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

Fire Chief Darren Hughes, right, pulls the old Firemans Park sign off ahead of the parks name change. The new sign for Firefighters Park is coming. (Oak Bay Fire Department Twitter)
Oak Bay changes the name of Fireman’s Park

New sign for Firefighter’s Park on the way

The WHL’s Victoria Royals will compete in a 24-game season starting March 26, <strong></strong>based out of a Kamloops and Kelowna B.C. division bubble (Kevin Light/Courtesy Victoria Royals)
‘Important to cherish every moment’: Victoria Royals not taking bubble season for granted

The Victoria WHL team’s coach and GM calls the season a ‘privilege,’ expects fierce rivalries

Friends have identified the man killed in Friday’s shooting in Metchosin as Shane Wilson. (Shane Wilson/Facebook)
West Shore RCMP continue to investigate shooting death in Metchosin

Man killed on Sooke Road Friday night identified by friends

The Victoria Fire Department was able to contain a fire to one room after a bed placed directly against a heater ignited. (Black Press Media file photo)
Early morning Victoria balcony fire causes $20,000 in damages

Victoria Fire Department said nobody was injured in the fire on View Street

Postmark Group, an Edmonton-based development firm, bought two properties at 6641 and 6643 Sooke Rd. last year, and is reaching out to the community and local groups for feedback before they begin planning the designs for the development. (Photo contributed/Postmark Group)
Waterfront village development eyed for Sooke

Postmark Group development firm bought two properties at 6641 and 6643 Sooke Rd. last year

Const. Nancy Saggar, who has 11 years in policing, offers advice for other women who may pursue both policing and family. (Black Press Media file photo)
Pregnancy prompts sage advice from RCMP officer for women thinking about policing

West Shore constable with 11 years experience heads off on maternity leave

Cottonwoods Care Home in Kelowna. (Google Maps)
New COVID-19 outbreak at Kelowna care home includes fully vaccinated seniors: Henry

Two staff and 10 residents tested positive at Cottonwoods Care Centre

Excerpts from a conversation between Bria Fisher and the fake truLOCAL job. Fisher had signed a job agreement and was prepared to start work for what she thought was truLOCAL before she learned it was a scam. (Contributed)
B.C. woman warning others after losing $3,000 in job scam

Bria Fisher was hired by what she thought was a Canadian company, only to be out thousands

Provincial health officer Dr. Bonnie Henry and Health Minister Adrian Dix provide a regular update on the COVID-19 situation, B.C. legislature, March 2, 2020. (B.C. government)
B.C.’s COVID-19 cases: 545 Saturday, 532 Sunday, 385 Monday

Focus on Prince Rupert, Lower Mainland large workplaces

Rising accident rates and payout costs have contributed to billion-dollar deficits at ICBC. (Comox Valley Record)
B.C. appealing decision keeping ICBC injury cases in court

David Eby vows to ‘clip wings’ of personal injury lawyers

Hannah Ankenmann, who works with k’awat’si Economic Development Corporation, winces as she received her first shot of the Pfizer vaccine administered by a Gwa’sala-‘Nakwaxda’xw Family Health nurse. (Zoe Ducklow photo)
Vancouver Island’s small remote towns to get community-wide vaccine clinics

Island Health to take a wholesale approach to immunization, rather than age-based appointments

Anyone with information is asked to call Nanaimo RCMP at 250-754-2345 or contact Crime Stoppers by calling 1-800-222-8477 or submitting a tip online at www.nanaimocrimestoppers.com.
21-year-old motorbike rider dies after crash with ATV on Nanaimo back road

Incident happened Sunday afternoon near Boomerang Lake

(Black Press Media files)
Hosts charged, attendees facing COVID fines after Vancouver police bust party at condo

Police had previously received 10 complains about that condo

Most Read