“There’s a lot of grey areas (in medicine) that’s filled by opinion and ideology.” on people and they would already know a lot about them.” In addition, Freeman mentioned that the hospital’s policies allowed for Aboriginal ceremonies to be included in treatments. According to Lafontaine, practices like that are called ‘cultural competency.’ He says they are important as they create a welcoming environment for patients and introduce different cultures to medical personnel. Freeman’s interest in working with Aboriginal people arose after she took a course during her studies at the University of Toronto. It focused on providing health care in Aboriginal communities and was led by Nurse Pamela Walker. Walker has extensive experience working in Aboriginal communities since graduating from the University of Toronto in 1989. For her independent practice experience, she worked on a reserve in northern Manitoba. She was “hooked after that,” she said. After hearing stories of strength and resilience, she felt inspired to work with those communities and wanted to know more. Her expertise and competency were rewarded in 2011, when she won the Sensitivity to Equity and Diversity Award at the University of Toronto. According to the University of Toronto
ILLUSTRATION COURTESY OF DARREN BRYANT
website, the award celebrates instructors’ sensitivity to equity and diversity in designing course curriculums and student experience. Walker said teaching nurses about Aboriginal history and culture is a vital part in removing stereotyping and racism from the health care system and improving communication. She believes strongly that a basic understanding of Aboriginal culture is important in order to make an impact. “If lots of our nursing students have a sense of this (Aboriginal culture) for themselves and help other staff try to change the colonial thinking, that informs a lot of the interaction between Aboriginal people and non-Aboriginal health care staff,” she said. She said that part of that colonial thinking is that historically we haven’t been listening to Aboriginal people’s needs, which in turn has generated their distrust in the medical system. However, courses for new nurses and cultural competency don’t address the whole prob-
lem, according to both Lafontaine and Walker. “It’s good to be competent in understanding that there are different cultures, but the bigger problem in communication is that we are not reflecting on our own prejudices,” Lafontaine said. “There’s a lot of grey areas (in medicine) that’s filled by opinion and ideology…(doctors) have a lot of power within our system to support those ideas.” Walker and Lafontaine suggest practising cultural safety, a method of critical thinking, that helps communication and “asks people to learn about the real history and think about the own stuff they carry,” Walker said. Cultural safety will be a game changer according to both Lafontaine and Walker, in eradicating prejudice within the health-care system. Lafontaine says his organization strongly recommends that doctors practise it. “Let’s just think about it (history and prejudice),” Walker adds. “Let’s just challenge ourselves.”
VITAL SIGNS • DECEMBER 2013 23