Pharmacy Check-in: Meet Sasha Merasty
Sasha Merasty, PharmD candidate 2024 (she/her)
Pharmacy Student/Intern, University of Saskatchewan
Sasha is currently enrolled in her fourth year of the Doctor of Pharmacy (PharmD) program, graduating class of 2024, at the College of Pharmacy and Nutrition at the University of Saskatchewan. Raised in Saskatoon, SK, Sasha is a member of Peter Ballantyne First Nation. Sasha currently works part-time as a pharmacy intern at a community pharmacy in Saskatoon. Sasha has a passion for community involvement that started at an early age and she hopes to continue advocating for underserved Indigenous populations. Currently, Sasha serves as a member of IPPC’s Board of Directors, where she hopes to create more funding opportunities for Indigenous students interested in studying pharmacy. Sasha is a strong advocate for Indigenous health-care goals, and she believes that these goals can best be achieved by learning how traditional medicines were gathered and understanding the relationship between the land, the medicine and Indigenous communities. She hopes to provide opportunities to improve health-care awareness amongst Indigenous communities and wants to create learning opportunities for Indigenous patients to participate more actively in their health-care plans and goals. In Sasha’s pharmacy career, she hopes to encourage unbiased care and inspire others to continuously reflect on how we can better serve Indigenous populations in Canada.
Q&A with Sasha
We caught up with Sasha during Indigenous History Month to talk about some of the challenges and barriers Indigenous patients face in accessing services, and how pharmacists and pharmacy students can provide culturally sensitive, trauma-informed health care to Indigenous communities.
What is the #1 thing pharmacists can do to create a safe and inclusive space for Indigenous patients?
The most important thing pharmacists can do to create a safe and inclusive space for Indigenous patients is to understand Indigenous culture and Indigenous health-care goals, and I believe these goals can best be achieved by learning how traditional medicines were gathered and understanding the relationship between the land, the medicine and the Indigenous community. Pharmacists can provide culturally safe and trauma-informed care for Indigenous peoples by learning about and reflecting on the Indigenous history of Canada. This is the first step to truly understanding the health disparities faced by Indigenous communities in Canada.
Why is culturally sensitive health care important, especially in a pharmacy setting?
Culturally sensitive health care is important in pharmacy settings because pharmacists are often the first point of contact for patients seeking medical treatment advice, and they also play a significant role after patients have seen a doctor. Whether they meet the patient after they’ve seen a doctor or the patient has questions about over-the-counter medications, how pharmacists interact plays an important part in providing care that promotes safety and tries not to reinforce any previous traumas experienced in the health-care system. Pharmacists should create patient-centred care while eliminating the challenges that Indigenous patients often experience with health disparities to meet the needs of their patients. If pharmacists are culturally sensitive, they will see better patient outcomes. Recognizing your own biases as a pharmacist and learning about other cultures helps build rapport with the patient and increases cultural sensitivity, and a strong relationship between the patient and pharmacist will result in better patient outcomes.
How can pharmacists play a greater role as advocates for inclusive and culturally sensitive health care, especially for the Indigenous community?
Pharmacists can play a greater role as advocates for inclusive and culturally sensitive health care in Indigenous communities by establishing programs that look toward the future of health care in the community, for example, offering employment and mentoring opportunities to Indigenous people interested in pursuing careers in pharmacy and health care. The best way to make positive reforms to a system is strong and educated representation, so the more Indigenous peoples participate in the Canadian health-care system, the more Indigenous ways of knowing and medicine will be included in the Canadian health-care system. No single culture knows everything about health care and treatments, so cultural inclusivity can only build health-care knowledge. In addition, providing trauma-informed care and providing information to Indigenous communities on things like NIHB coverage and community resources provides community advocacy by teaching Indigenous communities how to benefit from the health-care system more productively. Finally, seeking out community members and supports with things like elder interactions and community outreach will establish a culture of support for Indigenous culture and traditional ways of knowing.
What’s the biggest mistake health-care providers make in caring for Indigenous patients and how can they do better?
One of the biggest mistakes health-care providers make in caring for Indigenous patients is not considering patient factors that may impact care transition to their communities and discharge processes that may act as barriers to care. Treatment plans for Indigenous patients from isolated communities must consider any difficulties the patient may have making travel arrangements and the proximity of nearest pharmacy, and they must also consider when these pharmacies close prior to discharging patients who require pharmaceutical drugs before returning to their communities. Beyond this, it is important not to dismiss Indigenous traditional treatments due to Western biases towards pharmaceuticals, and to ensure that pharmacists shape their care plans to the patients’ needs and health-care goals. Health-care providers can do better by being willing to work with Indigenous ways of knowing and medicine so that the patients’ cultural beliefs and traditions factor into care plans. Working with the patient when determining a care plan is important to patient-focused care, but it also ensures that the patient has agency in making health-care decisions and does not feel like their treatment is being imposed upon them. Also, patients who have agency in determining their own health care plan are more likely to stick to their plans and achieve their health care goals. We must help the person get to their idea of healthy, not our idea of their health.
What is the most rewarding part of your pharmacy practice?
The most rewarding part of my pharmacy practice is the relationships I build with my patients and community. Pharmacists are regarded as one of the most trusted health-care providers, and I want to uphold that reputation. It is an honor to be a part of and play a role in patients’ lives by supporting their health-care needs. Often, I get to share my knowledge and make an impact in their lives simply by helping someone with a cold, helping them choose the right medications for their child, or helping solve adverse drug interactions that may prevent side effects. I enjoy seeing patients smile when I have been able to assist them in cost coverage or have provided resources to support their community. Even something as simple as helping someone with their blood glucose monitor makes me feel rewarded because I get to go home knowing I made a small difference, and my goal each day to go above and beyond for my patients by making sure I do the small things right.
I also think getting involved in communities is rewarding and necessary because it helps one understand what foundations of health care are missing in the community. The foundations of health care are simple, but Indigenous people often either do not have access to these foundations—things such as personal health-care requirements like nutritious food, adequate housing and medical services and supplies—or they do not have access to the information required to understand systems that support health care, such as insurance providers like the NIHB.
Is there anything else you’d like to share about your practice, or about anything else that is important to you?
Indigenous populations would benefit from representation in the pharmacy and health-care system, advocacy in NIHB education and trauma-informed care. In my career, I hope to encourage unbiased care and inspire others to continuously reflect on how all health-care providers can better serve Indigenous populations. All people can sometimes get caught up in their everyday lives, but it is important as pharmacists to grow, try to improve our communities and help underserved populations. In particular, decreasing the health disparities in Indigenous communities is a goal that health-care professionals must achieve together, and opening in-community pharmacies that respect Indigenous communities, honour cultural traditions and form solid connections to existing services in their communities is a strong first step toward health care parity in Canada.