Metis reports chronicle racist incidents
Metis Nation papers chronicle anti-Indigenous actions in hospitals
Provincial Health Minister Adrian Dix says he hadn’t seen reports from March 2019 that came to light last week detailing systemic racism against Indigenous people in the B.C. health-care system.
The reports were released by Metis Nation B.C. and detailed both overt and surreptitious acts of anti-Indigenous racism.
The first, called Mapping the Harms of Anti-Indigenous Racism in the B.C. Health Care System, “was not a report that was brought to my attention,” the minister said on Monday.
The second, called Dismantling Anti-Indigenous Racism Within the Health Care System, includes 83 recommendations to eliminate racism. It’s still in draft form, Dix said.
In one case — which the first report said showed inequities perpetuated by health-care institutions that ignore poverty, inadequate housing, food insecurity and other health issues — an Indigenous man was discharged from hospital after surgery with no consideration of his living conditions. He slept on a mattress on the floor, and had no cooking or laundry facilities.
“He had a new colostomy which he was learning to master and it would sometimes pop off, so it was difficult to keep bedding clean,” the report heard from a health-care worker.
“I advocated that more time was needed in the hospital for the man to recover from the surgery and master the colostomy, and pointed out that he would not be able to manage OK at home due to his living environment.”
The surgeon discharged the man anyway.
“The dominant culture was totally at play here focusing on efficiency in the institution ... expecting the patient to manage on his own.”
The report was prepared by the Anti-Racism Think Tank, convened by the Provincial Health Services Authority, Aboriginal Health, and was based on analysis of the San’yas Indigenous Cultural Safety Training Program’s participant data.
Those participants were people who work across the provincial health-care system and had taken the San’yas Core ICS Health, Mental Health, or Foundations training, a program created 14 years ago to increase cultural sensitivity among health workers.
In some cases, witnesses told of people in health services shaming
Indigenous patients, dismissing them, or treating them as if they did not deserve care.
One said: “I remember a lady coming in, quite nauseated and vomiting, and someone said, ‘Must be drunk again.’”
In fact, the woman had not been drinking.
“She had cancer and chemotherapy was making her very ill. I never hear these comments for a white person.”
In other cases, Indigenous patients were not believed when they described their symptoms.
“One young (First Nations) mother came in with abdominal pain,” one nurse said. The nurse on the previous shift told her the woman did not look like she was in pain.
“This comment made me so angry — to be denied pain medication when in pain is awful. It turned out she was full of cancer when they finally transported her to a higher level of care and she died soon after.”
That was an instance of prolonging pain and suffering that could have been stopped, the report said.
Other definitions of needless harm being done, besides death and prolonged suffering, include individuals isolated from their families, coercion to participate in a treatment, and emotional, psychological, or spiritual harm.
I remember a lady coming in, quite nauseated and vomiting, and someone said, ‘Must be drunk again.’ ... She had cancer and chemotherapy was making her very ill.
More than a year ago, three dozen health-care leaders met in Vancouver for a daylong think-tank on anti-Indigenous racism within the health-care system.
The March 12, 2019 session began with the airing of examples of racism, drawn from more than 250 horror stories told by health-care workers during earlier training sessions on Indigenous cultural safety.
“These examples may be difficult and emotionally challenging to read,” said a cautionary note at the outset of the covering report on the harms done by anti-Indigenous racism. “For Indigenous people with lived experience, the examples may be familiar, and reading them can be difficult. If you find the material challenging please take breaks, talk to someone you trust. For non-Indigenous people, the examples may be discomforting and we ask that during today’s anti-Indigenous think-tank that you sit with this discomfort and remain engaged in the discussions.”
One example: “An Aboriginal woman came in as a trauma patient who required extensive surgery that lasted most of the night. As we were giving her a post-op bath (thinking she was still under anesthetic) a racist remark was made at her bedside. When I looked, she had tears in her eyes. I was mortified and it was too late. The damage was done.”
Two: “Working with nurses and doctors and various administrators I had to endure multiple negative comments about one remote community: ‘Oh that community is the dog’s breakfast!’ — from a senior rep in health. ‘Nobody wants to work in that community! It isn’t safe. There are too many addicts. Nobody can work there alone!’ This made it extremely difficult to recruit new providers to a community that desperately needed and wanted them. The stereotypes were based on an incident that occurred nearly 30 years ago.”
Three: “I have heard many negative things said in my career but one that was especially horrible was when an Indigenous client was pregnant with her fifth child and a co-worker stated, ‘God, when are they going to sterilize her already? Great, another kid we are going to have to support.’ What bothered me the most was not only what she said but that I let her say it.”
Four: “I was on shift (in the emergency department) when an Indigenous lady came in with slurred speech and an altered gait and was put on a stretcher away from the line of sight because the triage nurse assumed she was just drunk, despite no charted history of substance abuse. It turned out that this poor woman had had a stroke and had significant delay in being provided care because of the triage assessment.”
The think-tank followed those and other examples with a daylong discussion on the factors that contribute to racism and how they could be dismantled.
The final report — Dismantling Anti-Indigenous Racism Within the Health Care System — includes 125 observations on the contributing factors, plus seven major recommendations and 83 suggestions for dismantling racism.
The 35 participants, not named individually in the report, included representatives from the sponsoring Provincial Health Services Authority. Plus there were leaders from the Health Ministry, several health regions and Indigenous groups.
On Friday, one of the latter groups, the Métis Nation, released the two reports from the think-tank on anti-Indigenous racism.
At the same time the Métis made public an explosive allegation arising out of a more recent training session — about a game where staff in the emergency room were guessing the level of intoxication of patients, particularly Indigenous people.
Métis Nation CEO Daniel Fontaine cited the think-tank reports on anti-Indigenous racism as evidence that the guessing game wasn’t an isolated concern. He noted the apparent lack of a comprehensive response by the government to concerns that were circulated as far back as March 2019.
That assessment was confirmed Monday by Health Minister Adrian Dix himself. He said he hadn’t seen either report before the Métis Nation released them Friday.
The first of the two, detailing the above-quoted harm done by anti-Indigenous racism, was circulated internally within the system.
But the second and larger of the two was still only a “draft” that hadn’t yet been released publicly, according to Dix.
This despite a title page describing it as “the final report of the 2019 think-tank on anti-Indigenous racism,” conducted some 15 months ago.
So, no accusing the healthcare system of a rush to judgment in responding to all those recommendations and suggestions for dismantling anti-Indigenous racism.
Now that the Métis Nation has pre-empted the release of the “draft” report, the group is seeking input into the terms of reference for the review of the allegations.
Indigenous leaders endorsed Dix’s choice of Mary Ellen Turpel-Lafond, the former child and youth representative and now professor of law at the University of B.C.
But Fontaine says her terms of reference ought to include protection for health-care workers to come forward and testify.
He cited an example that came to his attention over the weekend: an unnamed former ER nurse who says she tried to blow the whistle on a guess-the-level-of-intoxication game. Health authorities failed to act and she was fired and given severance in exchange for a non-disclosure agreement.
Dix expects Turpel-Lafond to consult the Métis Nation and other Indigenous leaders on the terms of reference. But he also says “certainly, yes,” there will be protection for whistleblowers.
He noted the apparent lack of a comprehensive response by the government to concerns that were circulated as far back as March 2019.