“No way I’m taking that China vaccine,” is a phrase I’ve heard tons in #Zimbabwe from friends, family, & HCWs, after 200,000 doses of the #Sinopharm #vaccine arrived from China last week.

TLDR-this is racism. Get vaccinated.
2/ While governments have welcomed strengthening Sino-African relations, many people think of Chinese presence as neocolonialism. They’re half right. But it’s more complex than this.

3/ This has made anti-Chinese sentiment rife and acceptable in Africa.

My family members accuse Chinese restaurants of serving up stolen pet dogs to their patrons. Friends say they would never board a “xing-xong” airplane.

The complex geopolitics get conflated with RACISM.
4/ Thinking of a vaccine as inferior because it was made in China, and spreading that sentiment, is also racism.

More doses are on their way from China to other African countries.

We need to promote the uptake of *this* vaccine. We cannot afford to wait and see.
5/ Some healthcare workers are concerned about the safety of the vaccine because its phase III data is not published in a peer reviewed journal. But, short term safety is determined based on earlier phases, already published in @JAMAcurrent.

6/ This is not unique to Sinopharm. Other vaccines were rolled out before phase III data was published in peer reviewed journals.

Yes, we could do with more data, but that’s a different issue.

7/ To conflate the data issue with concerns over the vaccine being “Chinese,” is to consider this vaccine inferior based on its origins, not its contents.
8/ The answer is not to *force* everyone to get the Sinopharm vaccine. Or to keep calling it the "Chinese" vaccine.

We don’t call it the "American" Moderna vaccine.
9/ Instead, as healthcare workers, we have a responsibility to dismantle racism and share decision making with our patients. To help our community work through these strong feelings. To explain why they are wrong. To separate fake, racist news, from science.
10/ We also have a responsibility to lead by example in public health.

When I hear fellow HCWs turning down a vaccine that is ~80% effective cos we’ve allowed racism to creep into our profession, I am disheartened.
11/ If we can’t convince African *healthcare workers*, what will the repercussions be for the general population?
12/ The fight against COVID-19 is tough for HCWs. But it’s deeply intertwined with the battles against racism, corruption, sexism, and income inequality.

We’re nearly there. Let’s stick together as we cross the finish line.
To clarify, vaccine hesitancy is clearly multifactorial. Racism is not the only thing. People have real, valid concerns that need to be addressed.

Racism is just one that should be taken off the table early on.

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More from @kkidia

3 Dec 20

As a @harvardmed doctor, I will be one of the first people to get a vaccine. My family in Zimbabwe, however, will be some of the last, if they get vaccines at all.

In global health, vaccination coverage has been an issue since vaccines were a thing…
For example, in the 1990s, the oral cholera vaccine was added to the WHO essential drug list (a compendium of “must have” resources for all countries). The lifesaving vaccine costs under US$1, yet the global stockpile is tiny and saved for emergencies.

Because Western countries have adequate water infrastructure, they rarely experience cholera, and therefore it is not a global resource priority.
Read 15 tweets
7 Jul 20
1/ THREAD: VIP Patients

We can't let patients buy special treatment. It privileges the white & wealthy.

In residency, when I wouldn't provide unwarranted treatment, a “VIP" patient brought me to tears, yelling and asking where I went to med school.

Every hospital I’ve worked or trained in has a special floor where patients can spend thousands of dollars to get “better” treatment.

They are given rooms with wooden panelling, gourmet meals, and attentive nursing care.


Allocate your time based on patients’ clinical severity, NOT their social standing.

Don't give VIPs any more of your time or brain space than other similarly sick patients. It is inequitable and unethical to do so.
Read 11 tweets
23 Jun 20
1/14 *TWEETORIAL 4 New Interns*


Non-stigmatizing medical documentation

Your admission/progress notes can be harmful to your patients and will live in the medical record system forever.

Here are some tips. Please add so we can learn to together! #MedTwitter
Use patient-centered language: your patients are more than their illness.

“patient with sickle cell disease” *not* “sickle cell patient” and *definitely not* “sickler”

Don't put a patient’s race or socioeconomic status in their one-liner.

The one liner is for highly relevant clinical info that allows other clinicians to understand what is going on, and, in emergencies, make quick, critical decisions.

Read 14 tweets

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