Guest blog post by Abigail Barker

On April 1st, 2023, myself and six fellow Black medical students from the University of Saskatchewan attended the 4th Black Medical Students Association of Canada (BMSAC) Annual General Meeting (AGM) in Toronto. The BMSAC was formed by Dr Helen Teklemariam and Dr Yohanna Asghedom in 2020 to establish a national community with the goal of addressing the specific challenges that Black patients and healthcare professionals face. 150 Black medical students from all 17 Canadian medical schools convened at the Toronto Public Library for a day filled with learning opportunities, connection, and fun. The day started off early with a review of the progress made by each Black Medical Student Association (BMSA) chapter across the country. It was amazing to learn about the range of social events held by each chapter, as well as the advocacy initiatives addressing inequities experienced by Black patients and medical professionals. This was followed up by a series of informative presentations, including one focused on the Diversity and Inclusion in Cardiology Education (DICE) program, a mentorship program founded by Dr Mena Gewarges and Dr Tahira Redwood. Keynote speaker Paul Taylor, the former executive director of FoodShare Toronto and current co-CEO of Evenings & Weekends Consulting, delivered a thought-provoking speech on food insecurity and its links to systemic racism. Throughout the day, there were panel discussions on topics including wellness and student advocacy, particularly pertaining to the Black community. We were also given the opportunity to connect with each other through small group discussions on our personal experiences as Black medical students. It was a great feeling to look around the room and witness the direct result of the work that has been done to increase representation of Black people in medicine and I am grateful to the University of Saskatchewan College of Medicine for its ongoing support and provision of funding to offset the cost to attend these events.   

The 2024 BMSAC AGM takes place in Montreal, Quebec in April.

By: Kayla Cropper, Candelaria Aristizabal Londono, Lucas Fisher & Graham Beresh 

Making the links gave us the opportunity to expand our understanding of health both through theory and practice. The program works to provide us students with the information needed to understand health and health determinants within our community and well outside of it. The practical components work to reinforce the knowledge acquired through the theoretical courses. Additionally, the practical aspect of the certificate is rooted in reflective practice which not only helps to apply the theoretical knowledge, but it additionally works to further our understanding of health in our own community and in communities that differ from our own. The certificate helped to broaden our perspective on health outside of the walls of our own hospitals. It  provided us with valuable knowledge and the opportunity to live and practice in different settings. Overall, this experience helped us to develop an understanding of health that is difficult to shake and sparked a desire to give back and do better. 

In Saskatchewan, the Westmount and rural placements provided us with opportunities to engage in discussion around community needs. Our time at Westmount Community school gave us a first-hand exposure to the inequities that lower-socioeconomic neighborhoods frequently experience. One example that greatly impacted us was the lack of access to safe drinking water at the school as it was in an inner-city neighborhood that continues to use lead-galvanized pipes. Other impactful realizations were the quantity of food that students received from home and the lack of knowledge surrounding one’s health. Although the specific needs of the communities were different in our rural practicum, the struggles and lack of government support appeared to be similar. In Île-à-la-Crosse and Kawacatoose First Nation, two primarily Indigenous communities, we noticed difficulties such as limited access to healthy foods, poor access to healthcare, and gradual generational deterioration in cultural identity. Our practicums provided us with a deeper understanding of the needs of our Saskatchewan communities by learning directly from the community members through relationship-building and personal stories.  

We spent time in the classroom on theory-based lectures and readings so that when we entered a community, our experiences were guided by an understanding of the social and structural determinants of health impacting the people we were working with. We learnt about structural violence perpetuated through strategic economic development for example, and how structural neglect of the northern part of a country can translate to a North versus South health divide. This is something we recognized in Ghana, but also back home in Saskatchewan where northern communities face significant barriers to healthcare access due to factors such as poor road infrastructure. We also engaged in guided reflexive practice with our mentors during our experiences to analyze our self-position in real-time and the ways in which our presence can affect the community and our interactions within it. We will carry these lessons forward into the patient care aspects of our undergraduate medical training to better understand the experiences and perspectives of the patients we meet in our community.  

