Pain of being Kenyan nurse in UK

Sometimes, a question can reveal more than the person asking it intends.

Mary Wangui (not her real name) had been working in Britain long enough to recognise when an innocent-sounding conversation was taking an uncomfortable turn. A white patient asked where she was from, and she mentioned the part of London where she lived. He pressed further, wanting to know where she was “really” from.

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Wangui eventually told him she was Kenyan, but the exchange did not end there. When she later prepared to remove a surgical drain from the patient, he questioned whether she knew how to carry out the procedure despite her experience as a renal nurse specialist.

“I realised the two moments were connected,” Wangui said. “It was no longer simply a question about where I came from. He was also questioning whether someone like me could be trusted to do my job.”

A recruitment deal meets a harsher reality

Wangui is among Kenyan nurses who have travelled to Britain since June 2022 under a health workforce agreement intended to help address shortages in the National Health Service.

The arrangement was presented as a mutually beneficial partnership. Britain needed qualified nurses, while Kenya had trained professionals seeking employment opportunities.

The agreement was established in 2021 following then-President Uhuru Kenyatta’s visit to London. Thousands of opportunities were subsequently opened to Kenyan nurses seeking to work in Britain’s health system.

Getting through the recruitment process required more than a nursing qualification. Applicants had to satisfy professional regulators, undergo background checks, demonstrate clinical competence and meet demanding language requirements.

Many arrived expecting their training and experience to determine how they would be treated at work.

Instead, some have found themselves in an environment where racial discrimination remains a serious concern, both from patients and within the wider healthcare workforce.

Wangui says the discrimination is not always expressed through obvious insults. Sometimes it appears through questions about qualifications, accents or whether an African healthcare worker is capable of performing a task.

“The hardest part is when you have already proved yourself professionally, yet someone still looks at your skin or listens to your accent before deciding whether you are competent,” she said.

A recent NHS report has documented instances of patients refusing treatment from Black and minority ethnic healthcare workers, raising fresh concerns about the treatment of overseas staff.

The contradiction is stark. Britain’s health service depends heavily on international recruitment to fill staffing gaps, yet some of those workers face hostility from the patients they have been recruited to care for.

Professional organisations including the British Medical Association and the Royal College of Nursing have documented racial inequalities affecting minority healthcare staff.

Reports have included workers being subjected to racial slurs, accusations that immigrants are taking jobs and outright hostility linked to ethnicity.

Some patients have refused treatment simply because the healthcare professional attending to them is Black or Asian.

The prejudice can also centre on accents. Paul Awah, a 39-year-old radiographer from Nigeria, said some white patients have acted as though they could not understand him despite his clear English.

Awah has observed that those same patients can understand strong Scottish or Irish accents without difficulty. His experience suggests that the problem may be less about language and more about the assumptions attached to an African voice.

The abuse does not stop at hospital wards.

Kenyan nurse Kioko Mutua recalled an incident involving an ambulance team responding to a call involving two intoxicated women. The situation became hostile, with the emergency workers subjected to racial abuse.

One of the women referred to a paramedic using a racist slur comparing the worker to a monkey.

“The team was simply responding to a call and doing what they were trained to do,” Mutua said. “Nobody should have to accept racial insults as part of providing emergency care.”

When racism becomes a workplace hazard

Such encounters leave healthcare workers in a difficult position. Their professional duty requires them to care for patients even when those patients are disrespectful or openly racist.

Wangui says the pressure can be particularly difficult for international workers who have already made major sacrifices to build careers in Britain.

A nurse may spend years training, pass multiple examinations and travel thousands of kilometres only to find that some patients judge their ability through the lens of race.

“The expectation is that you remain professional no matter what is said to you,” Wangui said. “But professionalism should not mean remaining silent when someone is attacking you because of your race.”

The problem is not limited to individual incidents. Britain’s NHS has long acknowledged racial inequalities within its workforce.

Workforce Race Equality Standard data has shown that Black and minority ethnic staff experience higher levels of bullying from colleagues, are more likely to face disciplinary action and remain under-represented in senior positions.

International recruits can also feel vulnerable because many depend on their employers for sponsorship linked to their immigration status. That dependence can make challenging discrimination more complicated.

Some workers may fear that speaking out could damage relationships with managers or put their jobs at risk.

The result can be a culture in which employees are expected to absorb abuse while continuing to provide the standard of care expected of them.

Wangui believes there is an important distinction between a patient’s right to make choices about their treatment and a patient’s demand to be protected from healthcare workers because of their race.

Patients can decline treatment, but that freedom should not create a right to dictate the racial identity of the professional providing care.

“The patient has a right to make decisions about their care,” Wangui said. “That does not give anyone the right to turn racism into a condition for receiving treatment.”

The issue also exposes a difficult reality for Britain. The NHS has become increasingly dependent on nurses and other healthcare professionals recruited from countries such as Kenya, Nigeria, India and the Philippines.

These workers help keep hospitals operating during periods of severe staff shortages. They work night shifts, care for vulnerable patients and perform essential procedures, often far from their families and home communities.

Yet some still face questions about whether they belong.

The experiences of Kenyan nurses reveal the human cost behind Britain’s international recruitment figures. Every statistic represents a person who left home, invested in professional training and accepted the challenge of starting again in a foreign healthcare system.

Wangui’s experience also raises questions about how much responsibility should fall on individual nurses to confront racism.

Hospitals may have zero-tolerance policies, but policies mean little if workers feel unsupported when patients cross the line.

The Kenyan government did not provide a formal response to questions about racism and safety concerns affecting nurses working in Britain. Labour Cabinet Secretary Alfred Mutua declined to comment on conditions in British workplaces and referred inquiries to the State Department for Diaspora Affairs.

The wider debate is therefore no longer simply about whether Britain needs foreign nurses. It is about whether the system that recruits them is prepared to protect them once they arrive.

Kenyan nurses were invited to Britain because their skills were needed.

Their qualifications were recognised. Their experience was valued. Their labour was considered important enough to form part of a government-backed recruitment agreement.

Yet the experiences described by Wangui and other healthcare workers show that professional recognition does not automatically erase racial prejudice.

A nurse can be qualified enough to cross borders, pass British regulatory requirements and care for patients in an overstretched health system, yet still be asked whether they are competent because of the colour of their skin or the country they come from.

That contradiction is at the heart of the problem.

Britain needs these workers, but need alone is not enough. International nurses also deserve workplaces where their professionalism is respected and where racism is confronted rather than quietly tolerated.

Wangui believes the principle should be simple: patients deserve dignity, but healthcare workers deserve it too.

“A hospital should be a place where people come to receive care, not a place where workers are expected to tolerate racism because they are the ones providing it,” she said.