Dr. Marcia Anderson: Confronting Anti-Indigenous Racism in Healthcare

Stuart Murray  0:00  
This podcast was recorded on the ancestral lands, on treaty one territory, the traditional territory of the Anishinaabe Cree, Oji Cree, Dakota and the Dene peoples, and on the homeland of the Metis nation.

Speaker 1  0:20  
This is humans on rights, a podcast advocating for the education of human rights. Here's your host, Stuart Murray,

Stuart Murray  0:30  
well, welcome to humans on rights today, we're facing some hard truths about health care. A recent Winnipeg Free Press article revealed that indigenous and black patients in Manitoba wait longer in emergency rooms and are more likely to leave without care. Leading the call for change is Dr Marcia Anderson, a Cree Anishinaabe physician from Peguis First Nation and Norway House Cree Nation. She's a Vice Dean of indigenous health, social justice and anti racism at the University of Manitoba, and a national leader in advancing equity in Medicine, Dr Anderson joins me to talk about racism in healthcare and how we can create a system that truly works for everyone. Dr Marcia Anderson, welcome

Dr. Marcia Anderson  1:16  
to the humans on rights. Thank you so much for having me to talk about this really important topic.

Stuart Murray  1:21  
Yeah, so, so, Dr Anderson, maybe I gave a little bit of a brief about you. You've got a very, very interesting history, and I'll even open it up by saying I was thrilled and delighted to sit with you when you got your order of Manitoba. And we can maybe come back to that. But Dr Anderson, talk a little bit about your who you are, your background, and what you're working on, please. Yes.

Dr. Marcia Anderson  1:44  
Well, as you mentioned, I am Korea, nishinabe. I grew up in the north end, but like you mentioned, my roots go to Peguis, First Nation. My dad's a member there, and then through my grandpa's side, a long line of Cree half breeds actually going back to Norway House. I did go to medical school here and did half of my specialty training here. And it was during medical school and residency that I really learned about the impacts of anti indigenous racism in health care. Part of it was what I observed or things that were said to me when I was training. And then, unfortunately, my dad, who is still alive today, I'll just note, but he did have a very serious heart attack when I was in my second year of residency. And unfortunately, the care that he received was impacted by racism, by a common stereotype facing indigenous people about substance use as the reason for his presentation, when, in fact, he was in cardiogenic shock, a very severe heart attack. Fortunately, because I was in specialty training, I could get to the hospital and I had the knowledge I needed to intervene. But as I moved on in my training from that day, one of the things that really stuck with me is that while many indigenous people experience racism in health care, the vast majority do not have a physician in the family who can intervene and advocate on their behalf. And that really became my motivator and even my fuel for the work that I've done since one of the projects you've mentioned too, which is that I do lead the collection of racial, ethnic and indigenous identifiers on behalf of shared health Manitoba, we were the first province in Canada to do this systematically, and that gives us the ability to show differences in health Care Access and healthcare quality by race and indigenous status, to really highlight these important gaps and then work to close them.

Stuart Murray  3:49  
So let me just unpack a couple of things. Dr Anderson, you were in a very and I did meet your father, I think at that the order of Manitoba dinner. So yes, it was fantastic. Yeah, I love that evening, by the way. It was really, really tremendous. And so a double, a double. Great honor to speak to you today. But Dr Anderson, when you recognize that there were some issues going on with your father, just, let's just back up a little bit and talk about, as you were studying to get your medical degree, did you get a feeling that you personally were there issues that you personally felt that there were some very serious racist things that were being dealt with or talked about while you were learning your profession.

Dr. Marcia Anderson  4:32  
And I would say this happened in a few different ways, not all of which were malicious. I will say that. But as I started med school. There weren't many Indigenous learners in medical school at that time, a very small number of us. I mentioned I grew up in the north end of Winnipeg, one of the experiences I had, which makes me chuckle now, and made me laugh back then, too, was one of my peers once said to me, are there polar bears where you grew up? Right? Right? Yeah, and it's like, Well, I grew up in the north end of Winnipeg, but it's this idea that we all must be exotic and from very far away, right? I would have peers ask me if medical school was harder for me since I got in the easy way, or why did I work part time, since we get all of our education for free, these really common stereotypes that are actually incorrect. And then there were certainly some some more malicious things. One thing was we were still very much being taught that our poor health outcomes were were to be blamed on us. Right? They used to teach that diabetes was the result of this Thrifty Gene theory that we had inferior genetics, or that our poor health status was because we made bad decisions. Drank too much, we were lazy. And I remember one time when I was on my obstetrics rotation as a medical student and a senior resident actually said to us, a small group of us who were in the call room on st Boniface in the labor and delivery ward said that the best thing for Canada would be if native people stopped reproducing. Wow. And at that time, I was shocked. I was hurt, and I wasn't in a place where I could really intervene. I was a junior medical student. That senior resident was responsible for evaluating me, for teaching me, for making sure I had the exposure to deliveries that I needed to have, and so I couldn't do much at that time. But those were all the types of experience that really highlighted to me, you know, both personally and professionally, how anti indigenous racism was operating in health care and in health professional education.