Throughout the program, we learned of the broad structural inequities that permeate the medical field. These inequities, often perpetuated unconsciously, are rooted in historical, socio-economic, and political realities of the past. On all three of our practicums, we were able to witness first-hand how some of these structural biases came to be, and how they continue to pervade the healthcare sector to this day. For example, in Ghana we had the opportunity to visit the Slave Dungeons of the Gold-Coast. On this trip, we learned of the macro-scale consequences of the trans-Atlantic slave trade, including persistent health inequities in affected groups as well as improvements in medicine as a direct result of the atrocities that occurred during this time including the transmission of communicable diseases and the pathophysiology and management of severe malnutrition. For an example closer to home, we learned of the pernicious stereotypes that are foisted on Indigenous peoples in Canada, and how our government was instrumental in creating and promulgating these stereotypes throughout our country’s history. These negative stereotypes persist until today and can often dictate how interpersonal interactions occur in our emergency rooms and hospitals. It is important for us as future healthcare practitioners to recognize our own personal biases, as well as work to dismantle those that pervade our institutions.  

This program has built a strong foundation for our personal and professional growth, and we are so grateful to have this training early on in our careers as it will inform our future practice in medicine and has empowered us by building our knowledge and skillset for social accountability and advocacy. As future physicians, we must continue to improve our cultural humility and work with the communities we serve to better represent them in our future practices.  

The national Summer Institute on Sustainable Health Systems was created to fill a gap in healthcare professional training and provide health research and health professional trainees with the opportunity to increase awareness of sustainable health systems and current action in Canada. It is coordinated by CASCADES Canada with federal funding.   

Through guided learning activities, meetings with local sustainability leaders and nation-wide panel discussions, the Summer Institute aims to develop trainee knowledge, leadership skills and capabilities, and build professional, interdisciplinary networks of trainees and professionals with shared interests. Daily themes are outlined below.  

USask took the opportunity to host a local hub in June 2023 and spent four days engaging with a group of 7 learners from various disciplines. Our learners represented a pharmacy graduate student, a resident in Obstetrics and Gynaecology, a resident in Family Medicine, and four graduate students from Community Health and Epidemiology.   

Feedback from the participants and facilitators was overall extremely positive: 

“…local people who have been working towards making their workplaces more sustainable and observing how we all encounter so many difficulties. It gave me the nice sense of “we are so many, lots of people who want to do things”, but also showed the shocking reality of “the system is not really helping” 

“It was really eye opening to hear so many different perspectives within the group. I also really enjoyed the speakers and their informative talks. I thought the progression throughout the week was very well planned and allowed us to build upon concepts we had learned the day before.” 

 “It was encouraging to see that there are students and colleagues on the local level as well as on the national level who recognize that there is need and possibilities for action. We are not alone” 

 “I learned that there are steps that the healthcare industry can take to reduce climate change. I want to contribute to this mission one day.” 

Here’s a summmary of our last day from Zoe Schipper, a graduate student in Community Health & Epidemiology:

At the Saskatoon hub, we wanted to embed ourselves in the learning. Discussing temperature rise, environmental equity, and system change during the conference activities and presentations was meaningful inside a classroom but could only become heightened through the last day ‘making a change’ going out to see it. Our group visited Wanuskewin, a heritage park in just north of Saskatoon, Saskatchewan. Wanuskewin is unique in that it holds independent conservation status, above and beyond its provincial, and federal designations. Aiming to be a UNESCO heritage site in 2026, Wanuskewin educates on 6,500 years of Indigenous environmental practises and returning to land-based learning integration. By reintroducing 6 bison to the land in 2019, the heard has grown to 35+ with 4 new calfs born in June 2023. Learning through movement and enngaging in a space of nature brought about discussion of how to implement changes in our green spaces and how to best benefit from ecosystem services. We discussed the resilience of the grasslands to adaptation in times of drought and in collaboration with keystone species. We had the fortune of knowledge keeper guides to inform us about the species diversity in this landscape and how the reintroduction of the bison, renaturalizes the landscape with every year. Located in a deep valley by glacial erosions millions of years ago, this spot was essential to the Indigenous practice of the Fall bison jump to ensure food and materials for clothing, tipis and other essentials through the winter. Through this we discussed that each person has a role to play in the future of our environment, just as each member of the tribe had a role to play in ensuring a successful bison jump. Getting to bring our group there was a calling back to the roots of the Treaty 6 land which we get to enjoy to live, learn and collaborate. We hope to attend a nature park visit in the future and encourage other hubs to find nature-based programming opportunities to engage in kinesthetic and body-balanced learning.

