Group tackles racism in health care

Opinion

Hey there, time traveller!
This article was published 26/09/2017 (2932 days ago), so information in it may no longer be current.

Anti-Indigenous violence is a national emergency and Winnipeg is ground zero.

This was one observation of an event held in a packed room at the University of Manitoba last week to launch the interim report of the Brian Sinclair Working Group, titled Out of Sight. The group includes physicians, nurses, health and social science researchers, and lawyers whose expertise is in the field of Indigenous Peoples’ health. Out of Sight documents the role racism played in the death and inquest of Brian Sinclair, an Indigenous man who died nine years ago of a treatable bladder infection after being ignored in a Winnipeg hospital waiting room for 34 hours.

At the event, our group discussed significant points where indifference led to a failure to care for Sinclair and we identified how the inquest that followed failed to make Indigenous people safer in hospitals.

To view the report, see one of the following websites: libguides.lib.umanitoba.ca/indigenoushealth/ForBrian or ignoredtodeathmanitoba.ca. To watch a recording of the event, see: talbot.cc.umanitoba.ca/legacy/bann/med/racism_forum_2017_09_18/

Very rarely is racism acknowledged as a factor in Indigenous deaths and certainly this is the case for Sinclair. UCLA professor Sherene Razack, who spoke at the event, has reviewed many deaths of Indigenous people in custody and the inquests that followed. She found, in fact, that when the topic of racism is broached, people “go into overdrive” to explain how race was not a factor in the death: “You can’t talk about racism when it doesn’t exist.”

Instead, some Indigenous people are depicted as already on the brink of death and therefore difficult, if not impossible, to care for. We need to focus on those who fail to treat people, she argues, and the places that condone a refusal or lack of acknowledgement of needed care; we need to study how and why “empathy is blocked.”

For answers to these questions, Razack argued that turning to large systems and to concepts such as “bias” is unhelpful. We need to look to our colonial history and how that history shapes our actions and perspectives today. In Canada, it’s as if we see that those best able to manage land and resources are people who are not Indigenous. Indigenous people, on the other hand, are seen by some as not up to the challenge of modern life.

This difference reflects a hierarchy, and in all places where all lives do not count for the same, there are some who are treated as humans and others as sub-humans; this operates in all governments where all lives do not count equally. “Right now,” Brian Sinclair Working Group member Dr. Barry Lavallee emphatically stated, “racism is going on in hospitals in the city.” Many in attendance agreed.

The group made recommendations that focused on building anti-racist policy, improving education, and making institutions and staff accountable for racism in the health-care system. In the discussion that followed, several suggestions were made to enact changes in the health-care system that would encourage commitment and accountability to quickly change and improve Indigenous patient safety.

One suggestion was to gather evidence of racism in order to be able to identify and demonstrate when and where Indigenous people are being treated differently. Currently, there is no accountability for racism in the health-care system, so we need to establish a way to make this happen. For example, critical incident legislation can be changed to include experiences of racism that are independently investigated on and reported to the public. Moreover, we need to measure the health system’s performance by including race as a variable to indicate racial inequities and gaps in care in order to prevent patient deaths.

In addition, health governing boards in the WRHA do not have adequate Indigenous representation, with the WRHA board of directors and some hospital boards with no self-identifying Indigenous members at all. This is despite the fact that the WRHA estimates that at least (and likely more than) 40 per cent of patients accessing health services across the system and across the region at any given time are Indigenous. Those boards should not be able to meet without Indigenous representation.

Significantly, after the event, the CBC and the Winnipeg Free Press both reported that Winnipeg Regional Health Authority interim CEO Réal Cloutier acknowledged the need to address the issue of systemic racism.

“We all know Mr. Sinclair’s death was preventable, and we failed Mr. Sinclair as a health-care system,” Cloutier said.

“We need to understand that the perceptions we have, the assumptions we make about people all impact about how we deliver care to individuals, and we really have to come to terms that systemic racism has (an impact) on the way we deliver health-care services.”

While this is obvious to the group, until now it seemed that the WRHA has found this basic truth to be too provocative to accept and address. If Cloutier’s statement truly reflects the WHRA’s current mindset, that is promising.

The WRHA has finally opened the door to accountability on the issue of anti-Indigenous racism and its impact on patient safety. Changes can and should be made immediately. We can all look forward to seeing the changes that this accountability will drive and examine the WRHA’s record next year on the 10th anniversary of Brian Sinclair’s death.

Mary Jane Logan McCallum is a professor of history at the University of Winnipeg and a member of the Brian Sinclair Working Group

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