November 10, 2012 • Podcasts
Aboriginal Women’s Cultural Safety and Sexual Health
Continued from page 4
So, we hear pretty terrible stories. I mean there was one story – that’s in our report, so I can share it with you – she was a woman who was homeless, and she went to the hospital for something, I’m not sure what it was. And they lost her clothes, so she said, well, when she was going to leave, she was like, “well, where are my clothes?” and they said “are you sure you came in wearing clothes?” And she said, “I can’t imagine that they would say that to a white woman, that they would propose to be so disrespectful.” And so, stories like that, of course, the response is, “I’m never going back there again, like, I’m never going to be treated that way.” I mean, they obviously don’t need that, nobody needs that kind of treatment. But, particularly someone who’s looking for help and really might need help. So, what we’ve been trying to do, and there’s lots of folks who’ve been doing it for longer than I have, this whole movement started in New Zealand, this notion of cultural safety, is to try to develop some skills among health professionals, to not only prepare them to interact respectfully with Aboriginal people, but also to educate them about some of them historical and social determinants of those people’s lives that they might be interacting with. And one of the most important things about cultural safety is to encourage health professionals to acknowledge their own privilege.
CR: So some folks who often don’t encounter a lot of disadvantage in their life, don’t sometimes recognize how much privilege they have or the power dynamic that they might be participating in with an Aboriginal client.
RS: So what’s an example of that power dynamic that, maybe, wouldn’t be noticed, or that privilege that wouldn’t be noticed?
CR: Well, assumptions. So, assumptions about whether or not people have transportation, whether or not a person has cash or the resources to get medications, different therapies that might not be covered by either regular health insurance that everybody has and then there’s specific, non-insured health benefits that some First Nations people have, people who are status. So, sometimes people assume that a person is housed, or a person has childcare. If someone misses an appointment, oftentimes the inclination is to assume that person doesn’t really care about whether or not they receive the healthcare. And it might just be the person couldn’t - didn’t have money for the bus, didn’t have childcare, couldn’t get there. And again, in the case of HIV, we’re often talking – not always – but we’re often talking about women who are struggling, they’re struggling just to survive.
RS: Okay. And is that the main aspect of cultural safety…?
CR: I mean, it really does, it really does begin with the person recognizing what privilege is, how privilege affects our relationships with each other, and also though, to have a fair degree of familiarity with Aboriginal cultures. And I say cultures because it’s obviously, there’s not just one Aboriginal culture. People are often asking me, “Well can you tell me about Aboriginal culture?” I say, “Well, which one?” I mean, there’s like, hundreds and hundreds, right? And so, just understanding the diversity of Aboriginal people, understanding some of the structural determinants and some of the structural barriers. We called it relational care. We did a project with Aboriginal people with HIV and what we ended up discovering was that, it wasn’t so much whether the person they were interacting with was an Aboriginal person or not, it was about the relationship that they had with that person and if that person treated them like they cared about them and tried to understand the context within which they were approaching from.
RS: Yeah. And treated them with dignity.
CR: Yeah, it’s a pretty simple thing, and yet people don’t often get it, because there’s a lot of stereotypes out there.
RS: Yeah. Is there anything else you’d want to say about your work around cultural safety? How far have you gotten in terms of working with health professionals around this?
CR: Oh well, there are some wonderful programs that I’m not necessarily involved with, but there is a program in Vancouver Island and BC around cultural safety. The province has a great website, Cheryl Ward is the person who directs that. Health professionals can go to that websites and they can roll in these online modules to improve their cultural safety, but there’s lots of research being done and we’re still trying to figure out what the indicators of cultural safety are. So, what kind of awareness and knowledge and skills should health professionals have in order to provide appropriate care to Aboriginal people. And so, that means we just need to talk to more Aboriginal people about that.