The planning committee consisted of representatives from Undergraduate and Graduate Medical Education, Saskatchewan Health Authority, Community Health and Epidemiology, Division of Social Accountability (DSA), Office of the Vice-Dean Indigenous Health and Wellness, and students. We are grateful to all members of the planning committee, to DSA for support with coordination, and to local sustainability leaders who presented to share their work. *   

USask has been invited to host a local hub for the 2024 Institute. The recommendation of the planning committee is to accept the invitation and partner with other Health Sciences in hosting, to expand the pool of potential learners, speakers, and organizational support.   

By: Cassie Jones
President – Gender Engagement in Medicine

This past spring the SMSS has been making changes to improve students’ groups within the College of Medicine. There was a heavy focus placed on combining student groups with aligning values. The hope with the new changes is to encourage collaboration amongst groups to come together with a larger task force to facilitate events and experiences for medical students. What was formerly Gender Engagement in Medicine, QHealth and Association of Womens Surgeons have all been amalgamated into a new group under one mission statement. The new group will now be named Gender Representation in Medicine (GRM) with a mission to provide the medical student body with an intersectional and unbiased perspective to human health with an emphasis on promoting and understanding the ways that gender, sexuality, and sexual orientation can contribute to inequities for both physicians and patients. Through a strong emphasis on education and advocacy we will build a community of medical students keenly aware of these issues with the tools they need to be change makers. [GRM] aims to support and facilitate initiatives working towards a culture of inclusivity in medicine and medical education.

Events classically held by the individual groups will be continued such as the mentorship program for female identifying medical students with women surgeons to gain valuable insight into the gendered experience within surgery. GRM will continue sexual health awareness week formally led by Gender Engagement in Medicine with highlights such as Sexual Health Trivia Night and the Sexual History Taking lunch talk classically facilitated by Dr. Clark. GRM is excited to be involved in pride festivities in the month of June including the parades in both Saskatoon and Regina.

Looking to the future Gender Representation in Medicine would like to expand on what has been done in the past. In the fall members of GEM had the opportunity to speak with political leaders at the legislature building to advocate for increased abortion access within our province. With a larger task force and new roles GRM hopes to continue to advocate for gender issues within our province. New events and missions’ medical students can look forward to this year include the distribution of gender pins to be displayed on ID badges as well as introducing new lunch talks such as ‘Parents in Medicine” and the return of the Trans Health Panel where students have the opportunity to hear the perspectives and experiences from members of the Trans Community.

Gender Representation in Medicine hopes to expand their presence to social media in the fall term to expand their reach for educational content surrounding prevalent gender issues. The group is excited for all the new changes and potential for new and exciting initiatives this year.

Written by Moyin Onasanya from the Black Medical Students

Before Black History Month this year, I found myself reflecting on the year 2020: a year in which an international reckoning occurred regarding the issues of institutionalized racism and anti-Black discrimination after the death of George Floyd. This event prompted policy changes in education, government, entertainment, and health care. As years have passed, in 2023, my biggest fear is that we may lose momentum for inspiring societal changes to support Black Canadians.

The Black Medical Student Association (BMSA) was formed in 2020 to create a collaborative network of black medical students across Canada. The mission was to secure equitable representation of black students in Canadian medical schools and to advocate for more inclusive medical training that equips all learners to better serve the healthcare needs of underserved black communities across Canada. The Black Medical Students’ Association USASK chapter was formed the same year with the intention of supporting the growth and vitality of the black medical students at the University of Saskatchewan.

