Knowledge, Empathy, Understanding, and Recognition
Originally published in The Mortar & Pestle Winter 2020
Amber Ruben (BSc 2006), Inuvialuit hospital pharmacist and advocate, is no stranger to change. She experienced it when she moved from her hometown, Fort Smith, Northwest Territories to Lethbridge to attend the University of Lethbridge and then Edmonton to attend the Faculty of Pharmacy and Pharmaceutical Sciences (FoPPS); when she changed educational routes from neuroscience to pharmacy; and when, at times, she struggles to understand her identity in a society that historically took so much of her culture away. But now, Ruben has stepped beyond navigating change, and is using her expertise and experiences to create it.
“Coming to Alberta was really different,” says Ruben. “It was the first time I recognized the disparity, difference, and racism, because I had never experienced that in the North.” Ruben explains that the lack of integration in communities between Indigenous people and everybody else in Alberta was shocking, the major separation between them largely due to the reservation system. “At home, my community was integrative, with fairly equal numbers of First Nations, Metis, and non-Indigenous people living, working, and going to school together,” she says.
After finishing a Neuroscience degree at in Lethbridge, with a heavy focus on Biopsychology, she was going to do graduate studies at the University of Michigan, but she spent her final year of study in the lab, and she realized the PhD route was not something she wanted to pursue further. So, in 2001, Ruben moved to Edmonton to complete her pharmacy education at the University of Alberta – her hometown pharmacist had piqued her interest years before – though she was originally dissuaded by pharmacy’s Inorganic Chemistry requirement when she first considered the career path. But now, with a Neuroscience degree under her belt, she thought, “I think I can tackle that Inorganic Chemistry,” and moved to Edmonton to complete it and began the pharmacy program at FoPPS in 2002.
Fourteen years after finishing her pharmacy degree, she has worked as a hospital pharmacist at the Misericordia Hospital in family medicine, psychiatry, and now geriatric assessment and ICU. Her role in geriatrics connected her with Cheryl Sadowski, FoPPS Professor and hospital pharmacist at the out-patient clinic at the Misericordia. Together they have precepted resident students and now Doctor of Pharmacy (PharmD) students in their pharmacy. Around two years ago, Sadowski asked Ruben if she had an interest in sharing her experiences and background within the curriculum to better educate students on Indigenous history and health.
“Following Truth and Reconciliation, there were Calls to Action, and part of that was having education for professional programs regarding Indigenous people,” says Ruben. “[Cheryl] thought of me because I have an Indigenous background and because I’m a pharmacist and she wondered if I’d like to be involved. I was definitely interested but wasn’t quite sure what I could bring to the presentation.”
Ruben’s father is originally from Paulatuk, NWT, along the Arctic ocean. In the mid-1950s, he was taken from his family and sent to residential school, and later, to college in Fort Smith. Ruben’s mother’s family, from central Alberta, moved up north to Fort Smith around the same time to follow a job opportunity of her grandfather’s. Her parents met at Fort Smith, stayed there, and started their family.
“I always grew up thinking of myself as Inuvialuit – which is a type of Inuit people from the Northwestern Arctic. But as I got older, I thought, I wasn’t raised with my culture. My dad lost all of his culture. So, can I really think of myself as Inuvialuit? Is that really what I am? Is that who I am? Can I represent any of the people? So, I think that even over the past few years, I’ve struggled with that idea,” says Ruben.
“But, then I think, you know what? I do. This is how I have always thought of myself. I’m proud to be Inuvialuit. I’m proud that my dad was Inuvialuit, and so I’m happy to speak about my background and hopefully help educate and bring what I can to the conversation.”
This January, Ruben took on the majority of the three-hour seminar on Indigenous Health for third year pharmacy students in the Bachelor of Science in Pharmacy (BSc Pharm) program who will be transitioning to the new PharmD program over the summer.
