Lessons from Tuberculosis in Labrador

Lifestyle Blog April 12, 2018

With the tragic news of 14 year-old Gussie Bennett’s death in Nain, Labrador I am reminded of the work I was involved at Labrador-Grenfell Health in Happy Valley-Goose Bay (HVGB) most of which dealt with Tuberculosis (TB). Now that I’m removed, I’m able to reflect on how little I knew about our Indigenous Peoples, health inequity, the colonial nature of research/health all topped with my naïve approach to epidemiology within the sphere of northern, remote and rural health.

My role was a collaborative one with the public health nurse who managed TB clinics for a physician that lead TB treatment for all patients in HVGB and those from coastal communities. I collected patient level information for each outbreak, including laboratory results, treatment plans, contacts, transmission, and adherence to treatment. TB is rampant in some of Labrador’s remote coastal communities where resources are scarce, health facilities and their staff are spread thin and access to a primary care physician requires a chartered flight to HVGB. Everyone, from doctors and nurses to janitors and receptionists worked well beyond their means. That was what struck me most about Labrador, everyone always did more than just their part. As you can imagine, when you are involved in an area of health care that has so very many ties to the social determinants of health, you naturally become personally invested in the cause and the patients that are affected. I can remember countless nights thinking about what I could do as an epidemiologist that could potentially help reduce the burden of the workload for my colleagues. Tracking treatments more effectively, identifying gaps by conducting a needs assessment, evaluating current services and operations, learning about transmission patterns using software like pajek, all in an effort to be of some use to the staff on the ground. With it, however, came a sense of entitlement and ownership of the work I did, I wanted to be able to share it with the research and academic world to potentially have some positive impact. There was no malice or ill-intention in wanting to share my findings within the realm of academia; it was what I knew best. Publications, academic conferences, reports and presentations were the fruit of the endless hours of researching.

When we’re young, we are sold on the idea that we could be the next revolutionaries. We worship stars, world movers and shakers and are bent up on wanting to have the same positive impact on the world. For me, I dreamt of being with Doctors without Borders, being a sort of Dr. James Orbinski. While this is a noble thought and very well intentioned, it’s not needed or right. Someone else’s world is not mine to provide suggestions for and I most definitely cannot under any circumstances solely choose to present on any findings that I happen to stumble upon thinking I have the solution.  These startling realizations came during the opening remarks at the Northern Remote & Rural Health Conference in Labrador (October 2017) by Natan Obed (President of ITK). I remember sitting in the audience with the feeling of a spotlight shining above my head, my face flushed and fists clenched in disbelief because all I had ever wanted was to help be part of the solution. But it was clearly indicated that I was on the side that was part of the problem. I felt ashamed, a feeling I never associated with wanting to help, which led me to feel defensive.

As the day wore on, I reflected on the underlying root of my anger. I identified with, stood in solidarity with and supported the rights and freedoms of our Indigenous Peoples. I appreciated that there were long-lasting impacts due to colonization, trauma and discrimination that I could never understand, feel or experience. There is a shared sentiment amongst both refugees and immigrants with the Indigenous Peoples of Canada. We share histories of being colonized, brutalized and told our way was the wrong way. It’s as if I could say, I understand your pain because it’s in some sorts, it’s a pain I recognize and feel quite frequently. Yet, I failed to recognize that I, despite my personal will to understand, could never undo the damage of the past that Indigenous Peoples experience no more than anyone could undo the damage the Russians and Americans did in Afghanistan. I was ironically in a position that represented the oppressive system that collected, analyzed and made decisions for the Indigenous Peoples of Canada. I came in the form of those researchers that took first and never asked. I wanted to be a solution when in fact, I was part of the problem within the system that created injustices in not just healthcare but also in civil, judicial, social and cultural arenas.

The biggest pitfall of our system is that its an institution that was built on the principles of routine and hierarchy: do as you are told and do not question the legitimacy, intent and ethical code of our institutions practice because that’s how it’s always been and that’s how everyone else does it. Change isn’t easy and for large institutions and long-standing practices, it’s daunting to consider where one might begin. I don’t claim to have answers for our governments, our institutions and our research practices but there is a dialogue now with expressions of deep pain, suffering and a need for acknowledgement for the endless suffering of our Indigenous Peoples. This dialogue helped me realize how erroneous my own practices were and how much I needed to learn and grow. I hope it’s a conversation I continue to hear, learn from and implement.

