FILE – A health care worker is seen outside the Emergency dept. of the Vancouver General Hospital in Vancouver Monday, March 30, 2020. THE CANADIAN PRESS/Jonathan Hayward

FILE – A health care worker is seen outside the Emergency dept. of the Vancouver General Hospital in Vancouver Monday, March 30, 2020. THE CANADIAN PRESS/Jonathan Hayward

Healthcare racism probe must go to systemic roots, not just ‘bad apples’: Indigenous doctor

Doctor says that blood alcohol guessing game is not the only incident

Fran Yanor, Local Journalism Initiative Reporter, the Rocky Mountain Goat

Dr. Terri Aldred doesn’t recall her time in medical school altogether fondly.

“I grew up in a very remote place. I was very poor. I’m indigenous and I’m a woman,” said the member of Tl’azt’en Nation who practices primary care medicine in Indigenous communities in northern B.C. “I didn’t have an easy go of it.”

Particularly demoralizing was the so-called `soft racism’ or microaggressions. “It was kind of from all angles, in a lot of ways.”

One incident that sticks occurred when she was 24, while pulling an evening shift at a busy hospital emergency room in Edmonton. “The emerg doc said, `Oh, you should go help your drunk relative in Bay whatever,”’ said Aldred. “So I did. And, you know, they had been drinking but they were not even drunk. Not that it matters.”

The `drunk Indian’ stereotype is one of the most harmful in health care settings, according to a study led by UBC professor Dr. Annette Browne, which found, “Indigenous peoples experience individual and systemic discrimination when seeking health care despite efforts within the health care sector to promote cultural sensitivity and cultural safety.”

Last Friday, allegations of racism in healthcare hit the news when Health Minister Adrian Dix revealed a complaint he’d received about hospital emergency room staff playing a game to guess the blood alcohol level of Indigenous patients in the waiting room. Hours after learning of the complaint, Dix marshalled a press conference to announce he’d appointed Mary Ellen Turpel-Lafond, a Saskatchewan provincial court judge and B.C.’s former Representative for Children and Youth, to investigate. “If it’s true, it’s intolerable, unacceptable and racist,” said Dix, who referred to the allegations as `beyond disappointing.’

Turpel-Lafond will have the authority to investigate as she sees fit, the report will be made public, and the recommendations will be followed, Dix said.

Witch hunt or system change?

Aldred hopes it won’t devolve into a witch hunt. Pulling out the ‘bad apples’ won’t solve the situation. “There’s a system problem,” she said, “and there’s a way-that-we’re-trained problem.”

According to a 2015 report First Peoples, Second Class Treatment, “racism against Indigenous peoples in the health care system is so pervasive that people strategize around anticipated racism before visiting the emergency department or, in some cases, avoid care.”

The Metis Nation British Columbia condemned what it called a `Price is Right’ type game commonly played by hospital emergency room staff in B.C. to guess the blood alcohol concentration (BAC) of Indigenous patients. “The winner of the game guesses closest to the BAC — without going over,” according to a press release issued yesterday.

“We are in the process of trying to make systemic change,” said Dix, citing ongoing cultural sensitivity and humility work with the First Nations Health Authority, the First Nations Health Council, the Metis National Council, friendship centres, and others. “Those efforts have to be redoubled and tripled and quadrupled for whatever it takes.”

READ MORE: B.C. launches investigation into allegations of racist blood-alcohol guessing game in ER

Racism and stigma require persistent chipping away, said Dr. Carmen Logie, a social worker and University of Toronto associate professor who holds the Canada Research Chair in Global Health Equity and Social Justice with Marginalized Populations. The core of stigma is `othering:’ creating a separation between yourself and somebody else which includes the need to devalue, construct, and portray them as less than us, less worthy of dignity, value and respect, she said.

“Part of othering is separating you as being a healthy person from those sick people and then blaming sick people for their own issue,” Logie said. “Because you want to believe that that can’t happen to you because you’re a good person.”

Turning the Tide

Dark humour is something most physicians have fallen into, said Aldred, taking care not to condone the behaviour outlined in the allegation. “We depersonalize people to try and find some lightness to get ourselves through.”

Depersonalizing others, emotional exhaustion, and a reduced sense of accomplishment are all signs of burnout, said Dr. Jane Lemaire, director of wellness at the University of Calgary’s Cumming School of Medicine, and author of several papers about physician burnout. “We really need to tackle… some of the more toxic aspects of our profession,” she said, including the stigma around mental health issues, and the valour of 12, 16, or 23-hour workday.

Aldred says it also comes down to training.

“”It does not make it right and I’m not trying to create excuses,” said Aldred, “but as somebody who walks in both worlds, medical students weren’t trained properly in cultural safety and humility.” Training was aimed at creating confident practitioners who knew their stuff, she said. “They didn’t want the soft-spoken, tender-hearted person necessarily.” She recalls some of her fellow medical students as exceptionally caring and altruistic whose demeanour changed dramatically after going through medical training.

