What Black women do when the NHS fails them

When the first universal healthcare system, free at the point of use, was established in the UK – the National Health Service (NHS) – it claimed to grant residents, regardless of race or gender, equal access to its services. It was, theoretically, faultless.

In practice though, it is a dangerously flawed system and does not guarantee the universality of quality or safety. Black people’s lives, Black women’s lives especially, are hugely compromised by the system.

To contextualise its severity: during the peak of the Covid-19 pandemic, Black Britons were four times more likely to die than their white counterparts; in 2022, 65 per cent of Black Brits reported being racially discriminated against by a healthcare professional; another report in 2022 revealed that Black women are still four times more likely than white women to die in pregnancy and childbirth.

Dear Black woman, it is not in your head. In January this year, after a nine-day “fact-finding” tour, United Nations experts urged government ministers to take action against institutional racism.

Yet a statement on the NHS England website reads, “Despite years of trying to address issues of racism in the NHS, there has only been a limited amount of success.”

It is no surprise then, that Black women have trust issues when it comes to public health services in Britain. How can they trust a healthcare system that fails to safeguard their needs, value their humanity or protect their lives? Well, often they can’t.

In recent years, growing numbers of Black women have turned to alternative sources for health services and support, including myself.

Avoiding institutionalised healthcare

I’ve always been the “I don’t take pills” type of person, as if it is a character trait bestowed on me by some hippy healthcare god; I’ve always preferred to spend hours researching natural remedies than hours waiting for a doctor. When I was a teenager, a vaccination was being administered in schools to girls my age. I remember decisively not wanting it and speaking to my mum, who immediately understood.

I’d never really questioned the root of my high-level avoidance of institutionalised healthcare. But reflecting on it now, I can see it’s very much hereditary – a characteristic of a generational scepticism passed down through the women in my family and certainly more indicative of Rastafarian values than any European, hippy counterculture in me.

The clear identifiable source? My Jamaican grandmother. Part of the Windrush generation, she arrived in Britain in 1958, ten years after the birth of the NHS, at a time when racism in the UK was rife.

Looking back, my family and I have always compensated for misogynoir within the healthcare system through a blend of avoidance and ‘bush’ medicines. Tummy upset? “Tek a likkle ginger.” Got a cold? “Peppa fi sweat it out.” And as all Jamaicans know, cerasee tea “fix everyting”.

Consistent self-treatment

My grandmother was a medicinal matriarch. Whenever I showed symptoms of an impending sickness, I’d sit opposite her at the dining table as she delivered a prognosis before boiling a pot of water and rummaging through the cupboards.

A few minutes later I’d leave with a piping hot cup and a promise to feel better soon. Well, it was more of a warning, actually, that I wouldn’t get better unless I “drink it up and stop your noise”.

I was often prescribed cerasee, a natural detoxifying and purifying bush tea, and my no-nonsense Jamaican grandmother had no patience for my complaints about its rancid bitterness. Over time, I had organically internalised this inclination to natural remedies.

Then, in 2018 I decided that I wanted to increase my levels of medical autonomy and self-sufficiency. I moved to a farm in Tenerife for three months to develop agricultural skills, learn the principles of permaculture and deepen my knowledge of plants.

During that time, I was introduced to herbs like artemisia, which has antiseptic and antibacterial properties. I also learned loads about plants like aloe vera (anti-inflammatory), lemongrass (antifungal) and papaya (cardiovascular health) – all of which we grew.

Nowadays, I continue to seek out and learn about alternative remedies. I suppose it’s a bit of an ongoing educational commitment. I learn a lot from speaking to friends and from online research too.

At the end of last year, after many determined hours of research, I managed to reverse some damage to my scalp caused by a ‘protective’ hairstyle. The irony. I achieved this with just peppermint and olive oil, and the experience was hugely validating to my beliefs about medical self-sufficiency.

Community care

Illiyin Morrison, a 30-year-old birth-trauma specialist midwife and qualified hypnobirthing instructor from Norwich, is another Black woman advocating for the importance of sharing stories, workloads and information. She relies heavily on communal care to safeguard her own health. Illiyin shares candidly the importance of her “village” to protect her wellbeing as a Black mother of two.