Stuart Murray  6:50  
Yeah. And did you ever at any time Dr Anderson say, you know, I'm, I'm out of here like this is, you know, I got into this to help people to learn to make a difference. And the, you know, kind of the the the, I'll just say I don't toxic. Maybe that's an overused word, but an environment that is not is not positive about learning about what it is you're doing. I mean, did you ever have questions about whether you're going to proceed with your career? Never

Dr. Marcia Anderson  7:19  
about whether I was going to proceed with my career, but I did have questions about where was the best place for me to proceed with my career after my dad's heart attack, for a variety of reasons, continuing my education and training in Manitoba was not going to work. So I did leave Manitoba for a period of time I went to Saskatchewan for a couple of years, not because the situation is any better when it comes to anti indigenous racism, but I had a program director and a dean there who were really behind me and who offered me important supports for me to be able to continue. And so I did continue to experience racism there. In fact, my very first shift on call, I was in the intensive care unit. I had to go see a patient in the emergency room who was critically ill, had a breathing tube in, was sedated, so I was listening to the emergency room physician relate his history to me as I examined him, and on his way out the door the emergency room physician stopped. There is just him, the unconscious patient, myself and a male nurse in the room the emergency room stopped on the room. Physician stopped on his way out the door and asked if I had to jump out of the Indian posse to move to Saskatoon. Not a reference any other position has made. And I certainly thought to myself, Okay, I've jumped out of the frying pan and into the fire here, right? No kidding, but because I had a program director and a dean who had committed to support me, has some situations with that position escalated, I asked them for that support. I leveraged that support, they also ultimately supported me when I went down to Baltimore to do my master's in public health, where I specifically focused on the study of health and health care disparities that occur by race, which helped launched my career. So it wasn't that I thought about leaving my career, but I did know I needed to be supported differently in order to be able to proceed, and it was important to learn to me that there would be people in different places and at different times who were willing to offer me that support.

Stuart Murray  9:33  
Thank you for sharing. I mean, I It's, it's, you know, I don't really know where to start in those conversations, right? I mean, because it's just so it's so hurtful and so hateful and so not necessary, just not necessary at all. But Dr Anderson, one of the things that I'd love to explore with you is you've had all these anti indigenous, racist moments. Times issues, and you have now become like a national leader on these issues. And that really just speaks to who you are, in terms of your tenacity, in terms of your belief, in terms of a lot of you know, and I'll just say again, sitting around the table with you and your family at the order of Manitoba. I know where you get your your desire to be successful from, you know, I think you're blessed with a very strong family. But, you know, let's just talk about the fact that you, you have, you have written about this, you've talked about it. And I want to sort of come back initially to in the I think it was November 26 I'm just looking at my research here that said that healthcare workers receive to receive training to combat anti indigenous racism that was done in Winnipeg on November 26 2024 and in that article, Dr Anderson, you're quoted and regarding the importance of it. Just maybe walk through to those people listening what is involved in that. And maybe, if you could, as you're talking about it a bit, Dr Anderson, give a sense of how you feel going into those conversations with a group of people. And then as you're finished, when you start to look at the same group, whether it's after immediately or a couple of weeks after just share what you get a sense of how much learning has taken place during those sessions. One

