Dr. Anna Banerji has no doubt that “we live in a racist system.”
In 2005, Banerji adopted a four-month-old Inuit boy from the Arctic and often took him to visit his biological and foster families as he grew up. She hoped to make him proud of his roots by keeping him in touch with his culture. However, she says after her son’s brother passed away at the age of 14, he spiralled into a depression that exposed the systemic discrimination many Indigenous peoples face in health care.
Banerji says she begged for help from the Centre for Addiction and Mental Health when she noticed signs of her son’s mental well-being deteriorating, only to have her concerns “basically dismissed.” Only 12 days after Banerji’s cries for help, her son mirrored his brother and took his own life at 14 years old.
Pictured with her adopted son, Nathan, and foster mother, Monica, in 2004.
“I tell his story to say, as a non-Indigenous person, that I’ve had the experience of the lack of understanding, the ignorance that’s out there (…) especially in the health-care system,” says Banerji. She says that she hopes in telling her story, people will learn from it.
Today, Banerji is a pediatrician, an infectious tropical disease specialist and the founder of the Indigenous Health Conference and the North American Refugee Health Conference. She is also an associate professor in Pediatrics and the University of Toronto’s Dalla Lana School of Public Health. Her clinical and research focus is on vulnerable children.
Banerji says she has wanted to be a doctor and work with vulnerable populations since she was a child. Even prior to adopting her son, she often analyzed the health of Inuit children residing in the Arctic. Her initial visit in 1995 caused her to realize Inuit infants are more likely to end up admitted to hospitals sick with lower respiratory infections than non-Indigenous infants. She has published multiple pieces of research on the topic. She notes that young and premature infants in southern Canada receive Palivizumab, an immunization agent to protect babies from Respiratory Syncytial Virus (RSV). However, term infants in Nunavut who have the highest rates of admission in the world do not receive the RSV antibody shot, while others at lower risk do. Banerji has worked tirelessly to change this for two decades.
“I realized partway through that we had the knowledge and the facts, but what we found out was the issue wasn’t the data, it was the advocacy,” says Banerji, who is expecting the next year to be more serious for RSV. “And again, it’ll be another year where these babies get (medically evacuated) down south, when there’s something they can do.”
COVID has not halted her activism. She recently began recirculating a petition to bring the RSV antibody shot to Nunavut’s infants that was put on hold earlier this year due to COVID-19. It has garnered over 175,000 signatures to date.
When the pandemic hit, Banerji advocated heavily for rapid testing and vaccine prioritization for Indigenous communities. A petition to get more resources for Indigenous communities including priority for vaccinations gathered 57,000 signatures and resulted in a $305-million investment from the federal government.
In the past year, Banerji has been asked to join the Nishnawbe Aski Nation’s COVID Task Force to give advice on how to handle the pandemic in northern Ontario. She’s also visited communities in the North to help vaccine operations through ORNGE. On June 16, Banerji was found in Sandy Lake First Nation donning a bright orange every child matters shirt and a pink balloon animal on her head. Nicknamed “Dr. Balloon,” she was making balloon animals to distract fearful children from the needles.
“I’ve made balloons for kids all around the world, and I love that,” she says. “I taught all the nurses I was working with how to make animal balloons and they’re all making them now.”
When the pandemic hit, Banerji advocated heavily for rapid testing and vaccine prioritization for Indigenous communities.
Since the beginning of COVID she has been working in the COVID Clinic and the Long Hauler COVID clinic. Banerji says she’s encountered many people who are suffering with COVID-19 and aren’t being taken seriously by medical experts in their area.
“They don’t know what’s happening and they think some of the symptoms are weird,” she says.
“They get dismissed by a lot of physicians because they haven’t heard of the unusual constellation of symptoms.”
Banerji adds that she does her best to “legitimize their symptoms” and lets them know that they aren’t “being hysterical.” This is especially the case with Indigenous folks facing long-haul COVID.
“I say yes, I know your symptoms are like this and I have other patients that are long-haulers, and many of them have gotten better,” she says. “It gives them hope after they haven’t had hope for almost a year.”
Despite not being Indigenous or a refugee herself, Banerji hopes she’s seen as a genuine advocate for Indigenous and refugee rights. After the pandemic, she plans to continue to work with the Indigenous community as an ally and a strong voice to “shake things up.” She says she hopes to develop programs within pediatric Indigenous health, potentially in northern Ontario.
