If you watch television, you’ve probably seen ads about the symptoms of a stroke and how to minimize the damage. The most important thing is to get help as quickly as possible. But, if you’re Indigenous in Canada, that help may not come in time.
We’ve all seen the headlines about the lower quality of care Indigenous people receive in Canada’s health system. We also know that women in general receive lower quality care than men – their concerns are often ignored and, until recently, health studies almost exclusively focused on men.
That means that in health care systems, as in so many systems in Canada, Indigenous women often face significant barriers to accessing the care they need and have a right to.
On an intellectual level, I knew the stories and statistics. Elders die in waiting rooms because medical staff assume they are intoxicated. Children are forced to fly from northern communities for medical care without their parents because of government policies. Women are forced to go to southern communities by themselves to deliver their babies alone. The systemic racism that Indigenous people encounter daily in Canada’s health care system has high prices: emotional and mental deterioration, negative physical health effects, even death.
But I had only learned of the stories through the news. I wasn’t personally affected by them. While I always felt empathy towards those affected and anger at the system, I didn’t know how to do more than express my disgust.
Then my work as an Indigenous editor brought home just how deep the problem is.
Fellow editors sometimes ask for my advice when they have questions about how articles or stories about Indigenous people are written. They might be concerned that the language is inappropriate or need to know about whether to use certain words.
I was recently sent excerpts from an article that was being submitted to a medical journal. My friend was concerned about the language and wasn’t sure whether it would be a problem. She recognized that there were underlying issues but wanted some feedback.
As far as grammar, there wasn’t really anything to worry about so I updated some of it to current usage. That was the easy part.
The problem came when I began to read the sections that my friend thought had deeper problems. And she was right. Without the doctor intending it, the article almost oozed subtle (and not so subtle) racism.
The article wasn’t about medical procedures. Rather, it was about treating Indigenous patients. Patients that he saw as uninformed and unwilling to listen to him even when their lives depended on it.
One of the biggest problems with many doctors who work with Indigenous people is their refusal to see alternatives to western medicine. And this doctor was no different. His attitude was that patients who wanted to work with him while using traditional medicine were backwards. He didn’t use that word, but his meaning was clear. He could or would not see any alternatives to his treatment. Even worse, I suspect he wasn’t even willing to discuss the topic with his patients.
This matters. The most recent numbers I could find were from several years ago. But between 2001 -2012, the health status of Indigenous adults across Canada deteriorated from 22% to 18%. I have two big issues with this statistic. First, a drop in health status by 4% in the 21stcentury is intolerable and devastating. But what I found even more shocking was that 22% is the baseline. How can any country accept this low number and not do everything in its power to change it?
Whether by design or accident, our health care system negatively impacts Indigenous Peoples. Health care on reserves and in northern Canada generally falls below what communities need. Non-Indigenous doctors and nurses sometimes don’t understand how to build the community relationships that will make it possible for them to effectively treat patients. Or they come for short-term contracts that don’t give them the opportunity to make those relationships.
Those who stay and become part of the community may have to deal with a shortage of supplies or the equipment they need to treat emergencies and more serious illnesses.
In urban areas, many doctors who treat Indigenous patients won’t even attempt to understand cultural differences. They don’t recognize that seeing a patient for 10 minutes every few months will not build the trust that is needed between an Indigenous patient and their doctor. Without that trust, some Indigenous patients will naturally go back to traditional medicines that have healed for thousands of years.
An even more inexcusable issue in urban settings is health care professionals who allow their prejudices to determine how they treat Indigenous patients. The result? Assumptions that Indigenous patients are drug addicts who only want painkillers to feed their addictions. Or deciding that patients who come to emergency departments are simply sleeping off a drunk and refusing to see if they have a deadly infection or are having a stroke. Or maybe believing that patients are looking for handouts and taking advantage of the medical system.
The result? Some of these patients die while sitting in emergency rooms waiting for somebody to care enough to look after them. Or they are sent home with serious medical conditions and later suffer serious, life-changing health problems. And yes, we know this happens to non-Indigenous people as well. But those cases are much rarer than those where Indigenous Peoples health care is ignored.
And the parts of the article I read for my friend were no exception to this issue of neglect brought on by stereotyping Indigenous patients. The doctor was subtly critical of his Indigenous patients who didn’t trust his advice on cancer treatment. Given his language, I can imagine that he might not take the time to fully explain his treatment plan. Rather, I can picture him telling his patients what they would do and then getting frustrated when they questioned him. Was this what happened? I don’t know. But I do know it is the reaction many minorities communities get whether it is in medicine, banking or education. Our systems are designed to favour western ideals to the detriment of all other perspectives.
I’m tired of hearing these stories. I’m tired of people dying because they are seeking medical help as an Indigenous person. I’m angry that those with the power to change our systems refuse to do so.
Sometimes I feel helpless in the face of that anger. But my experience with this particular article taught me something important.
Next week’s newsletter, Part 2 describes Rhonda’s calls to action regarding discrimination in the Canadian medical system.
You can also download this entire 2 part newsletter as a PDF by clicking here.
Rhonda Kronyk is a settler/Dene writing, editing and grant consultant. She lives on Treaty 6 lands in her adopted city of amiskwaciwâskahikan (Edmonton). As a member of the Indigenous Editors Association, she is working to change the Canadian publishing industry to ensure books that are respectful of Indigenous Peoples and culture are published. You can find her on her website or firstname.lastname@example.org. Follow her on twitter @ThisAndThatYEG
In gratitude of Rhonda’s time spent on this article for Women Warriors, a small donation was made to the non-profit organization, Books With Wings – Supporting Literacy in remote First Nations communities.
News stories pertaining to racism within the Canadian health care system:
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