Why we need more Indigenous perspectives in health care
Things must, and will, change to improve fairness and equality in our society
This First Person article is the experience of Richard Budgell, a former public servant and current assistant professor at McGill University. For more information about CBC's First Person stories, please see the FAQ.
Where I'm from, you can't talk about yourself without talking about your family.
I am a member of the third generation of my family to work in health care. A hospital was established in North West River, our partly Inuit village in Labrador, by an international medical organization, the Grenfell Mission, in 1915. My grandmother worked in the laundry of the hospital until she was in her 70s.
My mother worked in the same hospital as an aide, as did her younger sister who later became a nurse. I worked as a health-care administrator in the federal government, managing a branch office in Montreal that provides funding and health services to First Nations and Inuit communities in Quebec.
My grandmother left behind no commentary about how she felt about her work in the laundry of what became a 30-bed adult and pediatric hospital. It was undoubtedly hard and physically demanding work, manipulating the linen through industrial washers and dryers. My grandmother was apparently a strict taskmaster who taught students and new employees how to fold sheets in a way that met her high standards.
My mother wrote and spoke very passionately about her experience working in the hospital and an adjacent boarding school dormitory, describing those periods as "slavery."
"These dictators ran everyone who worked around there like slaves.… I feel that these [English nurses] really delighted in taking advantage of us," she wrote.
My mother always said she could never forgive them for the way she was treated, but she extracted a lesson from her time at the hospital: "I have tried very hard to teach my children to be courteous and pull their weight without being used as underdogs."
My aunt had a different experience, some years later. She wrote, "To me, it was the most exciting work I've ever done.… Many a time a patient would say some little thing and it would make me glow inside like an electric light bulb."
She did her nursing training in Newfoundland, and then went to work in a fast-growing mining town, Labrador City, 500 kilometres west of North West River. On one occasion, she and two other nurses went to the newly opened hotel in town to have drinks in the lounge. They were told by the management that drinks would not be served to "native women."
Her colleague — a cousin — wrote to the premier to complain about this blatant racism; the policy was eventually changed.
Twenty-five years into my federal government career, I became the executive director of the Quebec regional office of the First Nations and Inuit Health Branch, which employed about 150 people. When I walked in the door of the office in Montreal, I was one of only two Indigenous employees there. I decided that should change — consistent with the Indigenous mandate of that branch — and we began to hire Indigenous students and employees.
Many of the existing employees and managers supported this shift — but a small group of non-Indigenous employees were viscerally threatened by it. The union local president requested that non-Indigenous employees be given hiring preference in other federal government departments, because they would supposedly have no future in my office (and risk losing their overwhelming dominance).
Fortunately, no federal hiring policy officially supports white preference, so the union president's request went nowhere. When I left in 2020, Indigenous students and employees were approaching 15 per cent of the workforce: not enough, but better than the less than one per cent when I arrived.
Indigenous people are sometimes accused of trotting out an endless list of grievances about wrongs done to us. If Canada, and Canadians, want this to be a just country, part of that involves telling the truth, and listening to those that do. None of the family members that I've mentioned were obsessed with wrongs committed; in fact, they were people who lived fully, and often happily.
My family has lived experience in the health system that gives us knowledge, and scepticism, about for whose benefit these systems sometimes work — and the power imbalances that have been inherent in them. My perspective is probably not the same as someone from a white urban family with generations of doctors. Which is fine, because all perspectives should be considered; there's just not a long history, yet, of perspectives like my family's being considered and respected.
I don't know that I can match the perseverance, or patience, of the women of my family. I hope, in my latest gig, as a professor in a large, prestigious university — with its own somewhat spotty record of inclusion — that I can persevere, push and be patient where required. But as my family has known for a long time, things must, and will, change to improve fairness and equality in our society.
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