“I talked about my background and my family and how some of the things, historically, have affected my family and me,” says Ruben. This is also how the seminar began for students, as they took time to talk to their peers around them about their own family histories and origins. And professors Sadowski and Marlene Gukert did the same.
Ruben also spoke about Canada’s colonial history and how it impacts Indigenous health, including residential schools, the Indian Act, Reservation System, the ‘60s Scoop, and political decision making beneath the disparities seen in health between Indigenous and Non-Indigenous peoples. She recalled her father’s step-mother, her Nanuk (grandmother), who spent many years in the residential school system and returned home without her culture. “She didn’t, and I don’t think ever will, give me examples, but she felt she needed to tell her story to the TRC,” Ruben says of her Nanuk. “Her description to me was that when she told her story, ‘grown men were in tears’. She not only lost her culture but had a very negative experience there.” Ruben’s Daduk (grandfather) taught her Nanuk how to hunt, fish, sew, and eat traditional foods later in life. “It was coming back to her culture that healed her,” said Ruben in the seminar.
Even though she was not directly affected by residential schools herself, having the opportunity to go to high school and earn two University degrees, Ruben explained that she still goes through feelings of sadness and anger of losing so much of her family’s culture. “There’s an internal struggle of identity,” she said.
“There’s been a real lack of education in terms of Indigenous history throughout our early curriculum – starting in primary school. It’s now starting to be rectified, but it’s left a whole population of people that don’t have a lot of history or knowledge about Indigenous people and history,” she says. “There are not often fantastic relations between Indigenous groups and non-Indigenous groups. And part of that is a lack of understanding of what has happened to Indigenous people for the last 150 years. It’s not from a finger-pointing perspective, it’s just really hard to get on the same page if you don’t understand what has happened.” Ruben stresses that through this seminar she wants to bring knowledge, but also empathy, understanding, and recognition that it will take time before things are better. “It will take many years for healing and reconciliation and for Indigenous populations to become healthy.”
The time that it will take to find healing makes itself apparent in Ruben’s career as well. She has faced strong and wrongly placed opinions about Indigenous people, co-workers who make inappropriate comments, and a general lack of understanding in her professional sphere as well. “I have ways of coping with trying to prevent facing any racism or discrimination. If I’m surrounded by new people that I know I have to communicate with on a social or work level, I’ll make it clear that I’m Indigenous, just so nobody will accidentally make comments that might be discriminatory,” Ruben explains.
This is why Ruben pushes herself to start conversations and help educate her fellow health care professionals, as well as students. “I have had discussions with other pharmacists on lunch hours, even though society tells us to stay away from these topics at work, where I mention things about Indigenous history and people will say ‘those didn’t happen for very long’ or ‘that really wasn’t a thing, was it?’ And it’s kind of jaw-dropping that people can be so educated and not understand [Indigenous history].”
Ruben knows that in order to help others overcome barriers, there needs to be true understanding of those barriers. “People can’t understand where Indigenous people are at socially, from a health perspective, from a financial perspective, without understanding the history behind it. That’s so important.” So, at the core of her mission is educating others – about history and about empathy. This, ultimately, is what she encourages students and colleagues alike to hold close and why she takes the time to lead seminars for students at the faculty.
“I think that it is easy when you are in health care to see the negative impacts that have been created in Indigenous health and populations. There is a lot of poverty, a lot of addictions, increases in [tuberculosis] rates, increased rate of diabetes. These interactions within the healthcare systems...you see the most unhealthy people within a population,” says Ruben. “So, I think it is important for students as they move into their careers, to take a step back and recognize that it’s potentially easy to draw stereotypes based on the populations that they see. Try to be self-aware. We’re people – we form judgements – that’s just how we are. Try to be aware of those judgements and try not to act on them or be discriminatory based on those judgments.”
“You can’t paint everybody with the same brush stroke. If there are things like addiction, there has likely been trauma that has led up to that. So have empathy and understanding and recognize that it is going to take a lot of years of healing for things to change.”
