Nurse Efe Obiakor stood at the front of the crowd, looking up proudly as her 18-year-old daughter Ada took center stage at a Black Lives Matter rally in central London.
“Let’s use this opportunity to have a community heal,” Ada told protesters as they poured into a sunny Hyde Park.
Obiakor was there to support her daughter, the lead organizer behind the June 20 anti-racism demonstration, but also to advocate for herself.
“As a Black nurse, it’s very important for me to come out today because in the system where I work, and in the NHS as a whole, there is racism,” Obiakor explained.
A practice nurse with 12 years’ experience, Obiakor, from London, says she has long faced discrimination and harassment in the UK’s public health care system, known as the National Health Service (NHS).
And she’s not alone.
CNN interviewed a dozen Black nurses across the UK’s healthcare sector. From students to medics with decades of experience, they work in different roles and different settings – hospitals, care homes and clinics – up and down the country.
They all say they have experienced racism in the workplace – and that it has gotten worse amid the coronavirus outbreak.
They told CNN the pressures of the pandemic have exacerbated existing racial inequalities, leaving Black nurses vulnerable to harassment and discrimination.
They say they have been pressured to treat Covid-19 patients without proper personal protective equipment (PPE), to work in the highest-risk areas with larger caseloads, and left too scared to speak out, for fear of reprisals.
Their testimony highlights what they say is a pattern of systemic racism in one of the world’s most highly regarded public health care systems.
In response to these 12 testimonies of racism, NHS England said, “Covid-19 has shone a spotlight on stark health inequalities in our country.”
The statement added, “Every NHS organization is expected to prioritize and carry out risk assessments for their BAME [Black, Asian, and minority ethnic] staff and other vulnerable groups as a matter of urgency, but in addition do everything possible to eliminate discrimination, and ensure the right processes are in place to address it swiftly and effectively.” The organization did not respond to allegations of PPE shortages.
‘It’s us again!’
Obiakor says she doesn’t trust the system to hear black nurses and correct discrimination.
“What it means daily is: I am not treated fairly,” she told CNN. “I don’t have a voice. Nobody is ready to listen to me. I might be screaming, they know I am screaming, but they are not ready to take action. That’s how it feels as a Black nurse.”
When seriously ill coronavirus patients began flooding UK hospitals as the pandemic took hold in mid-March, Obiakor says she knew who would bear the brunt of the burden.
“We are used to the Blacks being on the front line, so when we came in all we said is: ‘It’s us again!’” she said with an ironic laugh. “We were not surprised.”
Carol Cooper, who is the manager of Equality, Diversity and Human Rights at an NHS Trust in England, has been attending listening sessions on race and equality in the wake of the public health crisis sparked by coronavirus. She says it was inevitable that Black nurses would find themselves on the front lines of the fight against Covid-19.
“This is indicative of a larger trend,” said Cooper, when CNN shared its findings with her. “These are not random voices. These are the experiences being echoed all over the country.
“We are the faceless people in the back, but our talents never bring us to the upper echelons. That needs to stop,” she said. “There needs to be a very honest reckoning in the NHS.”
One in five of all nurses across England are from Black or minority ethnic backgrounds, but about 95% of executive directors of nursing are white, according to a 2019 report from NHS England.
For 42-year-old community nurse Monifa Thompson, the reckoning can’t come soon enough.
Thompson has spent much of the pandemic treating patients with suspected and confirmed cases of coronavirus in their homes, sometimes without getting proper PPE from her employer.
“I find racism is at the forefront of everything,” she said. “We are pressured to see a huge number of patients – I can see 21 in a day.
“You feel there is nothing you can change within this system,” she explained. “If you say something, you are labeled as ‘that nurse that’s lazy.’”
Systemic racism in sharper focus
Neomi Bennett, an agency nurse in London, says she paid the price for speaking out – but insists that the fear she could lose her life because of coronavirus pushed her to file a complaint about PPE.
“I was so paranoid I was going to die,” Bennett told CNN. “Some mornings I would wake up startled in my sleep trying to find something to smell, because loss of smell [is] one of the symptoms. I wanted people to know I was not protected.”
Bennett wrote to her bosses at one particular hospital, explaining that she had brought her own N95 respirator mask to a shift, only to be banned from using it. Instead, she says she was given a basic mask, gloves and an apron to wear while treating Covid-19 patients.
