Structural Racism in the COVID-19 Pandemic: Moving Forward.

The COVID-19 pandemic has taken a substantial human, social and economic toll globally, but its impact on Black/African Americans, Latinx, and American Indian/Alaska Native communities in the U.S. is unconscionable. As the U.S. continues to combat the current COVID-19 cycle and prepares for future pandemics, it will be critical to learn from and rectify past and contemporary wrongs. Drawing on experiences in genomic research and intersecting areas in medical ethics, health disparities, and human rights, this article considers three key COVID-19-related issues: research to identify remedies; testing, contact tracing and surveillance; and lingering health needs and disability. It provides a pathway for the future: community engagement to develop culturally-sensitive responses to the myriad genomic/bioethical dilemmas that arise, and the establishment of a Truth and Reconciliation Commission to transition the country from its contemporary state of segregation in healthcare and health outcomes into an equitable and prosperous society for all.

Settler Witnessing at the Truth and Reconciliation Commission of Canada.

This article offers an account of settler witnessing of residential school survivor testimony that avoids the politics of recognition and the pitfalls of colonial empathy. It knits together the concepts of bearing witness, Indigenous storytelling, and affective reckoning. Following the work of Kelly Oliver, it argues that witnessing involves a reaching beyond ourselves and responsiveness to the agency and self-determination of the other. Given the cultural genocide of residential schools, responsiveness to the other require openness to and nurturing of Indigenous ways of knowing and being. In order to illustrate the complexities and challenges of settler witnessing, the author reflects on her experiences in attending six of the TRC's national events and, in particular, what she has learned from Frederick "Fredda" Paul, Passamaquoddy Elder, healer, storyteller, and residential school survivor. The article analyzes (1) aesthetics and emotions in the staging of TRC events and (2) making meaning over time and the temporality of transitional justice.

The tools at their fingertips: How settler colonial geographies shape medical educators' strategies for grappling with Anti-Indigenous racism.

Settler colonialism implicates settler and Indigenous populations differently within ongoing projects of settlement and nation building. The uneven distribution of benefits and harms is a primary consequence of settler colonialism. Indeed, it is a central organizing feature of the settler state's governance of Indigenous societies and is animated, in part, through pervasive settler ignorance and anti-Indigenous racism, which has manifested in persistent health disparities amongst Indigenous peoples. This broader socio-political context surrounding medical schools, which are seeking to develop teaching and learning about Indigenous health presents a significant challenge. Understanding the cognitive and affective tools that settler educators use when grappling with questions of race, racialization, and Indigenous difference is an important step in addressing anti-Indigenous racism in health care provision. This paper reports on findings from in-depth semi-structured interviews with educators at one Canadian medical school. Our intent was to elicit respondents' understandings, experiences, and attitudes regarding Indigenous-settler relations, Indigenous health and healthcare, and the inclusion of Indigenous health in the curriculum as a means of identifying facilitators and barriers to improving Indigenous health and health care experiences. Respondents were generally sympathetic and evinced an earnest desire to include more Indigenous-related content in the curriculum. What became clear over the course of the data collection and analysis, however, was that most respondents lacked the tools to engage critically with questions of race and racialization and how these are manifested in the context of asymmetrical settler colonial power. We argue that this inability, at best, limits the effectiveness of much needed efforts to incorporate more content relating to Indigenous health, but worse yet, risks re-entrenching anti-Indigenous racism and settler dominance.

Structures last longer than intentions: creation of Ongomiizwin - Indigenous Institute of Health and Healing at the University of Manitoba.

