Celebrating South Asian Heritage Month 2021

To celebrate South Asian Heritage Month, the Royal College of Anaesthetists asked me to reflect on what South Asian culture means to me. Whilst a culture close to my heart, it is one I rarely speak about openly in a professional capacity. Here I hope to relay how being South Asian, Sri Lankan Tamil in my case, has affected my professional trajectory and perspective.

My family migrated to the UK during Sri Lanka’s civil war (1983-2009) - my roots are humble in keeping with many others from the medical profession, irrespective of whether they are native or migrated to the UK. Nuances however do exist. My family came to a new country, a new culture and a language that was not our first. Tamil culture is based on hope and perseverance, alongside a strong work ethic. The underlying philosophy is that in challenges lie a multitude of opportunities. Since the ceasefire (2009), I have had the opportunity to spend time at an orphanage during visits to the Northern Province of Sri Lanka. This remains some of my most humbling experiences. Here are orphaned children who have seen adversity at perhaps its worst and yet are filled with optimism for an education, stability and a belief they can strive for opportunities beyond what might appear in immediate reach.

Their eagerness to be ready at 6:00am to pick flowers for the morning Hindu rituals before a full day of school is heart rendering. On a personal note, I have witnessed change beyond what most might perceive as possible. Perhaps this underpins my belief that healthcare can be transformed; that we can and should continue to strive to do what’s best and appropriate for patients whilst being mindful of the workforce who deliver care – we are human, too.

South Asian culture, in my experience, is values based. In Tamil Hindu culture, we are taught a series of poetic couplets from a young age which cover all manner of high ideals for character – most teach to be kind, compassionate, generous and grateful. These qualities lie in leaders who most naturally inspire, and we are lucky in anaesthesia as there are many compassionate mentors and leaders. The nature of our clinical work denotes no one is exempt from ever being a few moments from humility, no matter their experience or expertise. The complexity of patients is changing and the current surgical backlog situation is challenging us in ways no one could have imagined, especially after over 16 months of pandemic intensity. Finding a community spirit centred on kindness, including to yourself, has sustained many of us during the pandemic and provides the fortitude for a career in anaesthesia. On a lighter note, did you know you may be asked no less than four times to stay for a meal when visiting a traditional Tamil household in keeping with our approach to hospitality!

A further core value is duty, or dharma (Sanskrit), and that is to oneself, family, wider community as well as in a professional capacity. Much like other cultures, family lies at the core of what motivates and inspires us the most. In South Asian culture, this generally spans beyond a nuclear family to extended family and the wider community. As a result of a search for professional opportunities in the 1960s and then immigration due to the civil war in the 1980s and beyond, the Sri Lankan Tamil diaspora is now international. As a consequence, the UK and especially London has one of the densest Tamil populations in the West. It is this family, which in South Asian culture considers wider community, who keep me grounded in my root culture. It means life is busy – balancing family, community and professional commitments has been the norm from a young age. Tamil calendars run on a lunar cycle and festival days (of which there are many) are often out of sync with traditional Western holidays. However, I have been so grateful for the flexibility afforded to me to balance commitments whilst training and now as a Consultant Anaesthetist. Colloquially, I developed a saying during training ‘scrubs on the weekdays and sarees on the weekend’, of course it runs much deeper than that. Having the opportunity to honour a culture which is the essence of who I am enables me to give more to my professional work.

So what does this all mean for my role as an RCoA Council Member? I feel having varied life experiences and perspectives breeds creative thinking and solutions. It is perhaps no surprise that I have a keen interest in people, whether it is anaesthetists in training, fellow Consultants or SAS equivalents and, importantly, patients. I believe taking the time to understand each other and the lens through which we each see life reaps dividends in furthering excellence in healthcare.

Dr Ramai Santhirapala

To find out more about the Royal College of Anaesthetists’ work on equality, diversity and inclusion visit the RCoA website.