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

Communities like Nakusp are grappling with the challenge of hooking high-speed internet up at individual homes. File photo
‘Last mile’ debate a Gordian knot in Slocan Valley’s fibre-optic cable plans

How do you bring high-speed internet not just to communities, but individual homes?

COVID-19. (Image courtesy CDC)
Interior Health reports 65 new cases of COVID-19

Province-wide, there are 887 new cases of the virus

(Betsy Kline/Castlegar News)
Nav Canada says it would never compromise safety at West Kootenay Regional Airport

Submission from Nav Canada regarding potential cuts to the West Kootenay Regional Airport

Ice slides are one thing that could occur in Rossland this winter. File photo
City of Rossland plans to hold scaled-back winter events

Small portions of Rossland Winter Carnival, Rekindle the Spirit events to occur for public

B.C. Health Minister Adrian Dix and provincial health officer Dr. Bonnie Henry update the COVID-19 situation at the B.C. legislature, Nov. 23, 2020. (B.C. government)
B.C. sets another COVID-19 record with 887 new cases

Another 13 deaths, ties the highest three days ago

Join Black Press Media and Do Some Good
Join Black Press Media and Do Some Good

Pay it Forward program supports local businesses in their community giving

Shoppers line up in front of a shop on Montreal’s Saint-Catherine Street in search of Black Friday deals in Montreal, Friday, Nov. 27, 2020. THE CANADIAN PRESS/Paul Chiasson
Black Friday shopping in a pandemic: COVID-19 closes some stores, sales move online

Eric Morris, head of retail at Google Canada, says e-commerce in Canada has doubled during the pandemic.

School District 27 announced the first confirmed case of COVID-19 this week (Nov. 23) at Lake City Secondary School Williams Lake campus. (Angie Mindus photo - Williams Lake Tribune)
Entire gym class at northern B.C. high school isolating after confirmed COVID case

Contact tracing by Interior Health led to the quarantine

After twice have their wedding plans altered due to COVID-19 restrictions, Suzanne Schmidt and Andrew Sturgess got married in Bakerview Park last weekend, with the only guests being their two daughters, Zoey (foreground) and Tessa. (Darren Ripka photo)
From New Zealand to Bakerview Park, B.C. couple weds in ‘backyard’

Twice scaled-down wedding ‘proof that good things still happen during bad times’

Arthur Topham has been sentenced to one month of house arrest and three years of probation after breaching the terms of his probation. Topham was convicted of promoting hate against Jewish people in 2015. (Photo submitted)
Quesnel man convicted for anti-Semitic website sentenced to house arrest for probation breach

Arthur Topham was convicted of breaching probation following his 2017 sentence for promoting hatred

Langley School District's board office. (Langley Advance Times files)
‘Sick Out’ aims to pressure B.C. schools over masks, class sizes

Parents from Langley and Surrey are worried about COVID safety in classrooms

The baby boy born to Gillian and Dave McIntosh of Abbotsford was released from hospital on Wednesday (Nov. 25) while Gillian continues to fight for her life after being diagnosed with COVID-19.
B.C. mom with COVID-19 still fighting for life while newborn baby now at home

Son was delivered Nov. 10 while Gillian McIntosh was in an induced coma

Most Read