Introduction
This essay explores the importance of systemic inclusivity in healthcare, drawing from personal experiences as an asylum seeker and observations in medical research. As a medicine student, I reflect on how navigating diverse cultural systems has informed my understanding of healthcare disparities, particularly in equipment design and patient care. The discussion highlights patterns of exclusion in respiratory protection standards and advocates for attentive, community-driven change. Key points include analysing systemic gaps in fit testing for firefighters and Sikh workers, and implications for future medical practice in diverse regions like Peel. Supported by academic evidence, this essay argues for a critical approach to inclusivity, emphasising research and listening to marginalised voices (Bhopal, 2017).
Personal Background and Systemic Observation
Growing up as an asylum seeker, displaced from familiar environments, I learned to navigate systems not designed for individuals like me. This involved observing structures from both insider and outsider perspectives, honing skills to quickly identify who systems centre and who they exclude. Such experiences reveal patterns indicating systemic biases, a concept echoed in medical literature on health inequities. For instance, studies show that healthcare systems often prioritise dominant groups, leading to disparities in outcomes for ethnic minorities (Nazroo, 2003). In my view, these patterns are not accidental but reflective of design flaws that overlook diversity.
This perspective is particularly relevant in medicine, where cultural expectations can influence patient-provider interactions. As a student, I recognise that awareness of these dynamics is crucial for effective care. Indeed, the ability to read systems—identifying exclusions—aligns with calls for cultural competence in medical education, which emphasises understanding patients’ backgrounds to improve health equity (Betancourt et al., 2003).
Case Studies in Respiratory Protection
At Ontario Health, my involvement in respirator fit testing with firefighters exemplified these insights. I observed a consistent pattern: women scored lower on fit tests, which I interpreted not as individual failings but as systemic gaps in equipment design. Presenting these findings provincially, I questioned the sex gap in respiratory protection, highlighting how standards often assume a male-centric model. Research supports this; a study on N95 respirators found that fit failure rates are higher among women due to facial anthropometric differences, underscoring the need for gender-inclusive designs (Regli et al., 2021). This example demonstrates how patterns signal broader exclusions, prompting advocacy for revised standards.
In a parallel study involving Sikh workers, many faced a dilemma: shave their beards for proper N95 sealing or risk job loss, with some working unprotected. This reflects safety protocols designed for a narrow population, ignoring religious and cultural needs. Collaborating with the World Sikh Organization, we explored adaptations like the Singh Thattha technique, which involves wrapping the beard to improve seal without cutting it. Such innovations reinforce that advocacy involves early pattern recognition and translation into change. Evidence from occupational health research indicates that culturally insensitive PPE contributes to higher injury rates among minority groups, advocating for inclusive policies (HSE, 2020). These cases illustrate problem-solving in complex scenarios, drawing on resources to address inequities.
Implications for Future Medical Practice
Peel’s diverse population demands sustained attentiveness beyond mere awareness. As a future physician in this region, I intend to deliver consistent care by prioritising listening and deliberate action. This means amplifying silent voices through research and community communication, rather than speaking for them. For example, engaging with local groups can inform inclusive practices, aligning with NHS guidelines on patient-centred care (NHS England, 2019).
However, limitations exist; systemic change requires institutional support, and individual efforts may face resistance. Nonetheless, integrating personal insights with evidence-based approaches can foster inclusivity, ultimately improving health outcomes.
Conclusion
In summary, personal experiences as an asylum seeker have shaped my critical view of healthcare systems, revealing exclusionary patterns in areas like respiratory protection. Through examples of gender and cultural gaps, supported by studies on equipment design and cultural competence, this essay underscores the need for advocacy via research and community engagement. As a medicine student, I am committed to applying these lessons in practice, promoting equitable care. The implications extend to broader medical education, encouraging a shift towards inclusive systems that serve all populations effectively. Arguably, such attentiveness is essential for addressing health disparities in diverse societies.
References
- Betancourt, J.R., Green, A.R., Carrillo, J.E. and Ananeh-Firempong, O. (2003) Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), pp.293-302.
- Bhopal, R. (2017) A four-step programme to tackle racism in the NHS. BMJ, 358, j3670.
- HSE (2020) Personal protective equipment (PPE) at work: a brief guide. Health and Safety Executive. Available at: https://www.hse.gov.uk/pubns/indg174.pdf (Accessed: 15 October 2023).
- Nazroo, J.Y. (2003) The structuring of ethnic inequalities in health: economic position, racial discrimination, and racism. American Journal of Public Health, 93(2), pp.277-284.
- NHS England (2019) The NHS Long Term Plan. NHS England.
- Regli, A., Sommerfield, A., von Ungern-Sternberg, B.S. (2021) The role of fit testing N95/FFP2/FFP3 masks: a narrative review. Anaesthesia, 76(1), pp.164-174.
