 So, good afternoon everyone and welcome to the Health Law Institute seminar series. I'd like to acknowledge that we are in Makmaqi, the ancestral and unceded territory of the Makma. We honor the Makma people who have taken care of this land and we show respect for this land and we acknowledge that we live and create on these lands in the spirit of taking care of them for all. We are all treaty people. My name is Joanna Erdman. I'm the Associate Director of the Health Law Institute. The Institute is a group of university faculty, policy analysts and student fellows who are committed to the advancement of health law and policy and the improvement of healthcare systems and practice. I see some of our members are here today so welcome. To learn more about the Institute I welcome you to visit our website or come to our offices. We work across a range of health domains and we know that we are part of a large and diverse health community here at Dalhousie and we look forward to meeting many of you. So welcome to our seminar series. This is a platform for sharing research and ideas on health law, health practice, health policy and this is our opening seminar for the 2019-20 season. It is my absolute pleasure and big thanks to Dr. and Professor Omishore Dryden who is kicking off our series. Dr. Dryden holds the James R. Johnston Chair in Black Canadian Studies is an associate professor in the Department of Community Health and Epidemiology Faculty of Medicine here at Dalh and is also the co-president of the Black Canadian Studies Association. Today Dr. Dryden will speak on anti-black racism, homophobia and Canadian blood donation practices. Please join me in a welcome. How are you? Good. Not bad. Thank you. Do you have power? Yeah, well I know you have power. Do you have electrical power? Yes? Or you have no more generators? So I'm from Toronto. I could not live more inland if I tried and I actually was in Toronto for the hurricane and I was like okay. Got back Sunday night, drove in from the airport, listened into tunes from my phone, get to my street, darkness. I was like oh no. I go to my building. Okay, there's lights. No, that's just the generator for the outside. So I got into my apartment, there was no lights and because I was streaming music from my phone the power on my phone was really low. Who would have thought that I probably should have used that 30 minutes to charge my phone as I was driving in from the airport. But it was fine because now I have power. Well I always have power. And I have electrical power. And I've entered everything from my fridge. And I've done a little bit of grocery shopping because I'm going to have to take some time to replace all of those things. So thanks for the warm windy welcome to Halifax. Thank you to Joanna for this lovely invitation and you sent me a lovely welcome to Dallas. I appreciate that. Thank you to Ashley for your profound patience. Hi Dr. Jiden, do you have your PowerPoint? Oh yeah, I'm getting that. Hi Dr. Jiden. No, no, it's coming, it's coming. Seriously it's coming. Which I brought right nearly this morning. In addition to acknowledging the land that we're on and that we gather on these traditional and seated territories at the mouth seat. I also want to acknowledge that this past August this like last month marks the 400 year 400 years since the transatlantic slave trade began. So what does it mean? Well it means that black people have been in Canada and in North America and a conservative estimate for 400 years. In fact black people have been in North America including this region we call Canada before slavery, through slavery and of course after slavery. So to that end I acknowledge this and black LGBTQ and two spirit folks who were here, who were forced here and continue to make home here. I need to get to my slide. Oh, thank you. Do I? Oh no, yes. Wow, that was magic. Okay. Will you give me five minutes? Sure, thanks. So Canadian blood services posits that becoming a blood donor is easy. However the donor questionnaire process demonstrates that it's not quite that easy. Blood is a site through which political power, the law and activism occur. Lesbians and gay men in Canada have fought to be included through various political and legal challenges. However it's important to note that there is a simplification of narratives regarding this activism. Shifting a lesbian and gay Canadian experience to become the lesbian and gay Canadian experience thus deploying a singular cohesive narrative which creates an often deployed singular understanding which posits lesbian and gay people as containable, non-porous cultural group that is easily identifiable within a larger Canadian multicultural framework. And as such discussions of colonialism, colonization and anti-black racism become understood to be decidedly external though at times perhaps slightly connected with normative narratives of lesbian and gay politics and sexuality in Canada. How the political, legal activism to have gay blood included in the national blood supply employs the tenets of hominationalism including the claims