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Systemic racism in First Nations medical care the subject of visit

UBC medical faculty dean is working for change
UBC’s Dean of Medicine, Dr. Dermot Kelleher, visited the Stellat’en First Nations where he spoke about the need for changes in the way medical services are provided to First Nations. (Tim Collins photo)

A visit to the Stellat’en Wellness Centre on the Stellat’en First Nation by Dr. Dermot Kelleher, the Dean of the Faculty of Medicine at UBC, along with a pair of students from his faculty, was heralded as an important event by First Nation’s leaders.

It was, they said, an important step in ending the systemic racism facing First Nations in accessing medical care in B.C.

“We are still dealing with 150 years of oppression, malnutrition, mis-education and the attempts to eradicate our culture. But one area where we seem to be making some progress, at least here at Stellat’en, is in medical care,” said Chief Archie Patrick, at the luncheon offered to the visitors from UBC.

“It’s so important that the health care system is aware of the kinds of problems we face on a daily basis. We are still in the midst of poverty, and poverty presents a whole series of challenges when it comes to all aspects of well-being.”

According to Dr. John Pawlovich, one of the four doctors who provide part time services to the Stellat’en Wellness Centre, the problems associated with poverty are exacerbated by a systemic racism in the provision of medical services to First Nations people.

“People hold a set of beliefs about First Nations people and carry that forward in the way they provide medical care. It’s often a hostile environment,” said Pawlovich.

“There is good research that shows that racism plays a role in providing First Nations patients with a sub-standard level of care. They don’t get the same tests, for example.”

Pawlovich went on to say that, when First Nations people get sick, they will often consider past negative experiences they or others have had, and will strategize about whether to even go to a health care facility for fear of continuing those negative experiences.

“That’s not a consideration you and I have to consider,” he said.

Kelleher echoed the concerns, and equated the health of First Nations communities to the health of the entire province.

“The way we educate our future doctors is critical to improving the provision of health care to First Nations,” he said, noting that the Faculty of Medicine has adopted a strategic plan to ensure that its graduates learn about more than illnesses in isolation of the person.

“We learn about heart disease, diabetes and cancer, but in the First Nations tradition, there are considerations of wellness and health that also embrace the environment, the spirit, economic factors…they all play a role, and we need to understand and respect that.”

As part of the efforts to develop that understanding, the Faculty facilitates visits by students to First Nations so they can gain a first hand appreciation of the challenges faced by their First Nations patients.

Privia Randhawa and Chelsea Monell are two first year student at UBC and came to Stellat’en with Kelleher. They are spending a week working at the Wellness Centre with Pawlovich to gain that first hand experience.

“This is a unique opportunity to be immersed into the community and develop the relationships that are at the heart of medical care,” said Monell.

“I know of situations in Prince George where First Nations people have left the community to look for health care elsewhere because of the racism they faced at home. I want to be part of changing that culture (in the medical community).”

Chief Patrick acknowledged the importance of building the relationships with the medical community and acknowledged that First Nations have a role to play as well.

“We have to wake people up from the pall of negativity that 150 years of oppression has put over our people and work to show government that we have basic needs that need to be met. We need jobs – we need homes to live in – and we need health care. And my hope is that we will get there,” he said.

“This is a start.”

For Kelleher’s part, he referred to his own experience dealing with decades of oppression by a colonial power in Ireland, and referred to the Irish poet, William Butler Yeats, and his poem, Gratitude to the Unknown Instructors, for inspiration on what can be accomplished.

The poem reads “What they undertook to do, They brought to pass; All things hang like a drop of dew, Upon a blade of grass”.

“It’s the promise in that drop of dew that can bring all things to pass,” he said.