She says, “For me, the root of communal care is in fact family – chosen or given… our power is in togetherness… in collective reflection.” Illiyin dedicates much of herself to growing an online community on Instagram. There she regularly interacts with her virtual network, using the space to educate, empower, answer questions and document.

Having felt “unseen, unheard and unsupported” during the birth of her first child, Illiyin describes that experience as one that changed her personally and professionally. After having her daughter, she left clinical midwifery and transitioned into perinatal trauma, setting up her own private practice. She now provides postnatal and prenatal debriefing sessions to parents as “an opportunity to speak through your birth experience or to discuss your fears… find closure and feel validated”.

Illiyin is vocal in her work about the importance of addressing racial inequalities within maternal care. She says, “If we can have better care and outcomes for Black and Brown women, then we will all receive good treatment.”

In her book ‘The Birth Debrief’, Illiyin dedicates three chapters to race (‘Birthing While Black’, ‘The Myth of the “Angry Black Woman”’, and ‘Do Black Women Feel Pain?’). This is significant because in childbirth and maternity literature that is not specifically about racial justice, there are often no chapters devoted to race. In the first, she recommends Black expectant mothers “choose appropriate birth support” as a means of self-protection. This includes educating your support person on issues such as racial stereotyping and preparing them to advocate for you most effectively.

Herbs rather than hospitals

Marcia, a 54-year-old university lecturer from London, expresses anger at the system and feels as though specialists aren’t helping her enough with her chronic condition, especially when it comes to referrals.

She says that instead of referrals, her doctors insist she undergoes a new surgery. According to the NHS Race Health Observatory, Black patients in the UK are subject to more intrusive treatments than other races. Marcia told me, “I feel like my thoughts are dismissed, my ability to think for myself is not respected.”

She recalls one such encounter. A doctor asked, “You don’t mind if these students watch the examination, do you?” as seven or eight students stared at her in the consultation room. What was about to take place was a full body examination of Marcia’s condition, which affects her intimate regions. She would be completely naked.

Thankfully she had the assertiveness to say no. Following that, she remembers that the atmosphere became hostile. Here we go… the angry Black woman trope. She says, “That is not respect. And that is not going to happen to absolutely anyone… what they try with me, they wouldn’t try with a white woman.”

As an alternative method, Marcia tried herbal treatments to try and help with her condition instead.

“I was reading this magazine and read about a child whose severe eczema had significantly cleared up after visiting a Chinese herbal medicine practitioner in north London. So I phoned, I went, and the lady did an examination. She gave me a load of advice and some herbs with instructions on how to use them: boil it down, take out the stems, boil it down again and then drink it in one go. The first one cost me £370, then I went back and bought another lot for £400, which was a bit bigger.”

The herbal treatment contained 11 ingredients in total including pu gong ying (dandelion), gan cao (liquorice root), and jin yin hua (honeysuckle), and despite bringing the desired results, Marcia says, “I only did it twice because I didn’t want to get myself into the habit of having to find £400 every two weeks. I wasn’t working at the time. I was my mum’s full-time carer. I felt upset that I couldn’t fund it for longer.”

Marcia is not alone in turning to herbs rather than hospitals. In a study conducted in 2006, over half of the participants (of African-Caribbean origin in England) relied on herbal remedies for general health and wellbeing. And in recent years, Black TikTok herbalists have grown in mainstream popularity.

Solidarity and support

Online and in-person, Black women in the UK make use of the powers of conversation, community and education to compensate for racial discrimination.

By adopting a similar focus on communication, healthcare systems could become more inclusive by learning about and responding to their users’ actual needs. Marcia agrees, “To support Black women, you have to take what they say seriously and not be offended when we say how we feel.”

Whatever happens, Black women will continue to do just that – to listen, empower and support one another. In doing so, not only do they raise awareness about alternative remedies, but they also provide reassurance about the shared realities of navigating an unsafe medical institution. For many Black women, being heard is an essential part of being healed.