Health Means Care
By:
CJ, May and Darshpreet
Podcast Transcript
Intro Music (10 seconds)
Introduction (CJ): On September 28, 2020, Joyce Echaquan tragically passed away due to medical negligence and abuse she suffered in the Centre hospitalier de Lanaudière in Saint-Charles-Borromée, Quebec. Unfortunately, the circumstances of Joyce’s passing are not unique, rather it is indicative of pervasive, overarching themes of racialized misogyny and settler colonial mentality that produce and are reproduced by institutions of biomedicine and technoscience. In this episode of Health Means Care, Darshpreet, May, and myself contextualize the futurity and possibilities of an inclusive, equitable healthcare system within the ongoing COVID-19 pandemic and a framework of institutional collective care.
Question 1 (May): Great CJ, thank you so much for that introduction. My first question is actually going to you. So when you close your eyes, how do you or what do you imagine a transnational feminist health care system to look like? What would that look like to you? What does it involve or entail?
CJ: It involves important consideration to how continued legacies of oppression that produce, reproduce, and maintain white, cis-heteronormative power structures work on and through bodies across time and space, and resist homogenizing “multiple, overlapping, and discrete oppressions”. This framework is especially important for the Canadian context where healthcare is considered a universal right for citizens. Dryden talks about how ethnonationalist citizenship is deployed in “A Queer Too Far” that makes distinct categories of citizenship and belonging, with different participation levels and necropolitical status. And it’s this illegibility in citizenship and healthcare that also creates bodies as threats to public health, subjecting them to racialized, medical surveillance or medical abuse and neglect. And this is evidenced in Dr. Bailey and Dr. People’s research on Black Feminist Health Science Studies discusses how Black people’s health is already impacted by socioeconomic discrimination that creates poverty, food and housing insecurity, so basically it exacerbates existing vulnerability in health by creating an environment of distrust and fear. You really need a healthcare system that is both aware of its past and committed to working for and with communities that continue to be medically exploited, abused, and neglected. So, to make a long story short: it is a system that ensures equitable access to appropriate care that meets the needs of the entire public, regardless of citizenship status, gender identity, or other aspects of an individual’s identity that have resulted in disparities in receiving care. And it is sensitive to the valid, real iatrophobia that individuals have and responds with compassion and flexibility. It is health that cares.
Question 2: (May): Thank you CJ for that great explanation. I completely agree with you in that we truly need a healthcare system that is both aware of its past and is committed towards working for and with our communities. As we all know, communities across the globe have been struggling with the pandemic. I’m interested in knowing Darsh, how you think about a system, like the one CJ mentioned, would respond in our world today? How it would respond to COVID-19?
Darsh: That is an important topic to touch on in today's context. This is an essential backbone to our health care system to ensure fairness in institutional responses to the COVID-19 pandemic. A transnational feminist health care system will flag out structures and practices which portray a lack of accountability in medical care and medical surveillance. It should also weigh in and hold accountable state policies that reproduce social oppression. It would urge the governments to allocate more tax dollars to medical facilities to increase the resources to treat everyone equally during the increasing demand for treatment (both emergent and non-emergent care) in this Covid-19 pandemic. As we know there are medical technologies that bring awareness to the spread of Covid. A transnational feminist framework would ensure that fair data is collected in all suburban populations to ensure that ethical values guide these surveillance apps in order to mitigate the vulnerability of the most disadvantaged groups in society. An inequitable health care system can stem from the lack of fairness in the Covid-19 apps with discriminatory storage of data for marginalized communities and that can fabricate the stigmatization of the most vulnerable members in our society. Covid-19 apps should involve ethical values in terms of how data is stored and who has access to them so that we can see structural changes to the entire medical system from curriculum to practice.
Jeffrey Monaghan talks about how a settler-colonial mentality is rooted in racialized surveillance. This process erases indigenous beliefs and heritage and replaces white colonial mentality. That is because indigenous people continue to be labelled with characteristics of dangerousness, which positions them to be threatening to white societies. Because discriminatory surveillance is generally immune in our institutions, implementing ethical considerations will reform the health care system. It's crucial to see through a transnational feminist perspective how health care should prevent discriminatory medical surveillance in response to Covid so that we do not see another medical negligence, as seen in Joyce's case. The lack of health care that Joyce received portrays the undermined value of life and the lack of rights that women of colour have. A transnational feminist model should aim to prevent the transgressing colonialist violent practices and not deem any bodies to be disposable, regardless of the limitation of medical resources to treat COVID-19 infections.
