POLL: Racism still alive in Canadian health-care system: study

“I think we have received concerns from First Nations patients. Most of their concerns have been on the quality of care that’s been delivered. They may see concerns about cultural competency as part of the issue and we need to continue to explore ways to improve the care,” she said.

She said when they receive these complaints, like any other, they would investigate and look at options to improve service.

“Our organization continues to work at ensuring all patients receive services that are culturally appropriate and that they’re treated with respect and dignity,” she said.

According to one First Nations family, this is something their brother didn’t get.

William (Billy) Ballantyne was pronounced dead in a police cell in November 2012. A coroner’s inquest revealed that he was taken to the Victoria Hospital from his home for stomach pains and confusion, which upon his death was discovered to be caused by an accidental acetaminophen (Tylenol) overdose.

Ballantyne waited several hours to be seen by a physician and had become increasingly disorientated because of his condition. Before he had a chance to be assessed, he was taken to the police station because he appeared to be disrupting patients asking them for cigarettes. This is something his sisters don’t believe, and in December 2014, said they weren’t happy with how he was treated.

“My brother was not the kind of person to make noise, like he keeps to himself. He’s not the kind of a person that would go in and make a ruckus anywhere,” said sibling Blanche Naytowhow in December.

“Right from the ambulance, he was labeled as a drunk I guess you could say, a homeless person. They didn’t know him. They didn’t know he had a life, they didn’t know he had kids … They just assumed, just as soon as he walked into like, I don’t know if I should say this but, ‘this is just another Indian coming in that needs a fix.’”

Kimberly Stonechild, a lawyer who spoke on behalf of the family at times during the inquest, acknowledged there was no direct evidence from the inquest that linked Ballantyne’s appearance to his treatment, but said it may still have played a part.

“From the proceedings we heard that if a little bit of extra time was taken for Billy, if his concerns were taken seriously, perhaps if he wasn’t labeled as an intoxicated individual, if that one further step had been taken,” the severity of his condition could have been caught, she said in December.

Stonechild requested the jury make a recommendation relating to cultural awareness to prevent something like this from happening again.

“When speaking with the family I think everybody agrees that you can receive sensitivity training for your employment, but that doesn’t mean you incorporate it in your day-to-day practices.”

The Coroner’s inquest did not provide recommendations around the family’s concerns.

The jury’s recommendations:

-The police not remove patients from hospital when there are no public safety concerns without consultations with a medical practitioner

-Triage nurses be provided with an assistant to help meet time guidelines for patient reassessment and quality of care

-Whenever police find that any person in custody presents a medical abnormality they are unequipped to address, contact the sergeant so appropriate medical response can be facilitated

Hunt said the PAPHR is continuing to explore the response to the recommendations and have already changed the policy relating to the physician’s assessment of patients before they leave the facility.

“That happened almost immediately after Mr. Ballantyne’s very unfortunate death,” Hunt said.

She recognizes shortfalls in the PAPHR when it comes to accommodating First Nations needs, such as a translator that is available 24 hours a day. “That’s a gap in our service and we are exploring alternatives to improve access to language services.”

She said there isn’t enough space to support First Nations families during big events in a patient’s life such as post-partum or those facing death. She hopes that will change and improve in the future.

“We know that that’s also critically important to the remainder of the public we serve, but there are some specific needs of our First Nations’ patients who often come from far distances and may need to stay additional days because of access to flights,” she said. “We need to think through how we can be more supportive.”

The study does outline different ways Canadian health-care systems are working to make health care more available on First Nations and “mitigate the impact of racism” and the PAPHR is one of them.

“We do have, as an organization, mandatory aboriginal awareness and compassionate training for all new staff members,” Hunt said. “Our aboriginal awareness program … attempts to give new staff an awareness of the cultural issues of our aboriginal patients and the impact on the health services that we deliver.”

In addition, there is community focused care on the Ahtahkakoop Cree Nation and Big River First Nation where a nurse practitioner provides care. “So that’s, you know, one step in partnership with our First Nation[s] partners.”

Hunt said they also provide support for sexual health services in Muskoday First Nation and mental health services in several other First Nation communities throughout the health region.

“But we recognize that we have work that needs to continue, we have to continue to support staff and our physicians in understanding First Nations’ cultures and traditions. We also need to ensure First Nations families are aware that their spiritual needs can be facilitated in our building,” she said, noting they allow the smoking of sweet grass in the building.

“One of our very important next steps is around continued discussion with First Nations’ leadership and First Nations’ health-care providers. These individuals are key in assisting us to develop patient and family-centered systems that are responsive to First Nations’ values and spiritual beliefs.”

In the Mamawetan Churchill River Health Region, director of communications Elaine Kaloustian said they also follow the cultural training.

However, she doesn’t feel the health region would have as much of an issue with race as other health regions in the south.

“In our region because 85 per cent of people are aboriginal, that’s our population and that’s kind of our services, and maybe that’s a little bit different than some of the places in the south because of that,” Kaloustian said.

In addition, she said a lot of their staff are from the area.

“We have a nursing program in the community too, there‘s a lot that can feed from that.”

What’s next?

According to the study, several things need to happen to improve First Nations’ health care.

It said there has to be shift in how matters of racism and racialization are handled by social institutions beyond the health-care system.

“We must accurately apprehend and engage the realities of our shared physical and societal landscape. This requires a fundamental acknowledgement of the historical and ongoing colonization of [i]ndigenous people,” it stated.

Data collection must also be undertaken because the current population health data for indigenous people in Canada is limited.

“Data challenges pose a significant barrier to improving Indigenous health generally and for understanding the impact of racism specially,” it stated. “Meaningful data is critical to understanding and addressing the role of racism in the health disparities experienced by [i]ndigenous people.”

-With files from Chelsea Laskowski

sstone@panow.com

On Twitter: @sarahstone84

by Sarah Stone

POLL: Racism still alive in Canadian health-care system: study

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