Blame Canada's history for low rates of cancer screening among Indigenous women, doctor says

A B.C. doctor says the colonial history of Canada's health care system is preventing Indigenous women from being screened and treated for cervical cancer, and hopes the solution to the problem can be found in health care experiments in Eastern Africa.

Forced sterilzations, segregated hospitals created mistrust of system, says Dr. Sheona Mitchell-Foster

The Nanaimo Indian Hospital in November 1966, shortly before it was closed. (Times Colonist/Agnes M. Flett)

A B.C. doctor says the colonial history of Canada's health care system is preventing Indigenous women from being screened for cervical cancer and she hopes a solution can be found in a health initiative in East Africa.

Indigenous women in B.C. are 92 per cent more likely to develop cervical cancer than non-Indigenous women, according to a joint study from the B.C. Cancer Agency and First Nations Health Authority. The same study also found lower survival rates for Indigenous people with cancer.

Part of that disparity can be explained by the colonial history of healthcare in Canada said Dr. Sheona Mitchell-Foster, an obstetrician-gynecologist and assistant professor in the University of British Columbia's Northern Medical Program in Prince George. 

"Ultimately, it's a colonial system," she told CBC Daybreak North host Carolina de Ryk.

Dr. Sheona Mitchell-Foster works in Prince George, B.C. (UNBC/Northern Medical Program)

For decades, Indigenous people were treated in segregated, government-run "Indian hospitals" where, according to those who lived through the system, they were subject to abuse and experimentation that included forced sterilization hundreds of women. 

Mitchell-Foster said that history needs to be considered when looking at the modern-day healthcare system.

"If your aunty, if your mom, your grandma interacted with the healthcare system and, for example, was forcibly sterilized or sterilized without her consent as a part of a reproductive exam, that's going to have a profound impact on whether you engage with the healthcare system," she said.

Other factors cited by Mitchell-Foster include the distances Indigenous women in northern B.C. have to travel to be screened and that many doctors who administer pap smears are men.

"That's a uniquely invasive exam," she said.

To counter this, Mitchell-Foster is working with Carrier Sekani Family Services and Métis Nation B.C. to give Indigenous women in northern B.C. take-home kits that allow them to self-test for the human papillomavirus or HPV, the virus that causes cervical cancer.

The screening model is based on a project the B.C.'s Women's Health Research Institute is running in Uganda. 

Should the experiment see increased rates of screening among participants, Mitchell will advocate for it to be adopted in rural B.C.