In Canada, individuals do have an issue that they pay higher taxes every year but there is a heavy drain on societal resources like what we are seeing right now with the COVID-19 pandemic. It is saddening to see that one's socioeconomic status reigns over their wellbeing. Adopting a transnational feminist structure would ensure that there should be an unbiased distribution of benefits to all members of society. It would be fair to make the benefit available to more people since every taxpayer pay for the health care system. With that being said, a transnational feminist response to COVID-19 must consider that the level of health care an individual receives is not dependent on their identity markers. This would only favour individuals with power, wealth and status and disproportionately affects visible minority groups.
As the health care system becomes increasingly complex people have to wait hours and hours in emergency wards to be assisted by a nurse. Especially with the scarce time and resource during the Covid-19 pandemic, a transnational feminist model would propose an efficient health care model where there is efficient and proper health care and the ones in dire need get the services first then those who don’t require urgent care regardless of one's socioeconomic factors. No individual who requires the need of ‘urgent’ health care should be denied the rights to get health care because of financial criteria, instead, they should be assisted right away so that their suffering can be dealt with in a timely, consistent and affordable manner.
May: Great, thank you Darsh. Moving on I want to get into collective care. CJ in your own words, what is collective care and, in our institutions today, how does it look? Is it present? Is it not? What does it look like in our everyday institutions?
CJ: So, when we think about collective care it really is about collaboratively promoting health at both an individual and community level, typically through mutual aid or grassroots organizing. An example most people are usually familiar with are GoFundMe’s to cover medical costs that are circulated on social media. For me, the emphasis for collective care is having a complete, comprehensive understanding of individual and group health needs that provides resources to communities and allows them to allocate it as they see fit to ensure each member is cared for.
When we consider collective care in institutions, though, you really have to contend with organizational resistance to both give resources without expectation and allow for communities to allot resources that they may or may not be a privy to. So, I’d say the first step is for institutions to provide the resources communities need—like financial, spatial, professional, et cetera—without expectations of reciprocity or even a “thank you”, as these institutions may have contributed to or entirely created the conditions that require collective care in the first place. The next step would be to allow communities to allocate resources and funding as they see fit, primarily by deciding who will collaborate with them on health concerns, where they wish to be treated, and how that collaboration and appropriate healthcare will occur. And this specifics on how communities choose to organize their care is a private decision, just like any other decision you make with your doctor about your own health, especially when medical concerns people have may be stigmatized, like HIV status, or there is legitimate fear of disclosure, like someone who wants to start the process of medically transitioning but isn’t publicly out yet. It is about providing the institutional, structural framework of medicine that continues to be deprived from populations that creates disparities in healthcare, like conditions for medical neglect and abuse, at their own discretion and on their own terms. And institutions themselves have to grapple with the potential to be effectively excluded from the process beyond providing the resources to people who need them. So it really does loop back to this idea of a transnational feminist healthcare system that is critical of its previous iterations that resulted from failures in the very foundation of medicine itself, like discriminatory curriculum or how much of medicine is built from the exploitation of and coercive or non-consensual experimentation on Black bodies.
Outro (CJ): As we end this podcast, we’d like to remind listeners that our imaginings of an inclusive, equitable healthcare system involve a focus on futurity rooted in a transnational feminist framework and actualized, structural changes to the entire medical system — from curriculum to practice. Thank you to Dr. Charles and Dr. Bailey for allowing us to participate in the Black Feminist Health Science Studies Symposium, and you, the listeners, for tuning in to the first and only episode of Health meets Care. For more information on the futurity of equitable, inclusive healthcare and its current disparities, we recommend Dr. Bailey and Dr. Peoples’ “Towards a Black Feminist Health Science Study” and Dr. Johnson’s “Dominating the Disease: A Transnational Feminist Perspective of U.S. Health Coloniality”.
Outro Music (10 seconds)
Bibliography
Bailey, M. (2016). Misogynoir in medical media: On Caster Semenya and R. Kelly. Catalyst:
Feminism, Theory, Technoscience, 2(2): 1-31.
Bailey, M., & Peoples, W. (2017). Towards a Black Feminist Health Science Studies. Catalyst:
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Dryden, O. H. (2015). “A Queer Too Far”: Blackness, “Gay Blood,” and Transgressive
Possibilities. In Disrupting Queer Inclusion: Canadian Homonationalisms and the Politics of Belonging, 16–32. Vancouver and Toronto: UBC Press
Monaghan, J. (2013) Settler governmentality and racializing surveillance in Canada’s North-
West. Canadian Journal of Sociology, 38(4), 487-508.