Lisa Richardson MD
@RicharLisa
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Gen Int Med @UHN | Associate Dean @uoftmedicine | Indigenous Health @WCHospital | Med Ed | Mixed Anishinaabe | She/Her | Views are my own
Toronto | Art by Ning Teevee
Joined August 2019
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Today is Red Dress Day. It is a day when we honour missing and murdered Indigenous women, girls & gender diverse people. We remember & uplift them. We support their families. We recognize this disproportionate violence as a national tragedy. We advocate for change.
#MMIWG2S
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In 1995, Dudley George was killed by a police sniper after three days of occupying land near his traditional territory that had been taken by the federal government. I have been thinking about him a lot these days—especially when I see photos of protesters in hot tubs.
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I’m fortunate to be spending the weekend with a very experienced human rights lawyer who outlined how vaccine requirements in schools and other institutions do not infringe on human rights but actually enable those who are vulnerable to participate fully/be included.
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Text from a friend just now:
“Watching the news and I can’t believe it. The police are not even in riot gear. They always wear riot gear for Indigenous protests—even if there are only 10 people around.”
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Not recognizing or valuing oral history is a form of racism called epistemic racism—where certain forms of knowledge are considered superior to others.
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I hope to have freedom from harassment for my choice to continue to wear a mask indoors—it is a pragmatic choice and not an ideological statement.
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My beautiful sis, Sara Richardson Roque, died today at sunrise.
Her generosity, creativity, fierceness, brilliance and laughter inspired so many in the arts and beyond…May her vision live on and may her journey be peaceful.
Grateful for the compassionate care provided by
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Snapshot from the frontline:
I am covering for a colleague with covid. There are residents off with covid. We are admitting patients with covid. Have encountered many with long covid.
This virus continues to cause major disruption in our healthcare system.
#MaskUp
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The fact that several elected political leaders in Canada are openly supporting a movement whose alleged leader uses phrases like “depopulation of the Caucasian race” and the need for the “procreation of Anglo-Saxons” is haunting me.
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I held up my hospital badge a few times to get through the convoy crowd on my way to work and must have seemed pretty no-nonsense in my mask and my mukluks because people literally moved out of the way.
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I was at a meeting with an Elder last week who now uses the term assimilation camps rather than residential schools.
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My loved one is immunosuppressed and just left the cancer centre after receiving treatment. The idea that they may have been cared for by a person who is not vaccinated--IV insertion, physical examination, close monitoring during infusion--is distressing.
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Being an Indigenous woman, girl or gender-diverse person is not a risk factor for experiencing violence. The risk factors are misogyny and colonialism and their complex intersections.
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I think there may need to be a campaign to take back the word freedom.
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Medicine should be trauma-informed. Education should be trauma-informed. Justice should be trauma-informed. And journalism should be trauma-informed.
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Next time you hear a land acknowledgement, please remember that acknowledging the land where one is standing does not make up for the history that it was taken from Indigenous people.
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Just received these masks in the mail (which I will use despite the end of mandates) and they are made by a certified Aboriginal Business!
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Imagine if Indigenous people got to take a day off on Sept 30 and allies spent the day at work creating policies to hire and support more Indigenous people, create environments where they are valued and hold organizations and individuals accountable for anti-Indigenous racism.
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For those who are tweeting at me that residential schools existed decades ago, a reminder that there are people who are now 30 years old who were there.
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The “return to normal” movement undermines the principles of inclusive design and public policy by marginalizing those who are more vulnerable.
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There is a huge amount of collective trauma and grief today across the country due to this discovery.
May the families, their nations and all survivors of residential schools be surrounded by love and support.
#AllOurRelations
An "unthinkable loss." Remains of 215 children found at former residential school in British Columbia.
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We do not need cheers and pots and pans. Just to be left alone to enter the hospitals in peace and not be surrounded by symbols of hate.
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I learned a new concept in a meeting today called “sanctuary trauma”. It refers to when people enter an institution where they expect healing and instead experience trauma and hurt.
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It is frustrating to be told to discharge patients more quickly—as though we are inefficient and hold patients in hospital longer than necessary—by leaders and administrators who have no clinical background.
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The architectural drawings from many Indian residential schools included cemeteries.
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Kind of tired of people who do not work in the hospital describing what is happening here and debating how to categorize covid admissions.
Is there such a thing as a hospital-embedded position for politicians and policymakers? Happy to have them join me on rounds.
