DR. VANESSA Apea is on a mission to bring about greater ‘health equity’ in the NHS, particularly in Sexual Health.
London born Apea is currently a consultant physician in Genito-urinary and HIV medicine and the clinical lead for Sexual Health at Barts Health NHS Trust.
Having been inspired to pursue a career in the medical profession since she was a young girl, she explained to the Voice her journey took an about turn, when she realised there was a distinct dearth of representative information, for or about black people, where certain ailments were concerned.
Conscious that if left unchecked the NHS could head in the direction which sees it providing care that leaves black people underserved, Apea said her new path saw her determined to ensure ‘our lived realities’ became a ‘part of decision making’.
“In terms of my main day to day work, I’m a consultant in sexual health and HIV,” Apea clarified.
“With sexual health and HIV, you can’t get away from the fact it’s got its own inherent inequalities in the outcomes of sexual health and HIV.
“When you look at certain populations, they are more affected by sexually transmitted infections and HIV, and this is for a number of reasons.
“So, within my work and research, me as a woman, as a black woman, me as a clinician, it all kind of comes together in really making sure that our communities are aware of these inequalities and making sure that people are educated and supported so we can move forward.”
Apea continued: “I always say with inequalities, the definition is that they are systematic and unjust differences in health outcomes.
“There are bits that we can do to kind of improve our outcomes, but a lot of it is the system, and it is the kind of world we find ourselves living in, but we can’t challenge the system if we don’t know there’s a problem.”
Apea, of Ghanian heritage, admits she didn’t wake up one day and decide to pursue the position she finds herself in today. She had ambitions to work in the medical field but her dreams looked a little different.
“One of my cousins had a really bad burn, and when she was young I watched how she was managed and the care she received,” Apeah shared.
“I was quite young then, and I apparently said to my parents, oh, I definitely want to be a doctor after that.
“My mum’s a nurse, it’s kind of built in, in terms of that care, but I actually wasn’t going to specialize in sexual health and HIV. Initially I was going to specialize in oncology and cancer.
“It was a real passion of mine, and I went into that, but then I did sexual health and HIV for one rotation during my jobs and I loved it.
“I also felt that we needed more representation in it. We needed to change the conversations that were happening about sexual health and HIV. It just felt the right place. And I’m glad I did it.”
With the bit firmly between her teeth, Apea is on a mission to ensure that the representation runs deep into the core fabric of decision making within the NHS.
Speaking on some of her ambitions within the industry which she would be keen to impart on the road to dismantling inequity, Apea said: “So, I think one of the key things, is our community having a voice where I am today, but it is about having a voice and participating in research, participating in hospital decision making and our lived realities being part of decision making.
“Because, what you find a lot, is that our lived experience isn’t written anywhere, and it isn’t captured. And often, it’s easy to say that we are hard to reach.
“I challenge that in every meeting. We’re there. You ask us, we will speak, we love speaking. We love sharing.
“Our heritage is from storytelling, which is important to us. So, if we are given the space and we are given respectful spaces to enter, we will go there.
“I always say in terms of trying to achieve health equity first of all, you need to acknowledge the differences, be aware of them and then you need to respond and address it as well.
“Part of that is getting people’s experiences, understanding what their needs and concerns are and what are the barriers to them, engaging in care, engaging in the behaviors that support better health.”
Underscoring the importance of the NHS pursuing a better understanding of culturally appropriate care, Apea added: “We can make an assumption that, let’s say as a doctor, I’ve asked someone to do something and then they’re reluctant to do it, or they don’t follow the instructions, it’s easy for the system to say, ‘oh, they’re just stubborn’. They didn’t listen’.
“But how did I tell them, what did I tell them? Did I make sure that it spoke the right language? And I mean, not just whether it’s English or not, it’s whether it’s in a language that relates to them and what was my demeanor, and did I offer an appointment at a time that I didn’t create any flexibility for them?
“What was the letters that I received and the wording? Did I offend them, there’s so many things in how we interact with healthcare. And there’s so many things that can shape someone’s response to healthcare, and really either support them to feel safe and to feel that, OK, I want to work with this doctor or healthcare professional.
“Or it can be like, I don’t trust you. I don’t know what you’re saying, what you’re saying, doesn’t relate to me. And they pull back.
“So, I think for me over the next few years, it’s about raising the awareness of our communities, pushing us to have a voice, involving us in research.
“And that’s not just clinical research, that’s qualitative research. Documenting our experiences, making sure those experiences are given and directed to policy makers.
“So when they are making policies, there’s a lens of us within it. So we can see ourselves within it. And we’re advocated for.”
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