A vulnerability is a state of helplessness, of being exposed to harmful condition without an immediate way out due to the prevailing conditions. It is closely associated with poverty, however, the two are distinct and the latter creates the former. Inequality, on the other hand, is the state of being unable to receive an equal measure of standards as do others of the same need. Inequality comes as a result of discrimination among the individuals. Discrimination and inequality are generally due to ‘heartlessness’ of the service providers in the health sector due to the current status of the patient. There are, however, many factors that have contributed to patient groups experiencing these challenges of discrimination and being a victim of inequality (HCPC, 2016). Though the cases of health inequality and discriminations have been witnessed in many of our health centres, it is a vice that should be dealt with as soon as possible in order to save human rights.
The factors that are associated with discrimination and inequality in the healthcare sector can be as a result of social, economic and religious factors. Social factors, however, is the most predominant factor that has caused vulnerability, inequality, and discrimination in the healthcare provision facilities. This factor is affecting both the developing and developed countries. In the developed countries, not everyone is a benefactor of good health care. The less fortunate an individual is in the arena of a socio-economic field, the more liable an individual is too poor health (HCPC, 2016).
The level of education is one of the social factors that has made many individuals be victims of discrimination and inequality in receiving the healthcare facilities. They are therefore vulnerable to a poor health condition. The higher the level of education an individual has attained, the more privileged he is in receiving better health facilities (Brookes, 2014). This is partially actuated by the respect he has earned in the society but above it all, by the fact that the individual is able to pay for his medical bill. It is a common trend in our society that even the economic status of an individual is measured in terms of ‘how learned’ that person is. For the individuals who bear certificates with low levels of education, fewer job opportunities with good payments are left at their disposal and thus less income to pay their medical bill (Brookes, 2014). As a result of this, this class of individual will opt for cheap healthcare facilities hence leading to poor health. They, therefore, become vulnerable to a poor health condition.
Employment status is another factor that has recently been of great concern in creating and promoting the level of vulnerability to poor health and discrimination. Through employment, one is able to generate income for both the domestic bills and even the medical bills (Brookes, 2014). The less income-generating job an individual is engaged in, the fewer chances of obtaining good healthcare facilities. Patients with poorly paying jobs are usually discriminated and the priority and the service due to them are given to their counterparts from well-paying jobs. For instance, a craft man and a government official when diagnosed with the same sickness would not receive similar treatments with same facilities. The government official will be considered as a very important person, and as many would say, (VIP) and better services would be given him. This would also suggest that every job has a respect accorded it, and the more respected a job is, the more respected the employers are. This is most often referred to as job reputation (Brookes, 2014).
The income level of individuals is another factor leading to vulnerability, discrimination and service inequality among patients. At any point in the health centres, there must be individuals from different backgrounds with different in the earnings. Poor patients, that is, the group that is poorly paid are often discriminated and given poor services (Brooke, 2014). The discrimination also comes as a result of these patients being unable to pay their bills or purchase the required prescription which may be slightly expensive than their income. A typical example is given when an old woman, once visited a clinic and one of the pharmacy attendants literally insulted her because of her inability to pay for the full prescription. It is very true, however, that an individual who has more income than that woman would not have received the same insults. In this case, the woman became vulnerable to poor health and was a victim of discriminate (Brookes, 2015.
Gender is a factor promoting vulnerability and discrimination in the health sector, however, its effect is not heavily felt in the society (Hampton, M, 2010). This factor though numbered among the factors that have led to discrimination and inequality in the sector of health, it is not a global factor in some countries the issue of gender is not a concern. We cannot again generalize that a particular gender is a victim of discrimination and inequality in service provision in the health field since in different countries, different genders are treated differently. However, in many instances, the feminine gender for over the ages has been a victim of discrimination and inequality in health provision. Many societies believe that the feminine gender is less inferior and that services due to men are not meant for them. But later in the development of the human race, many non-governmental organizations have sprung up to fight for the rights of the female gender (Hampton, M, 2010).
Racial factor. Racism is a crime that has given birth to too many other crimes including discrimination and inequality in service provision and thus racism is nearly the mother of all crimes. This factor is majorly experienced in areas where different people of different racial origin live together. Some races believe that they are more superior to the others in their thinking, their conduct and even their civilization and hence discriminate the others (Hampton, M, 2010). Most often the white has for a long time looked down on the blacks- the Negros to an extent that even the services provided to these groups of people vary in quality. A typical example is given in South Africa, during the colonial era, when the British government launched apartheid laws that brought a line of separation between the whites and the Negros. The whites had their own healthcare facilities where the blacks could not seek medication. This perpetuated discrimination among the blacks since they were considered less important in the society, in fact, they were regarded as monkeys, who deserved not an equal treatment as human beings-the whites (Jones, I, 2009).