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North West River, Labrador  Sunset

Morocco in 5 Days

Lifestyle Blog March 22, 2018

I travelled to Morocco in February 2018 for 5 days with Rhonda M, a math teacher from the States. She planned and paid for the trip but wanted someone who spoke Arabic to accompany her. I don’t speak Darija, which is the Arabic that is spoken in Morocco with words in Spanish and French due to it’s history of being colonized. Locals did speak and understand traditional Arabic, which was helpful! We travelled to Casablanca, Rabat, Tangier, Chefchaouen and Fez by car with designated Moroccan driver who spoke Arabic, Spanish, French and English.

I did not feel unsafe or uncomfortable in any part of Morocco, in fact I felt extremely at ease chatting with locals and walking around alone. An important thing we made sure of was to dress modestly and to respect local customs as advised by our driver/tour guide. The expectations for tourists are minimal, however visiting Mosques and more traditional areas required us to dress in long pants and longer sleeves (and sometimes covering our head with a hijab). It was fairly cold while we were there (10-16 degrees C) and wearing long pants and longer sleeves was actually a necessity for the most part.

For anyone looking to travel to Morocco, I would encourage you to plan it in advance because there is a lot to see and experience! It was well worth every penny to have a tour guide that was knowledgeable about the history and to help with navigating the Old Medinas (old streets) because they are very intricate and confusing. Morocco has the kindest people, there aren’t many strays (they are community cats and dogs), the streets are clean and the food is amazing. I don’t have anything negative to say about Morocco and would encourage anyone who wants to travel to visit Morocco!

Here are some pictures from the trip!

 

 

Essential Travel Tips

Adventure, Lifestyle Blog February 27, 2018

We rely on google for almost everything from medical symptoms to research on foreign countries and religions. But just as symptoms of a common cold are fetal conditions on the internet, the same is advertised for foreign countries and their people. Fear is usually the immediate response because according to google, you’re likely going to die in both circumstances. In order to avoid panic, you must always tone down the results of your google search by at least 50%. So, just like the cramping pain in your belly is not pancreatic cancer; assume that you will not be kidnapped and die in a foreign country. BUT in both scenarios take caution and be vigil; always!

I may have a slightly different set of tips for travelling than the majority of blogs out there. As second generation Canadian, I am always identified both in the Canadian context as well as foreign context that I am different. In Canada, I am always asked where I am from and then “where I am really from?” When I travel abroad, I am again asked where I am from and then “whats your ethnic origin?” As someone who has never belonged anywhere where ever I go, I have a lot of experience in constantly bridging cultures together and really understanding how to belong even when you don’t. Being the odd one out has provided to be helpful when travelling because I am exceptionally experienced at the art of “trying to blend in.” Blending in will help you not get kidnapped in a foreign country and  ensure that you are not pissing locals off, travelling under the radar and making friends.

Whenever you’re travelling to a new country I suggest following TWO rules. The first is to respect the law and customs of the land. Do your research and follow the rules that locals follow without disrupting or disrespecting the foreign nation. Despite the common belief that as a Canadian or American (or whatever else), that you are exempt from respecting local traditions, you are wrong. Although there may not be explicit rules that need to be followed in North America for traveller, it is important to recognize that other nations operate differently. Be respectful, be humble and ask what is expected of locals.

The second, uphold the values, virtues and integrity that you would maintain in your own home country. For example, if you are not a cheater in your home country, it is not okay to cheat in a foreign country. That’s extreme but more subtle values must be upheld that are often disregarded when people travel to foreign countries. For example, if you don’t normally pose with children on the street and take their pictures without their parents consent, why is it okay to do it there? If your country does not give you special treatment for your race, class or gender; you must uphold those values elsewhere. You are not above any other person in a foreign country and you are not exempt from human decency.

Now, yes sounds like I’m being a bit harsh but in all honesty, it has to be said. I see it and also feel the awful feeling of being around someone who acts on their privilege. Please put yourself in the other persons shoes and just be a RESPECTFUL human, that’s all.

Live on Purpose

Lifestyle Blog February 11, 2018

As I make my journey through this life, I am forced to reflect deeply on the past and how it shapes me, my life and my worldview presently. Acknowledging the invisible scars, accepting trauma and forgiving myself and others for decisions and actions that can’t be undone. Reflecting on the past has helped me appreciate the present, the people who made it with me and the difficult lessons I can now carry with ease. I’ve learned to shed the weight of societal pressure, religious obligation, parental approval and the need to fit in and the fear of missing out. I am free and on some days, I feel like I can almost float.

When I look to the future, I am excited to live it with complete sincerity and honesty. To be unapologetically myself and upholding the values I cherish and to have integrity in all aspects of my life. My desire to live fully is fuelled by the works of incredible women who challenge me, inspire me and force me to be better each day. I remind myself of them, their work and lives when I feel uninspired, unmotivated or just lazy.

