Since its inception, our Foundation has committed to helping strengthen the public health system so that it will be better equipped to respond to current and emerging threats to the health of our communities. This also means looking at the ways our health system has responded to threats in the past — like COVID-19 — and how this response impacted different communities and populations in our province.
This commitment is what led us to fund a 360° COVID-19 review, completed at the Office of the Provincial Health Officer (OPHO), that sought to understand the way its own structures, policies practices, norms, and values upheld white supremacy and Indigenous-specific racism during the OPHO COVID-19 response.
This work was conducted by the Unlearning & Undoing White Supremacy & Indigenous-Specific Racism Lab for population and public health (U&U Lab), led by Co-Principal Investigators Dr Danièle Behn Smith, (Eh Cho Dene of Fort Nelson First Nation and Franco-Manitobain/Métis from the Red River Valley), Deputy Provincial Health Officer, Indigenous Health, and Dr Kate Jongbloed (white occupier), Senior Scientist at the BCCDC, with support from Research Coordinator Kristen White, and Research Assistant Chelsey Perry.
In dialogue with Indigenous partners, the U&U Lab reviewed the OPHO policies and processes used to make decisions during the state of emergency. This work was prompted by In Plain Sight recommendation 15, which asks for the BC government, the Provincial Health Officer, and other governing bodies, to develop a robust Indigenous pandemic response planning structure that addresses issues that arose in the context of COVID-19.
The goal of this work was to:
- Illuminate which OPHO structures, policies, practices, norms, and values upheld systemic white supremacy and racism during the COVID-19 state of emergency.
- Catalogue the central issues that arose within the OPHO’s sphere of influence during the COVID-19 state of emergency.
- Share findings with public health leadership, to help develop and implement anti-racist pandemic response strategies for future public health threats.
The review identified several main issues — what the U&U Lab calls ‘colonial knots’ — that contributed to anti-Indigenous racism during the COVID-19 state of emergency. Among these issues were:
Whiteness in decision making
- Health systems founded on settler colonialism, whiteness and the decisions of white occupiers continue to reinforce white supremacy and Indigenous-specific racism.
Public health is not yet trustworthy
- Both historical (small pox response, Indian hospitals, Residential Schools, H1N1 response) and current (the child welfare system where, as of 2021, 53.8% of children in foster care are Indigenous, despite being only 7.7% of Canada’s child population) systemic anti-Indigenous racism demonstrate why there is ongoing distrust of the Canadian public health system.
Settler dominance & Indigenous invisibility
- Due to the ongoing genocide of Indigenous peoples in Canada, settlers outnumber Indigenous people 96:4. Because of this, OPHO state of emergency orders often did not reflect shared decision making or the health interests of Indigenous peoples.
Barriers to exercising jurisdiction and legal pluralisms not upheld
- COVID-19 brought into focus the government and public health structures that actively prevent First Nations from exercising their inherent rights to jurisdiction and health sovereignty. BC First Nations had to fight to exercise decision-making over their land through community protection blockades to protect collective well-being.
Baseline under-resourcing of First Nations, Inuit, and Métis governing bodies & organizations
- Indigenous-led health organizations in BC, i.e. FNHA, Métis Nation BC, and First Nation band health departments play a critical role in delivering comprehensive care and addressing public health crises, including COVID-19, toxic drug poisonings, climate change, etc. Organizations and communities also carry the weight of responding to ongoing colonial violence and racism (e.g., unmarked graves at Kamloops Residential School).
Data sovereignty is not fully realized
- The programming and infrastructure needed to fully implement First Nations, Métis and Inuit data sovereignty does not currently exist, and without this data, it made self-determination for Indigenous peoples very difficult during COVID-19.
Accountability to Indigenous peoples not accepted by system
- Directives, like the Truth and Reconciliation of Canada Commission’s Calls to Action, the Missing and Murdered Indigenous Women & Girls Calls for Justice, In Plain Sight Recommendations, among others, are legal, institutional, and professional obligations, yet many remain unmet.
The issues identified in this review have real world consequences. Racism in healthcare, and the subsequent distrust in the health system, including public health, creates poorer health outcomes for Indigenous peoples. The work of Truth and Reconciliation begins by finding and daylighting the truth. Coast Salish Knowledge Keeper, Shane Pointe, (Sulksun) gifted six teachings to the Provincial Health Services Authority (PHSA), where this work took place. One of these teachings, “Thee Eat”, translates to “tell the Truth”.
“We all must not deny the truth of the history and we must remain committed to addressing it.” – Sulksun
This review takes Sulksun’s teaching to heart by telling a difficult truth — revealing that during the COVID-19 pandemic, systemic white supremacy negatively impacted the health of Indigenous peoples in BC. This is something that Indigenous peoples have always known, but the settler system is now seeing the truth. The U&U Lab is now sharing these findings with public health leadership, to develop and implement anti-racist pandemic response strategies before our province is impacted by another public health threat. This work is also providing insight into upholding Indigenous rights, reconciliation, and anti-racism in the current toxic drug poisoning emergency that is disproportionately impacting First Nations people in BC, and contributing to a decrease in life expectancy.
We are so grateful to our donors for helping us support programs that uphold Indigenous rights, work toward reconciliation, and help to eliminate Indigenous-specific racism in public health. Together, we are having an immediate and measurable health impact in communities across BC, and together, we are advancing equity and social justice for all.
