By Matthew Brett

The killing of George Floyd and the death of Joyce Echaquan sparked widespread calls for institutional change to address racism faced by Black, Indigenous and people of colour (BIPOC) communities. We spoke with two leaders at McGill University’s Faculty of Medicine and Health Sciences who are working to address these systemic issues within the Faculty.

Dr. Saleem Razack is Director of the Social Accountability and Community Engagement (SACE) Office, which is leading the Faculty’s Action Plan to Address Anti-Black Racism, a framework of which is available for review here.

Dr. Kent Saylor is Director of the Indigenous Health Professions Program (IHPP), which hosted a November 2 workshop titled “Introduction to Indigenous Health Teaching” that was attended by nearly 200 faculty members. IHPP has a broad mandate with an overall goal of improving the health of Indigenous peoples in Canada.

In Part 1 of this two-part series, we spoke about how these recent tragedies are triggering institutional change. We discussed important differences between their respective portfolios, along with opportunities to work together. We grounded this conversation in the lived experience of Indigenous, Black and racialized students within the Faculty.

Both of your portfolios have received heightened attention as a result of recent tragedies. These tragedies are outcomes of far more systemic issues. I was hoping to get your preliminary thoughts on these tragedies – that is Joyce Echaquan and George Floyd that I’m referring to. If you can perhaps situate this within your work and within a broader historical and social context.
Dr. Saylor. With George Floyd, that really came up much more with Black faculty members and the Black Lives Matter movement, which has always been there, but became much more heightened. People at that time were saying, ‘we should be talking about Indigenous peoples as well,’ but I really felt the focus should be on anti-Black racism at that time.

What happened with Joyce Echaquan – that really brought things to the forefront for Indigenous peoples, obviously. And for our office and for me, I have gotten a lot more requests about, ‘what are we going to do about this at the McGill level and then also at the clinical level?’ Many people are talking about, how are we going to address this in our clinical teaching sites?

And even at the national level, this has prompted a call from the federal government to look at systemic racism much more deeply for Indigenous peoples. There’s going to be work done there and we are being asked to participate at all of those levels. I didn’t get that much specifically from the province just yet. So that’s what’s happening. People are actually just coming to us saying, ‘what do we do?’

Dr. Razack. The death of Joyce Echaquan reflects a very disturbing example of what I have seen in my clinical practice. It’s a very graphic example of the outcomes of systemic racism. Everything that I do in my office (SACE) is about trying to help people to recognize the existence of the structures of systemic racism in healthcare.

One of the mantras that I try to make clear is that the big three for systemic racism are: our healthcare systems, educational systems and legal systems, including the police. Don’t think of us – those of us in healthcare – as being apart from all of this. That’s a major educational objective. We (medicine and its institutions) are integral structures to all of this. We must own this role, as much as we own the good parts of our role. For anti-Black racism, the thing that needs to change – the specific thing – is to understand this as a Canada problem, not just a U.S. problem.

The dynamic that I would hate to see happen is this – I would hate to see a situation set up where a bunch of oppressed groups are fighting for white peoples’ attention. I don’t want to see that. That is classic colonization. That’s what all the colonial powers did wherever they went, which is divide and conquer. The message we have to figure out is solidarity and specificity. We have to figure out the solidarity, and in that solidarity, we have to find space for the specificities in different struggles, such as those of Black people and Indigenous people.

That ties nicely into my next question, which is to explore those overlaps and differences. The SACE Office has a very explicit mandate to address anti-Black racism and the IHPP is working very specifically on Indigenous education and health. But there are overlaps and intersections; for example, social determinants of health, complex histories of colonialism and racialized oppression. There are reasons for solidarities and also specific differences. Can you dig into those specificities, but also the potential for collaboration and solidarity?
Dr. Saylor. One of the biggest differences for our peoples is the history – the history is very different for Indigenous peoples versus Black people in Canada. The history of colonization, the history of how much death there was (after contact with Europeans), the history of the policies to assimilate Indigenous peoples into mainstream Canadian society. All those policies that were there are still there, and they play a major role in how Canadians think about us in general. These are ongoing things.