Maya Angelou’s is a woman whose never needed an introduction; she is nothing short of inspirational, moving, profound and incredibly courageous. Here’s a list of a few of her suggestions to live a life of purpose.

  • Always do RIGHT
    • Right by you, right by your internal compass, right by your morals. Do what feels right
  • Be courageous
    • Courage is the most valuable virtue, without courage you will never be able to achieve other virtues consistently
  • Love
    • Spread love
  • Laugh
    • Just have fun, enjoy your life and learn to laugh at yourself
  • Be a blessing to somebody
    • If you can be the rainbow in someone’s cloud, do it! Simple
  • Turn struggles into trumps
    • Find the silver lining; it’s always there
  • You are talented
    • Believe it, own it and never let someone else tell you otherwise
  • Learn to say no
    • Stop putting yourself second and stand-up for yourself and just say ‘no, thanks’
  • Always do your best
    • If you don’t give it your all, you won’t get it all
  • Keep rising
    • If someone puts you down, rise above it (also don’t internalize it)

And get a pet, they just make you smile every day and remind you that they need you and love you unconditionally every day and forever!

2018: Planning for the Past

Lifestyle Blog January 11, 2018

It’s the New Year and everyone is excited to plan the change they anticipate will transform their lives. The key difference about the start of the year verses any other time, is that the drive for change is often motivated to experience a personal re-birth; it’s often very personal and self-directed. That idea is wonderful and it’s truly the starting point of life changing experiences but the problem is that at the start of every year we imagine that in the future we will be better than the past and the future ‘us’ will be thinner, more successful and happier. That somehow, what the future holds is significantly better and that we need to be ready for the amazing future that awaits us. This is the equivalent of dreaming of building an amazing sand castle at the start of every year, imagining it to be spectacular when we finish but not realizing that waves will undoubtedly wash into your castle. Against the magnitude of a large or even small waves, the foundation of your sand castle will be compromised. This isn’t to say that we shouldn’t dream of building castles, it’s realizing that life is fragile, unpredictable and unsustainable without a strong, consistent, resilient and thought-out plan for your castle. So does this mean you put your future plans of amazing transformation on hold in fear of storms and waves?

No. 

CastleInstead, we should start every year by looking backward and really assessing, compiling and evaluating our lives in order to build new blocks on the existing information from our own lives. Taking the first step to look back will help you decide when, where and how to build your castle if you decide to build one. And most importantly, who you want around when those inevitable waves will hit your castle.

This takes significantly more energy and time, and it is exceptionally difficult to critique your life with yourself. I was able to do that for the first time in the most unexpected way and in the most unlikely of places; Labrador. Labrador was the best opportunity for me to hit pause on my life for two years. I reflected on what I wanted and reflected on the years that ran past me. Now, at the start of this New Year, I have started a new job, in a new city and a renewed sense of self-worth. I’ve made a deliberate effort to remove all that does not serve me in a positive and healthy way and plan for the future with a keen focus on the lessons I learned from life.

So, as you start planning for the future, look back at how you started the year before and the year before that and determine how you want to start the year based on the people, lessons and experiences that you lived through to make the best of the new ones that are to come! The best indicator of the future, is the past. So plan for your past, because the future will never come and the past is all that will remain!

 

Being my own Hero

life, Lifestyle Blog December 18, 2017

When I was younger, I used to think I had all the answers; whether it was how to end world poverty or how to fix a broken printer. I was fixated on being able to provide a solution to any problem. And so my dream of being a physician would then allow me to provide everyone with helpful advice and allow me to be a hero.

It took a bachelors, two master’s degrees and two years of working as an epidemiologist to firmly say, I know very little about how anything works or how to fix anything. What I learned instead was the exact things I needed to do for myself; find my own answers, fix the broken pieces and be my own hero.

I spent so long being a “helper” of other people’s stories, to make “helpful” suggestions and provide unsolicited advice to anyone I deemed needed it. How often was I helpful? Probably not as often as I would have liked to believe. The reality I needed to embrace about being helpful was that I first needed to help myself. To understand, detangle and appreciate the soul which lived within the borders of my body. But how does one go about learning about their soul and about life?

busy

I used to think that I would learn more by doing more things, which is why I never took a break and never said no. I pursued my education relentlessly, no breaks between any degrees and also completed two graduate degrees simultaneously. Before I finished my degrees, I was already employed as a full-time epidemiologist working in a health care authority that was grappling desperately with a multitude of communicable diseases. I joined every sport, community event and every social event. I wanted to have answers and the way to get answers, was to do a lot of things.