Dr. Marcia Anderson  11:27  
thing that I would say is we have several different learning opportunities available, some of which I deliver directly. And then we also have what we call the Giga Mino Gano when Anishinaabe, we will take good care of the people online, cultural safety and anti racism training. So multiple different interventions. One of the forms that I personally do, and have done for a few years is I lead a group coaching program for leaders in anti racism, right? Because the education, whether that is an online course or a grand rounds lecture or the courses that we do for students in medical school, for example, all of that has to be reinforced in the actual practice environment. It has to be reinforced by the peer group, the team that we're part of, and by the team leader, right? We really wanted to develop multiple kind of puzzle pieces, or multiple places of intervention to make sure what we are teaching, again, whether that's me directly, or the online teaching or other people's teaching, gets reinforced in the practice setting. So one thing I've observed over the years is absolutely now there are more people who are committed to being part of the solution. They don't. Doesn't mean they always know exactly what to do, especially in the moment when they're observing something such as a stereotype about substance use going on, for example, and they might hesitate or be afraid to speak up. And that's where programs like the coaching program come in, right? Because we can talk about what are the fears that hold them back, we can practice the strategies that they might use, and we can talk about what supports they can give to other in the group so that they, all you know, share responsibility for speaking up when they do see ways that anti indigenous bias is impacting health care. And the other thing that I will just note, which is, in addition to the training, several years ago now, we passed an anti racism policy in the Brady Faculty of Health Sciences like it's really important to know that several of the regional health authorities, Northern and inter like Eastern, have already passed anti racism policies, and other regional health authorities like shared health and wha are working on them too, because this is a problem education alone is not going to solve, but leadership, support, policy, accountabilities, practice standards like that, through the College of Physicians and Surgeons of Manitoba, all of these things together are what going to come, what's going to combine and make A difference?

Stuart Murray  14:18  
And that's really a great answer, because part of what I always wonder in these processes, Dr Anderson, is, how long is a session like the one, not online, but just say, for example, if you're doing one in person, what what walk us through? Maybe a timeline? What's involved in that?

Dr. Marcia Anderson  14:37  
Please. So I would say, in general, a standard education session could range from 30 minutes to about half a day, depending on the goal and who is doing it. The sessions that I run as part of the group coaching program in anti racism are 90 minutes and so I always have a bit of pre. Reading or podcasts or YouTube video for the participants to watch. I purposefully pick resources that have been developed by indigenous or black or racially marginalized experts and professionals. During this session, we will talk a bit about the resources, and then we'll do a mix of activities, which might include online polling, might include some paired exercises where people are coaching each other, working through their problems together. And then the last thing I do in most sessions is I do an observed coaching session where I will coach one group member for 15 to 20 minutes on a real challenge that they're experiencing, and everyone else observes. The reason that I like a coaching approach is that coaching really draws on the person to understand their context and develop and find their own solutions. Like, as I've mentioned, we've given lots of inputs into that, but at the end of the day, the person draws on their own strengths, their knowledge of themselves, on the context, to develop a solution. And the people who observe almost always can relate directly to the experience that person is having. And when they listen to me ask that person questions, they can go through the questions themselves. It also helps to build a sense that, you know what, I'm not in this alone. Other people are going through the same things. We can talk about what we're each trying and what's working and what is not working. And that is why I have found this group coaching approach really helpful.

Stuart Murray  16:37  
And that's a great way, I think, to take it away just from, say, one person like yourself, Dr Anderson, leading it. It's talking more of a team, because it is a team approach, I think, that you work through in healthcare. And can I just ask, when you are doing these sessions, are they specifically focused on healthcare, or is it, is there a general issue you're talking about, you know, just we're to be a proper human, you know you shouldn't, you know, understand, you have to understand what anti racism for indigenous people is all about.

Dr. Marcia Anderson  17:08  
Well, I do focus on people in health care and health professional education, absolutely. But people experience the issues as well as the challenges that they have in responding to them, both in their personal and professional life. So sometimes, when people are feeling afraid of potential backlash in the work setting, of in of trying or experimenting with an with the anti bias intervention, let's say we might talk about where in their personal life, could they try it first? Do they have a friend group, a dinner table, a family setting, where maybe they could practice some of what we're talking about and then work their way up to practicing in the workplace setting? One of the things with systemic racism is it's not limited to healthcare. We see it across the range of our lives, so there's no shortage of arenas to practice in.

Stuart Murray  18:06  
Yeah. So Dr Anderson, do you find when you're in a group, and I don't know, maybe this is a bit of a question, looking at healthcare in terms of what the percentage of population of healthcare is, more women versus men, but when you talk about some of the education sessions you have, would you find that there's more men or more women, or 5050, would you how would you find sort of the is there something typical? There? Is it just so unique? It's hard to answer that.