of sexual exceptionalism, sexual exceptionalism. Regulation of gay identity and the discourses of racial neutrality and color blindness. The legal mechanisms that have dictated the categories of bodies through blood narratives and here I'm talking about blood protection laws, anti-miscegenation laws and practices, blood quantum and one drop theory which is not necessarily a law but something put into place and given legal support. Structure the ways in which we continue to speak about race. So the liberal inclusion of some lesbian and gay subjects is as much the consequence of hominormativity, a dominant form of sexual politics oriented towards privacy and domesticity as it is an animation of nationalism. So hominormativity and hominationalism concept made popular by the Sadegin in 2002 sustains dominant heteronormative ascensions of and about social life while fostering a gay sexual politic solidly anchored in the aspirations or dreams of what Laura Bernat Berlant terms good life, fantasy and is normative kinship structures, self-realization, domesticity and in this case becoming a good blood donor. So the opportunity to donate blood becomes an experience that demonstrates one's belonging. The drive to be recognized and recognizable within prevailing norms of authenticity requires that we subscribe to a practice that delegitimizes those sexual lives structured outside the bonds of marriage and presumptions of monogamy. In September 2010, the Ontario Superior Court made a decision regarding the case between Canadian blood services and Kyle Freeman. In 2002, Kyle Freeman, a white gay man sent an anonymous letter to Canadian blood services confessing that between 1990 and 2002 he had donated blood on a number of occasions. Canadian blood services was able to determine the sender of the anonymous email note to self nothing on the internet is anonymous. We know that, right? And so sued Kyle Freeman for making false claims and putting the donor's supply at risk. Kyle Freeman countersued Canadian blood services claiming that the donor screening process violated the Canadian Charter of Rights and Freedoms and discriminated against men based on their sexual orientation. In her decision, Justin Catherine Aitken ruled that the Canadian blood services ban on donation was not based on discrimination against sexual orientation but on health and safety considerations. The court determined that Kyle Freeman was negligent in his misrepresentation and that he did not have a Charter of Defense to claim. Kyle Freeman was held liable to Canadian blood services with damages of $10,000. What I'm particularly interested in is this framing of health and safety considerations. So in Canada, the presence of blackness and black people is both unimaginable and unexpected. We know this when we hear things like, you know, where are you really from? How long have you really been here? You know, no, like really, where are you really from? Like we understand that blackness continues to be a surprise when black people en masse are asked this question repeatedly. And when people are not a part of the nation's imagination they become erased in like that of Canadian national narratives and this erasure and unknowing is specifically a Canadian version of anti-black racism. So in spite of the longstanding, complicated, layered presence of black people in this late market-based economy white settler colonial nation understanding of black personhood remains difficult and ongoing work. Thus the presence of black people is often imagined as an epistemic dilemma, difficult knowledge, impossible validation. So for the short time I have today I want to focus briefly on three vignettes of blood donation in Canada. And the ways in which colonial and anti-black stereotypes of sexuality, gender, race, migration and nationalism have come to inform medical, health and scientific truths about HIV and AIDS and the parameters of safe blood in addition to how we have come to imagine who is the ideal blood donor. So the Canadian Rib Cross Society was an auxiliary to the government's military medical services in wartime and held its first public non-military blood donor clinic in 1940 in Toronto. With the slogan, make a date with a wounded soldier, these posters actually went up and about. Canadians were urged to donate blood with all donations reserved exclusively for military use. So if it was 1940 and you're in Toronto and you had somebody in the hospital who needed blood, you would need to organize with the hospital to get your own blood supply. So all of the blood collected at this public clinic you could not have access to at that time. It was then shipped to great distance to Europe for military use. This person here, Dr. Charles Drew, is an African-American, cisgendered man who developed procedures for collecting, storing and transporting not only large quantities of blood, but across great distances. He began the development of these procedures while he studied medicine at McGill University. And these methods and procedures have become the basis for national blood collection programs