Pictured above are Amy Lamb and Dr. Jaris Swidrovich. Photo courtesy of the Canadian Pharmacists Association.
The College asked two Indigenous pharmacy leaders to provide their insight on the opportunities for, and commitments from, pharmacy professionals to support Indigenous patients and communities. Through allyship, self-reflection, inclusive and diverse educational opportunities, and community-based collaboration, pharmacists and pharmacy technicians can contribute to the path to reconciliation.
What does allyship mean to you and how can we recognize it in action?
Jaris Swidrovich: To me, allyship in the context of Indigenous Peoples not only means supporting Indigenous Peoples philosophically but, more importantly, through action. Being an ally means taking risks, speaking up, holding, making, and giving up space, and persisting with such actions despite any push-back or discomfort from family, colleagues and the public. Giving up space can mean adjusting space that already exists, whether physical or through human resources. For example, this might include handing over relevant roles and responsibilities or restructuring places and spaces through an equity lens. Although allyship is critical, the practice of “nothing about us without us” must always be upheld.
What can pharmacy professionals and other healthcare professionals do to better support their Indigenous patients and deliver culturally safe and sensitive care?
Amy Lamb: The best way to support Indigenous patients is to engage with Indigenous communities and their initiatives. Reciprocity is especially important if your pharmacy is their sole or primary provider. Create space and time to hear and reflect upon the person behind the medication profile, allowing the stories of the Indigenous patients you care for to be weaved into the care plans, communications, and other care considerations. Creating space is both an acknowledgment of the physical and mental spaces that pharmacy professionals should reserve for Indigenous persons and care strategies. It is keeping Indigenous health issues and collaboration “top of mind”, and wherever possible, engaging or employing an Indigenous person directly into roles that are are defined by representation, leadership, and facilitate systemic change.
Review the barriers to equitable health access that occur for your Indigenous patients and spend time designing innovative means of healthcare delivery. Whenever you reach a systemic barrier, share your experiences with your advocacy, regulatory and other governing bodies. Advocate for those who have been, and continue to be, oppressed and silenced.
Create space and time to hear and reflect upon the person behind the medication profile, allowing the stories of the Indigenous patients you care for to be weaved into the care plans, communications, and other care considerations”
Jaris Swidrovich: Pharmacy professionals and other health professionals can and should take it upon themselves to fill in the gaps that were missing in their primary, secondary, and post-secondary education and training. Unfortunately, many of us experienced formal education that left out Indigenous Peoples and/or represented Indigenous Peoples and our health and wellness in incorrect or racist ways. Ultimately, providing better support and culturally safe care will mean learning and understanding the social determinants of health and the significant power imbalances in healthcare, which includes Canada’s colonial history and ongoing colonial policies and practices that leave Indigenous Peoples experiencing poorer health and wellness than our non-Indigenous counterparts in Canada.
Why is it important for Indigenous patients to have access to healthcare professionals who are knowledgeable about their unique cultural and healthcare needs? What opportunities do pharmacy professionals have to serve and connect with patients that may differ from other healthcare professionals?
Jaris Swidrovich: I think that many, if not most, people in Canada, see themselves reflected in their healthcare providers, which is an enormous and often unstated benefit and privilege. While I include ethnicity in this statement, I also think about common histories, experiences, knowledge systems, faith/religion, etc. Given that Canada sits on Indigenous Peoples’ land, with much of this land being unceded (aka “stolen”), it is staggering that Indigenous Peoples fare worse when it comes to health and wellness overall. This fact alone is enough to prompt pharmacy professionals and all health professionals and people in Canada to put in the work required to change the ongoing colonial and racist impacts on Indigenous Peoples in Canada. Pharmacy professionals are the most accessible health professionals and often ranked the most trusted professional of any kind. As such, it is undeniable that we have a tremendous task in front of us and that we are ideally situated to in Canada’s healthcare landscape to effect such change.
Why is a commitment to ongoing cultural competency and equity, diversity and inclusion learning important for pharmacy professionals?
Amy Lamb: Culture competencies ensure that the values of the patients cared for are respected. Historically, traditional healing practices have been ignored, ostracized and prohibited. Today, there is limited training and competencies in pharmacy practice related to traditional practices, medicines and competencies that continue to impose judgement, mistrust and harm upon Indigenous patients. Committing to the standardization of cultural competencies will not only create safer spaces for Indigenous patients, but expand our collective understanding of the sustainability, efficacy, and meaning behind ancestral practices.
The more we know about the people, families, and communities we serve, the more likely we will be to realize better care and better health and wellness outcomes in our communities.”
Jaris Swidrovich: We know that the human composition of the profession of pharmacy does not mirror the general population in Canada. I don’t think the people in our profession will ever mirror the general population in Canada, especially given the socioeconomic standing and privileges that working pharmacy professionals will have over very many other people in Canada. This hierarchy and power imbalance alone will always necessitate continuous learning about culturally safe care and equity, diversity, and inclusion. The more we know about the people, families, and communities we serve, the more likely we will be to realize better care and better health and wellness outcomes in our communities.
What should pharmacy professionals consider when reflecting on their professional obligations in order to identify continuing education opportunities?
Amy Lamb: Our professional obligations are designed to protect patients, facilitate our own commitment to excellence, and quality assure the practices of healthcare delivery. Ultimately, these define the systems that pharmacy professionals have built to create robust safety in medication dispensing and clinical care. It is just as important to study and reflect upon our professional standards with a lens of identifying those that might be systemically contributing to anti-Indigenous racism, inequitable health access, or detrimental to patient or work-place safety. We engage with a diverse variety of healthcare systems, and we collectively strengthen our understanding of the supports and resolution strategies that can facilitate reconciliation. It will be our collaborative efforts that will shape the development of professional standards and systems that will truly optimize patient care for ALL Canadians.
Jaris Swidrovich: Knowledge is ever evolving, and once people are outside of their controlled learning environments (e.g., post-completion of their professional education programs), it is imperative practicing professionals both seek and be provided with continuous professional development to keep up with the inevitable persistent changes in society and healthcare.
What final message would you like to share with your pharmacy peers to support the delivery of equitable care and access across the province?
Jaris Swidrovich: Stay curious, informed, and move forward with a strong sense of humility. Seek and request continuing education in the areas of anti-racism, anti-oppression, especially as it relates to Indigenous Peoples and Canada’s ongoing racist and discriminatory policies and practices that continue to contribute to the different health and wellness outcomes witnessed across Indigenous Peoples in Canada. Then, vote and advocate as both a person and as a professional until we see all of the changes that are required.
Amy Lamb: Nothing about us without us. As your organizations develop Indigenous partnerships, competencies, and standards, ensure that there are Indigenous pharmacy professionals or groups consulted with, and ideally, employed in positions that strengthen your partnerships and care for Indigenous communities. Challenge your employers to diversify their personnel to better reflect populations served. Review the excellent resources provided in partnership with Indigenous professionals, and when in doubt, reach out to the Indigenous Pharmacy Professionals of Canada at email@example.com!