In 2020, our founding members created the original draft of our calls to action to address institutionalized and systemic anti-Black racism within the College of Medicine. The main goals were to advocate for better Black representation within the College (including students and faculty), providing better support for Black medical students with issues such as racist mistreatment, supporting Black pre-medical students, and to increase diversity within the college curriculum. Since the creation of these calls of action, the academic board of the College of Medicine has taken action in various areas, including creating a Black physician-student mentorship program, the inclusion of diverse skin disease presentations in darker skin, the implementation of anti-bias training for students, and more. We commend the College for the work they have been able to do and the positive changes they have implemented.

In 2023, there are still ways in which we can improve to better support the Black students and the health care of Black Canadians. This includes creating greater diversity among standardized patients for student clinical learning, re-evaluating student mistreatment policies and protocols to deal with specific instances of racism, the consistent inclusion of diverse images utilized in academic lectures, the creation of a community of support for underrepresented pre-medical applicant groups, the potential creation of general application pool for Black applicants, and more.

As the years continue to pass, I hope that institutions, such as the College of Medicine, will continue to create initiatives and policies that support marginalized groups. I am proud to be a part of a group that is able to work along the College in creating an equitable future for all students, professionals, and patients in Canadian healthcare.

By: Lindsay Balezantis
Class of 2025, College of Medicine
President – Indigenous, Rural, and Remote Health Group

The Indigenous, Rural, and Remote Health Group (IRRHG) is a student organized group from the College of Medicine. We consist of passionate members who are motivated to spread awareness and advocate for changes to the barriers faced by people who live in rural and remote Saskatchewan. We are also dedicated to taking steps towards reconciliation and creating a peer-led space where Indigenous voices can be listened to and elevated to the greater community.

Foremost, IRRHG values highlighting the work of the incredible community organizations already working in the field. We have had representatives from the All Nations Healing Hospital in Fort Qu’Appelle, and Wellness Wheel Centre in Regina give guest speaker presentations to our college. These events raised awareness for programs available to those seeking culturally safe, holistic, and comprehensive care. We believe it is crucial for physicians entering the field of medicine to be aware of the variety of ways healthcare can be delivered and the community resources available to the patients they serve.

Our group helps to highlight the diverse job opportunities available for those working in rural and remote regions of Saskatchewan. We aim to provide resources for our peers who may be considering a career in these areas. We connect students with a variety of physicians working in rural and remote areas through lunch talks. We teamed up with the Artificial Intelligence in Medicine Group to give students a tour of the remote presence laboratory we have right here at the U of S. This tour and demonstration gave our colleagues a first-hand look at the incredible technology on our campus that can assist health care practitioners in delivering care in a unique and innovative way.

This fall, we organized a fundraiser for Indigenous Awareness Week, to raise money for the Saskatoon Survivors Circle. This is a group dedicated to providing opportunities and supporting those who have survived residential school. We also distributed infographics on social media to help highlight Indigenous culture and history, and the importance of reconciliation.

We collaborated with the Exercise is Medicine student group and were fortunate to welcome Tarrant Crosschild, who a Niitsitapi man from Kainai in Alberta, to share his riveting and heart-wrenching life story to Usask students. Through powerful storytelling, he exclaimed how his personal history and culture, as well as his passion for long-distance running helped him navigate his struggle with addiction. He also exclaimed the admirable work he does today, bringing employment opportunities to people living in rural and remote areas and underserved communities, as well as sharing his love for running throughout the country by organizing running clinics and races. We were honored to have one of Saskatoon’s best community engagement and reconciliation advocates speak for us.

This year upcoming spring, we are looking forward to doing research into the current state of rural healthcare in Saskatchewan and advocating to our MLAs. Saskatchewan has a strong and tight knit community, and we believe we can work together to ensure that every resident has equitable access to healthcare across the province.

For more information find the IRRHG on instagram @Wicihowin or email lindsay.balezantis@usask.ca

The College of Medicine distributed an EDI Survey from May-July, 2021 in order to start gaining a clearer picture of our large, distributed College membership, and the issues specific groups might be facing. The full report and a 1 page summary can be found here. It is important to note that ~514 people responded to the survey, representing approximately 13% of the total college population. For that reason, this data is not generalizable and should be treated with caution. Having said that, some patterns emerged that are important to pay attention to, including the findings among those who identified as having a disability.