And the other part of history that’s very unique is our unique relationship with the federal government with the Indian Act and with the treaties that have all been signed. All of the agreements that were made have somehow, up until this day, led to a lot of the difficulties and stereotypes about Indigenous peoples. The historical content and the ongoing stereotypes are very different between Black peoples in Canada and the Indigenous peoples. I do think there are major differences there.

Now, I do think there are ways of working together. Addressing racism in general and raising awareness of it – I think that’s something that we can do together. Addressing the lack of Black and Indigenous faculty members – that’s something we can work on together. Admissions policies for students is another area. Those are all things that we can work on together as a way of addressing racism.

I’d love to talk about our students because we’re talking about complex histories, systems and institutions but, at the end of the day, when we’re talking about education, these are lived experiences of learners. I was hoping if you could each talk briefly about some of the concerns that students have expressed in their daily lives. But then also some of the resiliency that you’ve seen in some of the incredible achievements that you see from your students.
Dr. Saylor. In terms of students, we don’t have big numbers of Indigenous students in the Faculty of Medicine and Health Sciences in general, but I am hearing some things from them.

The group overall is pretty quiet, and I have not heard a lot from them.  I am extrapolating a bit, but I do think there probably is some fear of speaking out. I do think there is some fear about speaking out against anti-Indigenous racism. And so that’s one thing.

But the concerns I have heard have almost always been primarily in the clinical teaching setting in hospitals. And those concerns are of McGill faculty members – actual staff physicians – who mock Indigenous peoples.

There was one student who came to me and said a certain department was about to see a few Cree people. And I forget exactly what the staff were joking about, but they went ‘whoo, whoo,’ like that. [Making a mocking gesture of bringing the hand to the mouth and making a vocal call.]

Sometimes when a staff member finds out the student is Indigenous, they feel very free to state what Indigenous people should be doing in Canada without being asked by the students. They will speak very roughly to Indigenous patients. And then you hear all these little micro-aggressions and that comes from more than just staff physicians. Generalizations like, ‘they are like this, they do that, they don’t take care of their children.’

There’s an agreement because of Treaty No. 6 to provide medical transportation for Indigenous peoples. And yet it happens over and over again, complaints like: ‘why do they get sent down? Why do we pay for that?’ You hear those things quite often. That’s the majority of what I’ve been hearing from the students.

Dr. Razack. It’s exactly what Kent said – it’s completely echoed for Black students and, in fact, all racialized students. Imitating accents, Indian accents and so on. That’s been brought up, so microaggressions are all over the place.

And they’re actually just reflecting typical problems between the classroom and the clinical environments, where there is a big divide between what you get taught, and then you go to these places like our hospitals and clinics, and they’re highly imperfect.

There’s also the reality that BIPOC students and faculty members are getting minority taxed all the time now. I feel like that there’s a risk of exhaustion. Kent knows this very well, but if you’re the only one, you’re going to be on every committee. And you’re going to be called every single time, and that’s the minority tax.

I think the students are feeling a bit exhausted. But they’re also elated to be part of the process, so we have to figure out ways to protect them and to recognize their contributions and that’s a challenge. In terms of resilience, I think the resilience that I’ve seen  with Black students is the beginning of networks, more organized networks being built as well as this sense of participation and change.

I’m also really, really seeing what Kent said about maybe there being a fear of speaking up. And I think that other students, not just racialized and Indigenous students, but in general, students want us to talk about the tough stuff. They actually don’t want us to candy-coat it, and they want to hear about the tough stuff. We need to bring this into curriculum spaces. Students want to have that conversation.

In the second of this two-part series, we talk about the importance of community partnership with Indigenous and racialized communities and discuss how Faculty community members can get involved in anti-racist initiatives.

November 27, 2020