in schools and universities. This composition is also reflected in our white political group, for example. What this means for an intersectional approach to modern health care quickly becomes clear: currently, important perspectives and impulses are missing, and the health care system is just one of many examples, showing that postcolonial continuities have inscribed themselves in the world that surrounds us. We are aware that as a group we are still in the beginning stages of our critical and intersectional engagement with racism.

Being affected by racism, sexism, classism, ableism and other mechanisms of exclusion can be the cause of mental illness such as anxiety disorders or depression and post-traumatic stress. In this context, experiences of racism and microaggressions in everyday life, flight and other existential adversities affect BIPoC to a high degree and increase the likelihood of becoming ill. The aforementioned mechanisms can be understood as social determinants of health that have a significant negative impact on access to health care. In addition, external circumstances that cause illness also often act as barriers to addressing illness and beginning a healing process. For example, Serpil Temiz Unvar, the mother of Ferhat Unvar, who was a victim of the racist right-wing terrorist attack in Hanau on February 19, 2020, said:

"What good is a therapist to me as long as this danger is still there?"

Therapeutic work with trauma sequelae can usually only begin properly when external circumstances permit and there is no acute threat, contact to perpetrators, or current reference to the traumatic event. Other circumstances that negatively influence a healing process are racist police violence and racial profiling, failures of security authorities, victim blaming or severely protracted, bureaucratized asylum procedures that often have no prospect of success.

In addition to more difficult access to health care professions and framework conditions that tend to hinder a healing process, groups outside the (white) dominant society are often at a significant disadvantage in (mental) health care as well. For example, it is significantly more difficult for Black people to find and keep a place in therapy. On the other hand, there are far too few anti-racist trained professionals with power-critical and trauma-sensitive approaches and there is a shortage of therapists, doctors and psychologists of Color, especially in Saxony. This results, for example, in the problem that BIPoC have to explain their own affectedness in a therapy setting when they work with untrained professionals. Under certain circumstances, this can also have a retraumatizing effect.

Medical research and literature is oriented towards white cis-male bodies, which can sometimes have deadly consequences for Black people if, for example, their skin color is not taken into account when making diagnoses. Many diseases, e.g. meningitis, manifest as a reddish rash on the skin on white bodies. Symtomatics on black bodies, on the other hand, look significantly different. FLINTA* or people with disabilities, are also structurally disadvantaged by the centering on white, cis-male bodies in medical research and literature.

Another social determinant is the intertwining of the issues of work and health. Migrants, people with a migration history, people with disabilities and FLINTA* are disproportionately often employed in precarious jobs in the low-wage sector with an increased risk of infection. In particular, during the Covid 19 pandemic, they are at significantly increased risk of contracting the disease. A study from the Robert Koch Institute (March 16, 2021) supports this fact and shows that Covid 19 deaths were significantly higher in socially disadvantaged regions of Germany than in less disadvantaged parts.

But even without Corona, the aforementioned groups work under conditions that make them ill, while health care as a social resource tends to be denied to them.

We hope that this text will lower the hurdle to contact us with a concern and to take advantage of our counseling services. We know that this is an enormous leap of faith! All the described conditions cannot stay like this and we have to work together to change them. Therefore, our demands are:

  1. (Post-) colonial and (post-) national socialist crimes and their effects on our coexistence today must be collectively recognized.

  2. Responsibility in racist, sexist, ableist, classist, queer- and trans-hostile, fatshamist, ageist and other contexts must be taken consequently and lead to a self-critical discussion. We are all perpetrators.

  3. Medical and psychosocial health care must be accessible to all people.

  4. From the asylum procedure to physiotherapy: medical and psychosocial professionals must be trained to be critical of power, anti-racist and sensitive to trauma.

  5. Professional literature and medical research must reflect diversity and not only be based on cis-male, white bodies.

  6. Interdisciplinary and intersectional collaboration at the community level must be encouraged.

  7. Access to health professions must reflect societal diversity.

  8. Working conditions should be safe for all people, not just on paper but in reality.

next post

Politics

For a feminist solidarity-based health policy

March 2021