Report details racism in health system
- Angela Hill | February 09, 2015
Topic is priority of Saskatchewan Human Rights Commission
The questions were asked quickly and loudly, what drugs are you on, what are you taking at home?
Rob McCallum was in the hospital with chest pain and initially health staff couldn’t figure out why. While he was waiting for results from the first set of tests, there was a shift change and another health-care worker came in.
“She kept going and didn’t even give me a chance to talk,” he said. “I was so angry, but I didn’t say anything.”
He believes the person was making assumptions because he is aboriginal.
Stories like these are ones that Dr. Janet Smylie has seen and heard throughout her career.
“I would hear people making assumptions about aboriginal people, like a teaching point of a resident was ‘these people have a lot of babies and don’t know how to care for them,’” she said.
Smylie and Dr. Billie Allan co-authored the recently-released First Peoples, Second Class Treatment report, that details racism within the health-care system in Canada.
It was published by the Wellesley Institute, a Toronto-based health research and policy group.
The report reads, “that 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 altogether.”
A study example was Brian Sinclair, the 45 year old who died of a treatable bladder infection in an emergency room waiting area of a Winnipeg hospital.
There are more examples Smylie can give, including the man in Iqaluit who was thrown in jail when he was having a stroke because police thought he was drunk.
“Those are the faulty logic things where people have stereotypes in their brain and then they make a wrong diagnosis,” Smylie said.
Discrimination is a far-too-common problem in Saskatchewan, according to Chief Commissioner with the Saskatchewan Human Rights Commission, David Arnot.
“We hear a lot of stories from people who have experienced discrimination in the health system, we have a lot of anecdotal evidence; we know it is a serious problem. Really, it’s a huge problem in Saskatchewan. It can’t be denied. It can’t be understated,” he said.
It is systemic discrimination that needs to be fixed by systemic advocacy, he said, and something the Saskatchewan Human Rights Commission is making a priority. Arnot said he has met with Federation of Saskatchewan Indian Nation’s chief Kimberly Jonathan and they share this focus.
The human rights commission is creating a plan, and Arnot said it will move to action during the next fiscal year.
“Everybody in the health-care system does not want to be tarred with the brush of having a system that they work in that’s in fact discriminant on a systemic basis. We know that,” he said.
“We also know that we need to work with them so that they have the tools and there are policies in place, so that people can make the right decision at the right time and not be seen to be, or perceived to be discriminatory.”
He said there are prominent members of the health community that are involved and want to do “social context education,” addressing racism, gender discrimination and aboriginal culture values.
Saskatoon family doctor and health-equity advocate, Ryan Meili, said there is increasing training and conversation around these issues, but more needs to happen.
“I’ve witnessed … people getting mistreated or spoken badly about because of their background, because of their race, because of the colour of their skin and it’s really inappropriate,” he said.
There needs to be more research into the area, he said. There needs to be questions asked, why is it happening, when does it happen, do health-care providers have enough time to provide a high quality of care, have they heard stories from people who have been discriminated against?
Smylie also said the research has only just begun.
“Unfortunately in Canada because we are so in denial, we are not asking about racism or tracking it,” she said.
Her study does point out that there are some promising responses. Smylie gives the example of an aboriginal-focused birth centre in Toronto.
Meili points to SWITCH and Westside community clinic in Saskatoon, where he said there is intentional attention to local cultures.
The Regina Qu’Appelle Health Region has developed a half-day aboriginal awareness training workshop, which all employees attend. It teaches treaty understanding, myths and misconceptions, representative workforce information and employer relations, said Michele Vogt, executive director of human resources.
The best care possible needs to include the recognition of cultural and spiritual needs, said Cecile Hunt, the CEO of the Prince Albert Parkland Health Region. She said they have done a few things to support quality care, including working to support the use of sweet grass.
“(There) is a collaboration between First Nations health-system providers and our own staff especially at the community level trying to provide care as close to home as possible.”
But it appears there is still some way to go – when Arnot read the Wellesley report, he said he found it to confirm their Saskatchewan evidence.
“It appears that … Aboriginal people do not access the health care system to the extent that they should, or could, or need to, based on feeling that they won’t be treated fairly,” he said.
“That is an element that is very worthy of noting,” because it is a consequent that hasn’t been discussed much.
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