in the United States, in Canada, and in Britain. He is this black man, the father of blood donation as we know it today. The first blood transfusion recipients were white American and British soldiers and following the direction of the American Red Cross Society, the Canadian Red Cross Society racially cataloged all of the blood that was collected based on the people who donated blood to ensure that white soldiers did not get blood from not white people. As the creator of the modern blood donation system, Dr. Charles Drew rigorously objected to this practice of racial segregation of donated blood, arguing that there was no scientific evidence to support such a practice in 1940. However, the practice prevailed. Public health officials said we understand that there is no scientific basis for this, but the health policy, the health and safety considerations that we want to put into place means that we must racially segregate the blood based on the donor to make sure that white soldiers don't get not white blood. Get blood from not white people. It's also important to note that between 1940 and 1942, women who largely ran the clinics were not allowed to donate blood, as it was suggested that women would not be able to handle the physical process of that blood loss. In this act, the Canadian Inception of Public Blood Donation is based upon the perception of separate and unequal races informed by anti-indigenous and anti-black racism, colonialism and racism, in other words, and racial bias, because there was and is and continues to be no scientific evidence of race. Yet even though this is the case, as I said, for health and safety considerations, blood was segregated based on race of the donor. So that's vignette number one. Number two, again, very, very brief, overview of HIV and AIDS, not the science per se, but instead the assumptions and stereotypes that inform the science. So, HIV and AIDS and the way that we understand it are steeply based in these practices of morality for true. Discussions and notions of health, wellness, illness, disease, homosexuality, and foreigners. Canada reported its first case of AIDS in March 1982. And so, in order to keep the blood supply safe, North American health officials, so Canada and the United States, placed a ban on men who have sex with men from donating blood. AIDS was considered to be exclusively a gay-related disease at first. The homophobia of early detection included assumptions of the lack of moral correctness, the lack of self-control among men who have sex with men, and because of this lack, it was argued, and many pockets continues to be argued, was the creation of AIDS. To keep the blood supply safe, men who have sex with men were called upon to take ownership over their lackness and slackness and assume responsibility for the virus. As Sir Ron Somerville argues in her 1994 article, Scientific Racism and the Emergence of the Homosexual Body, the emerging notions of sexuality at the turn of the century were profoundly influenced by scientific discourses of race, specifically scientific racism. And I'll come back to that. In 1983, the Centers for Disease Control and Prevention released a list detailing the dangers of HIV contamination by naming four vectors at that time. Homosexuals, heroin addicts, hemophiliacs, and Haitians. So again, we return to blackness in blood and blackness in disease. Blood donor operators were asked to bar these groups of people, homosexuals, heroin addicts, hemophiliacs, and Haitians, from donating blood, but also to put them under surveillance. Haitian people, regardless of citizenship, were included in this ban, mid-80s. So just on a side note, in the 80s, the political situation in Haiti was catastrophic. The influx of Haitian people during this time to Canada was met with xenophobic fears. As newcomers to Canada, Haitian people faced challenges, including racially motivated violence, and this is documented in any of the newspapers throughout Montreal at the time, racial harassment and racial discrimination. It's not surprising then that when HIV and AIDS began to be diagnosed within Haitian communities, the desire to find the origin of HIV and AIDS shifted to include Haitian people. Haitian people were described as, and I quote, mysterious, isolated, disease-ridden, blood-maddened, and engaging in exotic, violent, voodoo rituals. And here I'm citing Paul Farmer's work, AIDS and Accusation, Haiti and the Geography of Blame. So not only was Haiti framed as a place riddled with HIV and AIDS, but also all Haitian people were considered to be carriers of this deadly disease. The CDC released a list. So predictably, after the CDC and the Red Cross released a list, and the Canadian Red Cross issued a pamphlet asking people at high risk to stop donating blood, predictably these actions were met with outrage and protest. On April 20, 1990, about 80,000 Haitian people and 150,000 Haitian people, I think in this shot, the shot I did not include is the one from Montreal, my apologies, and then 150,000 Haitian people marched across the Brooklyn Bridge protesting being