LOOK AT US NOW: PODCAST TRANSCRIPT

Carae: Hey there! You’ve stumbled onto a brand-new episode of “Look At Us Now”, the podcast where BIPOC women look – and talk back – to the world.

Whether you’re a part of the of the BIPOC community or looking to be an ally you’ve stopped at the right place. Today, we’re going to be about Transnational Feminist Healthcare, asking the big question – what could a transnational feminist healthcare system look like in the time of COVID-19? We can’t talk about this without thinking about collective care, so that will be another central piece!

In this episode, we bring in guest host Anam Samdani, another curious BIPOC woman ready to go beyond the status quo when it comes to serving, protecting and advocating for our bodies. Are you ready? We’re looking back in 3…2….

Carae: Hi there everyone! I’m Carae Henry, and welcome back to another episode of Look at Us Now. Today, I’m joined by an awesome guest.

Anam:  Hey there – it’s Anam Samdani and I’m excited to be here for today’s topic. Especially in the current pandemic, reimagining health care is so critical. So, let’s get into it. COVID-19 has been a unique experience for all of us, but it’s been especially challenging in areas with large populations of Black, Indigenous and People of Colour. I remember looking at data from a recent Statistics Canada report that revealed in these communities where 25% of the population is a visible minority, the mortality rate for COVID-19 was nearly tripled compare to the communities where less than 10 percent were visible minorities^[1].

Carae: I mean that’s tough but isn’t that the pattern that we’re used to though? In Canada, we can look to the ways that Indigenous communities have been dismissed by the healthcare system. When we look closely at Indigenous communities, their risk for contracting COVID-19 is much higher, but this is not new. Most recently, the pH1N1 pandemic in 2009 showed that First Nations people had a three to eight-fold elevated risk of death from respiratory illnesses or influenza; and this is pretty similar to the corona virus^[2]. The health issues that heightened their risk still exist today – that’s high rates of diabetes, high blood pressure, asthma, breathing problems, and cancer^[3].

Anam: But you know, if we’re going to talk about this whole issue of Indigenous health gaps or disparities, we can’t leave out the bigger piece of settler colonialism. It’s a term we may be familiar with – meaning efforts to exert control over and erase Indigenous peoples as the original settlers of a land – but what does it look like in the lived reality^[4]? If we put it into simple terms, the death of the Indigenous person is absolutely necessary for the livelihood of the colonizer^[5]. This means that everything, and I mean everything in colonial states like Canada becomes implicated in this story. Indigenous health is a threat to colonization, so it makes sense that past pandemics have done so little to preserve Indigenous life.

Carae: That’s such an important lens to be looking through Anam, because it’s at the heart of so much intergenerational trauma that has compromised Indigenous persons today. Colonization is a social determinant of health, in the same way that low income, education and living conditions are. We may even say that it’s the actually primary social determinant of health because resulted in low income, a lack of education, and often insufficient housing and even lack of access to food. And what has COVID-19 done? Its cut income, strained education and placed a burden on those with inadequate housing. So, between the legacy of colonization and the demands of the coronavirus, our Indigenous communities are being suffocated here.

Anam: I want to go a bit more into racism and barriers to healthcare for Black and Indigenous folks. Current conversations around healthcare for BIPOC folks is discouraging right? You would think that after nearly a decade of training, the people with the power to hold the scalpel would at least be properly equipped to do so, right?

Carae: I mean that’s the thing, right? Having the medical skills to practice should only be seen as half of the picture. There is so much ethnocentrism in medical education, that centers white bodies and the experiences that happen to them as the norm, and everyone else as non-essential. What does this do? It reinforces power systems that put Black and Brown bodies at risk.

Anam: Even the tools used to measure health are biased against BIPOC experience. Things such as the Tanner scale, that marks phases of sexual and physical development, have been based off of white, European standards. When BIPOC folks come into the picture, appraisals of us are completely skewed^[6].

Carae: And I think we need to emphasize that this isn’t just a matter of preference – it’s quite literally a matter of life and death. There are long histories of harm done to Black and Indigenous bodies in health care. I’m wondering how many people know that Black women are more than twice as likely to be murdered in the healthcare system alone. This isn’t coincidental, or some figure we draw up for shock value. It’s a lived reality that stems from misogynoir. Coined by Moya Bailey, this term combines misogyny and anti-Black racism that targets Black cis and trans women^[7].

Anam: Recent conversations in pop culture have mentioned the harmful narrative that Black people don’t feel pain, which is pretty scary to think about^[8]. And these narratives aren’t isolated to Black folks. In Alberta, medical staff at one hospital were exposed to be playing a racist game of “what’s the blood-alcohol level” when treating Indigenous patients. Not only is this extremely disrespectful, but it directly opposes the goal of providing care^[9].

Carae: It’s troubling. We have to begin to see the medical system as an extension of projects to disempower Black and Indigenous people. In Brazil, the medicalization of sterilization has disproportionately disadvantaged Black women^[10]. What does this mean? When you deny Black women autonomy over thier women’s bodies while allowing white women this privilege, this reaffirms a hierarchy that blocks Black women from gaining the opportunities or any economic power that white women have. When look at the media, these cases are nonstop- misogynoir is laced into every fabric of the system^[11].

Anam: I feel like it’s the same message wherever you look: this medical system wasn’t built for us. But what would it look like if it were?

Carae: So, some of the problems we identified in this episode so far have been the legacy of colonialism, ethnocentrism, misogynoir, and racist discourse that inhibits holistic care of BIPOC folks. As Anam and I have been talking about recently, we think there are three key pieces of a transnational feminist health care system.

