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

(FILE)
COVID-19 exposures confirmed at Central Okanagan schools

Schools in Lake Country, Kelowna, West Kelowna confirm exposures of the virus

Kelowna Rockets face off against the Vancouver Giants at Prospera Place, Kelowna, on January 26, 2020. (Marissa Baecker/Kelowna Rockets)
‘Joy for the players’; Kelowna Rockets staff react to season restart

WHL players set to arrive in Kelowna, Kamloops March 13 to begin 48-day, 24-game season

Kelowna General Hospital (File photo)
Second death reported in Kelowna General Hospital COVID-19 outbreak

A total of seven cases have been identified at the hospital: six patients and one staff

A nurse performs a test on a patient at a drive-in COVID-19 clinic in Montreal, on Wednesday, October 21, 2020. THE CANADIAN PRESS/Paul Chiasson
36 new cases of COVID-19, one death in Interior Health

The number of active cases in the region is at 366

Mussel inspection sit set up at B.C.-Alberta border. (Contributed)
Okanagan Basin Water Board calls for stronger invasive mussel protection

Letter sets out six recommendations for environment minister George Heyman to consider

B.C. Health Minister Adrian Dix and provincial health officer Dr. Bonnie Henry head for the B.C. legislature press theatre to give a daily update on the COVID-19 pandemic, April 6, 2020. (B.C. government)
B.C. nears 300,000 COVID-19 vaccinations, essential workers next

564 new cases, four deaths, no new outbreaks Thursday

The B.C. Supreme Court ruled Feb. 26 that the estate of deceased Sooke man and Hells Angels prospect Michael Widner is to be divided between his wife and his secret spouse. (Black Press Media file photo)
Estate of deceased Vancouver Island Hells Angels prospect to be divided between wife and secret spouse

Michael Widner’s 2017 death left a number of unanswered questions

This Dec. 2, 2020 photo provided by Johnson & Johnson shows vials of its Janssen subsidiary’s COVID-19 vaccine in the United States. THE CANADIAN PRESS/AP-Johnson & Johnson via AP
Canada approves Johnson & Johnson’s 1-shot COVID-19 vaccine

It is the 4th vaccine approved in Canada and the 1st that requires just a single dose

Walter Gretzky father of hockey hall-of-famer Wayne Gretzky waves to fans as the Buffalo Sabres play against the Toronto Maple Leafs during third period NHL hockey action in Toronto on Tuesday, Jan. 17, 2017. THE CANADIAN PRESS/Nathan Denette
Walter Gretzky, father of the Great One, dies at 82

Canada’s hockey dad had battled Parkinson’s disease and other health issues

Riverside Centre includes a theatre hosting local plays, visiting musicians and dance troupes. It is also used for community events such as public meetings and fundraisers. Photo Town of Princeton
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

COVID-19 numbers provided by Interior Health show Salmon Arm and Revelstoke in the 200-plus range from January 2020 to February 2021 while Vernon, with a larger population, tallied more than 600 over the 14 months. (BC Centre for Disease Control map)
14 months of COVID-19 data show Kamloops cases doubling Vernon’s

Jan. 1, 2020 to Feb. 28, 2021: 605 cases reported for Vernon, 243 for Salmon Arm, 1,246 for Kamloops

Penticton Fire Department pulled a kayaker from Okanagan Lake on Wednesday after he had fallen out of his boat and called 911. The man was taken to the hospital for treatment. (Western News - File)
Kayaker rescued from Okanagan Lake after falling in and calling 911

The Penticton Fire Department’s Marine Rescue pulled him out suffering from severe cold

The Greater Vernon Chamber of Commerce’s general manager Dan Proulx, left, hosted a virtual Official Opposition town hall meeting with Shadow Cabinet Minister Small Business Pat Kelly, right, and North Okanagan-Shuswap MP Mel Arnold March 3, 2021. (Screenshot)
Tourism key to business recovery in North Okanagan-Shuswap: MP

Easing travel restrictions, limiting taxation and debt management critical to COVID-19 economic recovery

Most Read