Of the total respondents, 8% identified as having a disability, and the distribution within this group regarding type of disability is as follows: 46% physical, 43% mental or psychiatric, 17% intellectual or learning, and 17% sensory. Findings indicate that those with a disability gave significantly lower scores as compared to their counterparts regarding perception of a safe environment, fairness in pay and evaluation, inclusion in informal networks, perception of achieving success as their authentic selves, and overall feeling of belonging. Residents and undergraduate students with disabilities gave some of the lowest scores in the entire survey, highlighting the need to do better regarding communicating safety to ask for accommodations, accessibility, and following inclusive practices that take into account the variety of experiences among people with a disability. An easy place to start is to be aware and communicate the services of USask Access and Equity Services for students who are experiencing barriers to their education.

Erin Prosser-Loose PhD
Senior EDI Specialist

The Department of Community Health and Epidemiology has a long history of working with and in communities to accomplish a vision of a society in which all people have equitable opportunity to experience optimal health. As a department, we acknowledge that reconciliation for historical and contemporary harms on Indigenous Peoples and communities is an essential process for achieving that vision. We learn, teach, work, and live on traditional Indigenous territories that in Canada include treaty lands, unceded lands, and Métis homelands. We pay our respects to First Nation, Métis, and Inuit ancestors.  The University of Saskatchewan is on the Homeland of the Métis and Treaty 6 territory.  In our commitment to this place we value respectful relationships with the people around us -past, present, and future – and the animals, lands, waters, and skies that nurture us all. We strive to live these values in our programs, activities, and interactions: relationships grounded in safety and humility, respect for all peoples and their world views, reciprocity in all relationships, relevance to wholistic wellness, and responsibility for informed pedagogy and practice.

In order to structure our reconciliation efforts, a committee was established with representation from staff, faculty and students in the department. The committee is dedicated to advancing the department’s responses to the Truth & Reconciliation Commission of Canada’s Calls to Action (C2A) through focusing on reconciliation in the areas of teaching and learning, research, and community engagement.

With the gifting of ohpahotân I oohpaahotaan, let’s fly up together The Indigenous strategy for the University of Saskatchewan, the Reconciliation committee has continued to incorporate the direct asks of us as a department to implement ohpahotân into our ongoing work. Specifically, the Seven Fundamental Commitments:

• Safety – Creating and realizing inviting, welcoming and safe spaces
  for Indigenous peoples, free from racism and oppression.
• Wellness – Integrating wholistic healing supports for the University’s Indigenous
  community, including students, staff, faculty and leaders
• Stewardship – Preserving and amplifying Indigenous cultures, languages
  and protocol learnings.
• Representation – Uplifting Indigenous peoples in University spaces and places
• Right Relations – Supporting active and respectful partnerships and engagement
  with Indigenous peoples – ethical and relational spaces
• Creation – Acknowledging, resourcing and investing in wise practices and
  activities— conjuring the creative spirit that inspires innovation
• Renewal – Strengthening and sustaining pathways of access and
  success—connecting with Indigenous youth

These committments have offered us a framework on which to build, monitor and measure our reconciliation work. As a committee, we have recently undertaken a review to hold our work against ohpahotân to help us celebrate our successes as a department and identify areas that continue to require attention.

Although we recognize reconciliation is a journey without an end point, we will continue to engage with our students, colleagues, and communities for the benefit of all.

Carlyn Seguin, Global Health Manager

In honour of pride month, the Division of Social Accountability has connected with medical students Colten Molnar and Jovana Miladinovic to highlight the great work of the student groups: qHealth and Gender Equity in Medicine (GEM). Colten and Jovana provided answers to our following questions:

Q: How do qHealth and GEM focus their energy?

A: The Queer Health Interest Group (qHealth) is focused on providing opportunities for queer and ally medical students to engage in advocacy and education regarding 2SLGBTQ+ health topics. It supports and facilitates initiatives to work towards a culture of inclusivity in medicine and medical education. The landscape of advocacy is changing rapidly, and a dedicated queer health interest group is necessary to advance such advocacy work at local and national levels. We wanted a space where members of the 2SLGBTQ+ community and allies have a chance to work together to make medicine a safer and more inclusive space for our colleagues and patients.

