Health inequalities, COVID-19, Black Lives Matter

On either side of the Atlantic, the US Black Lives Matter protests over the death of George Floyd, and the calls for a UK enquiry into the disproportionate death rate from the COVID-19 infection of black, Asian and minority ethnic (BAME) groups, are energising communities and fair-minded folk globally.

On either side of the Atlantic, the US Black Lives Matter protests over the death of George Floyd, and the calls for a UK enquiry into the disproportionate death rate from the COVID-19 infection of black, Asian and minority ethnic (BAME) groups, are energising communities and fair-minded folk globally. In point of fact, no-one in any country should be complacent about health inequalities and human rights.

Racism is systemic, and the social determinants of health – those economic, social, education, living and working conditions that affect healthcare and health status – lead to disparities in just about everything – life opportunities, wealth and income, social mobility, life expectancy and the distribution and exercise of power.

We write while the pandemic is at its peak in many countries and there are very concerning signs that the next wave might be underway in others. All the while equality campaigns, rallies and protests are occurring in many towns and cities.    

The rapidity of the spread of concerns, demonstrations and advocacy for a better world has been astonishing. We believe that every crisis affords opportunity: opportunity for change, opportunity for improvement, opportunity to build, or rebuild; or conversely, one can choose to ignore these opportunities.

We have only been witnessing and personally experiencing the COVID-19 threat to our health, as individuals and as populations, and all of the restrictions that have accompanied this vicious virus, for a few months – so this is early days.  Yet already, we can all see in this locked-down world how people can sincerely display empathy, and reach out via the internet, video-meetings or social media to colleagues, friends, and those in need.

Indeed, many people have been moved to show concern for others in this strange new world – but that is not enough.  The pandemic has also brought into the sharpest of focus that the BAME community is truly being impacted in a more severe way – due to many factors, some of which are outlined in Public Health England’s report on COVID-19 deaths, identifying major inequalities, with mortality risk significantly higher among BAME groups.   

Exacerbating the situation, the impact on mental health is immense given the changes in our lifestyles and rising levels of anxiety and depression that have been brought on by the virus.  Our lives are being transformed and many of us feel powerless to control what is happening.  As the stress levels rise, due to unemployment, the economic downturn, levels of social restrictions, and the switch of education and work to the home, it is not surprising that many people are close to their breaking point.  

It was clear as these responses to the pandemic progressed, it would only take an additional stressor, a catalyst, for the bonfire to be lit. The death of George Floyd was that trigger for many people – to reignite the reality of unacceptable racism faced around the world.

The Mission of ISQua is to inspire and drive improvements in health, and to promote the safety and quality of healthcare worldwide.  The Board of ISQua has a clear strategy and many initiatives underway to realise this mission.

Our commitment is to work with people and institutions across the world, whether from low-, middle- or high-income countries. Our role is to contribute to the reduction in health inequalities and improve the quality of care for all – and to support initiatives such as #blacklivesmatter, and help level the playing field for BAME groups in all health and social matters. We wish to strongly affirm this support, and recognise the principles of equality, health for all and healthcare as a human right, and to support universal access and quality care for everyone, no matter their circumstances.  These principles permeate all our activities and initiatives.

We are not the first to note that, with all this change, and the high levels of concern being expressed, that the world is at an inflection point in history. Together, we have a unique opportunity to heed this clarion call for a better world.  Together, we can work to turn the situation around.  This state-of-affairs which we have allowed to fester – infused with racism, income inequalities, and social inequities, and which has in reality been known for decades – needs to change.

The result might be a radical transformation, with change occurring almost before we know it. Or it might unfold as a tortuous journey, with every gain hard won, and manifest as merely incremental improvements over decades. Either way, change for good will require our unrelenting commitment and collective efforts.  As we march ahead together, it behooves each and everyone of us to reflect on these issues, and take deliberate steps to contribute to the solutions – as individuals, in small groups, as institutions, across whole populations, and internationally.

So, while right now the US and UK seem to be the major flashpoints, the imperative for equality is relevant to the people of every country and also between countries across every continent.   We do indeed have an opportunity.  While hurt and inequality will continue, protests will be held, and calls for inquiries made, and while more individuals are destined to suffer negative consequences, a window for progress has opened. ISQua commits to playing its part.

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Nourhan Kawtharani


Nourhan, a quality and safety coordinator with eight years of experience in ambulatory healthcare in Lebanon, aims to deepen her understanding of the systemic and holistic approach to healthcare through this fellowship.

She aims to identify gaps and develop tailored interventions that address specific contexts rather than applying general solutions. Engaging with diverse professionals and perspectives during this educational journey will expand the application of these concepts across different cultural settings.

