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1. RACISM AND MARGINALIZATION

In our interviews we heard stories of explicit racism being exhibited by health care providers within Eastern Health.

 

➤ Racism

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This Inuit patient supporter had this to say about a nurse she had encountered at one of the Eastern Health hospital sites:

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Anti-Indigenous racism can be expressed in many ways. In addition to the above examples, we also heard about other forms of marginalization, described below.

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➤ Marginalization

Aside from explicit discrimination, we heard stories of marginalization. Here, we use the concept of “marginalization” to describe the process of social exclusion in which individuals or groups are denied economic, political, or symbolic power and are treated as outsiders. When asked for specific examples to explain discrimination in the hospital system, the APNs explained the subtle ways in which discrimination can be manifested: 

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Similarly, the experience of being discriminated against through marginalization was explained by this patient supporter:

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Speaking in reference to the APN office (which has since been moved to a larger space in a location that it is more easily found by patients) one patient/supporter said:

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A second patient/supporter also made reference to the APN office space in his comments on systemic racism and marginalization within Eastern Health and the province in general. He referred to the lack of windows in the APN office, the fact that the APN office is out of the way and hard to find, and the province’s ongoing practice of removing children from Innu communities and fostering with white
families, as examples of ongoing systemic discrimination. He referred to the entire system of discrimination as a “big blanket”.

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Marginalization was thus experienced in many ways, from subtle microaggressions to systemic prioritization of settler norms and values.

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➤ Patient perceptions of under-resourcing of the APN program

Apart from the comments by patients and patient supporters about the APN office space as a symbol of the marginalization of Indigenous peoples in general, resourcing of the APN program was not raised as a problem to us by the APNs or by other frontline staff or decision makers. However, we were struck by the number of comments we heard from patients, patient supporters, health care providers, and EH decision makers about how the APNs were going “above and beyond” and “far beyond” their duties. While this language was meant to positively convey how very committed the APNs are, this praise also signaled, for us as outsiders, a likely need for greater resourcing of the APNs.

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"I heard a lady about a month ago got called a savage ... It’s hurtful, it’s hateful, and as you I’m sure you know this as well as anybody else, we’re outnumbered big time and they choose their own ways and that’s it ... It’s almost like we’re told .... 'Either you shut up or put up and whether you like it or not this is how we’re going to treat you'." [Indigenous patient 3: Inuit woman – patient and patient supporter]

"When my child was admitted to the Janeway, the admitting nurse was speaking very loud and slow at my mother who was there with my child and I. It was very condescending, and the admitting nurse was acting like my Mum was deaf and stupid. It was insulting to be treated that way. Cultural competency training should be a requirement by all eastern health staff." [Anonymous respondent, Indigenous patient survey]

"I had an allergic reaction and was broken out in hives while at the Psychiatric Short Stay Unit. The doctor accused me of being a sex trade worker because I am an Indigenous woman. She said 'Many women like you are sex trade workers' – I'm a university educated woman who has been working with [names field of employment] for the last 6 years. She accused me of having herpes all over my body due to working in the sex trade. I explained to her that I am a [names field] employee, happily married in a monogamous relationship, and she said it's probably herpes all over my body. I asked for a second opinion and the next doctor confirmed what I had believed – that I had allergic hives on my body. It was insulting to be accused of being a sex trade worker because I am Indigenous. This is just one example of how some staff at Eastern 41 Health have treated me like an inferior person because of my ethnicity." [Anonymous respondent, Indigenous patient survey]

"A lot of them I find are still ignorant about Aboriginal people ... I was here for an appointment, and when buddy was there talking and talking to me he said “Don’t mind me talking missus”, he said, “I can talk a leg off an Eskimo”. And I said well “We’re not called Eskimos no more, we’re called Inuit and Innu” ... That was here at the Health Sciences [Centre] not even a year ago probably .... And [the man] didn’t say sorry or “Oh my gosh” or didn’t feel bad about it at all. Then I went out the door and he told me to go one way and I went the other way and he said 42 'You don’t take directions very well either'. So I mean there’s still racism going on." [Elder, Advisor to project]

"It’s just the way that they act ... Like you just know by their actions and the way that they speak to you, the way they look at you." [APN]

"There were four patients in [the hospital room] including my husband, and I was there and this doctor came in ... My husband was the only patient that was there from the north coast and the other three patients were from Newfoundland ... And the first patient he went to see – he was there talking to him good, and asking him how he was and telling him whatever, and then he went to see the patient across from him and the same thing, like, you know, just asking him questions, being really nice and stuff like that. And then when he came over to the section where my husband was, it’s like his attitude changed, I noticed that ... We could tell right away his attitude was different toward us. He was speaking to us but he wouldn’t let us speak, something like that. Like when we tried to ask a question he would just, like, ignore us, he wouldn’t listen to us, so I noticed that right away. So what I did, I tried to, like, I butted in and tried to ask him a question and he wouldn’t even hear me or, like, he wanted to like shut me up or something ... And my husband got really, what do you call, discouraged or felt really bad and he just wanted to leave the hospital. He didn’t want to stay there and stay at the hospital anymore because of how he was being treated." [Indigenous patient 6: Inuit woman – patient, patient supporter, and interpreter]

"I mean, two of them are in one office and I mean like when you got sit down you’re – there’s very little room, I mean you got three people in a tiny little room, and I bet you the room was probably no more than 8 x 8 probably, or 8 x 7, it’s not a very big space ... I could be wrong but I think the reason why they’re shoved in a little closet – I would say they’re supply rooms or janitor rooms – and I could be wrong, I mean I’m not a person to put anybody down, but I think when it comes to the Indigenous people, like we’re looked at abnormal when it comes to the higher offices ... In the other office rooms in [Health Sciences Centre], I mean [staff are] out in the middle with glass doors and this and that – they sees everything. What Katie and Sol is in, they don’t see nothing." [Indigenous patient 5: Qalipu man – patient and patient supporter]

The big blanket, you know ... How do you tear the blanket? You can’t do it. There’s a lot of change to be done and we don’t have [Innu] police officers, that kind of thing. We have social workers whose hands are tied because they got to go by the system. We have RCMP go with [i.e., side with] the social workers when they apprehend kids or go to people’s houses. The justice system because ... the judges, right, we aren’t looked at as well educated. Because that’s the system they’ve created, we’re assumed to be criminals, and looked at in all sorts of ways ... [It’s] racism by the police, by the government, you know. [Indigenous patient 1: Innu man – patient, patient supporter and interpreter]

"My perception is they’re doing a lot more than navigating – like, they’re going to the airport picking people up, that was never the intent of their job but they are working way outside the scope of a traditional navigator. People really rely on them because of cultural, not even language barriers, right, and their roles obviously weren’t meant to do that kind of thing. The Native Friendship Centre [First Light], that’s more their role because they provide a phenomenal support and because they have transportation vans that come back and forth. I mean there’s not an hour of a day I’m sure they’re not parked in front of the Health Sciences [Centre] picking up and dropping off people; but because I think Katie and Sol are so integrated into acute care, people really rely on them very strongly. They’re very busy. [Participant and another EH Decision Maker] worry about them a lot actually. [We] monitor and help support them in any way we can. They’re awesome people." [EH decision maker 3]

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