Anti-Black racism – Page 2

“In some ways, Canada very much is a welcoming place. However, that can act as a barrier in understanding how racism manifests — it’s not just the racial slur. It’s not just the racist targeting. But it is in the very systems of continuing to practice race-based medicine. Even if we had more funding and even if we had more Black physicians and practitioners, if we do not address the very real reality of anti-Black racism — in structures and in practice — we will continue to see poor health outcomes from Black communities.”
Dr. OmiSoore Dryden, Associate Professor, Faculty of Medicine, Dalhousie University

Delia Douglas

This month’s blog continues Rady’s response to the Scarborough charter. We would first like to extend our gratitude to Dr. Onye Nnorom (University of Toronto) and Dr. Omisoore Dryden (Dalhousie University) for the October 19th workshop: #Blacklivesmatter in health care: historical roots and legacies of anti-Black racism in medicine and the October 20th grand rounds: addressing anti-Black racism in the clinical setting: a look at the social and physiological heath impacts of injustice.

Anti-Black racism – what is it and why does it matter?

Dr. Akua Benjamin, professor emeritus at Toronto Metropolitan University, conceived of the term anti-Black racism to underscore the distinct nature of systemic racism on Black people in Canada that is the result of the enduring legacies of enslavement and the colonization of people of African descent in this country. Anti-Black racism is manifest in policies and practices embedded in Canadian institutions such as, health care, education, and justice that reflect and sustain beliefs, attitudes, prejudice, stereotyping and/or discrimination towards people of African descent.

Consider that the first medical education program in Canada was established in 1824, a decade before the end of enslavement in Canada (1834), and while residential schools were operating.

In 1918 Queen’s University senate voted to ban Black students from enrolling in its medical school. At that time 15 Black men were enrolled in the university’s medical school, and while those students were not formally removed, the administration actively encouraged them to leave the program. Bolstered by the ban, white students put on a minstrel show; approximately half of the Black medical students left the program, while the other half remained. Several decades later, in 1965 Black students returned to register at Queen’s School of Medicine. The ban would not be repealed by senate until the fall of 2018 and an official apology was given in 2019.

In addition, the medical schools at McGill University, Dalhousie University, and the University of Toronto also excluded Black students, or placed restrictions on their admission, for varying periods of time.

Systemic anti-Black racism is evident in the ways people of African descent have long been used to “advance” medicine. For example, J. Marion Sims, the founder of gynecology, and the doctor credited with the creating the speculum was known for developing a surgical technique to repair vesico-vaginal fistula. His breakthroughs occurred at the expense of his subjects, namely enslaved Black women, who he operated on without use of anaesthesia. Henrietta Lacks’ cervical cancer cells were taken and used without her consent. Named after Lacks, the hela cell line represents one of the most important human cell lines in medical research; they have been instrumental in cancer studies and aids research, as well as in the creation of polio and Covid-19 vaccines.

Simply put, the past and present histories of enslavement and settler colonialism in Canada form the foundation of these institutionalized expressions of anti-Black racism in society in general, and in the field of medicine and medical education programs in particular.

Anti-Black racism(s) affect the health and well-being of Black communities in multiple ways. In addition to undermining trust in health care delivery systems and practitioners, it impacts the quality of care that Black people receive, resulting in poor physical and mental health outcomes.

It is therefore imperative that medical and health education professionals are taught about how anti-Black racism affects the social and structural determinants of health for Black people.

Marcia Anderson

In order disrupt the anti-Black racism patients experience, we have to disrupt the anti-Black racism that Black learners and health professionals’ experiences. These experiences are widespread, pervasive, and cause harm including decreased academic performance, burnout and high staff turnover. Disruption requires understanding how anti-Black racism was built into our systems.

The current special issues (volume 194, issues 41 and 42) of the Canadian Medical Association Journal (CMAJ) are an important intervention into this knowledge gap.