Dr. Marcia Anderson  18:33  
It's very setting dependent. I would say in my group coaching program, for sure, there's been more women than men signing up and participating for this more kind of intense and and personal practice focused approach. If I'm going to do something like a grand rounds presentation on anti indigenous racism, the departments look pretty different. Anesthesia and surgery still look pretty different than OBS GYN here, or family medicine, for example. And I will say when I do a group coaching program, everybody wants to be there. They might be hesitant, they might be nervous, but it's voluntary. If I go to a Ground Round setting, the gender dynamics might be different, but also the level of willingness versus resistance can be different too. And so it's a different dynamic that sometimes have to be managed. And I really have to role model intervening if someone is responding with resistance and anti indigenous racism to try to keep that learning session safe for everybody

Stuart Murray  19:36  
else. Yeah. Dr Annas, you mentioned the term ground rounds. Am I saying that right? Grand Rounds. Grand Rounds, okay, sorry, I was just thinking you're going for coffee somewhere. So Grand Rounds. Can you explain what? What is, what does a grand round? Please?

Dr. Marcia Anderson  19:50  
Yes, absolutely. So Grand Rounds are the weekly or bi weekly lecture series that most clinical department. Have in medicine. It's a way to keep up the professional development that is required of physicians, as well as gives our colleagues a chance to present their evolving work and the knowledge base too.

Stuart Murray  20:11  
Okay, and you said that, depending when you do your grand rounds, sometimes there was you would see some differences in that the way they look. What did you mean by that? Can you just explain that a little bit?

Dr. Marcia Anderson  20:24  
I get invited to speak across the country, so I'll visit different provinces, different medical schools, as well as sometimes different departments here in Manitoba too, that is where, as I mentioned, you can see quite different gender makeups in the audience, as well as racial, ethnic makeups in the audience, depending on dependent. We still do have some specialty fields that are more male dominated, some that are more women dominated. And then, not as a rule, but for sure, there is a different feel to some audiences. There are some places where I go and because of education that's already happened, because of commitment of the leadership. Maybe they already have an anti racism book club. Maybe they have an Indigenous Health Practice Lead, for example, people are a bit more open to what I'm saying and want to know more. And then if I go to another place where there hasn't been a lot of leadership support and there hasn't been a lot of development, I can see when the body language is actually different and people may be maybe sitting with their arms crossed, there might be eye rolls. There might be more people on their phones not actually paying attention, and that can also lead to some more hostile questions or comments when we move to a question and answer session.

Stuart Murray  21:53  
Yeah, and, you know, again, it's, it's always a fascination. You know, when you're you're in a position where you know whether the word is teaching or whether the word is learning. You know, the opportunity is to understand. And if you step back a bit, Dr Anderson, I mean, you think about the fact that Canada's is going through this whole truth and reconciliation period. And you know the that that is one of those areas that I just remember I was, I was very, very honored to have some time with, with Murray Sinclair. And a conversation was when I was at the Canadian Museum for Human Rights, and we had a conversation, and I was trying to say to him as somebody who is, you know, I grew up in a small town in Saskatchewan, and there were first four First Nations around where I where I grew up. And so I had, you know, I grew up in a very interesting area. As a matter of fact, I think Gordon reserve was one of the areas that got the first apology, I think, from the Canadian government to one of the on a residential school issue. But I was trying to say to him, because he understood this so well that that the learning part, the learning part, is not about a week a day, a month a year. It's, you know, it's kind of, as he would say, generational and and so dr Anderson, one of the things that I was trying to say to him is that is a concept I don't really understand. I need to understand what does that look like? Because a lot of times, you know, a report will come out, it's, you know, like the Truth and Reconciliation, that the TRC comes out with all the recommendations, and then there's kind of a sense, well, you know, this should be, what, a couple weeks, maybe a long weekend, we should be good to go, and away we go. And it's like, no, you have to stop before you even think that you're you, you know, you have to slow down and stop you know. How do you explain, if you get a question, as I'm posing to you? Dr Anderson, how do you explain that this, this anti indigenous racism, is not something that, I mean, we would love it to go away in a week, or two weeks or or the closer this month, or whatever it may be, that's just not where we're and I don't want to be, I don't want to be negative, because I do think, and I want you out of your, you know, you've had the experience, which is fantastic about some good, positive things. Dr Anderson, but I look at just sort of the bigger issue, because I, you know, I want to make reference to a more recent article that you wrote in the Winnipeg Free Press, but we'll get to that. But how do you, how do you frame the conversation around what we need to you know, people say you have to unlearn or you have to learn. How do you, how do you frame that?