Ongomiizwin - Indigenous Institute of Health and Healing at the University of Manitoba's Rady Faculty of Health Sciences (RFHS) was launched in June of 2017 with a mandate to provide leadership and advance excellence in research, education and health services to achieve health and wellness for Indigenous peoples and to implement the Truth and Reconciliation Commission of Canada's Calls to Action within the Faculty. The RFHS Reconciliation Action Plan has five broad themes: (1) Honoring traditional knowledge systems and practices, (2) Safe learning environments and professionalism, (3) Student support, mentorship and retention (4) Education across the spectrum and 5) Closing the gap in admissions. Community engagement is the focus of our work. Learners and practicing clinicians are grounded in the knowledge of ongoing colonial harms, engaged in critical self-reflection on one's own biases and trained to confront anti-indigenous racism in health care. This alignment is changing the health human resource landscape in northern Manitoba and beyond.

Bearing witness in nursing practice: More than a moral obligation?

In this paper, we explore the concept of bearing witness in nursing practice. We examine the description of bearing witness in the nursing literature, particularly that offered by William Cody who suggests that bearing witness results in the limited moral obligation of "true presence." We then turn to Lorraine Code's work on testimony, drawing parallels between the concepts of testimony and bearing witness. Code suggests that receiving testimony results in a responsibility to respond, and that this is an ethico-political obligation. We discuss these ideas in relation to a Canadian exemplar of witnessing the Truth and Reconciliation Commission of Canada's work to understand and address the historical injustices done to Indigenous peoples in Canada. Here, we focus on the Commission's definition of witnessing and highlight the experience of Shelagh Rogers who served as an honorary witness. As an outcome of our analysis, we suggest that bearing witness in nursing practice is most usefully conceptualized as both a moral and a political obligation. Implications for nursing practice are suggested, including first, the need to critically examine our own understandings of power and privilege in order to authentically bear witness and avoid being complicit in injustice, and second, the concomitant responsibility to take action to challenge injustice once we have borne witness to it.

Conflict, Complicity, and Challenges: Reflections on the South African Truth and Reconciliation Commission Health Sector Hearing.

PURPOSE: This article describes the work of the South African Truth and Reconciliation Commission (TRC) in examining the role of the health sector in human rights violations in the protracted conflicts during apartheid. ORGANIZING CONSTRUCT: The enabling legislation contained in the Promotion of National Healing and Reconciliation Act of 1995 allowed for in-depth examination of violations and complicity in human rights abuses. We provide an overview of the process of the public hearings, soliciting submissions, examining evidence of abuse, personal testimony of conflict in situations of dual accountability, and ultimately the recommendations made by the TRC. The article also outlines the responses of various health professional training institutions to the TRC's recommendations, the implementation of university health and human rights courses, and some current challenges post-TRC. CONCLUSIONS: The health sector hearings of the TRC provided a window into the structural unequal access, racial discrimination, prejudice, and abuse in the health services under the apartheid regime. Examination of past violations perpetrated by an abusive regime and by those such as health workers operating in such a system is imperative to ensure that these abuses are not repeated in the future. CLINICAL RELEVANCE: In delivering comprehensive, compassionate, and ethical care, healthcare professionals have accountability to respect and promote the human rights of their patients. Training in human rights and its relationship to health should be incorporated into all health professional programs.

Impacto Psicosocial de la Comisión de la Verdad y Reconciliación (CVR) en una Muestra deEstudiantes Universitarios de Lima-Perú / Psychosocial Impact of the Truth and Reconciliation Commission (TRC) in a Sample of University Students from Lima-Peru / Impacto Psicossocial da Comissão da Verdade e Reconciliação (CVR) em uma Amostra de Estudantes Universitários de Lima-Peru / Impact Psychosocial de la Commission de Vérité et Réconciliation (CVR) dans un Echantillon D'étudiants Universitaires à Lima, Pérou