“I felt uncomfortable and bullied. I did not wish to continue my shift without proper PPE protection,” the letter, seen by CNN, reads. “However, I believe that had I left the department, this would have compromised patient safety.”
Her words went unheeded, and she says the only solution was to refuse to work in that ward again.
As an agency nurse, Bennett works at multiple hospitals, and says she has found ways to quickly recognize the places she won’t be welcome as a Black nurse.
“Some of the (Black) nurses will sort of give you code,” Neomi said rubbing two fingers on the back of her hand as if to highlight the color of her skin. “It means the staff here aren’t really fond of Black people, and there is going to be some form of discrimination in the shift.”
As more and more minority healthcare workers have lost their lives to the Covid-19 pandemic, the systemic racism they say they face has been brought into sharper focus.
Minorities make up about 20% of England’s NHS medical workforce, but early analysis shows they have accounted for 60% of healthcare worker deaths due to the coronavirus, according to British media reports.
At the height of the pandemic, the British public poured praise on its nurses and doctors, with thousands of people gathering on the doorsteps of their homes each week to applaud the efforts of health care workers.
But as the country was “clapping for carers,” many of the nurses CNN spoke to say they were fighting for PPE.
Nurses’ union the Royal College of Nursing (RCN) told CNN “our own recent survey showed that only 43% of BAME nursing staff had enough eye and face protection equipment.”
The RCN has called on employers to “take swift and comprehensive action to support and protect staff,” including providing effective PPE.
“No nurse should be placed at risk of contracting Covid-19 in the course of delivering care,” a spokesperson said.
Limited government guidance
Ken Sazuze knows the risks. He and his wife Elsie, from Birmingham, went back to school as adults, in order to become nurses.
“I was aware of the tough side of student life, but I wasn’t aware of the discrimination side of nursing,” Sazuze told CNN. “Until I studied, then I saw it: Boom! It’s different. It’s dangerous.”
He says the childhood sweethearts faced constant harassment and bullying but endured it as a team. Elsie, several years ahead of her husband in her studies, soon graduated and got a job.
“She hated it in the NHS. I could tell she wasn’t happy,” Sazuze said. “Not only because she was Black. Because you are Black and you are trying to change the system, because the system is designed [so that] Black will be the last.”
After four years, Elsie quit the NHS – Sazuze says her decision was, in large part, due to racism. She found a job at a local care home and he said life got better. And then it got much, much worse.
In April, as coronavirus spread, largely unchecked, through Britain’s care homes, there was limited government guidance on PPE.
“Elsie was wearing basic gloves, basic mask, and an apron and that’s it,” Sazuze said.
The couple began displaying coronavirus symptoms (fever, cough, severe headaches, fatigue, and loss of taste and smell) on the same day, Sazuze said.
The pair followed UK government advice to call 111, the NHS’s non-emergency number; Sazuze says they were advised to self-isolate at home – away from their children – take plenty of fluids, and call back in five days if their symptoms worsened.
Four days later, Sazuze said his 44-year-old wife woke at 2 a.m,, unable to breathe. He called for help and filmed her on his phone.
“I was like, ‘Honey … you’ll be fine. When you’re better I’ll show this to show you how strong you are,’” Sazuze recalled.
As the paramedics took Elsie to hospital, her husband said she told him: “Don’t worry.”
But the mother of two never recovered. When her condition worsened, she was placed on a ventilator. She died, days later, on April 8.
Sazuze is heartbroken, and grieving, but not afraid. He says he plans to complete his nursing degree.
“I want to continue her legacy,” he told CNN. “She loved helping people.
“I don’t let the bad people change me,” he insisted. “No, I will always help people regardless where they come from, what color they are, what they say to me.”
When called on to do their part to help save the country from a deadly virus, each of the 12 nurses CNN spoke to said they had acted without hesitation, driven by a duty to care for the sick.
Now they are pleading to be treated as equals at work and in life.
Back in London’s Hyde Park, Obiakor says she feels she’s been fighting two battles at once: Racism and coronavirus. She says she is more determined than ever to emerge victorious – on both fronts.
“If I know when I speak that there is going to be a change, I will speak every day,” she said. “I will bring the facts. I will bring the figures. I will bring witnesses.
“We want the NHS to be a place where everyone comes in and they feel at home. They are not bothered about how my manager is speaking to me, or what’s going to happen tomorrow, no,” she added.
“It will be a beautiful place to work.”