Lessons in allyship

Consultant ophthalmologist, Evelyn Mensah, outlined the principles of authentic allyship during her 100% Optical presentation, Allyship in practice.

Mensah shared that race is a social construct that was promulgated during the seventeenth and eighteenth centuries, with white philosophers putting forward the idea of a hierarchy of races.

“They decided to put themselves at the top of the racial hierarchy tree,” she said.

Mensah highlighted that this idea of inherent difference between racial groups was popularised during the Age of Enlightenment, despite being scientifically flawed.

“If you look at our genes, 99.9% of our genes are all the same,” she said.

Mensah explained her preference for the term ‘global majority’ when describing people who previously may have been racialised as ‘ethnic minorities.’

She highlighted that this phrase refers to people who constitute 80% of the world’s population.

“If you look around the world, people who look like me – black or non-white, brown – make up the majority of the population,” Mensah shared.

She shared that, as a result of their daily experiences, sometimes people from global majority backgrounds can be led to think that they are in some way flawed.

“There is nothing wrong with us – it is the system that is wrong,” she said.

How to be an authentic ally

Mensah shared that allyship is defined as a ‘supportive association with another person or group; more specifically, with members of marginalised or mistreated groups to which one does not belong.’

The first principle of authentic allyship is appetite – Mensah shared that individuals must have the appetite to immerse themselves in the complex world of race equality.

Mensah highlighted that the second principle is to ask. She encouraged delegates to read widely on the topic of race.

Mensah shared that she finds it challenging to have conversations with people who are in denial about the effects of racism.

“I prefer to work with people who are genuinely curious,” she said.

The third principle of authentic allyship that Mensah discussed is acceptance.

“Accept that there really is a problem, and that more data is not needed,” she said.

Mensah highlighted that around 48% of NHS workers complete an annual staff survey.

Racism is the most common form of discrimination reported by NHS staff as part of this questionnaire. Mensah acknowledged that different aspects of identity play a role in discrimination.

“We don’t live in a monolith. I am black and I am also female,” she said.

“There is a degree of intersectionality involved,” Mensah emphasised.

The fifth principle of authentic allyship is to apologise, Mensah shared, adding that this involves expressing sympathy that racism is affecting people from certain groups.

She highlighted that within the NHS, although 24.2% of staff are from global majority backgrounds, people from these backgrounds make up only 10.3% of senior management positions.

Mensah shared how a ‘cliff edge’ exists when it comes to the pay of global majority staff within the NHS – people from these backgrounds are over-represented in lower pay bands, with representation dropping off in the higher pay bands.

Turning to the issue of disproportionate professional conduct investigations, Mensah highlighted that people from global majority backgrounds are two times as likely to be referred to the General Medical Council (GMC).

She added that global majority medics who qualified in another country are three times as likely to be referred to the GMC.

The sixth principle of authentic allyship that Mensah discussed is avoiding assumptions.

“Develop informed views by seeking understanding from individuals,” Mensah shared.

She added that this involves taking time to understand the situations that people are dealing with.

“I think it is the responsibility of everyone to understand each other’s backgrounds so we can effectively communicate and interact with people across cultures,” she said.

Action is the seventh principle of authentic allyship that Mensah shared.

This involves taking demonstrable steps to establish equality. As an example of action, Mensah described how trainee surgeon, Dr Rachael Harlow, highlighted a problematic question within a medical textbook.

The pair contacted the publishers of the textbook, who decided to recall the book and issue a new edition with a replacement question co-authored by Mensah and Harlow.

The eighth principle of effective allyship is appreciation. Mensah highlighted the importance of understanding the difference between equality and equity.

Equality can be understood as everyone receiving the same thing, even if they had more than they needed to begin with.

“Equity is the distribution of resources according to need,” she said.