The Gender Engagement in Medicine student group – or GEM for short – is committed to providing the medical student body with an intersectional perspective on human health. Our goal is to promote an understanding of the ways in which gender and sexuality can contribute to health inequities, and also to educate and guide medical students so that they are well-equipped to establish future practices that are safe and inclusive of all patients.

Q: What are some initiatives related to 2SLGBTQIA+ health that your groups have been involved with this year?

A: This year qHealth worked with the Provost’s Advisory Committee on Gender and Sexual Diversity to present to interested students a workshop entitled ‘Positive Spaces’. This experience gave medical learners the opportunity to develop their understanding of what a positive space is and to develop strategies for implementing these principles in clinical medicine. This workshop was relevant to learners at all levels of medical school, from pre-clerks practicing inclusive language with SPs to soon-to-be residents looking for skills specific to their patient populations of interest. qHealth was also able to secure funding for pronoun pins for CoM learners in years 1-3.

Furthermore, qHealth continues to be involved with letters of advocacy geared towards developing pronoun best practices in clinical settings and increasing visibility of providers that commit to practicing inclusivity towards 2SLGBTQIA+ people.

GEM held its annual Trans Health Panel on the Trans Day of Visibility. We invited healthcare professionals with experience working with this patient population – including a family doctor, psychiatrist, and pharmacist – as well as folks with lived experience to speak on this panel. They provided us with valuable insights regarding the health needs of trans and gender nonconforming patients, systemic barriers to accessing care, and strategies to foster safe spaces in healthcare.

Q: What were some of the takeaways from the Trans Health Panel this year?

A: We spent a lot of time discussing barriers that transgender and gender non-conforming people face in accessing care. The relative lack of family doctors in the province makes accessing primary care challenging for all patients, and patients from marginalized communities are disproportionately affected by this barrier. It is difficult to find a family doctor at all, let alone one who is affirming, knowledgeable, and well-equipped to support trans patients. Our curriculum doesn’t adequately prepare us to deal with the unique health needs of various underserved groups, including trans folks–healthcare providers must engage in their own learning to be able to provide safe, evidence-based care. Many physicians lack knowledge or experience working with this patient population, so they tend to refer their trans patients to providers with a special interest in queer health. Unfortunately, in Saskatchewan, these healthcare providers are few and far between, and their waitlists are long. As such, trans and gender non-conforming patients face a bottleneck when it comes to being able to see a doctor who can provide them with appropriate healthcare.

Access to certain gender-affirming surgeries is impeded by outdated provincial requirements. In Saskatchewan, a psychiatrist must be one of two healthcare professionals who provide patients with a referral letter for bottom surgery, which is performed in Montreal. This is not in line with (dated, soon-to-be-updated!) guidelines from The World Professional Association for Transgender Health, which only specify the need for a “qualified mental health professional” to be involved. This requirement further exacerbates trans patients’ difficulties in accessing gender-affirming care, especially given our shortage of psychiatrists. Additionally, while the surgery itself is covered, the costs of travel and accommodation aren’t, nor are the costs associated with bringing a support person. Once again, this contributes to health inequity by placing affirming care further out of reach, especially for patients at the intersection of multiple oppressions.

Q: In the spirit of pride, what can we all do going forward to truly make a difference for 2SLGBTQIA+ patients?

A: If you’ve made it to this point in the blog you are already off to a great start! Through our collective experiences as queer students, patients, and allies, we feel that the single change that anyone can make with the biggest impact is to begin educating themselves.

We challenge you to explore the resources available through the USask Library Guide at https://libguides.usask.ca/c.php?g=706788&p=5030005 and to begin conversations with colleagues about how you can contribute to the betterment of care for 2SLGBTQIA+ patients.

If you are a medical student, please consider joining us in a weekly summer book club run by the Canadian Queer Medical Students Association to spend some time discussing 2SLGBTQ+ health and the ways in which current systems can be reimagined to be more effective, safe, and joyful. The book club runs on Thursdays in June and July – you can find more details here https://twitter.com/CQMSA_National/status/1527420113091280919?s=20&t=EmWnGrYNWcwjU4Nli0GeXg

Lastly, join GEM, QHealth, and the 2SLGBTQIA+ Mentorship group in Saskatoon as we walk in this year’s pride parade on June 18th! Last year GEM was able to participate virtually https://youtu.be/Duiy5KCpLlw?t=6097 and this year we look forward to walking together with our CoM family as a tangible representation of our commitment to bettering care for our 2SLGBTQIA+ patients. For more info on the parade please reach out to us at qHealthSK@gmail.com.