“After almost 30 years of working with Indigenous communities and having an Indigenous son that died because of a system that failed us, that, you know, my heart is there,” says Banerji. “I have a skill set that I can use to try to advocate to make things better (…) whether it’s in Ontario or somewhere else.”
Dr. Banerji and son Nathan during their trip to Iqaluit in 2013.
This is the first profile published as part of the Pillars of the Pandemic series – brought to you by the Dalla Lana School of Public Health and Closing the Gap Healthcare. We will release new profiles in the coming weeks, with 13 people being honoured in total.
The comments section is closed.
Thank you Dr. Banerji and your past meaningful contributions and sincere efforts to save our vulnerable children’s lives is commendable. I certainly agree with you that we have a lot of work to be done to save our children. Indigenous children’s injury should be an important public health concern in Canada for several reasons. First, injury is one of the leading causes of visits to the emergency department and is the leading cause of death for children and youth in Canada. Furthermore, injuries account for more than one quarter of all Indigenous deaths and more than 40% of potential years of life lost (PYLL). An improved understanding of the burden of injury among Indigenous children in Canada together with the associated risk factors, can lead to improved injury prevention. Harrop et al., (1) study found that Aboriginal Canadian children injury mortality is significantly higher compared with non- Indigenous Canadian children. The adjusted relative risk for all-cause injury death (Indigenous vs. non- Indigenous) was 4.6 (95% CI 4.1 to 5.2).One study noted that child drowning deaths are associated with boats and falls to open water. Indigenous population represents 3-5 percent of Canadian population and account for 26 percent of all snowmobile related drowning (2). In the RHS 2008/10, 12.2% of all Indigenous children were reported to have been injured in the 12 months prior to the survey. Comparatively injured children had more emotional or behavioral problems than other uninjured children of the same age (3). Deaths in Canadian Indigenous children and youth are caused by off road motor vehicle crashes (4). In the RHS 2008/10 survey nearly one third of youth reported that they had been injured in the 12 months prior to the survey (3).
In overall injury prevention programs and initiatives must be strengthened through the adoption of proven culturally appropriate prevention work. Policies and programs that focus on promoting a culturally relevant approach to injury prevention and safety promotion among Canadian Indigenous populations are needed. Effective programs and policies to reduce injuries among Canadian Indigenous people must start with community trust building processes, and be built collaboratively through continued processes that support Indigenous leadership in the governance and management of the data collection and surveillance systems (5).
The big question: Has research on injury prevention and safety promotion in Indigenous communities been able to incorporate community perspectives on health, knowledge, truth, relationships and program success? In our recent systematic review, we found that the programs that were successful in improving child passenger safety were more likely to be tailored to individual communities and mindful of local circumstances and culture. Those that incorporated Indigenous views on health and wellbeing, truly involved the community, included accessibility and these tailored educational components were the more successful ones (5).
REFERENCES:
1. Harrop AR, Brant RF, Ghali, WA, Macarthur C. Injury Mortality Rates in Native and Non-Native Children: A Population-Based Study. Public Health Rep. 2007; 122(3): 339-346.
2. Saylor K. Injuries in Aboriginal children. Paediatr Child Health. 2004;9(5):312-4.
3. RHS (2010) First Nations Regional Longitudinal Health Survey, RHS Phase 2 (2008/10) preliminary results: Adult, youth, child: http://www.rhsers.ca/sites/default/files/ENpdf/RHSPreliminaryReport31May2011.pdf (Accessed Oct. 21, 2021).
4. MacMillan HL, Jamieson E, Walsh C, Boyle M, Crawford A, MacMillan A. The health of Canada’s Aboriginal children: results from the First Nations and Inuit Regional Health Survey. Int J Circumpolar Health. 2010;69(2):158-67.
5. Ishikawa T, Oudie E, Desapriya E, Turcotte K, Pike I. A systematic review of community interventions to improve Aboriginal child passenger safety. AJPH. 2014 Jun;104 Suppl 3:e1-8. DOI: 10.2105/ajph.2013.301683. PMID: 24754652.
Thank you for moving the conversation forward with regard to the systematic racism in the Canadian Healthcare system. As an Indigenous and Black woman I have been reflecting upon my experiences with health care and have come to recognize how it has impacted my body, mind and spiritual health over the years.