Two years later, I was burned out, frustrated and at my wits end. Beneath the exterior was a girl who faced early life trauma and a women who ran from the realities of deceit, humiliation and alienation. I put on a brave face and said, no one can see the inside so I will be successful on the outside. I didn’t give myself a chance to succeed the way I envisioned. I wasn’t happier or felt better about anything. I was successful in one small aspect of my life. The rest, I ignored and when it would come up, I would bury myself in “productive” tasks (like studying for my mcat).

When I moved to St. John’s, everything somehow came to a standstill in my world. I stopped making the same kind of effort to do things, I didn’t spend the same kind of hours coordinating what academic, volunteer, extracurricular, sports and social activities to occupy my time and mind with. I often just sit in my cozy, warm and safe apartment with my cat of 5 years every night reflecting while I crochet and drink tea. I do everything alone from shopping to eating out at a restaurant. It is so liberating to be able to sit with myself and my thoughts. I miss friends and family, but I don’t feel alone or lonely. I feel at peace with where I am and I am detangling myself mentally from some difficult experiences from my past so I no longer feel the need to carry them with me in the future.

meditate-sunset

It’s not always easy or comfortable, but I am guided through it by my mentor and guide who is always there when I need her. She simply catches me when I use words that are self-sabotaging and helps me re-tell my own story so that I am able to make peace with it. Every detail, every excoriating detail is sometimes discussed multiple times. We’ve been doing this for three years, but now I am better equipped to understand my emotions and particular events. And beginning to let them go.

In attempting to understand my own story, I have become more understanding of other people and learning not to make a judgement on someone’s character. We are all capable of great damage when we impose our own interpretation of how we think others should behave. Instead, refocusing that lost energy into ourselves is so much more fulfilling, enlightening and comforting. There’s no use in helping others, if you can’t help yourself first. Because if you feel good on the inside, you will always be good on the outside.

(Re)-Defining Gender Roles

Lifestyle Blog December 5, 2017

I was raised with clearly defined gender roles of leaders and followers; decision-maker and obedient subservient; the man and the woman, respectively. They were clear directions of what my role was to be within the society I belonged to. To nod, agree, be pleasant, supportive, understanding, helpful, and most importantly, not ruffle feathers.

When we think of this, we think of societies and countries where women are monitored and controlled as commodities or objects. Yet to a lesser degree this is evident in Western societies as well when women are not generally leaders in the political world, used as sexual objects and are shamed for things that men are not. These things are embedded deeply in our histories because it wasn’t long ago that women couldn’t vote (1915) and an even scarier fact that it was nearly 150 years ago when women were considered a man’s property. The Married Women’s Property Act of 1870 allowed married women to be legal owners of money and inherit property for the first time.

These are remnants of the old world that still impact our lives today. The gender pay gap is evident in all parts of the western world, where women systematically are paid at least 20 cents less on the dollar in academia and corporate settings. Women are expected to do it all, be a mother, a friend, an expert and still be fashionable yet respectable. This expectation is only for the women, men are not mandated by society to take a leave from work when they become fathers, their relationships depend greatly on who they are (whereas women need to be nice to everyone) and there is no requirement to dress a certain way whereas women’s dress codes are moralized in a public setting.

This behavior is literally costing women in the professional world and I’d argue in a greater sense in their own lives. For example, agreeable women are seen as more likeable in the workplace whereas agreeable men are seen as weak as reported in numerous studies. The research in this area is astonishing when considering the gender divide in a professional setting but also in a public and social setting. Women are expected to be demur to be liked, otherwise they are called bitchy.

I often think about whether others like me, if I sound friendly enough and worry if I have offended others, did they think my outfit was too scandalous. As a result, I am always saying “sorry,” almost as if it’s a reflex to ensure that those around me know that I am willing to make amends for anything I may have done.

Why can’t I just be okay with the reality that not everyone is going to like me, no matter how nice or friendly I am. Why can’t I just be okay with saying exactly what I think and feel without the worry of “people pleasing.”

We diminish our own value with “just.”

Just wanted to see if I can take the afternoon off? Just wondering how you were doing today? Just asking if it’s okay to use your lawnmower?

Just phrases are the epitome of submissiveness and they diminish the competence, confidence and value we have. When we use just we are asking for permission, instead of stating a need or request. I’m very guilty of this, and I still have trouble with it.

I will be taking the afternoon off, How are you? Is your lawnmower available ?

The words we use define us subconsciously. Let’s instead, consciously use every word and action to build ourselves in an assertive, self-entitled and self-assured way. It takes practice and reminders to be gentle and kind to yourself first.