barred from donating blood. This action tied up traffic per hour while simultaneously shutting down Wall Street trading. That's a badass action. Later that month, later in April, before the end of April 1990, the ban was overturned. Racism and homophobia lead public health officials to believe that simply banning minimum sex with men and Haitian people regardless of citizenship and sexual orientation from donating blood that that simple act would then protect the blood supply and the general public would remain untainted. Here we see again this idea of who's included in the general public and who is considered wanting to storm the walls, who is considered a danger to the general public. When we think through this long history of how anti-black racism works, how anti-black racism and scientific racism fuels, how we even understand sexuality today, homosexuality, heterosexuality, and in an un-conforming folks' chance folks, we need to think through how these practices have been informed not only the trajectory of scientific research, but also the trajectory of legal practices, policy practices, and policy implementation. I'll provide more information in just a minute. This whole climate, this piece around, it's gay men, it's Haitian people, it's sex workers, it's heroin users. These are the people who are not a part of our families, not in decision-making rooms, not involved in running the country in the way that we are involved in running the country. These are the people that we need to make sure that we can contain, that we can surveil, that we can make sure are held accountable so that our blood supply, the way that we need to maintain our own health is protected. Obviously, I'm not the hour in that sentence, but I think we're good there. So the Canadian federal government, so all of this, this kind of framework, is what actually established the conditions for the tainted blood crisis, and how we understood the tainted blood scandal. And as you know, the Canadian federal government established the Royal Commission of Inquiry on the blood system in Canada, otherwise known as the Creaver Commission in 1993. And one of the recommendations from the Creaver Commission was to remove blood donation responsibilities from Canadian Red Cross Society and create a new organization called Canadian Blood Services, and that was in 1998. All right. Very brief. We'll have time for questions later. And, you know, the pieces that I was unable to fill out. But let's get to Canadian Blood Services. So Canadian Blood Services has had a number of slogans over the years that's in you to give. Becoming a donor is easy. Join the movement today. And most recently, together, we are Canada's lifeline. And all of these stand alongside a detailed and in-depth blood donor questionnaire. Canadian Blood Services argues that it's required donor questionnaire specifically, scientifically designed to effectively screen potential donors. The questionnaire asks a number of questions regarding travel, medical background, drug use, sex, and sexual encounters, and also included are questions regarding geographic locations, and is ostensibly to determine where one is from, where one has been, and for how long, and the range and scope of sexual contact potentially engaged whilst there. The current gay and Black debates have been structured in a way that includes other queer and trans interrogations into who has good, healthy blood and begs the question, what are other proximal moments? And so for this reason, I trace the exclusions from blood donation through a Black queer trans lens, one that insists on the interconnectedness of experiences, and I think through what some of the experiences may have been like for Black queer and trans people at the inception of blood donation. And so this is why I go back to that 1940 moment, right? Because if we just start with the gay blood donor questionnaire, or gay blood activism the way it's colloquially understood, then nowhere in that do we understand the long and historical practice and presence of anti-Black racism in that. And so if we actually start with Black queer and trans people and say what has been the experiences of Black queer and trans people and Black people when it comes to blood donation, then we have to go back to the first public blood donor clinic in 1940 that clearly said, oh great, yes, Black people can donate blood, but we're just gonna like segregate it over here and use it only for not white people, and white people can only get white blood, blood for white people. So today the 1940s blood segregation, Haitian people being described as a vector of disease, vector and carriers of disease, 1983 and 1990. And then in 1998, with the inception of Canadian Blood Services, the focus shifts to Africa. So until from 1998 to 2005, the following questions were asked in the donor questionnaire. Cameroon, Central African Republic, CHAP, Congo, Equatorial Guinea, Gabon, Niger, Nigeria, were you born there, were you born or lived there since 1977, had to have sexual contact with anyone who was there, or have you traveled