Has dentistry kept up with matters relating to diversity?

Shareena Ilyas Chair of the Ethics, Education and Dental Team Working Group and Co-Chair of the Equality, Diversity and Inclusion Committee, asks whether change has truly happened

As an Asian growing up in the 1970s, being called a 'Paki' daily, being bullied and physically assaulted frequently was the norm. Growing up during the National Front riots of Southall of '79, spilling out into our nearby areas of Hillingdon was frightening. Some of my first memories as a child were of palpable fear when skinheads were firebombing 'Pakis'' homes, and praying we were not going to be next. Our amazing white neighbour fitted up the house with hosepipes in case the worst happened. I vividly remember the terror of the times when the National Front held an election. The time when a peaceful protestor against the tide of hate, Blair Peach died after he was beaten by police, and when the Hamborough Arms was burnt down only a few miles away from us. I was only 5 when Blair died, and it took another decade for his partner to get justice.

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Attending Cardiff in 1993 for an interview, I was asked by the panel asking me where I was from, I answered London, they then asked where my parents were from. I insisted it was irrelevant, however, they persisted in asking and did not understand how my Hindu mother from Kenya met my Pakistani Muslim father. The reason given for asking was because 'Asians got their dental degree and took their qualifications abroad costing taxpayers' money.' Considering I had never lived outside the M25, I would have found it comical had it not been offensive. They gave me an offer with one grade less than expected, possibly because I challenged them. I vowed not to go there. Thankfully my memories of my university were much better, though I remember cliques forming defined by religion. As I respect both my parent's religions, I did not see it as a 'label' I ascribed to.

The experiences we have when we are young shape our lives, and my journey led to my passion for defending human rights and my drive to ensure dentistry is a fair and equitable place for anyone, and everyone, to work. What is clear is there is a link between racism and mental health and well-being. The sense of belonging is important in this context and when it comes to productivity and effectiveness, in a climate of prejudice it makes it impossible to cultivate.

In my professional life, I have experienced a combination of racism, sexism and, to a degree, Islamophobia. We cannot pretend inequality does not exist in dentistry, and we must tackle it head-on. Dentistry is not alone in facing these issues, and I would suspect that every sector in the UK has problems. It is inspiring to see colleagues in our profession working towards change with the Dental Schools Council and the GDC actively working on ethics diversity and inclusion (EDI) issues.

Dentistry should be a career that anyone can aspire to. What is saddening is that we have been hearing repeatedly of issues related to discrimination in the workplace, and even for those trying to secure a place at dental school. Progress has been made, but questions about how much progress are valid.

Most people have suffered from some form of discrimination, at some point in their lives. Humans seem to enjoy fixating on the differences between us rather than the similarities, whether it be religion, colour, sexual orientation, accent, socioeconomics, age or as absurd as the type of tea we like to drink! If we spend a minute looking at the many parallels we have, we would surprise ourselves. I am concerned that prejudice can be unrecognised by the recipient. It makes the definition of what is considered discrimination difficult, especially when it can be covert and subtle. We have all heard when microaggressions are dismissed as 'banter' when they are clearly not.

One example is the recent BDJ article on past BDA Chief Executives that unfortunately only gave a cursory sentence to the contribution of Linda Wallace, the only woman to hold the post. I do not think it was intended sexism from the author, but it perhaps shows a lack of understanding about how women feel when their achievements are not given parity with their male counterparts - ask any woman, and I suspect that they will have something to say about this. Linda's role may have been temporary and short-lived as Acting CEO and therefore limiting her impact on the organisation in the role, but her contribution as Director of Policy and Advisory Services at the BDA (essentially the BDA's number two at the time) should not have been reflected as flippant as it was. I understand the BDJ is now reviewing its policies and guidelines for written pieces to help authors with submissions.

In my professional life, I have experienced a combination of racism, sexism and, to a degree, Islamophobia. We cannot pretend inequality does not exist in dentistry, and we must tackle it head-on.

The reaction to that piece shows society has changed. By acknowledging that it is unacceptable to treat someone differently because of the colour of their skin, accent, social class, sexual orientation, gender, or any other 'difference', to me it shows progress and how much there is still to do. I joined the BDA's PEC last April and was pleased to find they were invested in EDI work as a key part of their strategy from the previous year, before George Floyd, the infamous leaked university letter and before COVID-19 and the structural inequalities the pandemic brought to the fore. Our President, Russ Ladwa, made equality, diversity and inclusion a key theme of his Presidential year.

Since joining, I feel valued and empowered by my fellow Directors on the BDA's Board, and my voice is listened to and have a true sense of belonging. While I understand the desire to 'balance the boards,' there continues to be a misunderstanding regarding how processes work at the BDA. Our Board is different as it is a special body, which means PEC must adhere to Trade Union Law, meaning no one can be appointed. They must be elected democratically directly by the membership.

I think the issue here is engagement from the wider profession with the BDA. We have seen many people who stand for PEC from diverse backgrounds but do not get elected. For the BDA to work and be truly representative of the people we serve, we need everyone to play their part. The simple act of voting in elections is hugely important.

The BDA's committees drive the direction when it comes to each sector of our profession and this is where the real action is. Our Committees thrive on having passionate, knowledgeable and experienced people to drive our agenda forward. One way to get that is to get involved at a local level first, be it a BDA branch/section or your LDC. I know this is not always easy for a myriad of reasons and we need to understand the barriers to people getting involved. Again, I cannot stress the importance of voting.

All forms of discrimination in dentistry are not going to be fixed overnight. Our first steps have been to ask opinions from all sections of our profession and in December 2020, we opened a profession-wide survey to investigate the experiences and views on racial discrimination. We know it is not an easy issue to raise for many. I have heard so many stories of unequal treatment and people who were too scared, too embarrassed, to speak up. Part of the issue is who do you go to?

For high street dentists who are self-employed, they do not have the same protection offered by contracts of employment for those who are salaried. However, even for those who are salaried in the CDS, hospital, and academic sectors, I have heard shocking stories of unfair treatment, and of colleagues who will not 'rock the boat' for fear of retribution, or worse still, losing their position. It saddens me that it is happening in 2021. I also wonder how many dentists have witnessed discrimination and have wanted to speak up for colleagues but have felt that same fear and have had to turn a blind eye.

Now is the time for everyone to speak up and we want to support you to do that. Your stories will help us find where the pressure points are in our profession and what we can do to work towards making a fairer, healthier, more progressive place to work. We should embrace the diversity that is within our profession, and I believe it is one of our core strengths. We need to overcome our unconscious bias and ensure that we nurture the talent of colleagues and treat everyone else with the same respect we would expect to receive ourselves.

It's not too much to ask, is it? ◆