Addressing systemic racism and discrimination in pharmacy

The Indigenous Pharmacy Professionals of Canada (IPPC) is a new Indigenous-led association aimed at connecting and supporting Indigenous pharmacy professionals and ensuring that pharmacy practice across the country reflects the principles and commitments of the Truth and Reconciliation Calls to Action.

Q&A with Dr. Jaris Swidrovich & Amy Lamb, IPPC co-chairs

Pharmacists Amy Lamb and Dr. Jaris Swidrovich announce the creation of the Indigenous Pharmacy Professionals of Canada during the Canadian Pharmacy Conference on June 10, 2022.

Please tell us a little bit about the work you’re doing to create a dedicated space for Indigenous pharmacists and why.

Jaris: Since I began pharmacy school in September 2006, I was always looking for a community of Indigenous pharmacy professionals in Canada to not only be mentors for me, but also to be part of a community that I could see myself reflected in and where I felt a sense of belonging. Unfortunately, no such organization existed and I have had a difficult time identifying First Nations, Métis and Inuit pharmacists across the country. After completion of my Bachelor of Science in Pharmacy (BSP) and post-baccalaureate Doctor of Pharmacy (PharmD), I ventured into a PhD in Education, where I have been studying Indigenous Peoples’ experiences with pharmacy education in Canada. Although my dissertation is not yet complete, the data collection phase of my PhD exposed the strong desire for Indigenous pharmacy professionals in Canada to have a community that can lift us up and help us support one another, but also to collectively assist in effecting positive change. We understand the importance of the philosophy “nothing about us without us,” and we want to ensure that Indigenous engagement work in the pharmacy profession is Indigenous-led, anti-racist, anti-oppressive and culturally responsive.

We also want to create and support important work being done to recruit and retain Indigenous pharmacy professionals, including scholarship programs, mentorship and assisting with needed changes in curriculum for both pre- and post-licensure pharmacy professionals. Recognizing that pharmacy professionals are among the most accessible health care professionals and knowing the greatest gaps in health outcomes experienced by people in Canada are between Indigenous and non-Indigenous Peoples, we are well positioned to lead the way in naming the historical and ongoing oppressive policies, practices and racism that are at play in creating and re-creating these gaps, but also to work together on closing such gaps.

Why is this group important for Indigenous pharmacy professionals?

Amy: This group is a collaboration of perspectives, experiences and expertise of Indigenous pharmacy professionals to collectively build a foundation for anti-racism, anti-oppression and cultural safety in the delivery of pharmacy care to and by Indigenous Peoples in Canada. There is a vast range of traditions, experiences and evolution of healing practices and medicines across our many nations and regions. Ancestral knowledge has been disallowed from health care and cultural standards through generations of suppressive systems and cultural genocide. For many Indigenous pharmacy professionals, there is a deep yearning for cultural and professional competencies that we can deliver back to our communities and share with our non-Indigenous colleagues along the way.

Indigenous pharmacy professionals are examples of the intergenerational strength and resilience of our people. This network of shared strengths, spoken stories, foundational approaches and examples of effective care delivery will establish the future of pharmacy care for our relatives and communities. As with any reconciliatory process, we must be the knowledge keepers, the leaders of change and the voice of those who need to share in our successes. We also anticipate this group will allow Indigenous Peoples across Canada to see themselves reflected in the profession of pharmacy and feel a sense of belonging throughout their educational and career journeys in pharmacy.

Safe spaces are a foundation for the healing of Indigenous communities and health care has faltered in creating safe spaces for its professionals, especially within the growing health crises like addictions, mental health, HIV and the COVID-19 pandemic. Indigenous pharmacy professionals, like our communities, experience health disparities, discrimination and racism. Challenging and seeking resolution to these barriers can traumatize or retraumatize an individual. This group will seek to provide a voice to those who are experiencing, or witnessing, anti-Indigenous racism, practices, leaders and systems. We hope to inform clinicians, employers and decision makers alike on the standards with which we can strengthen and empower Indigenous pharmacy professionals in Canada.

Why is it important for Indigenous patients to have access to health-care professionals who are knowledgeable about and sensitive to their unique cultural and health-care needs?

Jaris: Indigenous Peoples are the first peoples of this land and we have every right to be able to access care and medicines that have been with us for millennia. Unfortunately, though, Western medicines and practices have been positioned as superior since colonization and it is mostly, if not only, Western medicines and practices that are taught, learned and practised in the profession of pharmacy. It is critical for Indigenous patients to have access to health professionals who not only recognize and appreciate the one-sided nature of our health systems in Canada, but also to be able to access health professionals who can provide culturally safe and affirming care that honours the individual and collective realities that Indigenous Peoples experience.

We would like to note that it is first critical to recognize that any of the inequitable health disparities within our communities have been systemically imposed by design and that cultural competencies in the care of any BIPOC population begin with recognizing and deconstructing those contributing factors. The unique cultural needs for Indigenous patients, specifically their health-care needs, require that such care accurately reflects our collective and individual understandings of health and wellness, recognizing the complex interplay between mental, emotional, physical and spiritual health and wellness, but also the health of the land and other environmental factors.

What can non-Indigenous pharmacy professionals and other health-care professionals do to better support their Indigenous patients?

Amy: Although the response to this question could never be appropriately captured in a succinct way, we firmly believe that education is critical and foundational to providing the best possible care for Indigenous patients. Unfortunately, our primary, secondary and post-secondary education systems have not best prepared health professionals to either understand the ongoing systems of oppression at play that contribute to poorer health outcomes for Indigenous Peoples, or to engage in health practices that are anti-racist and anti-oppressive. Forming a trusting relationship, based on authenticity, service and shared stories, is central to supporting Indigenous patients. It is incredibly important to be patient and sensitive to the tenuous relationship between Indigenous Peoples and Canada’s health systems with respect to the historical and ongoing experiences of racism and discrimination. We advocate for health care that is intersectional, affirming, anti-racist, anti-oppressive and accessible. We are confident that practising in this way will better support Indigenous patients and all patients.

Dr. Jaris Swidrovich, BSP, PharmD, PhD(c), AAHIVP, RPh, is from Yellow Quill First Nation and is a Saulteaux First Nations and Ukrainian man. He is a Two Spirit/queer person and was Canada’s first self-identified First Nations Doctor of Pharmacy. Professor, mentor and community leader, Dr. Swidrovich brings his experience of bridging organizational needs with health care mandates. He is passionate about health, education and how Indigenous and marginalized people are impacted at all levels.

Amy Lamb, BSP, RPh, practises in the communities of Prince Albert, Red Earth Cree Nation, Cumberland House Cree Nation and Wollaston Lake. As a Métis woman, she provides clinical services to Indigenous communities with a focus on preventative, holistic and culturally appropriate care and is a passionate advocate for equitable and compassionate care for Indigenous Health and Women’s Health.

CPhA is committed to advancing truth and reconciliation through pharmacy. We are proud to support the work of the IPPC and to help foster collaboration and meaningful change within our profession to dismantle systemic racism and ensure that pharmacy is a safe and welcoming environment for all people in Canada.