A report published by Public Health England (PHE) this month, on the impact of coronavirus on minority ethnic groups, found that people of Bangladeshi heritage are dying at twice the rate of their white counterparts. Other black, Asian and minority ethnic groups had between 10% and 50% higher risk of death.
The answer is simple for those who live in Bangladeshi communities across the country: this is a disease which thrives on pre-existing inequalities within our society.
Saidul Haque Saeed, a community worker in Birmingham, lays the blame firmly at decades of inequality within clinical commissioning where the health needs of smaller population groups have consistently and historically not been met.
“What Covid-19 has done is to lay this inequality, this postcode lottery in health, bare overnight. This deadly disease has been able to carve its way quite easily through those communities where there has been inaction and ignorance of their health needs. The problem of years of a communities health needs not being met are now coming to roost,” said the 41-year-old.
Saeed said it was offensive to suggest that the higher death toll was solely as a result of lifestyle choices in these communities, such as living in multigenerational households.
“This is not the issue; in fact, saying that is another form of structural racism, and is a way of avoiding addressing the real issue, which is that the Bangladeshi community is a minority within a minority and for years health commissioners have not been interested in our very unique problems,” he said.
Saeed’s thoughts are echoed by the charity worker Mashkura Begum, who says the number of deaths and cases has devastated the Bangladeshi community in the West Midlands. Begum, who is the interim executive director at Saathi House, an inner-city women’s organisation, believes there is a combination of reasons for the higher death toll.
“It is a lot more sophisticated and not just about austerity,” she said. “Many Bangladeshi people are keys workers so [are] at higher risk, then there was the language barrier which made it really difficult for people to understand the severity of the disease and social distancing probably didn’t get picked up until slightly later and of course, yes, there is the problem with the health postcode lottery,” she said.
Another factor that has played a significant part, according to Begum, is that once the community had fully appreciated the seriousness of the situation they began to suffer in silence.
“What you have here is a very compliant bunch of people and once the message had got across to them about how bad it was they stopped trying to get help. They didn’t want to be a burden on the NHS. I heard so many stories of people having symptoms but just staying at home, and then dying. It has been so traumatic,” she said.
Unlike in other BAME communities where the disease has affected particular age groups, in the Bangladeshi community, anecdotally at least, it seems to have been indiscriminate, with victims of all ages.
Bashir Ahmed, trustee of the Union of Muslim Organisations Walsall, who met Dr Justin Varney, the national strategic adviser on health and work at Public Health England, last week, said many feared for their lives.
“Everyone knew somebody who had died and it wasn’t just middle-aged men … younger people were dying too. I was preparing for death myself. I did a will, I was so scared. Every day we heard another person had died and all this compounded into a fear factor and we began to feel totally helpless,” he said.
During the meeting with Varney it was agreed that ongoing research would be conducted to understand the root causes of the higher death toll among the UK’s Bangladeshi communities.
“We really need to try and figure out what happened here. Is it genetic, is it our lifestyle, or is it simply an outcome of years of deprivation and health inequalities? It’s hard to explain the shock that we all feel and this disease has raised so many questions that will have to be answered to protect us in the future if something similar happens again,” said Ahmed.