Dr. Marcia Anderson  24:37  
It's an excellent question. One of the ways that I talk about this is there is a book by a scholar in the US called stamped from the beginning. The scholar's name is Ibram X kendi, and the subtitle of the book is the definitive history of racist ideas in the Americas. Right in the very beginning part of the book, it might. Even be in the in the preface to the second edition, I think he talks about, when he looked across the centuries of American history, kind of post contact. What he saw was not a steady progression towards racial justice. What he saw was actually a dual and dueling force, the dual and dueling forces of racial equity, progress and the evolution of racism. Okay, and so that is, I think, a very foundational concept to understand, is that we're not on a straightforward, linear path here. We're in a bit of a war, and I think especially in the last well, since Trump's second election, I will say we're seeing that. And the one specific thing I'll mention, although there's many things that could be mentioned, was when he said something around birthright citizenship for Native Americans, like he didn't necessarily think Native Americans should have birth right? Amongst other things, it's a bit of a signal that challenges history and the place of Native Americans there, back to Canada, though, and when we think about how that can apply, you mentioned the late honorable Murray Sinclair, who is something I learned a great deal from also, he talked about and said frequently that the child welfare system was essentially the evolution of the residential school system. Right? There were more kids in child welfare than there were at the height of the residential school era, and causing many of the same harmful health and social outcomes, right? It wasn't that residential schools ended as an act of anti racism and progress. Most of them were shut down because of fires or TB outbreaks or things like that, and we saw this evolution into a different system also had significant embedded racism in it. And so when, when the late Justice Sinclair talks about this is generation, what I believe he's referring to is that we've baked versus racism into our systems for generations, when I think about this in healthcare, it's understanding that our health care system was built at the same time as residential school systems were built, right at the same time as the justice system was being built by the peers the university and social and class peers of the architects of the residential school system, and we had many of the same problems express themselves in healthcare. We had completely segregated Indian hospitals. Actually, we had for CE Moore, who was the physician and architect of the Indian Health System, write, quite frankly, in an article for the Canadian Journal of Public Health that the reason for the government to get involved in Indian health care, and I'll use those words specifically in the historic context only, the reason was maybe for, he said, for humanitarian reasons and to protect prevent the spread of disease to white people.

Stuart Murray  28:18  
What year? What year are we talking about Dr Anderson. Do you recall roughly

Dr. Marcia Anderson  28:22  
that article was published in 1946 we are talking about in the same kind of decades lead up to to Tommy Douglas and Medicare. So these been baked into our health care system, so we don't know actually how to have a health care system that is free of anti indigenous racism where we're at right now is, I would say there are more people who agree there is racism in the healthcare system, and we need to do something about it, then disagree. And we have to learn how we can make it different now. And this is the generational problem that's going to happen at the same time, we're going to see backlash to racial progress. We see this anti woke is in this quote, unquote anti dei initiative. People will frame that also as being anti reconciliation. Unfortunately, just last week, we had a residential school denier on campus at the U of M and at the U of W. Those are the kind of backlash that fights against and draws people attention away from the type of racial justice and human rights education we're trying to promote.

Stuart Murray  29:30  
And, I mean, you know, not to sort of go down a rabbit hole. It's too bad that even those people even get, you know, media coverage, you know, like that's the trouble, because, you know, at some point, you know, and people are dealing with a lot of issues. There's mental health issues, there's a whole lot of things that there's a lot of stigma that we deal with in the world. But you know, I mean, knowing full well that, if you you know, it's like a Holocaust denier, it's the same thing. If you go out and sort of do that, you're going to be on the news. And that's unfortunate, because, you know, we. One Voice versus, you know, against many who are trying to sort of change that narrative, that one voice seems to be louder than the others combined, which is so unfair, so unfair. Dr Anderson, I want to just, we're going to talk about some of the things that you see that are great. But, you know, I made reference to the Winnipeg Free Press article that you were involved in in November 26 2024 but the one that really caught my eye, and the reason I reached out to you was just the one that was in the paper, June 17, 2025 so not long ago, and the headline was hard truths, indigenous black patients wait longer to be seen in Winnipeg hospitals. And that's in a quotation, and that is really sort of from you and the research that you found. Why? I mean, why did you feel it was important to come out? I understand the work you're doing and the great work you're doing, but why did you feel it was important to come out in June with kind of those hard truths which are factual,

