Cultural humility is a lifelong process of self-reflection and self-critique (BCCNM, 2024). This Truth and Reconciliation assignment has allowed me to continue my journey toward cultural humility through this self-reflective practice and knowledge acquisition which I am grateful for.
When tasked to identify a significant body of text representing how Indigeneity and Indigenous people are represented in texts, several works came to mind. I reflected on fictional stories I was exposed to during my youth, such as the novel Indian in the Cupboard or the Disney movie Pocahontas, and how they contributed to the anti-indigenous socialization that existed throughout my youth. I also reflected on the In Plain Sight report released in November 2020 and how this document has impacted my responsibility toward truth and reconciliation as a healthcare professional. The In Plain Sight report found evidence of indigenous-specific racism in BC and attributes this racism to a lower life expectancy, increased infant mortality and the increased presence of chronic health conditions in our Indigenous population. With this in mind, I wanted to better understand and answer the following question: What level of implicit and explicit bias exists in medical journals? I conducted a journal review using the terms Indian, Indigenous, Aboriginal, First Nations, and Native to gain awareness of the language used in medical journals. I wanted to look at the most historic journals possible and organized my search findings to list from oldest to newest. I was unable to access many of the journals electronically. However, the titles alone allude to the explicit bias and racism that has occurred in healthcare historically. For example, “We, too, have an Indian Problem,” published in 1951 by O’Hara, or the journal article “A Nurse among the Indians” by Grondin, whose title suggests “othering” language. More recent articles, however, were accessible. An article by Thompson (1990) discussed the prevalence of heavy birth weights in Native Indians in British Columbia. The lack of people first language was evident throughout the body of this text, for example, “the Natives were economically poor” (p. 443). There was also evidence of assumptions and bias: “Although no data on height or weight of British Columbian Native women were located, it is generally believed that Natives are heavier than non-Natives” (p. 446). I found the term Native Indians was commonly used in the 1990s and therefore added this to my search.
After sifting through multiple research articles, I found myself asking a different question. The In Plain Sight report came out in 2020, but did awareness surrounding the lack of Indigenous cultural safety exist in nursing research prior to this conversation? When did our language change from Indian/Native Indian to more appropriate and people-first terminology in medicine? I added the search terms of cultural safety, colonialism and anti-racism to gain insight into any progress made over the past few decades. Trying to narrow down a topic as expansive as racism in healthcare was challenging; however, limiting my search to Canada and specifying Indigenous racism allowed me to streamline the research. I was pleased to find evidence to support that this work was being done. My search resulted in articles discussing colonialism’s impact on Aboriginal health and health equity from the early 2000s. For example, Brown et al.’s article “The Relevance of Postcolonial Theoretical Perspectives to Research in Aboriginal Health,” published in 2005 and “Our Land, Our Language: Connecting Dispossession and Health Equity in an Indigenous Context” (Brown, 2012). Even more promising was the increasing amount of research conducted in the past 10 years.
This assignment aimed to understand historical teachings to pave the way toward reconciliation. I hope that my post has also highlighted how anti-indigenous socialization has existed not only in our educational system but also in our healthcare system and the work that needs to be done to ensure Indigenous cultural safety.
References
British Columbia College of Nurses & Midwives. (2024). Indigenous Cultural Safety, Cultural Humility, and Anti-Racism. https://www.bccnm.ca/RN/PracticeStandards/Pages/CulturalSafetyHumility.aspx
Browne, A.J., Smye, V.L. & Varcoe, C. (2005). The relevance of postcolonial theoretical perspectives to research in Aboriginal health. Canadian Journal of Nursing Research, 37(4), 16-37.
Brown H.J., McPherson G., Peterson R., Newman V. & Cranmer B. (2012). Our land, our language: Connecting dispossession and health equity in an indigenous context. Canadian Journal of Nursing Research, 44(2), 44-63. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=med9&NEWS=N&AN=22894006.
Grondin, O. (1954). A nurse among the Indians. Canadian Nurse, 50(9), 730-2. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=med1&NEWS=N&AN=13190501.
O’Hara, H. (1951). We, too, have an Indian problem. Nursing World, 125, 280-282.
Thomson, M. (1990). Heavy Birthweight in Native Indians of British Columbia. Canadian Journal of Public Health / Revue Canadienne de Sante’e Publique, 81(6), 443–446. http://www.jstor.org/stable/41989958