Nourhan emphasizes the importance of promoting a culture of continuous learning and improvement within healthcare institutions, considering it a vital leadership responsibility to integrate quality and safety initiatives into the organizational culture.

Nourhan's commitment to patient safety and quality management includes sourcing practical resources and transforming insights into actionable knowledge to drive continued progress in healthcare practices and outcomes.

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Elom Otchi


Elom is passionate about improving quality of care and patient safety outcomes.

In view of this, he has had the opportunity to work in various capacities with various organisations including AfIHQSA, WHO, UNICEF and others undertaking research, supporting the development of national quality policies and strategies, facilitating the establishment of quality governance systems across all the levels of the health sector and building capacity of national and sub-national quality leads/teams to institutionalize the practice of quality and patient safety across the continent.

He has also worked extensively across all levels of care in the health sector of Ghana, including leading the Quality & Patient Safety program in its largest teaching hospital.

I would like to use this Fellowship as a learning platform and an opportunity to acquire the requisite knowledge, skills and competencies to complement ongoing efforts by like-minded individuals and organizations to continuously advance improve the quality and patient safety in Ghana and the continent.

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Stephen Taiye Balogun


Stephen is a Senior Programme Officer at the Institute of Human Virology in Nigeria as well as Country Representative for Health Information for All (HIFA).

Stephen plans to use this opportunity to maximise his impact by championing the cause of patient safety and quality in Nigeria and across Africa.

Stephen says "Quality and safety is a major wheel through which universal healthcare coverage can be achieved. The goal is to be a bridge in the gap between the International Quality Improvement and Patient Safety community and my country to ensure rapid spread, adoption, implementation and practice."

We are looking forward to working with both Stephen and our 2020 winner Rhoda Kalondu over the next year.

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Dr Rhoda Kalondu


Rhoda is the Head of the Patient Safety Unit at Kenyatta Hospital in Nairobi and wants to use this Fellowship to learn how to establish a culture of safety and develop systems for assessment and analysis at her institution, and more widely. As well as this, Rhoda intends to develop and execute an intervention to improve patient safety in Kenyatta National Hospital.

It is one thing to institute measures and processes for improvement, but quite another to change the culture of an environment. Rhoda's ambition to lead others in this change inspired the panel.

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Dr Subhrojyoti Bhowmick


I am an MBBS graduate from Calcutta University with a Gold Medal in Gynecology & Obstetrics.

I have completed M.D in Pharmacology from IPGME& R, Kolkata and have over 12 years of experience in the field of Clinical Research, Pharmacovigilance and Medication management in Hospitals.

I have completed certification in Clinical Research Administration & Project Management from Stanford University, USA and in Patient Safety from Johns Hopkins University, USA.

I am an Assessor for National Accreditation Board for Hospitals & Health care providers (NABH), India assessing hospitals for medication safety and clinical quality standards and NABH Assessor for Ethics Committee Accreditation program in India as well.

I serve as the Chairperson, Institutional Ethics Committee of Health Point Hospital, Kolkata and am associated with 2 other Hospital ethics committees as a member.

I finished my Fellowship in Healthcare Quality from the International Society of Quality in Healthcare (ISQua) from Ireland in 2017.

I have published several research articles and have also authored a chapter on “Regulations governing Clinical Trial” in the book “Fundamentals of Clinical Trial & Research”.

I am a peer reviewer for prestigious international journals like the British Journal of Clinical Pharmacology, CNS Drugs and Drug Safety case reports.

I am the recipient of the UK Seth Oration Award for Best Clinical Pharmacology paper by the Indian Pharmacological Society in 2009 and the “Most promising Healthcare professional in Patient Safety in India” award by the Asian African Chamber of Commerce and Industry in October 2018.

Recently in April 2019, I received the Young Quality Achiever award by Consortium of Accredited Healthcare Organizations (CAHO), India for 2019 for my work in the field of medication safety and clinical research.

I have a keen interest in teaching and am visiting adjunct faculty of Pharmacology at KMC, Mangalore, India and for Healthcare technology at MAKAUT, Kolkata, India.

I was associated with Stanford University School of Medicine, in the USA as a Senior Clinical Research Associate from 2015 to 2017 and have certification in Biostatistics, Evidence-based Medicine and Medical Writing from Stanford University.

Currently, I am working as the Clinical Director of Academics, Medical Quality and Clinical Research at Peerless Hospital and B K Roy Research Centre, Kolkata.

I am very happy and thrilled to receive the prestigious ISQua Lucian Leape Patient safety Fellowship Award for 2019 and I look forward to honing my skills further in the field of healthcare quality and patient safety through my experiences during this fellowship.

I sincerely believe that successful completion of this fellowship will help me evolve as a more confident Patient safety leader in India who in turn can provide significant inputs on policy changes through NABH for the Indian healthcare system.

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