Dr. Marcia Anderson  30:57  
the work to get to the public release of that data took a solid eight or nine years of effort, because it started with building the case for us to even collect racial, ethnic and indigenous identifiers, to even give us the ability to look for the impacts of racism in our health care system. Canada as a country, has not really wanted to do that. In the past, we've taken the position that because we have this publicly funded health care system that is supposed to be universal and accessible, that we shouldn't have these kind of gaps in health care despite all research reports and other forms of evidence to the same so it took us a very long time to get to that point. I will make one correction. This was a bit confusing in the media in that it's not actually research. I've been working directly with the healthcare system to use this as part of the regular way. Going forward, we will look at healthcare quality and health systems performance measures so to become part of routine healthcare quality and patient safety work to consider the impacts of racism, because it's so pervasive. We worked very closely with governing partners to do this in a way that was respectful of indigenous data sovereignty and respectful of human rights, and to ensure we had an expert health and critical race and human rights narrative around it. The one thing I would say is, if you asked most of my colleagues, they would say, we treat everybody the same, and I knew that we were going to be stuck with taking different action if we could not show data that showed, despite your best intention to treat everybody the same, I believe that is your intention, the data shows we're not reaching that ideal as a system.

Stuart Murray  33:00  
It's one of those, you know, a couple of things that just sort of come out as you're saying that. Number one is, do we really need data? Like, it's just evident, you know, like you're saying, Well, you could get, what does the research say? Well, I mean, just observe, right? Just sit and observe. You'll see it, right? I mean, it's evident. I understand from your background, it's important to have data right? Because that's that is, that is, that is critical. But does it? Does it strike you odd that you, as a First Nations Doctor, are leading this conversation and that there's no white person, or am I mistaken? Is there any white people that are leading this conversation to say we got to do a better job here,

Dr. Marcia Anderson  33:43  
I would say that the project manager on my team is white, and she is excellent. She's learned so much, and she actually is the machine that makes a lot of this happen. And over the years, I've had very close support from several non Indigenous, including white senior leaders, and that's important. The one thing I will say is, I think it is perfectly appropriate for me to lead some parts of this work, including pushing this data work forward. I am well trained for that. It is best that it's led by an indigenous or black or racially marginalized person. Where it is really important we have non Indigenous people, and in particular, white people, stepping up and doing more of the leadership work is when we're encountering resistance, when we need different decisions made around the policy table, when we need people to do the work of saying that seems a bit colonial, or that seems like it might be rooted in white supremacy, those conversations are best led by white people among the other people in the boardroom. And so I'm encouraged when I start to see more people stepping up to do that. And I think that is a. Good model for reconciliation, for me to lead the work that I'm best placed, and for non Indigenous people to lead the work that they're best placed to lead, like like countering that

Stuart Murray  35:10  
resistance. So Dr Anderson, when this article came out in in June of 2025 again, I want to read the the headline, because it's important. The headline was hard truths, indigenous black patients wait longer to be seen in Winnipeg hospitals. What was the response that you got to that article?

Dr. Marcia Anderson  35:29  
It was mixed, as you probably would imagine. Many people reached out specifically to me, one on one or on social media to say thank you for doing the work, because they felt like it really validated concerns they had tried to raise that they'd been shut down. It really, yeah, it was validating to many people in their experiences to see the data prove what they'd been saying and trying to raise and we treated it very carefully in terms of the analysis and the comments that we made around it. For sure, there were some people who only wanted to focus on the fact that the emergency rooms aren't working well for anybody right now, and there will be some people who will continue to think if we could fix wait times, overall, we would fix the gaps too. I would be very cautious around that there's actually no evidence that without deliberate attention to close the gaps, we can close the gaps. And I would say there is a small minority of people who are actively resistant to the findings. Don't think education will work. Think that there's problems with the data, or there are some justifiable reasons for why black and indigenous people in particular are waiting longer.

Stuart Murray  36:54  
It was a sobering article, for sure. I'm glad you, I'm glad you, you You did what you did. I'm glad you're out there. I'm glad you continue to do what you're doing. I don't want to look through rose colored glasses in any way, shape or form. Dr Anderson, but you know, Have you have you seen some positive outcomes? Have you seen something where you say, Okay, this is definitely one foot that has gone in front of the other, not backwards? I mean, there's work to be done. It will continue to be work every single day. There will be work to be done. But are you starting to see a sense of of, you know, if I could use even the term hope, I know it's not a strategy, but from your perspective, are you starting to see that there are starting to be some traction on what it is your what it is that you and others, not just you alone, but I mean your leading voice, but you and others are starting to see.

