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A HIDDEN HISTORY:
African Women and the
British Health Service

1930–2000

Sarah Amani

Sarah Amani arrived in the UK to study in 1996 from Malawi. She came and stayed with her sister who was living in London at the time. In her interview, Sarah describes her upbringing in Malawi, motherhood, institutional racism in health care, and being African in Britain.

GROWING UP IN MALAWI

"My memories of where I grew up? Malawi is a very small country, the same population as London. So what I remember is that everyone is like your parent, because it’s such a small community and everybody knows about each other. It’s good on one hand, because you always have somebody to depend on. On the other hand, everybody is in everybody’s business so it’s like a crazy beehive of gossip. So privacy can be an issue – that’s what I remember about growing up in Malawi. I went to boarding school in South Africa at the age of 10. That was scary, I just remember thinking 'Where are my parents going? Why aren’t they coming to pick me up?' They had explained to me what was happening, but at that age, I think I was too young to appreciate that suddenly I was going to live and study in this new environment. I do remember it being a very prestigious school and I would say a lot of what I have achieved today is probably due to the education I received in South Africa. So as hard as it was to adjust I’m pretty lucky that I had that opportunity."


RACISM

"I remember my first job was in the wards. One of the challenges there would be, being a nurse and also being a black female nurse, sometimes people assume that your capacity to undertake tasks are very limited. So they’ll task you with menial things and won't necessarily ask your opinion about what's going on with your patients. They might ask you to make teas and coffees [and] limit your role in the meeting. So I had to change that by showing I was capable of more maybe sophisticated tasks like helping to devise a care plan, talking to parents and families who are worried, etcetera. But I have to say I didn’t experience huge discrimination so I’m probably lucky in that regard. I actually whistleblew in the first year of my career." 


WHISTLEBLOWING

"Whistleblowing is when you notice unsafe practice and you basically alert senior management. At the time, I was on a work visa and people used to ask [if] I was scared that maybe my employer might revoke my work visa. Because whistleblowers can be seen as troubler makers. I just thought that there was something wrong and it was my duty to call it out. I didn’t really worry about the repercussion."


CAREER HIGHLIGHTS

"Seeing people have that difficult time but come through at the other end and get better I would say is the best feeling in the world. To share that success with them. The specialism I ended up in is psychosis and that’s a disorder that typically happens when people are young. The average age is about 22. At that time of life, most young people are looking forward to starting their higher education or careers so this disease can really rock the foundation from right under them. But to see them come through that and families can have hope again is yeah – it’s really rewarding."


IDENTITY

"I would say I see myself as both Malawian and British. It depends on the context, actually. Sometimes if I go to certain Malawian gatherings, I feel more Malawian then British, because I am surrounded by all things Malawian. Whether that’s food, the clothes we are wearing, the language we are speaking certain things that are acceptable or not – that sort of thing. And If I am surrounded by all British people, I may feel more British, as I have to assimilate to their norm. It’s almost like having a duel identity."


"It’s been a theme of my time in the UK that I am the only black person. So here at the University of Oxford, I am the only black person in this department. When I moved to London it was very diverse, but I went to Greenford High school which is very south Asian, so I was the only black kid in my classes. But it was fun because I hadn’t been exposed to that group before and they embraced me with both arms. And there was a bit of a perk in that I ate a lot of Indian and Bangladeshi food as a result. It was difficult sometimes. For example when we were doing history and the teacher was touching on African history, he would look at me like I am an expert on African history. Which is ridiculous given how many countries are in Africa. So things like that were a bit embarrassing more than anything. But nothing too difficult to handle."


FAMILY

"My mother has inspired me because she’s a very strong character, in that she has overcome a lot of challenges in her life. She was very young when she arrived in the UK [it was] at a time when there were hardly any Africans here. She made a success of that and then after 10 years she went back to Malawi at a time when it was very ‘male driven’. She did nursing until she discovered that the doctors, who were mostly male in Malawi, were being abusive to pregnant women, like slapping them whilst they were in labour for screaming too loud. So she resigned. Most people wrote her off. [They would] say she was ‘just a housewife’. But she had bigger dreams and she wasn’t going to condone that kind of bad practice anyway. So she started a day-minder for mums who were working, to support other mums. It was so good that the mums [asked] “Could you open a nursery school?" Then they came and [asked] “Can you open a primary school? Before I knew it, she had a whole stream of schools. She made a real big success of that – it was one of the best schools in Malawi at the time. I remember watching her in action, attracting the best teachers from, not just Malawi, but from South Africa and the UK. These kids now are all grown up, in really good jobs and raising their own kids, and they really value education. She instilled those sorts of values in a whole generation. So that was inspiring to watch."

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