In the short break between 2nd and 3rd year medical school I joined a small medical team and spent a week travelling to 4 First Nations villages in the interior of British Columbia. We travelled 1600 kilometres and slept on the shores of three of BC’s largest northern interior lakes. The small team consisted of three medical students (myself and two classmates), a family practise resident, a rheumatology resident and the doctor who spearheads this work, Dr. John Pawlovich. He spends one week each month travelling to 5 communities in this region and in the remaining 3 weeks he services the communities fulltime by telehealth, an extraordinary technology that allows him to video conference and virtually examine patients from the lower mainland through specialized bluetooth medical equipment.
Before we left we were told to expect long days and lots of work. We were told explicitly that complaining was not an option and that we were to put all biases aside. I’ve spent many years in northern BC. I’m not sure what my biases were but they have changed. I was expecting poverty, and I saw that. I was expecting geographical isolation. Yes. I was expecting people who live simply and have completely different priorities than those familiar to me. Yes, this was all true. But there were a few expectations that proved unfounded. I expected the reservations to be rougher, harsher and more violent. I expected the people to be more jaded, more suspicious, and more judgemental of me. I expected more alcohol. I expected that the hollywood version of Indian life as hunters and gatherers was a romanticized exaggeration of their current reality.
Here’s what I found: The people were quiet and gentle. The culture is peaceful and warm. Some of them struggle with drugs and alcohol. Those that do are open and honest about it. There are many who do not. They have arguments with family members. There are small town dynamics. They are generous. They still hunt and fish. A lot. People are important to them. They still honour their elders. Their culture is important to them and the elders in their villages are intensely passionate about passing it on to the children. Their culture is fragile and in danger of being lost. In all of villages we went to, the children had no high school. In one of the villages the closest high school was within 10 kilometres. In the other three, children had to leave home in grade eight and live with anyone they knew from the same village (family or extended family) hours away.
The communities were damaged and imperfect but they were also healthier and more beautiful than I expected. They are certainly not lost. These villages are crucial to preserving the traditions of a peoples group who have lived here for thousands, not hundreds, of years. They are cultural islands that need to be protected with fervour. My classmates and I spoke with the doctor on the last night. We asked about his long-term goal for the medical care of these people. Although he now has three other doctors committed to this work with him, there is clearly so much more that could be done. This doctor is charismatic, energetic and persuasive. It was difficult to imagine that he was unable to find people willing to join his work. The problem (of course) was funding. There is no more funding to recruit doctors to these remote communities. What about volunteers, we asked. (In my mind I was thinking that he could easily staff an army of volunteers). His answer landed solidly with me. “These people have had doctors fly in and out for years and it hasn’t been good for them. Do doctors volunteer in Prince George because they feel sorry for the poor northern people who live through the winters there? Canada is committed to providing equal healthcare for all citizens. Why do these people deserve less?”
I had no idea my bias even existed. Why should these beautiful people deserve nothing better than missionary medicine in Canada?