Tansi Nîtôtemtik/Negha Dagondih,
Racism in health exists on many plains and in various ways. Conscious and unconscious bias, stereotypes, and learned and taught false knowledge are just some of the ways by which racism is perpetuated in Canada. Once these assumptions, stereotypes, and ways of knowing are ingrained and solidified in an individual and society, they then spread and embed within people's personal lives, academic lives, and career lives. When nurses, physicians, and healthcare staff with these ideologies work within the medical field, racism then exists in health.
Call to Action #24 states:
“We call upon medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties and Aboriginal rights, and Indigenous teachings and practices. This will require skills-based training in intercultural competency, conflict resolution, human rights, and anti-racism.”[1]
Nursing programs and medical physician programs are in a position to work towards the TRC objectives by breaking down stereotypes, informing students and learners of patient-centered and contextualized knowledge, and contributing towards a better healthcare experience for Indigenous individuals and communities. Indigenous health is multi-layered and is not a simple linear issue. The impact of residential schools has caused immeasurable distrust between Indigenous peoples and Western medicine. For example, both Alberta and British Columbia enacted eugenics legislation; between 1929 and 1972, 2,800 people were sterilized under the authority of Alberta’s Sexual Sterilization Act[2]. The goal behind sterilization was to stop “mental defectives” from having children, and Indigenous people were regarded as such.[3] Further north, 26% of Inuit women aged 30-50 - reported in 1976 for that year - were sterilized by the Government of Canada.[4]
Health to Indigenous peoples is different from Western practice, and simply ‘dropping’ a clinic or hospital into a community does not address the need for support to health and health care, especially in Indigenous communities and territories. Medicine needs to fundamentally shift its ideologies and approach to health to dismantle forms of racism from within. One of the ways to differentiate between Indigenous health and Western health is to understand that Indigenous cultures frame health “as environmental and communal rather than individual, and [place] a greater emphasis on spirituality in health and health care compared with Western health traditions.”[5]
Photo by Marcelo Leal on Unsplash
But, sadly, the necessary shift in theory and practice has not yet been realized. On August 6, 2016, Hugh Papik, a 68-year-old Inuvialuit man, was considered drunk by nursing staff at an elder facility who had found him lying on the ground in his urine, and slurring his speech. The nurses called Hugh’s niece to say she had to “deal with him”.[6] Papik was suffering from a stroke.
"He just looked at me and he was yelling 'I'm not drunk! I'm not drunk!”[7]
Papik’s niece, Maggie, eventually got him to the Aklavik Health Centre, where the nurses there were also saying Papik was drunk, and it took them six hours before they ordered a medevac to Inuvik, which is 120 km away from Aklavik.[8] By the time they reached Inuvik, Papik didn’t know his name, and by the time they reached the Stanton Territorial Hospital in Yellowknife, physicians informed Maggie that Papik’s brain swelling was too extensive and that he was braindead.[9]
Racism is still within the minds of those who practice in the health care systems, and is therefore still present in communities where Indigenous people are to turn to when they need medical aid. Fearing about one’s treatment if ill, or if an emergency were to happen, should not be one of the first things to go through an Indigenous person’s mind. Indigenous people deserve to not be stereotyped, prejudiced or mistreated because of their ethnicity and FNMI identity. If medicine does not work on post-secondary educational courses, in-practise competency training, and listening to communities and nations to form proper relationships, then fear might well remain the first things that come to one’s mind when they think of needing medical aid/treatment.
Speaking to CBC about her uncle, Maggie said: "He was happy, joyful. He always made you smile, laugh, even if you didn't know him...He wasn't drunk. There's lots of natives that are being wrongfully treated. That's just not right."[10]
Dear reader, what do you think can be done to see positive change? What do you think needs to change? Share your thoughts so we can work together to actualize health and healthcare equity and equality for all of us.
Until next time,
Team ReconciliAction YEG
[1] Truth and Reconciliation Commission of Canada, “Calls to Action”, (2015) at 3, online (pdf): Government of B.C. <www2.gov.bc.ca> https://www2.gov.bc.ca/assets/gov/british-columbians-our-governments/indigenous-people/aboriginal-peoples-documents/calls_to_action_english2.pdf
[2] Yvonne Boyer, Moving Aboriginal Health Forward: Discarding Canada’s Legal Barriers (Purich Publishing Ltd., 2014). Alberta in 1928, and British Columbia in 1933.
[3] Ibid.
[4] Ibid.
[5] Stephen Wilmot, “Cultural Rights and First Nations Health Care in Canada” (2018) 20:1 HeinOnline.
[6] Hilary Bird, “Inuvialuit woman says uncle's stroke mistaken for drunkenness”, (Aug. 15, 2016) online: <cbc.ca> https://www.cbc.ca/news/canada/north/hugh-papik-stroke-racism-1.3719372
[7] Ibid.
[8] Ibid.
[9] Ibid.
[10] Ibid.