to these countries and received blood treatment, received blood products or blood treatment. At the time of this, at the time in 1998 to 2005, the Blood Services argued that this type of geographical deferral was necessary since people who lived in these countries may have been exposed to a new strain of HIV, which was HIV-I Group O, and as such were not able to donate blood. CVS also stated, and I quote, that this is not based on race or ethnicity, but possible exposure to HIV-I Group O. So the over-determination of blackness of HIV and AIDS includes additional information regarding this strain of HIV, specifically the fact that its presence, specifically the fact of its presence in predominantly white countries, France, Belgium, Spain, Germany and the United States. So it would seem that if this strain was beyond the testing capabilities between 1998 and 2005, well, 1998 and 2015, that all countries where the strain was present would be included in the ban. So that this would read Cameron, Central African Republic, Chad, Congo, Equatorial Guinea, Gibbon, Niger, Nigeria, France, Belgium, Spain, Germany and the United States. So when we add these predominantly white countries, then when you read the questions, suddenly they seem ridiculous. Have you had sexual contact with anyone in France, Belgium, Spain, Germany in the United States or anyone who was from there? Have you had products in any of these countries? Have you visited any of these countries or were you born and lived in any of these countries? It only seems ridiculous when you start to add, for some, it only seems ridiculous when you start to add the predominantly white countries. In 2005, Canadian blood services streamlined the questions. That's what they said. So now the questions read, were you born and or have you lived in Africa? Blood products, sexual contact. In the 2015 meeting I had with the medical director of donor and clinical services and the manager of stakeholder relations, I asked about the shift from eight specific African countries to the inclusion of all of Africa, all 54 countries. So from here to here. There's such a diversity in these eight countries, not to mention in all 54 countries in Africa. And if we think about it, there are 54 countries in Africa, plus two that are attested, which equals a total of 1.2 billion people and over 3,000 languages are spoken. As an aside, perhaps the amount of, perhaps that feels like this amount of information feels unruly in medical science. However, it is African and black people who are being treated as unruly and our identities are often thought of as singular. Canadians have a strong, strong, strong response to being called American, even though both countries share landmass, North America. There's a great deal of energy that's placed into this distinction, yet Africa, a continent, remains positioned as a uniform, homogeneous, distance space in place. So the medical director of donor clinic services informed me that this shift was to make the donor questionnaire easier to administer. She stated that it was too difficult to name each of these countries, to name each of these countries separately and that Canadian blood services in Health Canada felt it would be better instead to name Africa. So although the justification for the deferral of these eight specific countries was about the untestable strain of HIVI group O, the justification remained what all of Africa became Canadian blood services geographic region. So I was talking across the country about my research and why people have shared with me that they also have been, that they also, you know, when they go to donate blood and they've said to the clinic worker, yes, I was born in one of these eight countries or yes, I was born in Africa. They were instructed by Canadian blood services staff to answer no to that question because that question was actually not about them. So in just this one example, we see how these questions actually aren't about geography. The questions are operationalized based on anti-African and anti-black racist stereotypes. In other words, to be black, meant one was carrying the stigma of HIV and AIDS and needed to be diverted away from blood donation. In 2013, Canadian blood services moved to an electronic donor questionnaire uploading the questions to an interactive computer screen. Questions now voiced, pictures accompanying the questions. So we're going to talk about the images in a moment, but I want to think about health marketing and why you use images when you talk about health-based pieces. Often, when you're using an image in a health platform, it's in order to provide further clarification of what the text is saying, right? So you have an image, you have a text, but you want to clarify, when we ask you this question, you have the image, this is how we are interpreting the question. This is what we want you to get out of this question. So health marketing involves creating, communicating, and delivering messages on prevention, health promotion, and health protection. Wow, that's not worth it. It was so bad, it was like I