La presente investigación busca analizar el impacto de la Comisión de la Verdad y Reconciliación (CVR) en un conjunto de actitudes sociales y políticas de estudiantes de una universidad de Lima-Metropolitana. Para tal fin, se desarrolló un estudio correlacional por cuestionarios (n = 99) que indagaba por los niveles de conocimiento y actitudes hacia la CVR, la percepción sobre el nivel de cumplimiento de sus objetivos, el compartir social sobre la CVR y el conflicto armado interno en el Perú, actitudes hacia la violencia, actitudes hacia el recuerdo y el olvido del pasado, creencias sobre el perdón y respuestas emocionales producidas por la CVR. Los resultados muestran un nivel alto de desconocimiento sobre la CVR. Sin embargo, cuando ésta es conocida se aprecia un efecto positivo, aunque limitado, de sus alcances. Así, el conocimiento y el compartir social sobre la CVR y su lectura crítica sobre el pasado reciente de violencia en el Perú actuarían como un factor de protección contra el olvido del pasado, contra las actitudes favorables hacia la violencia, y en menor medida, actuarían incrementando las creencias sobre el Perdón, especialmente, si se tiene una actitud favorable hacia la CVR.

This research seeks to analyze the impact of the Truth and Reconciliation Commission (TRC) in a set of some political and social attitudes of students of one university from the city of Lima. To this end, a correlational survey study (n = 99) was carried out. The survey investigates: the level of knowledge and attitudes towards TRC, the perception of compliance of its objectives, the social sharing of TRC and the internal armed conflict in Peru, the attitudes towards violence, the attitudes towards remembrance and forgetting the past, the beliefs about forgiveness and the emotional responses produced by the TRC. The results show a high level of ignorance about TRC in the sample. However, when TRC is known, a positive, but limited, effect of it can be seen. Thus, knowledge and social sharing about the TRC and its critical reading about the past of violence in Peru, act as a protective factor against forgetting the past, against favorable attitudes toward violence and to a lesser extent, it increases the belief about forgiveness, especially if participants have a favorable attitude towards the TRC.

Esta pesquisa visa analisar o impacto da Comissão da Verdade e Reconciliação (CVR) em um conjunto de atitudes políticas e sociais dos estudantes de uma universidade da cidade de Lima. Para este fim, foi desenvolvido um estudo por meio de questionários (n = 99) que pesquisou os níveis de conhecimento e atitudes sobre a CVR, a percepção do nível de cumprimento de seus objetivos, o compartilhamento social sobre a CVR e o conflito armado interno no Peru, atitudes em relação à violência, atitudes em relação à memória e o esquecimento do passado, crenças sobre o perdão e respostas emocionais produzidas pela CVR. Os resultados mostram um elevado nível de desconhecimento sobre a CVR. No entanto, quando esta é reconhecida, um efeito positivo, mas limitado, pode ser visto. Assim, o conhecimento do compartilhamento social sobre a CVR e sua leitura crítica sobre o passado de violência no Peru atuam como um fator de proteção contra o esquecimento do passado, contra as atitudes favoráveis para a violência, e, em menor grau, atua aumentando as crenças sobre o perdão, especialmente se se tiver uma atitude favorável para a CVR.

Cette recherche vise à analyser l'impact de la Commission de Vérité et Réconciliation (CVR) dans un ensemble de politiques à des étudiants dans une université de Lima Metropolitana etles attitudes sociales. À cette fin, une étude de corrélation par questionnaires (n = 99) qui a enquêté sur les niveaux de connaissance et les attitudes envers la CVR, la perception du niveau de conformité avec ses objectifs, le partage social de la CVR et de conflit armé développé interne au Pérou, les attitudes envers la violence, les attitudes envers la mémoire et l'oubli du passé, les croyances sur le pardon et les réponses émotionnelles produites par la CVR. Les résultats montrent un niveau élevé de l'ignorance à propos de la CVR. Toutefois, lorsque ceci est appelé un effet positif, il peut être vu, mais s'y limiter la portée. Ainsi, la connaissance et le partage social sur le CVR et lecture critique sur le passé récent de la violence au Pérou agir comme un facteur de protection contre l'oubli du passé, avec des attitudes favorables envers la violence, et dans une moindre mesure, acte Il augmente les croyances sur le pardon, surtout si vous avez une attitude favorable à l'égard de la CVR.