Racism has become a global conversation over the past few months after the death of George Floyd and the consequential Black Lives Matter protests, prompting many in pharmacy to re-evaluate their relationship with racism – whether as a victim or a perpetrator, however unwittingly.

Individuals from black, Asian and minority ethnic (BAME) backgrounds experience racism differently, yet often they are bundled together under the same broad acronym. The term 'BAME' risks diluting and confusing the voices of different ethnic minorities, as an Indian pharmacy professional will not receive identical racist treatment to that of a Pakistani member of staff.

More than half of BAME pharmacy professionals (56%) received racist abuse from colleagues at least once in the last six months, according to a C+D survey that received 601 responses from people from BAME backgrounds between June 18 to July 27. But how do their responses compare when broken up into different ethnic groups – and what can this tell us about the challenges each group faces?

Of the 14 BAME ethnic groups surveyed, people from Indian (209 respondents), African (135) and Pakistani (105) backgrounds were the groups with the highest number of respondents. There were not enough responses from the other BAME ethnic groups to produce reliable data, but their comments are included in this article where relevant.

The likelihood of pharmacy professionals receiving racist abuse depends largely on their ethnic group, according to C+D’s survey.

African respondents received the highest level of racism from pharmacy colleagues, with 78% reporting at least one racist incident over the previous six months. The figure for Pakistani respondents dropped to 61%, and it went down to 49% for those identifying as Indian.

Daily racism

Some 6% of respondents experienced daily racism from colleagues across all 14 BAME groups. However, this figure fluctuated between ethnic groups, from the lowest figure among Indian professionals of 4% rising among Pakistani and African respondents up to 8%.

For those that experienced racism from team members weekly or more, the figures were highest for African respondents at 18%, while for the Pakistani group the number was 15% and Indian team members 8% – compared to the overall BAME figure of 12%.

The largest category across all the ethnic groups was filled by those who had experienced racism from colleagues “a few times” over the previous six months. The African group reported the highest percentage here at 52%.

Pakistani staff receive most verbal abuse

Over two in five BAME pharmacy professionals (42%) have suffered verbal abuse from colleagues while working in a pharmacy. The figure had a range of eight percentage points across the largest three BAME groups, from 38% among African respondents to 46% among Pakistani team members.

One Indian respondent says this usually happened to them “through jokes”, while a Pakistani respondent says one colleague had told him: “You’re OK for a Muslim guy.”

An African respondent says colleagues had asked “silly questions about [my] background, saying ‘all lives matter’ even though the meaning of Black Lives Matter has been explained [to them]”. Another says colleagues “made gestures behind my back [and] hated me for no reason despite my kindness to the staff…the ex-manager enforced the racism the two staff members had against me”.

One Jewish respondent says they had received “politically slanted jibes against Israel” from a pharmacist colleague.

Indirect racism

Racism is often not as obvious as a verbal slur in the pharmacy. Indian, African and Pakistani respondents reported racism from colleagues across all categories listed in the survey, including being ignored or assumptions being made about them due to their race.

Pakistani and African pharmacy professionals reported higher levels of indirect racism than Indian staff in all 11 categories except for being “excluded from work or social events” and “religious discrimination”.

The most common discrimination reported across all three ethnic groups, as well as in the BAME group as a whole, was “assumptions made about ability, character or behaviour”. This ranged from 34% among Indian respondents to 58% among African staff, compared to 42% of BAME respondents.

The category with greatest difference in ethnic groups was “religious discrimination”, where the overall BAME respondent figure was 19%. Two in five Pakistani respondents (41%) had received religious racial discrimination, with many reporting that colleagues had made Islamophobic comments. Two Pakistani respondents report colleagues had not allowed them to take prayer breaks. Some 7% of African pharmacy professionals had received religious discrimination.

Disparity between the ethnic groups also opened up in those who said they had endured “excessive scrutiny” and been “treated as an intellectual inferior”. Some 46% of African respondents had experienced these, while a quarter of Indian respondents said the same.

One Indian respondent says they faced “indirect, deep-rooted” racism from colleagues with questions such as “where are you actually from?” and “how do you say your name?” Another says colleagues had intentionally pronounced their name as “something completely different”.