got to go. It was like I can't. Even as these images are only available to those attempting to donate blood, the images are communicating and delivering messages on preventing illness and how to protect one's health and therefore one's blood in order to be a blood donor. We're turning to my 2015 meeting with the medical director of donor and clinic services at CBS. I actually, I asked, I asked when we were talking about these images, I said, so when you're asking if people receive blood transfusions or blood products in Africa, do you mean from people? I know that elephants are mammals, but nowhere in the work I've done on xenochransfusion have I seen any research on the transfusion of blood from elephants to people. I also asked about the acacia tree, and I wondered, is there something I'm missing about sexual contact in the acacia tree? So we're donors to assume that folks are having sex in trees, and if so, was this a particularly risky kind of African practice? One that resulted in transmission of an untestable strain of HIV. The medical director of donor clinic services, so like, let's be clear. These images, Becky, working in a cubicle at Canadian Blood Services on the Carlton Street location of Canadian Blood Services in Toronto, Becky working in a cubicle wasn't given a task by her manager to say, look up pictures of Africa and then uploaded it onto a screen that went across the country. Becky didn't do this, right? The board of directors who are paid by Canadian Blood Services chose these pictures, right? Somebody in the medical director's office, medical director of donor clinic services whose entire job is the wording of the questions of the donor questionnaire. Their entire job. So these are the images we think best describe what we're asking. And then Canadian Blood Services, a national organization said, oh my God, we nailed it. This is the best thing we have ever done. Here it is. And so the medical director said, I said, really, these images? And then she said, we thought they would elicit feelings of nostalgia and I think people are attempting to donate blood. In fact, uses of these images and these pictures are reminiscent of the imagery described in Joseph Conrad's Heart of Darkness and the early affectations of tropical medicine. European colonialists in Africa during the 18th to 19th century began the study of tropical diseases that were causing strife in settler populations, settler populations in Africa. Through which Western biomedical science made the significant assumption that disease transmission was a racial characteristic, just like skin color and skull shape. Excuse me, monogamy and polygyny are part of this 18th and 19th century racial discourse. So what we understand as the races were developed through these schools of thoughts on scientific racism, race biology. As we know, monogamy developed from the Christian narrative of the Garden of Eden, believed that people belong to the same species but were of different races and those who were white were the pure and original race and therefore closest to God. Polygyny believed that different races were actually different species with distinct biological and geographic origins. In both cases, racial mixing was deemed dangerous with both social and biological consequences. And we see this in anti-miscegenation practices that made it illegal for people to marry but specifically what they were attempting to make illegal was people having sex and having children. Blood protection laws used with Nazis in World War II. And just as an aside, the 1800s are also an important time in Canada. The first colonial medical school opened in Montreal in the 1820s. First residential schools run by the church and government funded in the 1880s and the first Indian hospital in the late 1800s which is a segregated hospital. It was argued to treat tuberculosis and other diseases but eventually became a site of medical experimentation. And let's not forget that slavery in Canada was a thing so it's important to read for black people in these spaces. It is reasonable to assume that black people and slave African people were also shuttled to residential schools in the Indian hospital. Okay, Indian hospital. In fact, this past year it was revealed that an African man named John Inzippo was listed in a residential school in the late 1800s. And we need to be careful and not assume that Inzippo as the only African person named now becomes the only African person in the state. This is the thing we need to be cautious about when it comes to documentation. So scientific assertions about racial difference were often articulated through gender and sexuality as I said before, studying Shabana Somerville's work. And in her work she cites Sandra Gleeman who states that any attempt to establish that the races were inherently different rested to no little extent on the sexual difference of the black. One need only think of the violence perpetrated against Sarah Bartman or as others have called her the hot and hot Venus. And today we see this type of violence perpetrated against folks like Serena