Canadian Medical Association

Indigenous Peoples from coast to coast to coast have made it clear: health systems in Canada have critical work ahead to eradicate Indigenous-specific racism.

BC Deputy Provincial Health Officer Dr. Danièle Behn Smith and health researcher Kate Jongbloed are leading that effort at the BC Office of the Public Health Officer (BC OPHO). In 2022, they launched an Unlearning Club to equip staff with the knowledge to challenge the status quo and support allyship with Indigenous Peoples. 

The club was launched as part of a series of initiatives designed to help staff recognize and unlearn white supremacy and Indigenous-specific racism by engaging in the three core practices of true reconciliation shared by Puglaas Jody Wilson-Raybould (We Wai Kai Nation): to learn, understand, and act.

These initiatives are part of province-wide efforts to address the watershed In Plain Sight report released by British Columbia in 2020, which confirmed the “widespread systemic racism against Indigenous Peoples” in the province’s health system, resulting in “negative impacts, harm, and even death.” 

Jongbloed, who is a CIHR-Health Research BC Health Systems Impact Fellow with the BC OPHO, joined Dr. Smith and BC Provincial Health Officer Dr. Bonnie Henry at the CMA’s 2023 Health Summit to talk about their approach. 

In advance of their session, the CMA asked Jongbloed for five key considerations in “unlearning” programs:

1.    Pay attention to who is doing the work

Educating others too often falls on Indigenous Peoples themselves. “We decided to use materials that have already been created to avoid putting additional burden on BIPOC people,” says Jongbloed.” The tools to address the impacts of colonialism and structural racism are already out there. It is up to us to pick them up and use them. 

2.    Remember — we all learn differently

The Unlearning Club is a 17-month, voluntary program. To lower barriers to participation, and support different learning styles, Jongbloed designed the curriculum to include both "quick dips” and “deep dives.” Podcasts and TED Talks are listed next to books and academic journals in each month’s learning module. About 70% of BC OPHO staff have gone through the training so far, and planning for the next phase is underway to make it available to more health leaders across BC. 

3.    Think local

“One of the tools of settler colonialism is creating one pan-Indigenous perspective,” says Jongbloed. Instead, the BC OPHO follows a distinctions-based approach that acknowledges the specific rights and concerns of Indigenous communities and their unique cultures, histories and governments. Jongbloed’s curriculum was developed with the BC context in mind, deliberately privileging BC First nations material where possible. 

“We recognize that First Nations territories stretch to every inch of the province called BC. We have a responsibility to learn from the peoples of these territories and uphold obligations our government has to those relationships,” she says.

4.    Build safe spaces

Jongbloed’s curriculum explores attitudes of white supremacy and the painful impact on Indigenous Peoples. Considerations were also made when selecting the closed cohorts to minimize unintentional, additional harm to colleagues who have experienced unearned advantages in relation to white supremacy and settler colonialism. She says staff appreciated learning with people who had similar lived experiences. It allowed them to show up as their most authentic selves, and created safe spaces to question, challenge and sit in discomfort together. 

To ensure free discussion about experiences at work, BC OHPO leadership and staff were placed in distinct cohorts as well.

5.    Change starts at the top

Research suggests about 70-75% of all organizational change initiatives fail, in no small part due to a lack of alignment and engagement from leadership. Dr. Henry made her support for the Unlearning Club clear by allowing sessions to run during work hours. Staff are also permitted to do the assigned homework while at work. 

At the Canadian Medical Association’s Fireside Chats on Indigenous Health, a series on moving forward on reconciliation, the need for health providers to reestablish trust with Indigenous Peoples was a recurring theme. Confronting “the inheritance that’s come from decades and decades of colonization” is an important step, said CMA President Dr. Alika Lafontaine. “There’s a lot of unlearning that has to happen.”

Learn how the CMA is working in allyship with Indigenous Peoples

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