Religion has of late become a factor that has contributed to the rise of discrimination and vulnerability in service provision in the health sector. Some faiths have been denied access to better health facilities as a result of the superstition many people have against them (Jones, I, 2009). For instance, in the United States, the Muslim Americans are generally stereotyped with bombing especially since the occurrence of the terrorist attack of the 9/ 11. From then these people have been denied access to better facilities like the normal citizens, health facility is one of the factors. Hence a patient from the Muslim faith in the United States would be lightly treated compared to their Christian counterparts due to this event.
This factor has therefore created a chance that a group of patients from the Muslim American community are highly vulnerable to a poor health condition (Jones, I, 2009). On the other hand, there are some religious groups that do not believe in the treatment from professional doctors. They entirely believe that for any sick person, prayers are enough! Yes, it is true for an individual to exercise his faith in God but this should not go to an extent that one is unable to seek medication. Trust in God is the only way a sick patient can get healed and this will encourage an individual even to seek better medical checkups. Such beliefs when practised may render an individual more vulnerable to poor health (Jones, I, 2009).
Traditional practices have in great magnitude become a major factor that can make a group of patients becomes highly vulnerable to poor health conditions. There are some traditional beliefs of a given society that may not allow an individual to seek better medication in the hospitals (Martin, J, 2015). These beliefs when strongly held by the community would increase the chances of deaths since there are a number of new diseases which cannot be treated using the traditional methods and thus the need to seek the attention of professional doctors. With the increase of human wickedness, there has been a proportional increase in the number of fatal diseases which cannot be treated by traditional means. This factor, however, depends on the level of civilization of given country and is thus majorly witnessed in the developing countries like the African nations (Martin, J, 2015).
Disability is another factor that can lead to discrimination from the service provider in the health facilities, however, this should not be the case. People with disabilities in some communities are regarded as outcasts and thus are not considered worthwhile to receive better medical attention (Martin, J, 2015). This factor can make a group of patients from this category to be more vulnerable to poor health conditions. Many times, the members of a community may not be willing to take someone who is physically challenged to seek for better medication, instead, they are usually left on their death beds to ‘heal up’ may be from some natural healing powers (Quinn, Humphreys, 1998). By this, this group of individuals is denied their right to better healthcare facilities and thus they are predisposed to dangerous prevailing conditions which may eventually lead to loss of life.
Poor infrastructural facilities is another factor which is majorly influenced by the economic status of a given society or country. This may not lead to discrimination but in one way, it may make patients from that given society to be more vulnerable to deaths emerging from fatal diseases. Poor roads are one of the infrastructural facility which may make it possible for accessing the health centres on time hence may lead to loss of lives. When there is a poor road, it makes it difficult for patients with sudden complications to get accessed to medical attention hence this factor puts at a high risk these patients to sudden deaths which could have been prevented if the medical attention would have been sought on time (Quinn, Humphreys, 1998). Poor or lack of better facilities in a hospital may also make it vulnerable for the patients to a poor health condition. There are some diseases which can only be diagnosed using powerful lab equipment. For instance, borne disease- borne cancer, which would require a very powerful X-ray machine to diagnose. When these machines are lacking in a given hospital then it is very certain that the patients will not receive the recommended treatment, and this may lead to death (Quinn, Humphreys, 1998).
How can a registered Paramedic protect a vulnerable patient?
A paramedic is a fully trained individual in the medical field, who is permitted by a recognized health body to offer medical assistance to sick patients in the community before the patient is taken to seek for medical attention from professional doctors in the hospital. A paramedic works in an outside-hospital environment. There are a number of ways in which a paramedic may protect the vulnerable patients in our society. A paramedic is then supposed to analyze the patient and ensure that the vulnerable patient is in good condition before reporting the case or even allowing the patient to seek medical attention in the hospital. When the paramedic suspects an abuse of the vulnerable patient, he should strive to do the following first (RMIT, 2016);
He should evaluate the situation and try to find out the safety or the well-being of the abused individual. The paramedic should use all the possible means to assess the situation. If the individual is in a very bad condition, then the individual may be taken to the hospital before investigations are conducted (RMIT, 2016).
When the paramedic feels that immediate assistance is needed or that an emergency attention is needful then the paramedic may contact the police at the emergency contact of 999. This would enhance the needful assistance (Vaughan, 2013).
But in case the situation does not require any emergency attention then, the paramedic may contact the nearby Local Authority Social Care Service (LASC) for relevant assistance (Willis, 2010).