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Imagining the dreams they had & the lives and careers they would have had…
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I try not to be a relativist but the inquest of
#joyce
, the stories of IUDs being inserted into young Indigenous girls and the unearthing of the remains of 215 children at a residential school—one who was only 3 years old—should bring reconciliation into focus for everyone.
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Here is a way to ask about a person’s cultural background during a medical history (from Diane Longboat)—with a. specific purpose rather than as just data-gathering:
“Are there any practices from your culture or background that will help with your healing right now?”
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I am no longer going to participate in “advisory” committees (vs. decision-making ones.) You can advise and advise and advise and see no change or accountability to the input, ideas, expertise, guidance, feedback and time spent.
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I heard a new term yesterday that describes a common form of racism experienced by Indigenous people in the healthcare system: acts of omission. It is when basic elements of care like history-taking, physical examinations, testing, referrals and consultations are not done.
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When you are at a protest where you see Nazi symbolism and a Confederate flag and you do not choose to leave, you are complicit.
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I went down a Twitter rabbit hole and came upon some very problematic comments about my friend and colleague,
@BogochIsaac
. Isaac is a phenomenal leader and educator, and I want to acknowledge all of the work that he has done and continues to do during this pandemic.
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Today is Red Dress Day. It is a day when we honour missing and murdered Indigenous women, girls & gender diverse people. We remember & uplift them. We support their loved ones. We recognize this disproportionate violence as a national tragedy. We advocate for change.
#MMIWG2S
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In the 1960s, the Ministry of Natural Resources burned the homes of Anishinaabe families in order to expand Killarney Provincial Park.
There should be a reconciliation plaque at every entrance to acknowledge this story.
Many other parks in Canada have similar histories.
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For healthcare workers who ask themselves why they are so tired at the end of the week, I would reframe the question to: what is wrong with the system that leads to this kind of exhaustion and burnout?
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My day started today with a quiet ceremony to smudge 125 Moderna vaccines prior to administering them to Elders & community members at Wigwamen Terrace, an Indigenous retirement home in T.O. Huge congrats to
@anishnawbe
Mobile Healing Unit & collaborators from
@WCHospital
!
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Imagine the day when a Prime Minister in Canada begins their speech in an Indigenous language as Jacinda Ardem does here in Māori?
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When 50 percent of a remote FN community gets
#covid
, it’s a reminder that structural factors like housing, heating, running water and healthcare access are critical social determinants of health.
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The normalization of poor health outcomes and gaps in health for Indigenous peoples over decades in Canada is one of the most insidious forms of systemic racism that exists here.
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The
#covid
mortality numbers are so abstract until you experience the loss of a loved one. And then they become so visceral and painful and you feel the cruelty of this virus in such a concrete way.
My family is mourning the loss of a giant in our lives today.
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One of my heartbreaking observations during the past few months: I have diagnosed too many people of all ages with an advanced stage of cancer--likely due to screening delays, fears about accessing care during
#covid
, major life stressors during the pandemic...
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Let’s not let a movement connected to white supremacy overshadow the discovery of 54 graves at former residential schools today.
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At some point, we need to stop giving media and social attention to a very small group of people who are flying a flag of hate and sending hateful messages. Protesting is fine but hate speech is not.
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Our whole organization just received an email message from the hospital CEO to cancel all non-essential meetings over the next two weeks—both to help us focus on
#covid
care and also to protect our physical and mental health. Very appreciated.
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Many physicians I know are experiencing burnout and there is an exodus of nurses from the profession. So hearing the shouts of anti-vaxx protesters outside the hospital over the last few days seems surreal.
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If wave 1 for health care workers was fuelled by adrenaline and wave 2 by confidence (“we got this”), wave 3 is underpinned by emotional, mental and physical exhaustion. We need to look after/out for one another more than ever.
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Today and every day:
Honour the lives of those lost at residential school and the stories and experiences of survivors and their families.
Commit to ongoing learning about the truth and to advocacy for reconciliation and healing.
#EveryChildMatters
🧡
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Please ask yourself today what you will do to advance truth and reconciliation in Canada because if you are not acting for change, you are upholding colonialism.
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In case people are wondering why I am tweeting while I am on call at the hospital, it is because I try to take a break every few hours, sit down in an empty room, take off my N95 mask and drink a lot of water. It’s easy to forget this basic aspect of self-care.
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Making false equivalencies — like comparing hate speech and behaviours to the protests in support of Indigenous peoples and survivors of residential schools — is a common tactic used to justify racism.
