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SAFELY EMBRACING CULTURE: THE ADEQUACY OF THE CULTURAL SAFETY PARADIGM...
Current healthcare provider training regimen are extremely superficial
when it comes to cultural understanding. This is particularly pronounced
in the realms of socio-cultural and historical underpinnings of Indigenous
health.’” 8 A care program that seems doable for a (more often than not)
White physician of the upper-middle class may be burdensome or outright
ineffective for an Indigenous patient (due to a myriad of social, cultural,
historical, or economic factors that disadvantage them), but healthcare
providers continue to be baffled when some of their patients have trouble
adhering to treatment plans. Healthcare providers simply do not understand
enough about their Indigenous patients to provide effective care. Thankfully,
North American healthcare systems (particularly in Canada") have been
made aware of this knowledge gap and have been attempting to address it for
decades.'° However, as evidenced by the decades of attempts, this gap has yet
to actually be reduced in any meaningful sense.
Although understanding Indigenous culture is a seemingly innocuous and
attainable goal, the means by which a colonial healthcare system achieves
this understanding tend to be ethically concerning, if not outright pernicious.
Indeed, ventures for learning about “other” (i.e., minority) cultures, more often
than not, result in the epistemic oppression and subjugation of Indigenous
peoples." For example, in 1933, a series of trials seeking to understand why
"Indians are far more susceptible to tuberculosis that are the White races of
mankind"" were undertaken at the OuAppelle Sanatorium in Saskatchewan
under the auspices of a proselytizing Canadian government. The subjects of
the trials, Indigenous infants with tuberculosis, were used to test the potency
of the bacillus Calmette-Guerin (BCG) vaccine (the effectiveness of which
was questionable'’), despite the existing knowledge that poor housing and
nutrition were the primary culprits of the poor health amongst Indigenous
groups. The vaccine proved to be effective, but its protective effects hardly
made a dent in the staggering discrepancy between Indigenous infant
2 Allana S.W. Beavis et al., What All Students in Healthcare Training Programs Should Learn
to Increase Health Equity: Perspectives on Postcolonialism and the Health of Aboriginal
Peoples in Canada’, BMC Medical Education, Vol. 15, No. 1 (2015), 155, https://doi.
org/10.1186/s12909-015-0442-y (accessed 5 December 2020).
Lloy Wylie and Stephanie McConkey, Insiders’ Insight: Discrimination against Indigenous
Peoples through the Eyes of Health Care Professionals, Journal of Racial and Ethnic Health
Disparities, 7 May 2018, 1-9, https://doi.org/10.1007/s40615-018-0495-9 (accessed 5 December
2020).
Truth and Reconciliation Commission: Calls to Action, 2015, 20.
Mary Jane Logan McCallum and Adele Perry, Structures of Indifference - An Indigenous Life
and Death in a Canadian City, Winnipeg, MB, University of Manitoba, 2018, 137-8.
Linda Tuhiwai Smith, Decolonizing Methodologies: Research and Indigenous Peoples,
2™ edition, London, Zed Books Ltd., 2012, 8-24.
17 National Research Council, Dominion of Canada, 1928, 44.
18 M. Lux, Perfect Subjects: Race, Tuberculosis, and the Qu’Appelle BCG Vaccine Trial,
Canadian Bulletin of Medical History, Vol. 15, No. 2 (1998), 281.
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