In a recent article, I described how my interacting with First Nations as CEO of the Provincial Health Services Authority (PHSA) in Vancouver changed not only the way I look at things but also the way I learn. One significant challenge when one starts the journey of changing the way one sees the world is to take stock of issues that become more apparent in the process. This may sometimes be very disturbing as the issues that come to the fore may have existed for a long time. One such issue is systemic racism against Indigenous Peoples in general and more specifically the different forms it may take within health systems. As I was learning about First Nations in British Columbia, a broader awareness regarding systemic racism in healthcare and in our society was also developing across the country.
In the summer of 2020, an allegation regarding a potentially racist game associated with the health system in B.C. hit the media. This prompted an independent investigation, which resulted in the “In Plain Sight” report. The report revealed a shocking reality, which fueled the learning process that many people were faced with, me included. The report confirmed that a significant effort was necessary to ensure that the rights of all people would be protected and that First Nations, Métis and Inuit Peoples should lead a joint process whereby appropriate steps may be taken to make the health system culturally safer. As this was unfolding in B.C. regarding the health system, other issues and tragedies related to the alleged systemic racism against Indigenous Peoples were being revealed by the media throughout Canada. Obviously, many things had been overlooked for way too long in our society regarding cultural safety; and not just in healthcare.
The main point here is not to simply go over the news and the reported issues to help take stock of what that means. The main point is to stress that developing awareness is merely the starting point. The meaningful step to be taken is to determine how to fix things in a safe and satisfactory way and to start the journey concretely. But how do we go about designing solutions for issues and problems that have been left unattended for so long? How do we do it in a way that is respectful to all? In a way that is well aligned with what the many different needs call for? Everyone is not necessarily at the same point in the learning and accepting process. How do we create a momentum to improve things without pushing too hard or making the mistake of not pushing hard enough? In a nutshell, how do we change a culture that has been both consciously and unconsciously nurtured for a long, very long period of time?
Systemic racism, whether recognized as is or through other forms of recognition, is not just in healthcare. We all know that. And the horrifying stories that we recently learned about regarding the residential schools confirmed that the challenge we all face collectively is to help our societal stance evolve both in terms of awareness and also regarding biased behavior. Not a simple task to take on. A cultural change of that magnitude may take a very long time to bear fruit. Experts suggest long-term strategies are optimal. Acknowledging that time is required for full change to occur, I would nevertheless suggest that we go back to basics to effect immediate changes; even if they are small.
Any culture change is ultimately rooted in how each and every one involved sees it; becomes aware and accepts the underpinning reasons making it necessary; and, first and foremost, takes action towards that change. Action, any action, is paramount and collective actions stem from individual ones. Small and simple actions are powerful. This is where cultural changes find their momentum: individual commitment. The small steps that one individual can make do matter. They actually matter in a big way as those steps amalgamate with the ones that others take and, all of a sudden, there is a critical mass of small steps that become a momentum that can be witnessed and felt. In turn, this becomes an incentive for others to join in and the cultural change is on its way.
There is no magical recipe for culture change. I do believe that the systemic racism, whether recognized by government or not, calls for our collective effort to change things. This starts with our own individual process of learning, developing awareness and then committing to taking steps. As I was learning about First Nations during my time in Vancouver, the development of my awareness was boosted by the concurrent emerging facts confirming that something very wrong happened and is still happening. Of course, a structured, institutional approach must be part of the solution. But I submit to you that the most important aspect of a cultural change is our own individual commitment to it. Even though we may feel that our small, individual contribution may not make much of a difference, it does. For instance, writing about it is one such small step. It may not be much and it may not be perfect. But it is an action, which comes from my commitment. And you? What do you think individual contributions could / should be? Do you believe what you do individually could make a difference? Write to me with your comments and ideas @ firstname.lastname@example.org. Your actions matter and your thoughts will be great fuel for future articles…
In the meantime, may you be well, may you be happy.