Dr. Marcia Anderson  37:44  
One thing I will mention. I'm not sure if you had a chance to see this recently or not, but there was an inquest report that was released in the past month or so into the death of a First Nations woman named Celine Samuel at the request of families Council. I had participated in that inquest. The inquest report is now public. It was a tragic and preventable outcome. The place there I found hope is when multiple systems who were involved in Miss Samuel's care, and in her case, including RCMP, including shared health, including Northern RHA, acknowledged that there was racism involved. You know, it is maybe a small step, but when I compare it to when I really started openly talking about what happened to my dad and working nationally on anti indigenous racism following the death of Mr. Sinclair. Your audience and yourselves might remember back then, the medical examiner refused to even consider whether racism impacted his death, and so the fact that we have this data that we released in June, we have an inquest report where the health system acknowledged the role of that racism played. To me, it took a long time to get to that point, but it's hopeful, because we can make any progress if we don't acknowledge there's a problem, and we don't have a way to measure how big the problem is. The next month, my team and I will be meeting with the leaders of every regional health authority in Manitoba to talk about their region specific reports and what else they can do at the local level to try to make some progress in closing these gaps. So I think you know approaching this differently in a partnership based way, both with emergency programs, but also with regional leadership, and their willingness to work in a partnership based way, is hopeful as well. I know we're in a very challenging place in healthcare, but the fact that people aren't trying to just shove. Us off to the side, hoping for the next new cycle to take over and distract us. To me, that is where I have to find the hope now and then. Like you said, hope is not a strategy. So accountability wise, we'll be able to look at the data every six months or every year until you know these early meetings, discussions, education, interventions actually translate into meaningful differences in outcomes.

Stuart Murray  40:25  
Yeah, and you said the key word, their outcomes. That's how you can measure what is the outcome? That's something that's measurable. If you were to, you know, if you had a blank sheet of paper in front of you and somebody was saying to you, okay, Dr Anderson, when should we start this anti indigenous racism training and and, I mean, I don't want it to be sort of global, and sort of saying, Well, you know, like the first day you're born, like I'm looking at from your perspective, from your your profession, from your background. So from the medical profession, is there, is there areas and times you would say, you know, in year one this should be, or how, from your perspective, when should you and how should that be introduced?

Dr. Marcia Anderson  41:13  
I will say it is very encouraging that even at a K to 12 Level, there is different education going on now, even just earlier today, I reviewed the timeline that my grade six child will be taught about the processes of Confederation and the kind of relationship between Canada and indigenous peoples. And so I know you asked me about medical school, for example, but that pre learning and what their kids are getting taught from elementary school, so important at the U of M, we do start teaching in the very first year of medical school about Indigenous Health. We talked about how colonization impacts health. My colleague, Dr buss leads a fantastic session called the Human Library, where we bring in different indigenous community members and peoples who have conversations with small groups of medical students, many of whom have never actually talked to an indigenous person before and only know us from you know, media representations and what is in the news. So we try to start what is sometimes called the unlearning right from that age, I find it becomes really important when they hit the clinical years again, because unfortunately, right now, many people are not seeing culturally safe care role modeled when they're starting their clerkship and residency training periods, when they're actually in clinics and on wards. And so we need to stay involved to help them debrief what they're seeing and how it's different from what ideal high quality, culturally safe practice would be. And that is the role of continuing professional development as well for physician colleagues, right? Like, here's what you need to be doing differently. Here's where you need to pause self reflect and ask yourself, are there stereotypes that I hold that are interfering with how I'm seeing or not seeing this patient right now?

Stuart Murray  43:13  
I'm just curious. You know, the you, the country, Canada, has established a day September 30, as as orange shirt day. Just, do you mind just sharing what? When you reflect on that day? What? What? What do you hope? What do you would you like Canadians to learn from orange shirt day?

