Stepping Beyond Inequities to Address Systemic Collapse

Sue in conversation with Dr Christine Gibson. Christine is 46 and works in three health centres on the east side of Deerfoot in Calgary, Canada, which support individuals and indigenous communities experiencing health and wellbeing inequities. Christine is also increasingly involved with the possibility of global systemic collapse and the impact that this will have on communities and cultures around the world. She has a Masters’ degree from the University of Dundee and supplementary training in trauma therapy and social innovation (systems change). In 2015 she gave a Ted Talk: Journey from Hero to Humility on the importance of listening to the needs of distressed or traumatised communities rather than pitching in with ‘medical expertise.’

Sue: Christine, can you tell me what called you to work with communities that experience inequities?

Christine: Since I was small, I have been aware of the inequities of life. This stems from my own roots. My dad grew up in a Scottish coal mining town and was working in a paper mill by the time he was sixteen.  He realised he didn’t have a chance of prosperity if he stayed there, so he emigrated to Canada where he met my mother. She came from a Ukrainian lineage. My mother’s great-great-great Ukrainian grandmother settled in Canada during 1903. But the family (on both sides) had an incredibly difficult life because of extreme racism. In the local newspapers, my ancestors were referred to as Bohunks and people used blanket statements stating they were all illiterate, smelly thieves. Really horrifying.

I think this has certainly influenced my choice of medical career and my desire to focus on working with people who are facing inequitable health issues. I started travelling when I was nineteen. I wanted to know what other communities and cultures looked like and how they lived. I’ve been to over 70 countries now, which doesn’t say much for my carbon footprint. But, for a while, I spent several weeks a year in rural Laos addressing health inequities and helping to set up better health care systems.

Sue: That must have a been a fascinating experience. How did it affect your career?

Christine: Yes, it was. The experience forged the basis for my own non-profit charity called Global Familymed Foundation, set up in 2011.  We work mainly with universities in Nepal, Ethiopia, Uganda, Tanzania, Rwanda, Kenya and Myanmar to train GPs in rural areas. 80% of people in most of these countries live outside urban areas, but 80-90% of doctors live in urban areas. So, there is a great mismatch.

My non-profit works closely with partners to see what is really needed. Mostly it’s about providing financial assistance to enable local trainee GPs to learn how to work in these rural areas. Once they spend time there and become more confident, they often get quite committed to the community. I also formed a residency programme (now called Health Equity, but formerly Global Health), which focuses on inner city health, indigenous health, and immigrant and refugee health. This developed into overseas projects supporting people who wanted to work with international organisations such as Doctors Without Borders or take part in international research. We always strive to listen to needs of the community and use our expertise appropriately.

Sue: What were the main issues that you worked with?

Christine:  The impact that trauma has on individuals and on their communities. I now work in health centres in Calgary that are constructed to provide help for people experiencing complex medical and social issues. We work in interdisciplinary teams to address housing and food insecurities and psychiatric illnesses.

Personally, I focus on the area of trauma. Trauma has a lot to do with childhood experiences and inequitable levels of health care. Unless this is addressed, it creates a circular destructive pattern which just continues. I see that mental illness and structural violence are so deeply intertwined that they can’t be separated. If you don’t manage the social spectrum of what is affecting a patient, they are just going to keep presenting back with the same medical issues.

Sue: That’s so true. I believe trauma is endemic in our society, but we don’t understand the ramifications of what it does to us.

Christine: I recognise that everyone walking through the door has had a lot of adverse childhood experiences and subsequent trauma as well as the trauma of dealing with health systems and systems in general. The indigenous community, in particular, has faced a great deal of oppression. So, I do a lot of trauma work to help people to learn tools for themselves, which can also support their communities to address the traumas they have faced historically. I think historic trauma is deeply embedded in psychiatric conditions, and I don’t think that medicine has a lot of answers for this. But the roots of trauma need to be addressed. It’s amazing to see the strides my patients have made in cocreating what healing looks like when a more holistic approach is taken.

I believe unaddressed trauma and inequity is driving planetary systemic collapse. We need to learn to pull back and look at the bigger picture. Whatever happens at the individual level is happening at the community level, and this feeds into the greater global metabolism. We need to explore ways we can intervene so we can mitigate or shift what is happening on all levels.

Sue:  When you speak of systemic collapse, what are the drivers that you are specifically talking about? 

Christine: I think poverty is the biggest issue. However, I also think racism and the legacy of white supremacy play a leading part in this. To enhance my understanding of the people I work with, this year, I completed two on-line courses which I would recommend to anyone. The first was White Awake, which tackles particularities of white racial socialisation. The second course was Me and White Supremacy. I realised that even though I had all these letters after my name, I only have expertise in one very small piece of the puzzle. I may have a Masters, and supplementary training in trauma therapy and social innovation, which means I am seen as an ‘expert.’ But what I need to do is to listen to the community to find out how I can be of real help.