Looking forward to being more informed and contributing to having better healthcare that meet folks’ healthcare needs.
Unintentional injuries are the leading cause of death in Canadian Indigenous children and youth. Death and disabling injuries not only devastate families and communities but take a heavy toll on health care resources. To reduce the rate and severity of unintentional injuries in Indigenous children and youth in Canada, Dr. Anna Banerji makes the following recommendations. She was the leading author of Canadian Pediatric Societies’ position statement on “Preventing unintentional injuries in Indigenous children and youth in Canada”. According to the position statement, injuries can be prevented, and an improved understanding of the burden of injury among Indigenous peoples in Canada, can lead to improved injury prevention. Indigenous injury is an important public health concern in Canada. She contributed immensely to injury prevention introducing best evidence intervention to prevent and reduce injuries to vulnerable Indigenous children and youth. Education, empowerment, enabling, engineering, enforcement and employment are the so-called ‘E’s’ of injury prevention. They are adapted for Indigenous populations:
Education
Identify community champions to help disseminate safety messages over local media and in school-based programs.
Use anticipatory guidance with families on personal safety measures, such as using helmets, PFDs and seat belts.
Develop IP programs such as First aid and CPR training, swimming lessons, water safety, fire prevention, emergency preparedness.
Empowerment
Incorporate Indigenous culture, language and beliefs into IP planning.
Ensure local participation in the design and implementation of IP strategies.
Enabling
Provide easier access and affordability to IP education and devices through combined community purchasing, installation or subsidies (e.g., smoke detectors, bicycle helmets and PFDs).
Engineering
Design safer products and environments (e.g., safer, well-lit roads and sidewalks, fencing around domestic animals, or designing winter clothing with built-in inflatable devices).
Enforcement
Involve band council members and community leaders in policy implementation and reinforcement.
Employment
Build capacity while designing and implementing IP programs, to enhance community participation and create revenue.
In Canada, poor children are twice as likely as those of affluent children to die of an unintentional injury. The landmark study on the correlation of socioeconomic status and injuries in Canada by Birken et al. (2), found that social inequalities have an impact on fire, drowning and fall related injuries. Given that Indigenous populations represent a high proportion of this stratum (3), and that the reduction of socioeconomic inequities in health is an explicit health policy objective in Canada (1, 2, 3, 4), culturally appropriate policies and programs are required to reduce the Indigenous/non-Indigenous disparities in the social determinants of health and injury (1, 4) Targeted prevention strategies addressing poverty, employment, education, food security and housing are needed. It is important that a national injury prevention strategy articulates and supports these priorities, and clearly identifies particular strategies aimed at Indigenous populations (1, 4).
There is a long overdue need for a more holistic approach to prevent Canadian Indigenous injuries. No doubt that, there are visible and preventable issues affecting Canadian Indigenous overall health and wellbeing. Justice, fairness, compassion and sincere true efforts are needed to address Canadian Indigenous child and youth injury related public health problems (5).
REFERENCE:
(1). Banerji A. Canadian Paediatric Society, First Nations, Inuit and Métis Health Committee, Preventing unintentional injuries in Indigenous children and youth in Canada. Paediatr Child Health 2012;17(7):393: http://www.cps.ca/en/documents/position/unintentional-injuries-indigenous-children-youth (Accessed September 30, 2021).
(2). Birken CS, Parkin PC, To T, Macarthur C. Trends in rates of death from unintentional injury among Canadian children in urban areas: influence of socioeconomic status. CMAJ. 2006; 10;175(8):867.
(3). Stanwick R. Canada gets a marginal grade on childhood injury. CMAJ. 2006;10;175(8):845, 847.
(4). LeBlanc JC, Pless IB, King WJ, Bawden H, Bernard-Bonnin AC, Klassen T, et al. Home safety measures and the risk of unintentional injury among young children: a multicentre case-control study. CMAJ. 2006;10;175(8):883-7.
(5). Desapriya E, Fujiwara T, Verma P, Babul S, Pike I. Comparison of on-reserve road versus off-reserve road motor vehicle crashes in Saskatchewan, Canada: a case control study. Asia Pac J Public Health. 2011 Nov;23(6):1005-20. doi: 10.1177/1010539510361787. Epub 2010 May 10. PMID: 20460293.
Thank you for bringing up another very important health issue for Indigenous children in Canada. There is a lot of work to be done for Injury Prevention!