When the abuse is literally brought to the attention of the paramedic, then the following actions may be taken by the paramedic; (Vaughan, 2013).
The paramedic should not panic but show some sense of calmness as to avoid shock. In case of the otherwise the vulnerable patient may even lose hope in the paramedic and once this level is attained, the reverse is not usually easy.
The paramedic should then employ the culture of listening skills. He or she should possess high powers of listening skills. He should listen to all the details being described by the reporter or the vulnerable patient (Vaughan, 2013)
Show some sense of concern and empathy. Try to be in their shoes and feel what they are feeling by the situation. Avoid all forms of arrogance and lack of concern.
Ensure that you are keen and give them also the assurance that you are indeed concentrating.
Try to explain to them that you need to report the issue and actually report the issue when there need be.
As a paramedic, you should not do the following.
Do not abruptly interrupt an individual who is explain something and is taking too long to recall a very critical event.
Avoid coaxing the individual into giving more information other than the ones he has voluntarily given.
Do not be too much judgmental. Listen to the person with an open mind (Vaughan, 2013).
Avoid making fake promises which cannot be fulfilled by assuring the patient that the story will be kept secret (Willis, 2010).
After following the above procedure, execute the necessary action and after that, you will have really helped the individual.
In conclusion, there are many factors which may create a group of patients experiencing vulnerability, discrimination, and inequality in service provision (Willis, 2010). As have seen in this study, it is very clear that these factors range from social factors, economic factors, and even religious factors. Some factors may not be experienced in the same manner globally like racial factor, however, are experienced in some parts of the world in greater magnitude.
Paramedics have a good step-by-step program that they can follow in order to defend the vulnerable patients in the society (Willis, 2010). This procedure is as outlined in this study. However, there are urgent steps that are not included in the list but which are very crucial. They can only be implemented in the field.
HCPC (2016) Standards of conduct, performance and ethics. Available at: http://www.hcpc-uk.org/assets/documents/10004EDFStandardsofconduct,performanceandethics.pdf (Accessed: 9 July 2016).
Oxford Brookes University (2014) Reflective writing: About Gibbs reflective cycle – Oxford Brookes University. Available at: https://www.brookes.ac.uk/students/upgrade/study-skills/reflective-writing-gibbs/ (Accessed: 11 July 2016).
Hampton, M. (2010) Reflective writing: a basic introduction. Available at: http://www.port.ac.uk/media/contacts-and-departments/student-support-services/ask/downloads/Reflective-writing—a-basic-introduction.pdf (Accessed: 2 September 2016).
Jasper, M. and Quinn, F.M. (2003) Foundations in nursing and health care: Beginning reflective practice. Available at: https://books.google.co.uk/books?hl=en&lr=&id=FKroWQSJ7z4C&oi=fnd&pg=PR5&dq=Beginning+Reflective+Practice:+Foundations+in+nursing+and+health+care&ots=vmVLFaDjiA&sig=yUSSqw6lI8OKx8SO-4dZd5fTt_M#v=onepage&q&f=false (Accessed: 2 September 2016).
Jones, I. (2009) Reflective practice and the learning of healthcare students. Available at: https://core.ac.uk/download/pdf/1639434.pdf (Accessed: 4 August 2016).
Martin, J. (2015) ‘The challenge of introducing continuous professional development for paramedics’, Australasian Journal of Paramedicine, 4(2).
Quinn, F.M. and Humphreys, J. (1998) Continuing professional development in nursing: A guide for practitioners and educators. Cheltenham: Stanley Thornes Publishers.
RMIT (2016) Online Tutorial – Writing a Reflection. Available at: https://emedia.rmit.edu.au/learninglab/content/writing-reflection (Accessed: 11 July 2016).
Vaughan, P. (2013) THE IMPORTANCE OF REFLECTION WITH IMPROVING CARE AND IMPROVING STANDARDS AND THE 6CS. Available at: https://www2.rcn.org.uk/__data/assets/pdf_file/0007/586654/ReflectivePractice.pdf (Accessed: 11 July 2016).
Willis, S. (2010) ‘Becoming a refl ective practitioner: frameworks for the prehospital professional’, Journal of Paramedic Practice, 2(5), pp. http://s3.amazonaws.com/academia.edu.documents/42660533/Reflective_Practice.pdf?AWSAccessKeyId=AKIAJ56TQJRTWSMTNPEA & Expires=1473586742 & Signature=npDpt3U5sFIDx8Lps%2BJ4s0uccbI%3D & response–content–disposition=inline%3B%20filename%3DReflective_Practice_for_P.(Accessed: 4 August 2016).