Here's how you can help advocate for culturally competent Canadian health care

| January 26, 2016
Here's how you can help advocate for culturally competent Canadian health care

Like this article? rabble is reader-supported journalism. Chip in to keep stories like these coming. has partnered with Aboriginal Legal Services of Toronto to launch a campaign urging Canadians to take up implementing the recommendations of the Truth and Reconciliation commission as a new year's resolution for 2016. Here's how.

Let's look at Recommendation #22:

We call upon those who can effect change within the Canadian health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients.

Health-care providers need to acknowledge the first step to meaningful and productive allyship is acknowledging that there are several amazing individuals and organizations that have taken the initiative to create spaces wherein traditional knowledge and medical care intertwine in a meaningful way.

Allyship is not an identity. It is a series of behaviours.

History of unethical experiments

"All health-care providers have a responsibility to ensure that they providing culturally safe care," says Emily Hill from Aboriginal Legal Services Toronto, adding, "Cultural safety starts from an acknowledgement that racism is present in Canadian social life and therefore also in health-care settings. Health-care institutions, administrators, and staff must examine the ways in which power relations, racism, and stereotyping influence the care provided to patients."

In 2013 several documents revealed that at least 1,300 Indigenous individuals -- most of whom were children -- were used as test subjects in medical research in the 1940s and 1950s.

Aside from the obviously unethical vitamin experiments, during the same time period, Indigenous individuals were also subjected to other forms of medical experimentation. Using individuals from residential schools, researchers used Indigenous bodies to test the effectiveness of certain kinds of medication.

In a CBC Radio interview, Justice Murray Sinclair of the Truth and Reconciliation Commission stated, "We do know that there were research initiatives that were conducted with regard to medicines that were used ultimately to treat the Canadian population. Some of those medicines were tested in aboriginal communities and residential schools before they were utilized publicly."

The 1970s saw the forced and coerced sterilization of Indigenous women. Karen Stote, an assistant professor of women and gender studies at Wilfred Laurier University, documents 580 sterilizations that took place in Canada between 1971 and 1974 in her book An Act of Genocide, Colonialism and the Sterilization of Aboriginal Women. This heinous physical and psychological torture scarred, not only the victims of these crimes, but entire families and communities.

All of the above examples, were enacted though, under the guise of health care. The distrust between Indigenous communities and health-care practitioners is not somehow unfounded or irrational. Unfortunately, many have paid the price for their trusting the system; many did not have a choice.

Being aware of your own bias

"Asking Aboriginal patients, health-care providers, elders, and cultural leaders to share their knowledge and participate in patient care will provide better health outcomes and will expand the skills of the provider," explains Hill.

The history of Indigenous-settler relations -- especially with regard to the state and state-sanctioned trauma -- means that there is a bias present in health care that needs to be acknowledged.

A study released earlier this year by the Wellesley Institute entitled "First Peoples, Second Class Treatment" outlines the pervasive nature of anti-Indigenous prejudice and discrimination in health care.

One account is that of 53-year-old Carol McFadden an Oneida woman who resides in Camosack, or, what is now Victoria, British Columbia.

McFadden recounts some doctors as being extremely vulgar, reportedly kicking the side of her bed to get her attention. Even though McFadden has not had an alcoholic beverage in over two decades, health practitioners still made assumptions about her lifestyle, boldly inquiring as to whether she drank or used illicit substances.

Even if health-care providers are not participating in extremely aggressive racist behaviour, even microaggressions such as the ways in which one may inquire whether or not somebody drinks, can be harmful.

Advocating for culturally competent spaces is another means of combating this. One example is Vancouver's St. Paul's hospital. It houses a "Sacred Space" to incorporate different Indigenous healing methods in the treatment or recovery journey.

Those in treatment join staff for weekly talking circles. Indigenous healers and Elders are also welcome to conduct traditional ceremonies in the space.

Advocates outside of health care

Hill reminds us that non-Indigenous allies can still effect change.

"First of all, the provision of health care is an important political issue and is part of any political platform in provincial and federal elections. As voters, we have a responsibility to ensure that political leaders and candidates know that it is important to us that the health-care system that Canadians are so proud of meets the needs of all Canadians and does not perpetuate further inequalities through discrimination," states Hill.

Besides going to the polls, Hill also points out the significance of being truthful witnesses. Brian Sinclair, an Indigenous man, sat in his wheelchair for 34 hours in an emergency room in Winnipeg, M.B. before dying of a bladder infection as hospital staff watched on.

Those of us outside of health care can speak up when we see somebody being discriminated against. It may look different in different circumstances. It is, however, better than silence.

More importantly, as Hill states, "When members of Indigenous communities describe their experiences of racism in health care, we must believe them and listen to what they want, rather than rushing to the defence of the system or challenging their experiences."

Although combining traditional and contemporary health-care spaces is a means of addressing the issue of fragmented health care, sometimes we must defer.

Consulting Indigenous health-care practitioners, Friendship Centres, or local organizations, such as the Native Women's Resource Centre of Toronto, and their partners is ensuring that the individuals you are reaching out to actually receive help and support.

Hill also points to The Canadian Nurses Association , Anishnawbe Health Toronto, and British Columbia and Indigenous Cultural Safety Training as great resources.

Ashley Splawinski is a student at the University of Toronto. Previously, Ashley worked as a producer and host of News Now on CHRY 105.5 FM covering Canadian social, political, and environmental issues. You can visit her personal blog and follow her on twitter @asplawinski.



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