As the COVID-19 pandemic put immense pressure on health care systems around the world, health care workers raised the alarm regarding the challenges they were facing in trying to provide care and save lives. Lack of adequate funding for health care systems and its workers, and limited access to personal protective equipment (PPE) were among the issues that were raised within the industry.

As a result, health workers participated in protest activity with greater frequency, according to a recent study published by the Accountability Research Center.

The research looked at 6,589 health worker protests in 149 countries in terms of five categories: working conditions and remuneration, resources, health system delivery issues, public policy, and other.

"By far, the largest category of protests during this period are those related to working conditions and remuneration. Approximately 66% of global protests in the 2020-2021 period expressed health worker dissatisfaction about issues such as: occupational hazards, unpaid wages, risk allowances, and job security," the report noted.

UK doctor Meenal Viz became a global figure after her one-woman protest outside Downing Street in 2020 following the death of a fellow health care worker just days before. Here she reflects on her decision to protest against the systemic issues health care workers are forced to confront.

I was born and raised in Gibraltar, which is a tiny little paradise right at the tip of Europe. I had a very comfortable life. I was raised in the sunshine, I was raised by the beach. There was always a sense of community and we never felt left out as kids — partially because my parents never allowed me to feel that way. My parents always instilled in me that you are as good as anybody else around you. But also, at the same time, I feel as though the way that the system is built in Gibraltar always really encourages unity and togetherness among the many different communities.

When I went to apply to medical school, I decided to take a year out. So, between high school and going to medical school, I spent a year in Mozambique. That was a very interesting year for me because I went to a very tiny and remote village in Chibuto right at the south of Mozambique. It was a very, very deprived area where I realised that, actually, this is the kind of situation that my father was raised in, in New Delhi, before he migrated.

My father came from New Delhi at the age of 25, I think, and he came into Europe and he lived in the slums. It was almost like there was no hope. But my father was very lucky because he was very bright and he was very determined to study hard and get out of that life — and he got a golden ticket to get out, but a lot of people didn't. And I think when I went to Africa, to Mozambique, I realised that for that one person who gets a golden ticket, there are 1,000 people who are left behind. [After that], I always had that question in my head — why is everything so unfair? Why is this world like this? I thought that I could just go back to my home and life in Europe after living in Mozambique and it just didn't feel right to me.

I eventually went to medical school in Prague in the Czech Republic and I was lucky that, during my studies, there was never a feeling of feeling left out or there was no discrimination. Everyone just wanted to help each other get through the six years. It was when I became a doctor in 2018, and I came to the UK, that my patient said, “Actually, I don't want to be seen by an Indian doctor. I want a white doctor.” I think that's when it really hit me that actually racism exists. And it was a visceral feeling. It was almost like I felt sick, asking why am I facing this?

This became a big grey cloud hanging over my head throughout those years, with me worrying about a patient saying a racist slur towards me while I walked through the emergency department, that my patients might not feel comfortable because of my skin colour. I never really questioned it because actually if I did, it would lead up to uncomfortable conversations. I didn't want to put my job on the line. And this took me full circle to me at the age of 18 when I had that question: Why is the world so unfair? Why can't we all live equal lives? I finally got the answer to that, which was that, actually, the system doesn't allow it.

There were many issues in the health care system and the pandemic really brought a lot of truths to the surface regarding social injustices, inequalities, racism, and sexual discrimination. However, in March 2020, I knew I had to speak up and I had no other choice because we were seeing ethnic minority groups in the UK dying. I saw my own colleagues, our own doctors, dying because of COVID and people didn't bat an eyelid. People just thought that it was okay to carry on. And that's when I decided to speak up because people weren't listening to me, managers weren't listening to me, and every time I spoke to a manager, they told me to go to somebody else. It was as if they were just shrugging off responsibility.

But the real moment for me was when nurse Mary Agyapong passed away. Nurse Mary lost her life after giving birth to her daughter and she never got to see her family again. Her family never got to hold Mary in her last moments because of COVID and the way the system tried to cover up that death was appalling. Not just her death, all the other deaths that were happening within the NHS (National Health Service), where they were trying to give gagging orders, where they were telling families not to speak to the media, and they weren't allowing people to grieve and they weren't allowing families to have that closure. And for me, that just felt like it was unjust and it really just felt like there were evil people trying to control the system. I made the decision the day nurse Mary had died because I saw the grief that hit her family. They lived down the road from us at that time. I saw the grief that hit her husband, who was holding a newborn baby without a mother. And that was not okay to me. That was not okay because we could have prevented that death. So, it was exactly six days after nurse Mary's death, on April 19, 2020, that I went to protest.

It was actually myself and my husband who spoke up. At the time, I was six months pregnant, and I was getting phone calls at ridiculous hours, at 10 or 11 p.m. at night, from my communications manager saying, “You're not allowed to speak to the media. This is not okay. Don't mention which hospital you're working at.”

They really tried to shut me down and they tried to threaten me, [telling me] not to speak up and not to let out the secrets of the system. I had raised the issues internally and nobody responded to me. Nobody wanted to engage in these conversations. And it was only after this exhaustion of trying to raise the concerns, and no one getting back to me that I decided that I had no other choice but to go to Downing Street. And remember, as I said, I was pregnant. I had better things to do. I had to take care of my health, to take care of my sanity. But I felt that that was the right thing to do because this wasn't just about nurse Mary or the doctors around me, but it was actually raising the problem that if you're not protecting us as doctors, what chance do we have to protect our patients?

So, this wasn't just a case of only trying to advocate for health care workers, because a lot of it was to protect the public. And that's my role as a doctor, to protect the British public and to protect my patients. And if we're not protected, then there is no chance to save anybody who comes through our doors. Because even once COVID started, we knew the science. We knew how this virus was transmitted. We knew how it was disproportionately affecting certain groups, but no one was listening. Leaders were creating guidelines which went against WHO advice. And it was simply because they just wanted to save their backs. They just didn't want to listen to the reality of what was happening on the ground. And they were pushing a completely different picture on the media to what was really happening.

Once I went public, my life changed overnight. I saw the impact that had, because people all over the world were messaging me on Twitter. My photo had gone viral on Twitter. People were saying, “Your courage to speak up has given us the courage to speak up. Your protest has given us courage to speak truth to power.”

And that’s what I wanted, I wanted to say to doctors that if you're not happy with what's happening around you, you can speak up. And I'm with you. I feel like a lot of things have changed in a positive way, such as people becoming more comfortable with the idea of speaking up. People are becoming more comfortable in accepting the idea that racism and inequities exist, and people are becoming more accepting of the idea that actual change is possible.

However, there were and still are challenges. We had ministers and leaders clapping for us, but at the same time, behind those doors, they were trying to find ways to cut funding, trying to find ways to privatise the NHS, and now they've cut free parking from NHS staff as well. Things that would ultimately hurt NHS staff.

NHS staff aren't burnt out because of their job — we see sick patients on a daily basis. This is what we love to do — to care with compassion, but if the system doesn't provide us with the resources to carry out our role adequately, we are left with nothing to keep us going.

As told to Gugulethu Mhlungu.

The 2022 In My Own Word Series was made possible thanks to funding from the Ford Foundation.

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