Race, Ethnicity, Indigenous Peoples and Politics

L13(b) - Race, Citizenship, Health and Basic Services

Date: Jun 4 | Time: 01:45pm to 03:15pm | Location:

Chair/Président/Présidente : Victoria Tan (University of Oxford)

Discussant/Commentateur/Commentatrice : Colleen Bell (University of Saskatchewan)

“So few people who are doing that work, and nobody is really funded to do it”: Navigating Care for Medically Uninsured Migrants in Manitoba: Lindsay Larios (University of Manitoba), Patricia Ahonon (University of Manitoba)
Abstract: Like many provinces, Manitoba continues to welcome students, workers, and family members to the province without extending them public health insurance or offering clear pathways to consistently and safely access care. Reproductive healthcare stands out as a particular challenge, as private insurance plans do not always cover it, the high costs of obstetric and perinatal care when uninsured, and the considerable impact pregnancy can have on immigration stability. To examine this issue in Manitoba, we conducted 10 interviews with people who have been pregnant in Manitoba while being medically uninsured and 20 interviews with 24 community, health, and social service providers across Manitoba. Focusing predominately on the experiences of service providers as they assist individuals and families navigating this issue, this paper uses a critical governmentality lens to examine systematized ignorance. We assert that systematized ignorance is a bordering practice, where the border is understood as not just something people encounter upon entering or leaving a given country, but as part of their everyday experience (for example, in healthcare). Our findings make the case the systematize ignorance of migrant realities in Manitoba allow these needs to go addressed. We also point to the ongoing maintenance of this ignorance by the system and the ways in which migrants and allied service provides are navigating and resisting it. We close with reflection on the implications of systemized ignorance for migrant pregnant people and service providers, and broader lessons learned about the role of ignorance as a practice of governance.

Indigenizing AMR Governance: Transforming Canada’s Response to Antimicrobial Resistance: Suzanne Hindmarch (University of New Brunswick), Chelsea Gabel (McMaster University)
Abstract: Antimicrobial resistance (AMR) is a growing challenge globally and in Canada. AMR occurs when microbes that cause infectious disease become resistant to medications, making diseases including TB, STBBIs, UTIs and skin infections more difficult to treat, increasing risk of illness and death. In the context of settler colonialism, AMR is likely to have a disproportionate impact on First Nations, Métis and Inuit peoples: the AMR response will be more complex in Indigenous communities because of the structures of and limitations in health services provision, and Indigenous understandings of health and wellness are often distinct from settler colonial approaches to disease response. However, Canada’s federal AMR response plan was developed with no significant consideration of Indigenous perspectives. To address this gap, this paper presents results from a research project using semi-structured interviews to learn about Indigenous representational organizations’ perspectives on AMR and health needs in the communities and Nations they represent. We identify unique impacts of and challenges in addressing AMR in Indigenous communities, and unique sources of strength. Results and recommendations include concrete strategies for building a strengths-based, distinctions-based approach with Indigenous-owned health data and health services. Beyond strategies for change within existing AMR policies, programs and health services, the research also emphasizes the need for more critical engagement with the politics of AMR. These include a deeper decolonization of the AMR response by decentring settler colonial ways of knowing and addressing the structural drivers of disease and wellness through Indigenous sovereignty.