Cultural Safety Module 2: Peoples Experiences of Oppression

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Linking Colonization and Culture

In Module 1, we explore how colonization affected, and still affects, the lives and health of Aboriginal peoples. The imposition of the colonizers' beliefs and values deeply affected Aboriginal cultures. Still, although many of these effects have been destructive, the strength of Aboriginal peoples to overcome them must not be underestimated.

The brief history in Module 1 of the impact of disease, dislocation, changes in diet, residential schools, and Indian hospitals on Aboriginal peoples gives you some insight into their experiences. Earlier in this module (Module 2), you read about the idea of culture and how we all participate in its creation. Now, we will look at how, as active participants in the creation of culture, we all contribute to what happens in our major institutions, that is, the health care, education, and legal systems.

The colonization process has determined what Canadian culture, including the culture of our health care system, looks like today. In the next two sections, "Social Location and Intersectionality" and "Talking about Race and Racism," a link is made between the life and health care experiences of Aboriginal peoples and the wider picture of how the dominant culture's privilege and power have affected the development of this culture.

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Social Location and Intersectionality

Social locations reflect the many intersections of our experience related to race, religion, age, physical size, sexual orientation, social class, and so on. Social location contributes not only to our understanding of the ways in which our major institutions work, but also to our ability to access them. The effect of colonization is such that the social location of someone in the dominant society may be very different from that of an Aboriginal person.

Nanaimo Indian Hospital, circa 1948

It is essential, however, not to assume anything about someone's social location until you take time to try to understand what a person's experiences have been. For example, it is not culturally safe to assume that every Aboriginal patient you work with has had access to traditional knowledge. Although many core Aboriginal values remain unchanged, colonization created large gaps in traditional knowledge and interrupted its transfer from generation to generation. Also, as with all cultural groups, because culture is always shifting and changing, Aboriginal peoples have a diversity of opinion on what traditional knowledge entails.

Intersectionality has been defined as "people's exposure to the multiple, simultaneous and interactive effects of different types of social organization or oppression" and, most importantly, their experiences of power.5 The concept makes more sense if you think about the historical, social, economic, and political context of someone's experience of health. Understanding the link between colonization and culture provides you with the opportunity to begin to understand the experiences of marginalized groups.

In nursing education and other academic disciplines, there is awareness of the intersection of oppressions in the lived experiences of individuals and/or groups. This realization has important implications for nursing practice and for improving people's health care access. People experience their multiple differences in various ways, some of which may highlight inequality in health care access.

Residential School photo, circa 1950s

For example, the health care experience of an educated, white female with an above-average income may be different from that of an unemployed Aboriginal man. Yet, in talking about oppression and marginalization, we risk perpetuating inequality unless we recognize that even though some people may experience "multiple difference,"6 they have the strength and capacity to work with it.

Intersectionality can also be understood as the "distance from centre".7 In this case, centre refers to privilege, and this view of intersectionality relates to the idea of marginalization. Bishop (1994) stated: "Groups that have a history of oppression and exploitation are pushed further and further from the centres of power that control the shape and destiny of society. These are the margins of society, and this is the process of marginalization."8

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Talking about Race and Racism

To understand intersectionality and marginalization, it helps to understand that we tend to categorize ideas in order to make sense of them. If, for example, we focus simply on "race" in terms of someone's health care experiences, we will racialize their experience and miss important dimensions of their experience. The same may be true if we judge or see someone in terms of only their age, ability, sexual orientation, or other visible or invisible differences.

Once you are aware that racism is institutionalized and embedded in language, you can move beyond categories and labels to search for and then try to understand a person's multiple experiences. Unfortunately, the dominant culture's tendency to explain Aboriginal peoples' experiences as due to, or in relation to, race has led to serious consequences for them.

A tragic example of this is assuming that a staggering Aboriginal person is drunk when, in fact, he or she is diabetic and having a serious medical reaction. Aboriginal people continue to be stereotyped as "drunk Indians" and thought of as less capable because their culture has been portrayed as "more primitive" than other cultures.

In health care, as in any other interactive setting, physical characteristics such as a person's so-called race, are often the first thing we notice. Research9 has confirmed that race is socially created, rather than biologically determined. Further, Henry et al. (2000) stated that "race is a socially constructed phenomenon based on the erroneous assumption that physical differences, such as skin colour, hair colour and texture, are related to intellectual, moral, or cultural superiority".10 "The idea of 'race' is relatively recent with the word 'race' first being used in the English language in 1508."11

Although people have obvious physical differences, there is no biological basis for separate races. The idea of race, especially as it has been used to differentiate between groups and individuals, has been extremely powerful throughout the colonization process and has shaped current cultures and society.

Take a moment to think about race. Do you think of race as a concept or as a biological factor? Is race something you understand? At the end of this module, think about race again to see if you still think about it in the same way.

Some writers 12 argue that we should stop talking about racism because we can perpetuate it just by the language we use-words such as "black," "white," "them," and "others." Solomos discussed the possibilities of this approach while asking the question: If we stop talking about racism and, more particularly, about genocide, do we risk them disappearing from our consciousness?13

Therefore, when we talk about racism, we must be aware of what we are saying and what we are doing (the dilemma often referred to as the "double-edged sword".14 According to Varcoe and McCormick, "Even in our most well intentioned efforts we can breathe life into racism."15 In other words, by talking about it, we may make it more real than it actually is. There is a conflict here between an idea that is unproven scientifically and one that has real social consequences.

The processes of racism and racialization relate to our discussion of race. Racism happens when physical characteristics are linked to social, psychological, or emotional characteristics. Racialization is the process whereby situations are explained in terms of race or other characteristics, such as physical size. Assuming that an overweight person makes poor diet choices and does not exercise is an example of racialization.

Take some time now to do Activity 4, Reflection on Discrimination.  

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