Manitoba MP Candice Bergen says focusing on Nazi flags at convoy protest is akin to honing in on the toppling of the Queen Victoria statue during the mostly peaceful Winnipeg march for residential-school reconciliation last Canada Day
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This is probably the nicest setting for a vaccine clinic that I have ever seen. It’s in Eabametoong First Nation.
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You can send out beautiful messages of support and have everyone wear orange shirts tomorrow but it doesn’t really matter if your org is not committed to action for truth & reconciliation. And the heavy lifting & emotional labour should not be carried solely by Indigenous people.
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What is the legal risk to school boards if they have not supported the needs of children with disabilities who are at risk of severe
#covid
infection? Have any been challenged on this yet?
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The irony of the new stat federal holiday devoted to reconciliation is that civil servants with gov of Canada will get the day off but many Indigenous people working in other sectors will not.
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I am going to remove the qualifier “micro” from the phrase micro-aggression because while the behaviour or language or act that it refers to may seem small, the impact usually is not.
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Yesterday, the charge nurse on one of the covid wards asked me about smudging and how they could facilitate it for a patient.❤️
#CulturalSafety
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Systemic racism is ignoring data that shows BIPOC communities have high rates of covid.
Epistemic racism is not listening to communities who know the solutions.
Structural racism is a lack of supports to vaccinate.
Interpersonal racism is hate towards those who speak up.
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George Armstrong, who died today at age 90, was the first player of Indigenous descent to score in the NHL (back in 1951). He was also the longest-serving Leafs captain. Love this photo.
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Today is Red Dress Day. It is a day when we honour missing and murdered Indigenous women, girls & gender diverse people. We remember & uplift them. We support their families. We recognize this disproportionate violence as a national tragedy. We advocate for change.
#MMIWG2S
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I think that our whole team felt very emotional when we were each gifted a beautiful pair of moccasins from Sandy Lake FN.
The generosity of the community was overwhelming and their organization and commitment to the vaccine program are a model for health leaders everywhere.
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Hatred is contagious. But so is love and respect and generosity.
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Acknowledging the trauma experienced by so many after the weekend—witnessing Nazi flags after the recent events in Texas, the Confederate flag as we begin Black History Month and the mocking of Indigenous ceremony after last week’s discovery of more children lost in the IRSS.
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I now use the “send later” function on my email so that people do not feel obligated to respond outside of working hours for non-urgent matters. I am hoping this becomes a routine practice for those of us who happen to correspond at unconventional times.
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I strongly dislike the phrase “speaking up for a person or community who does not have a voice.” Rather than speak for, what about creating structures where voices can be heard and guidance can be acted upon?
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Many people have expressed solidarity with Indigenous people right now which is so important. But hard for me not to wonder: where will they be next month/year/decade?
Reconciliation is a longterm commitment.
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When I turned on the TV tonight, I happened to see my friend/colleague,
@BogochIsaac
. He is the pandemic’s Eveready bunny: tireless and unflappable. Thank you for all that you do, Isaac.
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Heart-melting moment: when your teenage son who is now almost 6 feet tall bends over to give you a Mother’s Day hug and says in a deep voice, “I love you, Mama”...then gives you a beautiful hand-drawn card.
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The cognitive dissonance of being hesitant to get a covid vaccine but subsequently wanting any available therapy to treat the infection highlights to me how terrible it is to struggle for breath.
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The word “Chief” was formally removed from the titles of executives at
@WCHospital
yesterday.
In the context of the hospital’s significant commitment to
@WCHIndigenous
& Indigenous health, it was a powerful symbolic act. Thank you to all who led this work.
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The next time I am at a code blue resuscitation and the patient does not survive, I want to ask the team to pause for a moment of silence to honour the life of the person who has died.
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In my experience, reconciliation often hits a roadblock when it comes to discussions about accountability and redistribution of resources.
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An example of structural racism is when an institution’s anti-racism policy has to be vetted, adapted and approved by the very processes that perpetuate structural racism in the first place.
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Maybe just maybe the occupation of Ottawa has exposed to many Canadians the differential approaches to policing of white vs. BIPOC communities.
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I often wonder if my male colleagues who speak up about health equity have to spend as much time modulating their tone of voice, presentation style and language choice so that they are not perceived as angry?