Anam: Exactly. The first step that we imagine for a transnational feminist health care system is the adoption of a cultural humility approach, as opposed to training in cultural competency. A transnational feminist health care system in Canada would be well informed of the histories of harm done to BIPOC bodies, both at home and across the world^[12].

Carae: As our second step, we took some inspiration from conversations around de-tasking the police. And just as the police are surveillance system on BIPOC folk, so is our health care system. Alternatively, we recommend that we decentralize health care and embrace collective care models.

Anam: If you’re wondering what this is, collective care models are those that put the responsibility on all of a society’s institutions to maintain the health and well-being of its people. This means that the burden of health would not just be the responsibility of doctors and nurses. Instead, we would branch out this task to universities, social services, and workplaces.

C: And that’s what we’re hoping to see. The inclusion of programs that focus on both food security for Indigenous folks and increasing their literacy. We have to remember those social determinants of health from earlier – both education and food security play a role, so why are we treating them as separate? It’s a problem when we just see health care as medical.

A: Very true, I totally agree with this. This is what I love about applying a transnational feminist lens to health care. It highlights areas where we can disrupt patterns of inequality. It cannot just be an “add and stir” approach, it has to be radical. I think it’s fitting then, that our third, and final step we suggest is to strip our system entirely of tools and practices in which racism, sexism, misogynoir and colonial sentiments are well embedded, right. For BIPOC folks, these tools are tools of trauma. Instead of trying to amend them, I think we should build from the ground up. Let’s start with the question – “what is health?” and go from there.

C: Health is consideration of trauma, health is placing BIPOC experience at the center with attention to difference.

A: So, what does this look like in COVID, at a time where BIPOC folks are economically strained but still fearful of engaging in the system? I think it looks like starting with acknowledgement and validation of this fear, first and foremost.

C: I agree. I think, as we’ve seen, Indigenous remote communities have been placed as high priority for the vaccine, which is appropriate given the circumstances. But this is just the start. If health is going to last, we really need to revisit the infrastructure in these communities that are barriers to health and pay close attention to areas of instability that cause these problems and these inequalities in the first place.

A: 100 percent. And for Black and Brown folks that may have contracted COVID-19 and be undergoing  care, we need to prioritize immediate training of staff that dismantles the “they don’t feel pain” narrative. There is no room for error, it could cost them their self-esteem, their life as a person.

C: Exactly, when we think about the experiences [of COVID] and how harsh they’ve been for people, it’s a tough recovery process. It ignores the essential truth that our health is important – despite what history has told us. It’s really time to make a change about that.

A: Absolutely.

Carae: Thanks for listening to this episode of Look at Us Now where we talked about ongoing health concerns for BIPOC folks in the time of COVID and started to imagine the possibilities for adopting a transnational feminist health care system.

Of course, this was a great start to the conversation, but that’s all it is – a start. Keep the conversation going on social media and with your friends as we try to shift the reality of BIPOC health in Canada.

Bibliography

Bailey, Moya. “Misogynoir in Medical Media: On Caster Semenya and R. Kelly.” Catalyst: Feminism, Theory, Technoscience 2, no. 2 (2016): 1–31. https://doi.org/10.28968/cftt.v2i2.28800. 

Boggild, Andrea K., Lilian Yuan, Donald E. Low, and Allison J. McGeer. “The Impact of Influenza on the Canadian First Nations.” Canadian Journal of Public Health 102, no. 5 (2011): 345–48. https://doi.org/10.1007/bf03404174. 

Briggs, Laura, Gladys McCormick, and J.T Way. “Transnationalism: A Category of Analysis.” American Quarterly 60, no. 3 (2008): 625–48. https://doi.org/10.1353/aq.0.0038. 

Edu, Ugo Felicia. “When Doctors Don't Tie: Hierarchical Medicalization, Reproduction, and Sterilization in Brazil.” Medical Anthropology Quarterly 32, no. 4 (2018): 556–73. https://doi.org/10.1111/maq.12475. 

Gerster, Jane. “Canadian Health Care Isn't Immune to Racism, Experts Say. Here's Why.” Global News. Global News, January 29, 2021. https://globalnews.ca/news/7142275/systemic-racism-healthcare/. 

Hoffman, Kelly M., Sophie Trawalter, Jordan R. Axt, and M. Norman Oliver. “Racial Bias in Pain Assessment and Treatment Recommendations, and False Beliefs about Biological Differences between Blacks and Whites.” Proceedings of the National Academy of Sciences 113, no. 16 (2016): 4296–4301. https://doi.org/10.1073/pnas.1516047113. 

MacMillan, Harriet L., Christine A. Walsh, Ellen Jamieson, Maria Y-Y. Wong, Emily J. Faries, Harvey McCue, Angus B. MacMillan, and David (Dan) Offord. “The Health of Ontario First Nations People.” Canadian Journal of Public Health 94, no. 3 (2003): 168–72. https://doi.org/10.1007/bf03405059. 

Monaghan, Jeffrey. “Settler Governmentality and Racializing Surveillance in Canada's North-West.” Canadian Journal of Sociology 38, no. 4 (2013): 487–508. https://doi.org/10.29173/cjs21195. 

Paradies, Yin. “Colonisation, Racism and Indigenous Health.” Journal of Population Research 33, no. 1 (2016): 83–96. https://doi.org/10.1007/s12546-016-9159-y. 

Subedi, Rajendra, T. Lawson Greenberg, and Martin Turcotte. “COVID-19 Mortality Rates in Canada's Ethno-Cultural Neighbourhoods.” Statistics Canada. Government of Canada, October 28, 2020. https://www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00079-eng.htm.