For the month of May 2022, medical students from the SHIRP student group were our guest bloggers. Students Ryan Krochak, Anthony Kanz, Baljit Pandher, Sarah Valentine, Adrian Teare, Lauren Ritchie, Erin White and Adam Wandzura share with us the importance of harm reduction in Saskatchewan and the specific health advocacy efforts of SHIRP. You can find more about SHIRP  on Facebook (USask Students for Harm Reduction and Informed Policy), Instagram (@SHRIP_Sk), or by email (SHRIP.USask@gmail.com ).

Why is Harm Reduction Necessary in Saskatchewan?

The term harm reduction encompasses a range of health and social services that are rooted in respect and dignity. These services aim to minimize the negative consequences associated with substance use through non-judgemental and non-coercive methods. Harm reduction strategies offer an opportunity to keep people alive, provide support, and encourage positive change. Some examples of harm reduction include safe consumption sites, needle exchange programs, and drug testing strips.

In recent years, overdose fatalities have dramatically increased in Saskatchewan. The primary drugs driving the overdose crisis in Saskatchewan are opioids and methamphetamines.^1,2 Notably, fentanyl has heavily permeated the drug supply within Canada. With Fentanyl being 30-50x more potent than heroin, even very small variabilities of fentanyl in a sample of drugs can have lethal effects.³ According to the most recent report released by the Saskatchewan Coroners Service, there were 446 suspected overdose deaths in 2021, representing a 39% increase from 2020 and a 390% increase from the 2010-2015 average.⁴ It should be noted that there have been zero overdose fatalities at safe consumption sites within the province.⁵

As this overdose crisis continues to grow, clinicians in all medical care disciplines are increasingly confronted with the infectious complications of substance use. Currently, Saskatchewan has the highest rate of HIV and second highest rate of Hepatitis C in Canada.^6,7 The Saskatchewan Ministry of Health has identified that injection drug use (IDU) is the primary driving force behind the province’s HIV and Hep C epidemics.^6,8 It is estimated that 67% of new HIV diagnoses and 52-61% of new Hep C infections in Saskatchewan are transmitted via IDU.

The Start of SHRIP

Harm reduction is a topic close to the hearts of many students in the College of Medicine. Yet, when the members of the class of 2024, who are passionate about this topic, began their search for student interest groups to join, there was nothing to be found. A small group of then-first-year students – Anthony Kanz, Baljit Pandher, Sarah Valentine, Adrian Teare, and Lauren Ritchie – gathered around a kitchen table and expressed their desire to do something to address the situation. From these humble beginnings, Students for Harm Reduction and Informed Policy (SHRIP) was born. They set out with a mission to advocate for patient-centered approaches toward substance use with a focus on providing education and creating conversation about harm reduction, drug policy, and community advocacy.

Since SHRIP’s inception, our group has made every effort to advocate for underserved populations, and provide awareness and education on the benefits of harm reduction. With a very grassroots approach, we sought to collaborate with community members and organizations whenever possible to develop a network of experts around us who we could learn from and support as they worked toward making meaningful change. We have learned so much from those who have been working tirelessly on the front lines serving people who use substances and feel honoured to be included in this community of support.

Our group’s origin story is very much one of not having a concrete plan, but instead having the unbridled passion of our group members (plus the extraordinary good fortune of being welcomed in by the experts in this community) led us to a variety of wonderful endeavours and learning experiences.

The main goals of SHRIP are to advocate for evidence-based harm reduction policies, to collaborate and support community-based organizations, and provide education on harm reduction principles.

The Current State of SHRIP

Today, the main goals of SHRIP remain unchanged, though the size of the group and the scope of our operations have greatly evolved. SHRIP has become the largest SMSS ratified student group and to best utilize our large team and maximize engagement, we are split into four separate task forces.