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The phrase vaccine hesitancy in reference to Black & Indigenous people implies that it’s an individual problem rather than a response to years of mistreatment & unethical conduct in research & health care. It needs a structural solution: communities leading vaccination programs.
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The anti-vaccination movement seems to be a well-organized network with communication campaigns, outreach to hospitalized patients and rallies to foment mistrust. An organized response to it is needed and is very distinct from the need for ongoing vaccine education and outreach.
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I cannot emphasize this message enough. Our inpatient units are full. Our ERs are full. Our ICUs are full.
Please wear a mask, practice distancing, stay in your bubble, wash your hands and be safe.
Hospitals warn of ‘enormous growing risk’ as they urge stronger
#COVID19
measures, by
@megan_ogilvie
via
@torontostar
@OntHospitalAssn
#onpoli
#cdnhealth
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Learnings from Indigenous vaccine clinics: introduce yourself, create space for traditional practices like smudging, do not rush, build in time for dialogue, care for the whole person rather than focus just on vaccination, understand the impact of trauma & racism in healthcare.
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In addition to the encouraging example of Israel, we can see the effectiveness of vaccines closer to home in data from Indigenous Services Canada about newly reported cases of
#covid
in First Nations communities (on reserve):
Jan 10-16: 2519 cases
Apr 11-17: 50 cases
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I have received gifts like sacred medicines, invitations to ceremony, moccasins & many expressions of deep gratitude. Having now vaccinated 100s of Indigenous people, I have observed lots of vaccine confidence when implementation is done or guided by Indigenous orgs & leaders.
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We are living in a time when sharing knowledge about vaccines and speaking out against racism and discrimination make a person a target for hate and threats to personal and family security.
I am grounding myself in the teachings of respect and love and of courage and honesty.
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We were told to look out for anti-mask protesters who might try to enter the hospital today. All was fine but I just ran into them storming the grocery store on my way home.
I was in tears as I walked home thinking about patients with
#covid
and those who have died from it.
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If there is an exhausted employee sitting in an office in the Ministry of Health trying to procure rapid tests and PCR tests and then create a plan to distribute them quickly and fairly, how can we help you?
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Blaming a
#covid
outbreak in a nursing home on staff “non-compliance” with IPAC processes misses the structural analysis: understaffing due to hiring practices, low wage/low job security/high risk roles & a focus on profit rather than providing high quality care for elders.
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The emergence of Omicron demonstrates why global vaccine equity is not only an ethical imperative but also a pragmatic one.
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I want to acknowledge what it means when an Olympian speaks about mental health with the same candour as they speak about a physical injury. This is huge. 🙏🏼to Simon Biles for your leadership.
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People have known the stories of those who were lost at residential schools for a long time and many were not believed. But as knowledge keepers remind us, the land never lies.
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I have noticed a guardedness amongst some in
#MedEd
to speak anout racism because it is “too political”.
But racism structures heath outcomes. And to ignore it is to contribute to health inequities.
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We were asked today during a plenary panel presentation to describe a significant challenge as a leader. My response:
Working in a system which is hierarchical, transactional & individualistic while having a worldview which is non-hierarchical, relational & collaborative.
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I am really excited for the time when people from groups currently underrepresented in medicine will be leading in many roles rather than being called upon to advise leaders about diversity.
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After days of stories about the treatment of children at residential schools, we learn of a man who killed a family based on Islamophobia & of the sentencing of another who threw a trailer hitch at an Indigenous woman’s head.
The construction of the Other is deadly.
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Just as many people got vaccinated early on to protect the Elders, now it’s time to protect the youth.
#SevenGenerations
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Equity work is not just about cheerleading or speaking out. It involves the heavy, messy and uncomfortable work of dismantling programs, structures, systems, practices, etc. In my experience, this is often taken on by people who do so very quietly and with humility.
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I happened to walk by this mural of
#BrianSinclair
in Winnipeg today. 34 hours refers to the time he waited without treatment in ER before he died.
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Who would ever think that a cemetery should be incorporated into the plans for a new school?
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Reconciliation is not a performance. It is a deep commitment — including personal/institutional reflexivity and appropriate resources to support transformative change.
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Just received a big compliment from my daughter (an undergrad student in the humanities) who said that I have managed to remain a disruptive thinker even though I am “medium-aged”.
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"Dismissing anger at racism is racism."
-Sara Ahmed
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Quote shared with me recently by a friend (& strong woman):
"Dear strong woman,
You are not intimidating,
They are intimidated.
There is a difference."
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