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

  • Jun. 23, 2020 12:00 p.m.

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 – Wet’suwet’en hereditary chiefs have agreed to sign a memorandum on rights and title with B.C. and Ottawa, but elected chiefs are demanding it be called off over lack of consultation. (Thom Barker photo)
Wet’suwet’en hereditary chiefs, Lake Babine Nation get provincial funding for land, title rights

Government says it’s a new, flexible model for future agreements between Canada, B.C. and First Nations.

Kieran Christison, manager of Daybreak Farms in Terrace inspects eggs on Oct. 30, 2020. Christison wants to transition to a zero waste, cage-free facility. (Black Press Media File Photo)
Daybreak Farms aiming to achieve zero-waste, cage-free facility

Kieran Christison, manager, presented the farm’s future plans to Terrace city council

Mercedes Trigo, assistant manager, said that Trigo’s Lifestyle Store in Terrace has experienced four broken windows and an attempted break-in recently, leaving her feeling unsupported by bystanders and the police. (Ben Bogstie/Terrace Standard)
Trigo’s management frustrated by property damage, theft

In a little over a month there have been four broken windows and an attempted break-in at the store

Two RCMP officers have been recognized for their actions in responding to an incident involving a man with a weapon at 4501 Park Ave. on the afternoon of April 27, 2020. RCMP say it was an isolated incident and there is no danger to the general public. (Jake Wray photo)
Terrace RCMP officers recognized for acts of bravery

Two involved in arrest of armed suspect

Vancouver resident Beryl Pye was witness to a “concerning,” spontaneous dance party that spread throughout social groups at Kitsilano Beach on April 16. (Screen grab/Beryl Pye)
VIDEO: Dance party erupts at Vancouver’s Kitsilano Beach to the dismay of onlookers

‘It was a complete disregard for current COVID-19 public health orders,’ says Vancouver resident Beryl Pye

A syringe is loaded with COVID-19 vaccine at a vaccination clinic run by Vancouver Coastal Health, in Richmond, B.C., Saturday, April 10, 2021. THE CANADIAN PRESS/Jonathan Hayward
B.C. to open up COVID vaccine registration to all B.C. residents 18+ in April

Registration does not equate to being able to book an appointment

(Black Press file photo).
Multiple stabbings at Vancouver Island bush party

Three youths hospitalized after an assault in Comox

Selina Robinson is shown in Coquitlam, B.C., on Friday November 17, 2017. British Columbia’s finance minister says her professional training as a family therapist helped her develop the New Democrat government’s first budget during the COVID-19 pandemic, which she will table Tuesday. THE CANADIAN PRESS/Darryl Dyck
B.C. finance minister to table historic pandemic-challenged deficit budget

Budget aims to take care of people during pandemic while preparing for post-COVID-19 recovery, Robinson said

Each spring, the Okanagan Fest-of-Ale is held in Penticton. This year, as a result of the COVID-19 pandemic, the festival will not be held. However, beer is still available. How much do you know about this beverage? (pxfuel.com)
QUIZ: How much do you really know about beer?

Put your knowledge to the test with this short quiz

Lord Tweedsmuir’s Tremmel States-Jones jumps a player and the goal line to score a touchdown against the Kelowna Owls in 2019. The face of high school football, along with a majority of other high school sports, could significantly change if a new governance proposal is passed at the B.C. School Sports AGM May 1. (Malin Jordan)
Power struggle: New governance model proposed for B.C. high school sports

Most commissions are against the new model, but B.C. School Sports (BCSS) and its board is in favour

Pall Bearers carrying the coffin of the Duke of Edinburgh, followed by the Prince of Wales, left and Princess Anne, right, into St George’s Chapel for his funeral, at Windsor Castle, in Windsor, England, Saturday April 17, 2021. (Danny Lawson/Pool via AP)
Trudeau announces $200K donation to Duke of Edinburgh award as Prince Philip laid to rest

A tribute to the late prince’s ‘remarkable life and his selfless service,’ the Prime Minister said Saturday

B.C. homeowners are being urged to take steps to prepare for the possibility of a flood by moving equipment and other assets to higher ground. (J.R. Rardon)
‘Entire province faces risk’: B.C. citizens urged to prepare for above-average spring flooding

Larger-than-normal melting snowpack poses a threat to the province as warmer weather touches down

Vancouver-based Doubleview Gold Corp. is developing claims in an area north of Telegraph Creek that occupies an important place in Tahltan oral histories, said Chad Norman Day, president of the Tahltan Central Government. (THE CANADIAN PRESS/HO)
B.C. Indigenous nation opposes mineral exploration in culturally sensitive area

There’s “no way” the Tahltan would ever support a mine there, says Chad Norman Day, president of its central government

Most Read