Some people have experienced more hands-on racist behaviour, with one African respondent saying they were the only employee subjected to a body search.

Every aggression, micro or macro, risks pushing the victim out of the workplace entirely. A Pakistani respondent says that “disgusting behaviour” from other members of staff had led them to write to senior management and refuse to work for that company again.

“Overlooked many times”

Racism in the workplace can damage the careers of victims irreparably. In answer to a question on how racist actions from others had affected respondents’ careers, the most common answer was “others are prioritised in job applications” across Indian, Pakistani and African ethnic groups, following the trend for all BAME respondents, closely followed by “my salary would be higher”.

One Indian respondent says: “[I’ve been] overlooked many times, lumped into the same category as other Indians and not treated as an individual [for] not having a face that fits. Another Indian respondent says they’ve had opportunities denied and suffered a lack of recognition of their experience. “[It’s a] constant battle to be counted and respected.”

A third Indian pharmacy professional says they had been “promoted but given less support in terms of advice and staffing, then made to feel inferior when the results were not the same [as those of others]”.

An Arab pharmacy professional has had a similar experience. “Although I have the skills and continually achieve more than most of my fellow pharmacists in the area, I have been denied opportunities,” they say.

One African respondent says: “The majority of locums are undoubtedly of BAME background simply because they know they would not be given fair treatment as managers.” Another African respondent supports this theory, saying: “The psychological maltreatment I received [at a pharmacy company] prevented me from applying for a permanent role. I became a locum in 2019 after my contract ended.”

“I was given a zero score”

Pakistani and African respondents reported higher figures in every category of the careers impact question than Indian respondents, except for “request for training denied”. The greatest disparity was in the “prevented for applying for certain jobs” category: between Indian respondents – 17% of whom checked this box – and African team members, of which 30% said this had happened to them.

Racism in pharmacy can affect the careers of pharmacists before they have begun. One African respondent says: “In university, I was given a score of zero in a crucial third-year assessment by a racist student, and this was upheld by a racist lecturer. It was after I raised the case with a second lecturer that the injustice was spotted, and I was awarded over 80% for the assessment.”

One Pakistani respondent says: “I have to work four times more to secure my job. My performance always receives less praise compared to others. Most of the time no one mentions [me].”

African pharmacy professionals fared the worst in being “unfairly disciplined”, with this happening to 21% of respondents – five percentage points more than the figure for all BAME respondents. One person from this group says: “Over the last 10 years as a pharmacist, I’ve had to face disciplinaries on things that were so flimsy.”

Stress and demotivation

One of the worst impacts of racism is upon the victim’s mental health. Racism can cause depression, stress and even suicidal thoughts. The most prevalent effect of racism in the pharmacy was of “demotivation” – reported by 56% of BAME individuals. The figures for this category ranged from 52% for Indian respondents to 67% among Pakistani pharmacy professionals.

Many BAME people said they had left jobs in pharmacy because of racism. This ranged from 16% of Indian respondents to 23% of African respondents.

In addition, more than one in 10 Indian, African and Pakistani respondents said they had felt psychologically or physically unsafe in the pharmacy.

One African respondent says they have suffered from “extreme anxiety” because of racism. Another African respondent says they have “felt inadequate even though I know I am just as capable and intelligent as others”.

A Pakistani pharmacy professional says it has “caused me a great deal of heartache and affected my self-esteem and confidence”. Another Pakistani respondent says: “It’s hard sometimes and to survive I have to work really hard through lunch breaks, unpaid weekends, and late nights just to keep my job.”

An Indian respondent says that despite 17 years of experience in pharmacy they still lacked confidence due to racism and have only found it now after changing his workplace. “This racism has set me back years.”

The difference in results between each ethnic group confirms their varied experiences of racism from colleagues and the impact this has on their careers. But each percentage point reporting racism from this survey marks a problem requiring action, regardless of whether it is higher or lower than those of other ethnicities.

While separating the data into Indian, Pakistani and African respondents remains a narrow way of understanding race, it offers greater insight into the experiences of these groups than the blanket BAME term alone. By investigating these crucial differences, we can work towards a deeper understanding of racism in the sector.