Dr. Marcia Anderson  43:34  
What I would hope for orange shirt day is that Canadians really do take that opportunity to pause, right to pause and think, up until this day, what have I been taught about indigenous people? What have I seen and on this day, what can I maybe see differently? So I know there's the a day to listen on many Canadian radio stations that will be accessible to many people to listen to in that form. There'll be many community events. I really encourage people to think about getting engaged with the indigenous arts writers, TV shows, plays, even ballets nowadays, as a new way to see indigenous people and to learn about our own histories and presence and futures. I think the most important thing about September 30, though, is for Canadians to think about, what am I going to do differently in this upcoming year? Like, what is my personal commitment in response to the calls to action, whether that's continuous learning, whether that's maybe making charitable donations, whether it's trying to attend a community event once a month or or every other month, whether it is trying to have a commitment to interrupt a conversation and. If there is a stereotype or an element of anti indigenous bias, you think the most important part of September 30 is for Canadians to make that commitment to action for the upcoming year. Yeah.

Stuart Murray  45:12  
Well, that's really, really well said. Thank you so much for sharing that. Dr Anderson, you know, we sort of have an expression that, you know in this conversation, the hourglass, the hands of time, the sand starts to sort of find its way at the bottom. But I did want to say first and foremost, how much I enjoyed sitting with you and your family as you received the order of Manitoba. You know, just a great honor for you, and frankly, your family. But I wonder, Dr Anderson, as we sort of close out, is there any question that I haven't asked you about issues around the hard truths, or some of the anti indigenous racism that we're seeing that that you would like to address? Is there something I didn't ask you that you'd like to talk about?

Dr. Marcia Anderson  45:57  
You know, sometimes what people ask me, and what I I really like to answer over and over again is, but what do I actually do?

Stuart Murray  46:07  
Yeah, okay, for comment. Yeah.

Dr. Marcia Anderson  46:09  
I'm sure yourself, as well as many of your listeners, will be in places where they'll they'll hear things get said, and they kind of freeze in the moment, or they're not sure if it's the right time to intervene or not. So if it's okay, I'd love to give just a couple of pointers or considerations for people around you're in a circumstance, whether it's, you know, a family dinner, a work event, out at a hockey game, and you hear or see something that is rooted in anti indigenous racism. What are some things that you can do perfect? Yeah, please. And so the first thing I would say is, it's important to do something right. It is important that we mark it as inappropriate. And so this could be something as simple as saying, Hey, I'm not comfortable with that remark. You know, just something that Marx is that is inappropriate, and it can be left there if there's a power dynamic involved. So maybe it's a student towards a teacher, or a junior employee to a more senior colleague, a strategy I often encourage. Is a curious question. I'm not really sure what you meant by that. Can you tell me more or I don't understand why that joke is funny. Can you explain it to me? The question can be a really important intervention if someone's safety is at risk, because this happens. Unfortunately, we've all been in places where we've seen someone being threatened and we're concerned that there might be a gender or race related reason. Think you know things you can do. Of course, you want to assess your safety as well, but don't hesitate to call for help. If you're you're somewhere and you're unsure, don't hesitate to call for help, right? It might be that if you just said, Hey, what is going on here? Or ask the person, do you need help, that just being there and just letting the other person know who is threatening violence or yelling or intimidating, that someone else is watching and cares can be enough to stop it. I'm not suggesting to put yourself at serious risk, as you can tell from that, but sometimes being there is enough to stop something from becoming even more dangerous. Those are a few of the things I would say, from very low risk interventions up to somewhere there may be more of a physical threat, and trying to just call for helper,

Stuart Murray  48:44  
yeah? Well, I think, you know, what I love about that is that, under normal circumstances, you've taken a conversation, you you put it into the calls for action, right? I mean, you're talking about, here's what you can do. You know, it's not a matter of a conversation, here's what you can do. So, you know, what a beautiful way to sort of wrap up the conversation. Dr Anderson, and thank you so much for for what you do and what you continue to do, and for taking time to share who you are and what you believe in, and the great work that you continue to do on behalf of not only you know, sort of First Nations, but all Canadians in in trying to create an equitable health care system. I appreciate your time, and thank you for coming on to humans on rights. You're

Dr. Marcia Anderson  49:25  
welcome. And thank you for reaching out with the invitation.

Matt Cundill  49:27  
Thanks for listening to humans on rights. A transcript of this episode is available by clicking the link in the show notes of this episode. Humans on rights is recorded and hosted by Stuart Murray, social media marketing by Buffy Davey, music by Doug Edmond. For more, go to human rights hub.ca

Speaker 2  49:49  
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