Professor Dame Elizabeth Anionwu is the British nurse who revolutionised the NHS

Aaliyah Harris

Elizabeth Nneka Anionwu is an inspiration to say the least. She is widely known for her ground-breaking contributions to British healthcare. After founding the first UK specialist centre for treating Sickle Cell and Thalassemia in 1979, she still continues to raise awareness and to support a large population with the conditions in the UK.

As well as becoming the first sickle cell nurse specialist in the country, Anionwu has been at the forefront of fighting against inequalities and advocating for Black and ethnic minorities within the NHS.

But she’s not just an activist, she’s a mother, grandmother, professor and dame among other things.

Despite being retired, the soon to be 74-year-old is far from finished. She speaks to The Canary’s Aaliyah Harris about politics, racism and campaigning for a better NHS.

Anionwu tells The Canary:

When friends and colleagues heard snippets about my early life, they were gobsmacked that I had progressed so well in my career. They said, ‘Elizabeth, you need to tell your story, because what’s happened to you is not common. A mixed-race child, illegitimate and you grew up in a children’s home until you were nine’.

A troubled childhood

Born in Birmingham, from parents who both attended Cambridge University, Anionwu shares how her upbringing was far from stable. After moving from place to place, growing up in Nazareth Children’s Home and struggling with finances she started working for the NHS at age 16:

It wasn’t through choice. It was because of my family situation, my parents weren’t married, and they didn’t stay together. In 1947, it [single parenthood] wasn’t that common.

I grew up in a children’s home until I was nine, but my mum never gave me up for adoption. At age nine I went to my mother and stepfather. He physically abused me.

I then moved to live with my maternal grandparents in North West of England near Liverpool but at 16, she [my grandmother] suddenly sent me back to my mother and stepfather, which was… horrendous.

During her upbringing in what Anionwu calls ‘working class poverty’, she remembers how at times money was scarce:

I had very bad eczema and there was a caring nun in the children’s home who changed my dressings for that pain through distraction therapy. I discovered she was somewhat called a nurse and I thought, right I want to be a nurse! And nobody could sway me. So, when I had to start work much earlier, at 16 rather than 18, I became a school nurse assistant.

I knew from social circumstances, there was no question of me going into school because they [my parents] needed people to help bring in some money. But the stress of my circumstances, not the job, but the pressure, caused my asthma to get worse.

Privilege beats qualifications

Entrenched racism in Britain, especially during the 60s and 70s, still resonates today with how race, discrimination and elitism impacts diversity within workplaces.

While working in a children’s health clinic near to her home, Anionwu says:

When applying to London teaching hospitals, all application forms wanted to know the name of my father, his occupation and they wanted my photograph. They don’t ask people these questions now, but I didn’t know who my father was, I had my mother’s maiden name and I put my photograph first – a little brown skinned girl. None of those hospitals replied to me. And yet, I had seven O levels in five subjects, English literature, English language, French, geography…

I don’t know what the reasons were, but they saw my face in the photograph and I thought there was elitism going on. I didn’t know my father, his occupation and [thought] is it the brown skin? I was perfectly qualified.

She didn’t face the feelings of confusion and frustration alone. A mentor gave Anionwu the confidence to apply to the Paddington General Hospital, where she successfully secured a place on a three-year nursing course.

What is Sickle Cell & Thalassemia?

While visiting patients, Anionwu came across a previously unheard-of condition to her which would later become a passionate focus of her work.

Sickle cell and thalassemia are life-threatening conditions which, according to the NHS, are the most common recessively inherited blood disorders in the UK. There are around 240,000 healthy carriers of sickle cell disease alone.

NHS Inform says that the disorders are passed onto children from their parents through altered haemoglobin genes – a part of blood that carries oxygen around the body.

Anionwu tells The Canary:

I could put the drivers [towards my work on sickle cell] into three P’s – personal, professional and political. The personal and professional was the anger I had, as a young health visitor, working in Britain. In my early 20s, I visited a mother of a young boy with sickle cell anaemia. She had loads of questions about what could help her reduce the pain that her son was experiencing and wanted to ask more about the illness because she’d never heard of the diagnosis. I couldn’t help her because I had not been taught about sickle cell anaemia in my nurse training… in Paddington, West London!

The political [with a small p] is that I am of mixed-race background, Nigerian and white Irish heritage. During that health visiting period in 1972, I found my Nigerian father and I became more interested in black health issues, the civil rights era and impacts in Britain. It was around the time of the Mangrove trial.

Who does it affect?

Sickle cell disease is predominantly common in African and African-Caribbean people. Meanwhile, Thalassaemia tends to affect people of “Mediterranean, south Asian, southeast Asian and Middle Eastern origin”.

This means that Black, Asian and other ethnic minority communities are at most risk to these critical blood disorders. But why?

Anionwu says:

The reason that it’s predominantly found in those communities, is that if you are a healthy carrier, in childhood you have some protection against Falciparum Malaria.

