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Health

Whose Health Is in Harm’s Way?

How a pandemic and an international movement for civil rights converged to throw light on flawed systems

By Brnesh Berhe

January 07, 2021 •

On the surface, COVID-19 and the initial momentum behind the Black Lives Matter movement in 2020 seemed like two trains charging ahead, parallel to each other. But early in the pandemic, it became evident that the global health crisis and the way it affects racialized people are trains that share the same track. Rather than the disease showing flaws in a system, Catherine Clune-Taylor, ’16 PhD, an assistant professor at San Diego State University, says it shows a flawed system.

“People talk about how COVID-19 is revealing that there are people falling through the cracks,” says Clune-Taylor. “And I’m like, no, no, no, no, these are not bugs. These are features of the system; it was set up that way.” 

As a Black Canadian woman living in the U.S., Clune-Taylor has been navigating this intersection of crises. She says COVID-19 has shone a light on long-standing racist systems, which has in turn emboldened more people to demand swift, radical change. 

“Black and Indigenous folks are more likely to be exposed to the virus due to their overrepresentation in low-wage, essential service jobs and they are more likely to have bad health outcomes for a variety of reasons,” Clune-Taylor says, which include biases built into the medical system. She points to American studies that demonstrate it and to a recent case that illustrates that bias. “Just consider the story of Dr. Susan Moore, who died of COVID-19 after complaining of racist medical treatment,” Clune-Taylor says. A press release from a hospital where she was treated implies the blame lies with Moore, because staff were “intimidated” by her.

Research, Clune-Taylor says, is necessary to generate evidence. “So if we want interventions in one way or another, then we need to know about those experiences.” 

It would have been hard to predict in the early days of the pandemic that a global civil rights movement was around the corner, sparked in May by yet another police killing of a Black man, George Floyd in Minneapolis, Minn. Then in September, no charges were filed against police officers who shot and killed Breonna Taylor in Louisville, Ken. The following week, video surfaced of Joyce Echaquan, an Indigenous woman from Joliette, Que., who recorded herself being subjected to racist verbal abuse by hospital staff before her death. Bystanders filmed George Floyd’s death; Echaquan turned the camera on herself. Their deaths, as well as the absence of charges in Taylor's case, unfolded as COVID-19 cases rose in North America. 

A viral video of another life lost and its subsequent hashtag weighs heavily on many of us. As we grapple with the effects of a pandemic, part of the crucial work of figuring out how these things are related means knowing who the pandemic is affecting and how. 

Canada lacks strong race-based health-care data, making it hard to accurately report on how outbreaks affect certain racial groups.The Canadian Institute for Health Information (CIHI) released an update in May highlighting the need for consistent practices for collecting racial and ethnic data across all health databases. 

In the U.S., reported data shows Black Americans are dying of COVID-19 at a rate three times higher than white Americans. Ottawa Public Health recently reported that 66 per cent of COVID-19 patients in the city are people of colour (not including Indigenous people), while the City of Toronto reported that racialized people make up 83 per cent of COVID-19 cases in their city. Doctors Without Borders dispatched a team to the Navajo Nation — one of the hardest-hit communities in the United States. It marks the first time the humanitarian organization has deployed a team to work in that country. 

Black and Indigenous people have spoken up about unfair treatment in the Canadian medical system and a lack of accessibility to essential services. Patients from those same communities say it’s harder to be taken seriously when it comes to their health concerns. But without standardized evidence and an acknowledgment of implicit biases, it’s difficult for patients to prove their medical needs and advocate for themselves.

“Unfortunately, we are in this period of acceleration,” says Clune-Taylor. Even with a vaccine, she says, “the large-scale issues that have allowed the virus to emerge and spread in marginalized communities will not have gone away.” 

People watched bars and malls stay open in Canada while family members of COVID-19 victims were unable to hold funeral services during such a volatile time. Clune-Taylor has noticed some decision-makers “raise their hands and say, ‘Well, there’s not much we can really do about that.’ But in fact, there’s a lot they can do about it. And if you think about the way [countries] reacted in the first few weeks of this pandemic, it goes to show that governments and institutions can mobilize and do a lot of things very quickly if they want to.” She adds, “There is an insensitivity to the situation that we currently find ourselves in with governments who don’t recognize that they exist in service to all their citizens.”

All citizens have never been affected equally by illness. The Winnipeg General Strike, the largest strike in Canada’s history, happened in 1919 following the First World War and the Spanish Flu. Working-class immigrants were some of the hardest hit by the flu while the city suffered high rates of unemployment and inflation. The pandemic’s aftermath made existing social problems harder to ignore. Among a growing global workers movement, workers in Winnipeg demanded better conditions. When they were denied, 30,000 people (including public employees in solidarity) walked off the job. The strike influenced the growth of unionism across Canada.

Think about the demographics of strikers and the resistance they met with. It’s easy to take for granted how workers, many of them women and immigrants, demanding basic, safe working conditions and pay would at one point seem radical at all. Currently, calls to defund the police or reinstitute Indigenous jurisdiction (with the Land Back movement) are likewise being touted as radical. Most recently, we saw history repeating itself as Alberta health-care workers went on strike to protest the provincial government’s plan to outsource 11,000 jobs during the current pandemic. The demographics hit hardest by this also mirror the strike in Winnipeg 100 years earlier. This all adds to the myriad intersecting and urgent issues we need to deal with right now.

It’s hard to know how to prepare the road ahead and capitalize on any of the momentum to create real change. Corporate Black Lives Matter statements have more or less disappeared down their respective social media feeds, along with much of the initial enthusiasm. And with vaccines starting to be administered to Canadians, there is a very long road ahead to deal with the effects of the pandemic itself and the internal biases — the “features of the system” Clune-Taylor says it has revealed. And it can be exhausting.

“This is a real instructive moment in showing how ‘self-care’ is political,” Clune-Taylor says. “We have to actively keep this in the foreground, but how do we sustain ourselves? Because this is a marathon.”

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