Sue: What do you think listening to these communities can teach those of us who live in western societies? 

Christine: I believe our understanding of indigenous practices can help us in our own suffering. Many of us are used to living at a point of privilege and experience great discomfort when this is threatened.  But unless we examine what this means and get to a deeper level of understanding, I think we are going to remain stuck in old colonial patterns and feedback loops where we continue to believe we deserve our privilege. I believe this meritocracy drags the whole planet down. But this is so traumatic to think about that we either settleup or reject what’s happening. This makes it difficult for people to move forward into the compassion and resilience that’s needed to create functional communities.

Sue: Can you explain more about what resilience means in this context.

Christine: I think we need to build resilient communities to cope with any system collapse. The more we are able to live in social engagement and compassion, the more as we as individuals can create positive responses in our community and for the whole planet.

I was drawn to Jem Bendell’s Deep Adaptation work because I believe there are multiple systems in the stage of collapse right around the world. I see the evidence through the global work I do. For example, South America and North America are really struggling to create and sustain agriculture. However, we who live in wealthy countries like Canada haven’t faced the fall-out yet – but that doesn’t mean it’s not happening.  I was caught up in the 2015 Nepal earthquake. Right afterwards India and Nepal started to scrap over water resources from the Himalayas; and India imposed an embargo on food, fuel, and medicine that lasted for months. Is there going to come a time when the US will want Canada’s water resources? Yes! But these issues are not reported in the media, so people aren’t paying attention to it.

My social innovation lens helps me to understand what’s really happening. I see it as an image of a tree being on fire, but when you pull back from this tree, then you realise that the whole forest is on fire. Everything, from our personal health to the macro level of all our planetary systems are totally intertwined. You can’t separate the tree from the forest. If we don’t understand this, we are going to be facing system collapses completely unprepared on any level on how to deal with it.

Our response to this needs to be much more than permaculture or transition towns. We need to learn how to emotionally regulate so we go beyond traumatic reactions.

Sue: I completely agree with you on this. But how do we learn to go beyond traumatic reactions when we are terrified of what we are potentially facing?

Christine. I don’t think every single community can be ready for this. But I admire Margaret Wheatley’straining because she taken on the work of Joanna Macey, and designed a programme for Warriors of the Human Spirit to create leaders who can build communities, which she calls Islands of Sanity. To her way of thinking, if there are more islands of sanity cropping up throughout the world, there might be an alternative response to a destructive traumatic reaction.

Sue: This feeds into what living consciously for a better world is all about. But, do you think this is possible during massive systemic collapse?   

Christine: Absolutely. As much as humanity is deeply capable of patterns of structural violence, we are also deeply capable of compassionate responses. And, if we view scarcity as an opportunity to double down on inequitable issues, I think there’s less chance of mitigating the suffering that has already begun. I believe that if we can work towards these islands of sanity, we can become much more deliberate and conscious around how we chose to be.

For example, I think we, as individuals and as communities, can choose to be a certain way, even as systems begin to fail. Perpetual growth and perpetual inequity are not patterns that should sustain themselves. We need to ask, ‘Is there an alternative system that is possible?’ I don’t actually know if there is. But I was in rural Kyrgyzstan not so long ago and I saw how lots of nomadic people are living as they have done for millennia. They live in complete concert with the natural world and with their animals. It’s a totally interwoven existence. It’s not oppressive either, between species at least. It’s about holding deep respect for other species and for the land. We might call Kyrgyzstan a developing country, but, in order for us to continue –  if we are to – the world may need to look to people like this to remember what it means to have this interconnectedness. This is certainly a version of how humanity could be less affected by climate chaos.

We come from a culture that is utterly self-absorbed. The western mind is so linear in the way it thinks and approaches things. We have to step beyond this to explore how we approach the increasingly pressing question of systemic collapse.

Sue: How do you see your work developing from now on?

Christine: I have no idea of what the second half of my life is going to look like. I see myself as having experienced the peak of comfort – and being fortunate enough to hold a social position to be able to experience it the way I have. I believe part of my work is now recognising how our own human existence is complicit within the entire planetary systems.

To me, this means re-examining our entire social position and personal participation. I don’t necessarily hold specific hope for myself or for my community, but I do recognise that life will continue in some form. Humanity has had a great run at it, and even if there is to be human extinction, I believe we are moving the greater metabolism to a different level of understanding. Maybe the next evolution of sentient beings will be able create a greater civilization than we have presently, but I have no idea what this might look like.  All I know is that I feel privileged to have been along for the ride. So, personally, I am experiencing these changes with great joy, curiosity and humility. And, professionally, I believe we physicians need to the same,

We have been deeply complicit with the pharmaceutical industry and allowed them to provide medical evidence for us which has driven the curriculum of what we learn as doctors. We have forgotten other ways of healing, which, for centuries, have been part of indigenous communities and ourancestral knowing. As a profession, we have forgotten far too much about what healing means. It’s time to address this.

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