It’s not to do with skin colour, it’s due to the origin of the mutation of the haemoglobin that causes the sickle and thalassemia. The healthy carrier space offers some protection, if you’re living in those areas with limited protection against malaria.

Falciparum malaria is the most dangerous type of malaria, and as sickle cell modifies the shape of haemoglobin, this causes resistance.

Symptoms and treatments

The most serious type of sickle cell is called sickle cell anaemia. Effects can include severe pain, dangerous infections and anaemia. This long-term condition means people must have injections to prevent infections throughout their lives.

Those who suffer from thalassemia will often need blood transfusions every month or so, lifetime injections and tend to be extremely anaemic.

Treatments involve medicines, dietary adjustments, monitoring temperature and transplants.

The only cure for sickle cell disease or thalassemia is by receiving stem cell or a bone marrow transplant. But the procedure has very high risks and so it’s rarely carried out.

“I can’t believe I wasn’t taught about her alongside Florence Nightingale”

19th century nurse Mary Seacole was a businesswoman, traveller and pioneering Crimean War nurse who, despite contributing immensely to British medicine and healthcare, was often disregarded from history. Since reading Seacole’s 1857 autobiography, Anionwu made it her mission to campaign for the recognition of Seacole’s work.

Quoting Mary Seacole as an inspiration, Anionwu says:

We need to know about Florence Nightingale as nurses so how come we weren’t taught about Mary Seacole? It’s this deficit model due to racists. And she was buried only a quarter mile around the corner of where I trained as a nurse. The ignorance is due to a lack of interest.

When I had the opportunity, to set up my own nursing research centre at the University of West London I called it the Mary Seacole Centre for Nursing Practice, because I quickly found out that most of the student nurses and educators didn’t know about her.

What I didn’t expect, though, is that I’d end up being called upon to talk and write about Mary Seacole. But I enjoyed working with other researchers.

In June 2016, the first statue of a named Black woman in the UK, Mary Seacole, was unveiled at St Thomas’ Hospital, London. Anionwu acted as vice chair of the memorial statue committee and supported its fundraising campaign for almost 13 years before it reached the target goal.

Some argued that Seacole was “stealing Nightingale’s spotlight”. But the comments didn’t dampen the historical event.

Anionwu says:

Having been in the thick of it I can tell you that was a minority view. We’ve got so few women statues, everybody should have been celebrating the statue of a woman as far as I’m concerned.

It was very uncomfortable at times, but that’s part of campaigning. Even though you have this minority scratching at it, that was healed every time with the positive comments and donations.

NHS inequality

In a government report last updated in August 2020, data shows the percentage of NHS staff with different ethnicities. As the chart illustrates, it’s an overwhelmingly white workforce.

Ethnicity Facts and Figures GOV.UK

 

It’s little surprise, then, that the highest percentage of Black NHS non-medical staff are in the lowest board grade bands, meaning that there are fewer Black employees in higher ranking positions.

NHS Workforce Statistics, March 2019

 

Anionwu says:

Underrepresentation of Black and minority ethnic nurses and midwives in the upper echelons of the National Health Service is the same issue [as] in the media. Some improvements have been made, but not fast enough. And that’s starting to get recognition.

There are many Black and minority ethnic nurses and midwifes who should have progressed much greater in their careers than they have.

Honorary acknowledgments

Anionwu has had recognition for her work, including receiving both a CBE and damehood. She says:

That was a huge but a pleasant shock! I was thinking: ‘hang on you haven’t read my memoirs…’! The first MBE honour was offered in 1980 for sickle but I actually turned that down because there was not enough being done for sickle families with the NHS. I was angry that so many people involved with sickle cell felt they were hitting their head against the brick wall.

Later, in 2001, Anionwu accepted a CBE honorary, which is awarded by the British Empire for having a prominent role at regional level.

I don’t like the ‘empire’ bit. So, I’d been in two minds about it and I was very honest because it was for services to nursing. Black women play such an important role in nursing in this country, and I knew this would have a ripple of pleasure amongst such groups, if I accepted the award.

Then another letter at the end of 2016… I didn’t even know you could get two! The DBE for services, again to nursing, but also for the Mary Seacole statue.

Speaking of memoirs…

In October 2016, Anionwu’s self-published book ‘Mixed Blessings from a Cambridge Union’, launched, detailing the origins and experiences of her life’s work as well as exploring ideas of race, identity and relationships.

Fast-forward to now and her memoirs are due to be republished later this year in September with Orion, under the new title: ‘Dreams From My Mother’.

After reflecting, Anionwu narrows down two of her proudest achievements so far. She says:

On the professional it’s becoming the first sickle cell nurse specialist in the country no doubt about it. On the personal it’s becoming a mother and a grandmother.

When you look back at my own fractured family life, to manage to have a close relationship with my daughter and my granddaughter that would come first. Because you can be a high achiever and have a miserable personal life. 

Featured image via Elizabeth Anionwu

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