READ MORE: B.C. First Nations leaders ‘disgusted’ by allegations of racist blood-alcohol guessing game

Nearly 10 years out of school, Aldred is helping change the system from within. Besides her primary care practice with Carrier Sekani Family Services, she is site director with UBC’s Indigenous Family Medicine program, managing 10 medical residents in Victoria, Nanaimo and Vancouver. These days, residents get five times more Indigenous health content than Aldred did, and time spent working in Indigenous communities.

“It’s kind of like changing the tide on a tsunami.”

She said the medical residents are a secret army to alter its course.

“These are the people who are going to make the changes.”

As for the investigation, Aldred said any real shift will require health professionals, policy-makers, academia, patient partners and industry to come to the table and make commitments.

“Otherwise, people are going to walk on eggshells for a few months (until) they get tired and burnt out again, and it’ll just be something else.”


Like us on Facebook and follow us on Twitter.

Want to support local journalism during the pandemic? Make a donation here.

HealthcareIndigenousracism

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

Jogas Espresso Café was one of three Grand Forks establishments targeted in Sunday’s vandalism spree, Jan. 17. Photo: Laurie Tritschler
Vandalism spree targets Grand Forks businesses

City RCMP said they arrested a male suspect Sunday, Jan. 17

A map released by the BCCDC Friday, Jan. 15 shows five diagnosed cases of COVID-19 in the Grand Forks health area. Photo: Maps: COVID-19 cases in BC, British Columbia Centre for Disease Control website
Five COVID-19 cases reported in Grand Forks area

The BC Centre for Disease Control announced the cases in a weekly update Friday, Jan. 15

Zoey Uniat is now three months old. Photo: Submitted
Castlegar baby with rare disorder progressing towards coming home

Fundraiser for Zoey Uniat has raised more than $50,000

Pioneer Arena is closing for the season. Photo: John Boivin
Castlegar’s Pioneer Arena and Nelson Civic Centre closing for season

RDCK is closing the ice at two of its arenas due to financial concerns related to COVID-19

Les Cleverly, formerly of Grand Forks Fire/Rescue, is suing the city as well as current and former city firefighters over alleged workplace bullying and defamation. File photo.
Former Grand Forks firefighter suing department, city over alleged conspiracy, constructed dismissal

Plaintiff Les Cleverly filed a notice of civil claim with the Supreme Court of BC in last week

A scene from “Canada and the Gulf War: In their own words,” a video by The Memory Project, a program of Historica Canada, is shown in this undated illustration. THE CANADIAN PRESS/HO - Historica Canada
New video marks Canada’s contributions to first Gulf War on 30th anniversary

Veterans Affairs Canada says around 4,500 Canadian military personnel served during the war

Gin, one of the Kantymirs’ two sheep. (Martha Wickett-Salmon Arm Observer)
Sheep start up ATV, sit in cars and go for walks in Salmon Arm

Until they bought two sheep, Ken and Karleen Kantymir didin’t realize just how social the animals are

Heather Lucier, a pastor at Kelowna Harvest Fellowship, speaks to an RCMP officer outside of Harvest Ministries on Sunday, Jan. 10. (Michael Rodriguez - Capital News)
Kelowna church fined 2nd time for violating public health order

Harvest Ministries in Kelowna has previously said they will fight the tickets in court

Powell River-Sunshine Coast MLA Nicholas Simons was appointed to the NDP cabinet as minister of social development and poverty reduction after the October 2020 B.C. election. (Hansard TV)
B.C. job training fund increased for developmentally disabled

COVID-19 has affected 1,100 ‘precariously employed’ people

B.C. driver’s licence and identity cards incorporate medical services, but the passport option for land crossings is being phased out. (B.C. government)
B.C. abandons border ID cards built into driver’s licence

$35 option costing ICBC millions as demand dwindles

sdf
2nd in-school violence incident in Mission, B.C, ends in arrest

RCMP notified of local Instagram page with videos (now deleted) showing student assaults, bullying

BC Emergency Health Services has deployed the Major Incident Response Team (MIRRT) as COVID-19 positive cases rise in the Williams Lake region. (Monica Lamb-Yorski photo - Williams Lake Tribune)
B.C.’s rapid response paramedics deployed to Williams Lake as COVID-19 cases climb

BC Emergency Health Services has sent a Major Incident Rapid Response Team to the lakecity

(Phil McLachlan - Black Press Media)
RCMP say ice climber seriously injured after reportedly falling 12 metres near Abraham Lake

Police say man’s injuries were serious but not life-threatening

U.S. military units march in front of the Capitol, Monday, Jan. 18, 2021 in Washington, as they rehearse for President-elect Joe Biden’s inauguration ceremony, which will be held at the Capitol on Wednesday. (AP Photo/J. Scott Applewhite)
Biden aims for unifying speech at daunting moment for U.S.

President Donald Trump won’t be there to hear it

Most Read