Resources

Visit the CMAJ website to view the two special issues on Black health and anti-Black racism in health care:

https://www.cmaj.ca/content/194/41?current-issue=y

https://www.cmaj.ca/content/194/42

Black health education collaborative: The important role of critical race theory in disrupting anti-Black racism in medical practice and education:

https://www.cmaj.ca/content/194/41/e1422

Canadian medical journal acknowledges its role in perpetuating anti-Black racism in health care

https://www.cbc.ca/news/health/cmaj-anti-racism-1.6627312

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625534/

https://www.cmajopen.ca/content/10/4/E937

https://rnao.ca/sites/default/files/2022-02/Black_Nurses_Task_Force_report_.pdf

https://jamanetwork.com/journals/jamasurgery/fullarticle/2777800

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000324/

This first blog is an introduction and a conversation – a collaboration between our anti-racism and social justice work.

Visit the Canadian Public Health Association website for a statement on racism and public health.

Marcia Anderson

As a physician, I have seen unequal access and treatment of Indigenous, Black and racialized people in learning and work environment, and read countless journal articles documenting the same.

While we are trained as medical experts and scholars, what we know hasn’t been sufficient to disrupt or address racism in ways that have been shown to close these gaps in unequal care by race.

Delia Douglas

As a sociologist, I am attentive to the continuing significance of the legacies of enslavement, imperialism, and settler colonialism in the present.

I have examined racism’s impact in post-secondary institutions, the law and sport – and now I am working in the realm of health care.

That said, there are certainly many points of connection across different systems, organizations and institutions – the pervasiveness and persistence of racisms… I use the plural because racism is not one thing.

The events of the past two years – COVID -19 and the denial of bodily autonomy (the right to health and wellness, freedom from police violence, autonomy over gender and sexuality and the right to look after our children and families in safe and sustained communities) certainly exacerbated existing inequities and they have also produced new forms of violence.

The enduring legacies of residential schools as evidenced in the uncovering of the bodies of the 215 children who died at the Kamloops Indian Residential School (and the thousands more graves identified since), the death of Joyce Echaquan, the murder of George Floyd, and the reckoning with anti-Black racism, the rise in racism against people of East Asian descent, Islamophobia, and the death of Indigenous, Black, and racialized people in police involved shootings across the country.

These are not individual acts of racism, or the actions of a few bad apples, these are instances of systemic racism. These are acts that demonstrate how race influences who lives and who dies. Racism lowers life chances – racism kills.

I am reminded of the insights of the late Audre Lorde, a Black lesbian feminist writer poet and activist (1984). In her words, “We have the power those who came before us have given us, to move beyond the place where they were standing” (Sister outsider, p. 144).

I interpret Lorde’s remarks as both a responsibility and opportunity- our lives are shaped by all that has come before…

There is no quick fix, or toolkit, which can solve racism – if it were easy, we would be in a very different place. A new path forward towards racial justice is challenging, but possible if we commit to new learning, building relationships, cultural shifts, and structural change.

We have commitments – in our Faculty’s Disruption of all forms of racism policy, the Truth and reconciliation action plan, and Equity, diversity, and inclusion policy, and in the University’s commitment to the Scarborough Charter.

We have educational tools available (e.g., Learning module on disruption of all forms of racism policy and Manitoba Indigenous cultural safety training) and in development (e.g., Disrupting dialogues anti-racism speaker series, enhancing our racial literacy activities, and learning module on how to receive a disclosure of racism).

We all have a role to play.

What we need from our Faculty community is humility, accountability, courage, and open engagement with new learning, the application of new knowledge, and full participation in the organizational and structural changes required to create a more racially just environment.

If not now, then when?

Resources

Visit the Canadian Public Health Association website for a statement on racism and public health

Audre Lorde (1984): Sister Outsider.
Freedom, CA: The Crossing Press Feminist Series.

Disruption of all forms of racism policy