Visit your doctor on time
By Dr Brighton Chireka
IN my articles so far I have been advising everyone to visit their doctor and I have also been studying the research that has been carried out in countries such as South Africa, the United States of America and the United Kingdom on the use of healthcare by black people. I do not want to generalise and paint all black people with the same brush but I feel the results cannot be ignored.
I take the results as a feedback that we should reflect upon and take the necessary action to better our health; our health, yes because I am a black person and I do identify with some of the findings in these studies. Instead of being defensive about the findings I call upon those concerned to positively engage with the findings and come up with personal solutions to their health. Let us use this opportunity for our learning and growth in our healthcare.
Some of you know my page on Facebook which is called “Nothing About Me Without Me” which has got more than 28 thousand likes now. “Nothing About Me Without Me” meaning that no decision about you should be taken without you being involved. You should be at the heart of decision making of things that affect your health. Nothing About Me Without Me is not a phrase, it is not a motto it is what we must live, every day. My call is for you to get fully involved in decisions about your health and see a doctor in good time. Part of the reason why I am writing these articles is to make you visit your doctor and get treated.
Not so long ago the Zimbabwe Registrar General Tobaiwa Mudede was quoted to have said that contraceptive pills were dangerous. It’s worrying when those that have influence use their skills to present a one-sided debate and take advantage of our ignorance. Sadly there are some who will take this wrong advice and stop using contraceptive pills. In life, there is nothing that is risk free even sunshine or eating sadza but we do not stop using these things.
There was a scare in the UK about immunisation, wrongly claiming that a certain vaccine for measles, mumps and rubella causes autism (behavioural disorder in children). The doctor behind such falsehood was struck off the register and we are now picking up the pieces. The same will happen in Zimbabwe and doctors will soon be picking up the pieces.
Debate is healthy but is dangerous if it’s one side and must be stopped. I think people must know their areas of expertise and not embarrass themselves whilst putting people’s lives at risk. I am always keen to share good news such as the operation of the Siamese twins by our own Zimbabwean team led by the humble Mr Mbuwayesango than getting news that takes the country back to the Stone Age. It is this kind of misinformation that also make some people shun visiting their doctors.
In the USA, African Americans still lack overall confidence in the healthcare system and believe they are less likely to receive the same medications, treatments, or quality of care as whites. Black men are less likely to use healthcare on a regular basis whilst black women are less likely to have the time and energy for their own health needs due to family responsibilities and other stressors. Elderly men and women delay seeking care until activities of daily living are affected. This is against the background of the worrying statistics that diabetes is two to four times more prevalent in blacks than in whites. The highest incidence of prostate cancer and the greatest mortality is seen in black men and black women present with more advanced stages of breast cancer than white women.
In the UK, studies have shown that among African communities, recourse to health services is often delayed through a system of ‘lay referrals’ where friends and kin are consulted and one turns to a medical expert as a ‘last resort’, when the illness becomes unbearable. African migrants may be more concerned about immigration and socio-economic issues than about their health eg HIV status: as can be seen from a response by one african immigrant in the research: “I’m not worried about the virus – my worry is whether I will be allowed to remain here in this country”. CJ Riley Funeral Services is repatriating at least one body per month from the UK to Zimbabwe and at times the cause of death is easily preventable.
In South Africa there is a tendency, especially among the black people, for the diagnosis to be made late or if made early, there tends to be non-compliance with the proposed management including follow up. A study conducted by Hacking, Gudgeon and Lubelwana (1988) in the Western cape found that Xhosa women often presented with advanced breast cancer, having first sought assistance from traditional healers.
The results are not encouraging and the reasons for them are not simple but very complicated. It is beyond the scope of this article to go into details about the causes but I have a few questions that I need to discuss with you. Are you registered with a general practitioner (GP) or a family doctor? When did you last visit your doctor? Do you attend for routine check-up and participate in screening for cancer? When you last saw your GP, did you feel listened to and are you following the instructions as directed? Have you gone for the next appointment? What is it that is stopping you from making full use of your GP? What are you doing about it?
Do you have any of the following: unexplained weight loss, persistent cough for more than 3 weeks, coughing up blood, shortness of breath, chest pain, passing blood in stool, lump in your breast or another part of your body, and swollen glands to just mention a few symptoms. If you do have any of the above symptoms, you must see your GP for further advice. Please do not ignore these symptoms as there may be something sinister causing these symptoms.
Having made a call to patients, I want also to make a call to every health professional regardless of race to change their culture of stereotyping people. The race of a person does not tell you much about their behaviour or lifestyle and later on their health. Everyone has a right to health and the medical community must give people, especially black people that confidence. There should be mutual trust for the relationship to work properly. As a patient I am willing to give my story in confidence to a non-judgemental and fully concerned health professional. I also expect mutual respect from patients towards their GPs. Violence against health professionals does not help and is unacceptable.
Black people seek the same components of caregiving from doctors that other patients seek: kindness, sympathy, respect, an earnest attempt to assess their ailments, explanations in basic terms, and a shared approach to management. I also know that the health community is fully committed to engage with all people regardless of race so everyone should make use of their doctors. Nothing about black people without them and if it is for them, then it must be discussed with them.
I hope that this article will make at least one person pause and reflect about their health and visit their GP. Please feel free to share this article, comment or email me.
This article was compiled by Dr. Brighton Chireka who is a GP and a Patient Engagement Advocate (PEA) in Folkestone Kent, UK. He is also an NHS Certificated Change Agent (CCA). You can contact him at: email@example.com or read more of his work on DR CHIREKA’S BLOG
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Dr Chireka has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.