Content warning: This article discusses events of colonial violence against Indigenous peoples
With June being Indigenous History Month, the Gynecologic Cancer Initiative (GCI) celebrates the history, heritage, resilience and diversity of Indigenous People, while also reflecting on the historical and ongoing injustices of colonialism and intergenerational trauma that affects them.
Although we are connected with researchers across Turtle Island, many of the researchers and members of the Gynecologic Cancer Initiative (GCI), work on the traditional, unceded territory of the Coast Salish peoples– specifically the xʷməθkʷəy̓əm (Musqueam), Sḵwx̱wú7mesh (Squamish), and səlilwətaɬ (Tsleil-Waututh). We are grateful to Indigenous communities and leaders who have worked with us to develop culturally safe gynecologic cancer prevention and screening strategies for Indigenous communities across the province.
As a group of researchers and providers working to improve gynecologic cancer prevention, detection, survivorship, and treatment in British Columbia, we acknowledge the ongoing colonization of Indigenous communities that continues to take place today.
Colonization in the Canadian Healthcare System
Colonialism refers to the act of stealing land and resources from Indigenous peoples. It also includes the perpetration of racist laws, practices, and beliefs that invalidate the human rights of Indigenous people and force them to conform to the colonial state. Upon settling on the Indigenous lands that constitute what we know today to be Canada, the Canadian government has long perpetrated and tolerated systemic racism against Indigenous peoples in the healthcare system.
Historical medical injustices against Indigenous people have contributed to a legacy of fear and skepticism of the Canadian medical system. For many decades, Indigenous people were treated in segregated, underfunded, government-run “Indian hospitals,” created to ease white settlers’ fears of contracting tuberculosis by providing only half the amount of funding to these hospitals compared to community ones. These hospitals were also the site of abusive and experimental treatments on Indigenous people, including forced sterilization of Indigenous women. Since then, fear and distrust of the Canadian medical system have become common among Indigenous communities.
Unfortunately, racism continues to be present in our healthcare system. According to a 2020 study, 84% of Indigenous peoples shared that firsthand experiences with racism and discrimination discouraged them from seeking necessary care, leading to worsened health outcomes.
Racism in the healthcare system and inequitable access to preventive and primary care services has contributed to poorer health outcomes among Indigenous peoples. The lack of cultural and historical awareness at the policy and clinical level are among the major driving factors of Indigenous health inequity.
Indigenous Women & Gynecologic Cancers
Although Canada has witnessed a national decline in cervical cancer diagnosis due to enhanced prevention and treatment initiatives, human papillomavirus (HPV) infection rates, cervical cancer diagnoses and mortality remains high in Indigenous communities. This is the legacy of colonialism in the Canadian medical system.
A 2018 study in Ontario found that Indigenous women are 2 to 20 times more likely to be diagnosed with invasive cervical cancer than non-Indigenous women. This increased likelihood of diagnosis can be attributed to the fact that Indigenous communities have significantly lower cancer screening rates and the lack of culturally safe education and prevention programs. Despite the preventability of cervical cancer, Indigenous women continue to suffer.
The stark health inequity in Indigenous women’s gynecologic cancers calls for accountability and action at all levels to provide Indigenous women with the proper gynecologic care they deserve.
Our Role at the Gynecologic Cancer Initiative (GCI)
As a cluster of clinicians and researchers hoping to advance gynecologic cancer research, the GCI strives to ensure that Indigenous women are not left behind. Our Strategic Priorities delineate our goals and research focuses in the GCI– including improving Indigenous women’s health in partnership with Indigenous communities.
Several researchers at the GCI have dedicated their work to collaborating with Indigenous communities to address the high rates of cervical cancer among Indigenous women.
Dr. Sheona Mitchell-Foster is a GCI researcher, practicing Obstetrician-Gynecologist, and settler researcher with the University of British Columba’s Northern Medical Program with a keen interest in the reproductive health of marginalized peoples in Canada and Uganda. She has worked extensively with the Carrier Sekani Family Services and Métis Nation in Northern B.C. to provide Indigenous women with culturally sensitive HPV self-collection kits.
As the project lead for CervixCheck, a program that offers take-home screening kits to Métis women in Northern B.C, Dr. Mitchell-Foster believes that self-collection kits are an optimal alternative to Pap smears, whose invasive nature may bring discomfort or trigger past trauma. To learn more about her work with Indigenous women, you can watch her Research Rounds presentation here.
Dr. Gina Oglivie is a GCI researcher, Senior Public Health scientist at BCCDC, and Senior Research Advisor at BC Women’s Hospital and Health Centre. She is also a Tier 1 Canada Research Chair in Global Control of HPV-related diseases. Her research focuses on reproductive health, sexually transmitted diseases, and HPV prevention and screening.
As a lead of the Global Control of HPV Related Diseases and Cancer, Dr. Oglivie and her team have launched many projects seeking to promote HPV vaccinations and reproductive cancer screening and prevention in Canada and worldwide– especially in marginalized communities. As a researcher based in B.C., Dr. Oglivie also expresses the intent to strive to achieve equity in cervical cancer screening and prevention for Indigenous communities in Canada.
Dr. Gina Oglivie and Dr. Sheona Mitchell-Foster have collaborated on the Accelerating Cervical Cancer Elimination in Canada (ACE-Canada) project, which strives to help eliminate cervical cancer in Canada. To achieve this mission, they have recognized the need to work collaboratively with Indigenous communities. They are currently working with Indigenous leaders and community members to promote culturally informed education, screening, and prevention with regard to cervical cancer. Through their work with past studies and programs, ACE-Canada will evaluate the impact of self-collection and digital infrastructure in reducing cervical cancer rates among marginalized communities in Canada.
Self-collection and the close collaboration of providers with Indigenous leadership will hopefully help Indigenous communities overcome longstanding barriers to access to adequate healthcare. These projects strive to provide Indigenous women with the support and resources they need to reclaim their bodies and health.
Health Equity Does Not End Here
Although June is National Indigenous Peoples History Month, we invite you to celebrate and uplift Indigenous voices all throughout the year. At the GCI, we will continue to ensure that the Indigenous peoples are a key part in our efforts in becoming the first country to eliminate cervical cancer through effective screening and prevention practices.
We would also like to recognize the incredible work by the First Nations Health Authority and Métis Nation BC in ensuring that Indigenous voices are recognized and receive the care they deserve.
We invite you to explore the resources below to learn more about Indigenous health and history:
General History of the Indigenous People in Canada
- Overview of the Aboriginal Peoples’ History in Canada by the Canadian Encyclopedia
- 60-Second Short Films on Indigenous Heritage by Historica Canada
Learn More About Indigenous Health Inequities
- Article on Indigenous Health by the Canadian Encyclopedia
- An Overview of Aboriginal Health in Canada by the National Collaborating Centre for Aboriginal Health
- Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care by Mary Ellen Turpel-Lafond
Cancer Resources for Indigenous Peoples
- Indigenous Cancer Journey Road Map created by the First Nations Health Authority, Métis Nation BC, the BC association of Aboriginal Friendship Centre and BC Cancer.
- Cancer and First Nations People in BC Community Resource created by the First Nations Health Authority and BC Cancer
Indigenous Organizations in BC
- A list of Indigenous organizations and services in BC can be found here.