The Covid 19 pandemic has taught us several lessons. One of them is the importance and need for (harmonious) co-existence among human beings. The pandemic showed that human beings are resilient. It revealed our collective strength and generosity of heart, while  at the same time exposing our limitations and  vulnerabilities.  While we saw extraordinary acts of compassion and kindness, the pandemic also revealed (that we are capable of) behaviors reflecting the dark side of our humanity. For example, blatant acts of avarice, greed, and self-centeredness were witnessed that contaminated and paralyzed us from doing what was proper to benefit the whole. The price we paid for this has been high, as evidenced by millions of lives lost to the pandemic globally. Central to this tragedy is the inequity prevalent in various social structures that the pandemic mercilessly revealed. One of these systems of inequity is discrimination and acts of injustice meted out to members of underrepresented minority groups

I receive regular invitations locally and internationally to talk about diversity, equity, and inclusivity in academia and healthcare. These invitations are a sequel to world events that included the George Floyd murder, racial attacks on Asians in the United States and my outspoken advocacy for change in this area. For each of the events, I focus on emphasizing the phenomena of privilege and the sense of entitlement. I do not talk about the dichotomies of black or white, rich or poor, straight or gay but illustrate how the underlying perceived privileges constitute the root cause of the problems we witness in the world today. To buttress this point, I always borrow the analogy of the coin model by Stephanie Nixon in her 2019 paper and share her work about the coin model of privilege and critical allyship with my audience.

Not too long ago, following a presentation I gave on racism and leadership at an international conference, a senior colleague I regularly reflect with contacted me. This was triggered by the recent discovery of a mass grave of deceased indigenous children in a Canadian residential home.

Usually, this colleague and I convene to discuss topical and sensitive world issues around leadership. Hence, as this was a topic that was related to leadership, we planned a moment to meet and reflect. With his permission, I share an excerpt of the conversation we had after reading the article I shared with him on the coin model of privilege and critical allyship.

Excerpt from his email to me:

“….Admitting to not understanding the (Nixon) article fully…my personal view is that if I view the challenge from a leadership perspective, I should look forward, rather than back, to the vision of a truly inclusive society. And, in that context, what is it that I—my little self as a parent, citizen, privileged white male, and teacher of leadership—can do to contribute to that vision. 

However, I struggle with making sense of this surrounding the Indigenous issue in Canada: you may or may not have heard the news that last week using a ground sensor, some engineers found the remains of 215 Indigenous children in a large grave next to a Residential School. And of course, this has caused a lot of handwringing, despair, guilt, blaming…etc. My first reaction was similar—but then I reflected on the Nixon article you sent me. My interpretation was that this article says I must take on my personal responsibility to make a difference, rather than lay blame, or spend a lot of psychological energy in despair. I have always thought that if we are truly to address these issues we all must take ownership of our role in the system. Despite my knee jerk response to blame the Catholic Church, or the Federal Government, I am reminded of the systems principle: “There is no blame”. The system we have is one we are complicit.”

Moved and inspired by this act of humility, he, a senior colleague, white, privileged and accomplished male academic and myself a black, “not so” privileged, but accomplished clinician and academic I replied to him

My response to him:

“Thank you for your email and as always, it is always a joy to connect and reflect with you. Indeed, I have been following the developments of the recent mass grave discovery at the residential home in Canada, not to mention the recent events of the 1921 Tulsa massacre which recently hit the news in the US.

So coming to your question: the coin model paper illuminates that context defines who is privileged or not. Those contexts can be virtue of genetics, inherent abilities or importantly predefined social structures linked to wealth, class, or geographical location, for example.  Either way, we all end up finding ourselves in either a privileged or oppressed group at one point in time. Interestingly growing old and being retired also puts previously privileged individuals into a less privileged group at some time. So context (also) changes over time.

The most important thing however, is while the system places us into these different contexts, each one of us is responsible for building and sustaining the system(s)—and equally for changing them. Especially, those in positions of privilege who realise they will lose some of their (sense of) entitlements if things change. That of course forms the crux of the matter i.e. losing privilege and the entitlement that comes along with it. 

Indeed the knee-jerk response is to blame, but as you said, blaming would not make change happen. Rather people have to own up for their roles in the system. They should take responsibility rather than turn a blind eye, a deaf ear, or place blame on the victims of such injustices.”

So recently, while reflecting upon the impact of the pandemic, the physical and psychological toll it has had on all of us as humanity, I gained an insight that helped me understand the various global responses we have witnessed. To illustrate this, I will use an African analogy to make my point:

If you collect 100 black ants and 100 red ants, put them together in a glass jar, nothing will happen, but if you shake the jar violently and leave it on the table, the ants will start killing each other. This is because reds believe that blacks are the enemy, while blacks believe that reds are the enemy for disturbing the peace. However, the real enemy (who disturbed the peace) is the person who shook the jar.

As a human race, our differences, our values, our diversity are not our enemies. The way we see each other and the privileges we apportion to ourselves, regardless of whether they are truly deserved or earned are not the problem. Some may wonder that the pandemic is the enemy. That I believe is not the case either.  Instead, it is our (different) mental models or worldviews that form the source of ire and rift among us as humanity. The difference (i.e., distinction) and the translations (i.e., discrimination) associated with these phenomena influence our worldviews. It defines, modifies, or amplifies our empathy, compassion, and actions. Empathy with action is compassion; recognition of difference—can be both empathetically driven (compassionate) or hate driven (racism, genderism, otherism, etc.). So, it is not the privileges themselves that are the problem; it is how we see others from that perspective, and how we act afterwards. These, I would say, have caused, and continue to cause more harm than good.

So the next time, before we start to fight or accuse one another when the jar is shaken, let us pause and ask ourselves *Who shook the jar?* …  If we find out who shook the jar, let us take the time to try and find out * why the person shook the jar? *  This, I believe is some serious food for thought.

Dr Jamiu Busari

Jamiu Busari is an associate professor of medical education at Maastricht University and a consultant pediatrician and Dean HOH Academy at Horacio Oduber Hospital, Aruba. He was recently appointed as Associate Editor at BMJ Leader. He is a public speaker, writer, educator, and health care leader. He is also a fervent advocate for diversity, equity and inclusivity towards the marginalized in society.

Declaration of interests

I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.