The Community Engagement task force is responsible for developing relationships with local organizations and community members. We aspire to learn about our community-based organizations and determine the best ways to support them – whether that is through volunteering, fundraising, or collecting donations of physical goods such as winter clothing, diapers, or food.

The Events task force is responsible for raising awareness of harm reduction principles amongst our colleagues both in the College of Medicine and in other professional health colleges at USask. For example, our events taskforce has planned harm reduction trivia nights, naloxone kit distribution and training, and educational talks such as trauma-informed care, substance use amongst physicians, and psychedelics in medicine.

The Policy task force is responsible for advocating for evidence-based harm reduction in Saskatchewan and beyond. We aspire to use our platform to raise community awareness, create dialogue, and make change. Prior to the 2022-23 Government of Saskatchewan budget release, SHRIP had the opportunity to be honoured guests of the official opposition and attend question period at the Saskatchewan legislature. We were very fortunate that the Minister of Health and the Minister of Mental Health and Addictions offered to meet and discuss why safe consumption sites are necessary in Saskatchewan. In response to the Government of Saskatchewan’s decision not to publicly fund safe consumption sites, SHRIP penned an open letter that highlighted the humanitarian and economic benefits of safe consumption sites. Our open letter received support from many professional health organizations such as the Canadian Medical Association, Saskatchewan Medical Association, Saskatchewan Union of Nurses, Saskatchewan Association of Social Workers, and many others.

The Social Media task force is responsible for educating the broader community on the importance of harm reduction, sharing the work of other local harm reduction advocates and community-based organizations, and highlighting the great work that people in our student group are doing. Notably, our social media team organizes and shares a weekly “Lit Blitz” in which one of our group members critically analyzes peer-reviewed literature and summarizes the information so that it is more accessible for the public. Topics have ranged from examining the link between housing and harm reduction to how nutrition and food security are essential components of harm reduction.

Harm reduction saves lives. Our group and the organizations/individuals we have been fortunate enough to work alongside know this to be true, and it remains our mission to spread this message as widely as possible. We are incredibly excited for another year of peer education on harm reduction, supporting community-based organizations, and advocating for evidence-based policy change. If you are interested in keeping up with our operations and initiatives, you can connect with us on Facebook (USask Students for Harm Reduction and Informed Policy), Instagram (@SHRIP_Sk), or by email (SHRIP.USask@gmail.com ).

References:

1. Saskatchewan Coroners Service. Confirmed and Suspected Drug Toxicity Deaths (2010 – 2015) [Internet]. Government of Saskatchewan. [cited 2022 Mar 20]. Available from: https://publications.saskatchewan.ca/#/products/116473
2. Martell C. Meth takes up 10x larger share of addiction treatment in Sask. than five years ago. CBC News [Internet]. 2019 May 8 [cited 2022 Mar 26]; Available from: https://www.cbc.ca/news/canada/saskatchewan/sask-meth-10x-increase-in-treatment-share-1.5127570
3. Government of Canada. Fentanyl [Internet]. Government of Canada. Available from: https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/fentanyl.html
4. Di Donato N. “It’s right across the board’: Sask. reports record number of overdose deaths in 2021 [Internet]. CTV News. 2022 [cited 2022 Mar 26]. Available from: https://saskatoon.ctvnews.ca/it-s-right-across-the-board-sask-reports-record-number-of-overdose-deaths-in-2021-1.573800 0
5. Simmonds E-M. PHR executive director responds after safe consumption services denied by provincial funding [Internet]. Global News. 2022 [cited 2022 Mar 26]. Available from: https://globalnews.ca/news/8708461/phr-executive-director-safe-consumption-services-provincial-funding/
6. Saskatchewan.ca. HIV & AIDS in Saskatchewan (2019). Government of Saskatchewan;
7. Public Health Agency of Canada. Hepatitis C in Canada: 2019 surveillance data [Internet]. Government of Canada. [cited 2022 Mar 26]. Available from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/hepatitis-c-2019-surveillance-data.html
8. Hepatitis C in Saskatchewan (2017). Government of Saskatchewan; 2017. Available from: Saskatchewan.ca