Williams and Caster Semenya. Scientific assertions about racial difference through blood donation in Canada is also articulated through gender and sexuality. And this is why I start my work and engage my work through gay blood because in order for us to fully understand anti-black racism in this piece we need to take up all aspects of black life. And that black life includes LGBTQ folks. So back to these images. It is imagined that African people live in dirt and side by side with animals and vegetation. To realize that the senior administrative body of Canadian blood services felt these images most appropriately represented the question being asked is astonishing. Yet for many expected. So remember I spoke about HIVO and they were saying we don't have a test for this. A test did become available in 2009 approved by the FDA and approved by Health Canada for use. But Canadian blood services kept this band in place until this full band in place for another six years. 2015. In 2015 these questions shifted a bit. The elephant was released. The acacia tree stayed. Now it was Togo and Cameroon. And when asked about Togo and Cameroon the response was if there was a new strain of HIV we want to make sure that we have the time to develop a test for it. So the assumption that if there are new strains of HIV they will only come out of Africa. They won't come out of I don't know, the Halifax Shopping Center Young Dundas Square. They won't come out of these spaces. The acacia tree was used for the Togo and Cameroon piece but let's be clear. Togo and Cameroon are in the southwest. The acacia tree is not indigenous to Togo and Cameroon. These trees are indigenous to the southeastern region of the continent. Mozambique, Botswana Swaziland for example. So I give you this. Again I want to go back to Justice Aitken statement around health and safety considerations. Disease is considered a biological malfunction of or abnormality. Yet through the early scientific explorations of race, monogamy and polygyny blackness was also considered a biological malfunction or abnormality. Which is why we claim that black people have been and continue to be science into degradation. And we see the continuing practices of blackness being framed as a abnormality as an abnormality and malfunction when 1940 were racially segregating blood that's being collected. When in the 1980s were claiming Haitian people regardless of citizenship need to be barred. And when from 1998 to like 2018 African people for a variety of reasons were barred from donating blood. So this language of diversity that we like to include in pretty much all of our work and we see increasingly in health research fails a transgressive politics that seeks effective change in unyielding policy practices. The use of diversity as a strategy that serves to manage normativity, harmony and civility but ultimately does not facilitate a disruption of systems of oppression. The baseline in the work of diversity is maintaining the status quo and here we just need to look at the work of Dr. Melinda Smith. Diversity works produces a culture of silence and in effect attempts to gesture to more diversity than actually exists. I venture that in Canada this reluctance to acknowledge anti-black racism particularly in medicine, health and science is bound up in a commitment and belief in a Canadian origin story that speaks to a tolerant and welcoming society. I venture that there is an overlap between the desire to claim color blind objectivity alongside Canadian claims of all are welcome here. And however it is an aggressive practice of the nation state that enters into an audiological structure struggle intent on regulating relations of representation. And so I think I'll end it there. I'm interested in your reflections and we can have some questions. Great. Thank you. Wonderful. Thank you. Let's open it up for some questions. Thank you. I really enjoyed that. But it is interesting that your perspective is 2019. My perspective started with HIV while we didn't know it was. All we knew was it was killing people in 1982 or 1901. And we had very, very good information about it. But in the beginning and so therefore it might be analogous that these days age something like the Ebola virus something like a fatal disease. No cure, no treatment. We didn't even recognize we couldn't have any idea. And then some information came out that there were certain groups of people who seemed to be who had more of the disease than anyone else. And they were from Haiti at that point and they were gay men having sex with men. We didn't know about heterosexual transmission. We didn't know about transmission at that time. And so that it was a very, very difficult time for everyone regardless of who you were. And so the blood service in the Red Cross decided to be from the point of view for information they had to be on the state side. In retrospect to do with HIV Hepatitis C yellow fever and all the diseases through the ages it's taken a long time to figure this out and to identify the virus in HIV. Now we now have Hepatitis C as well. We now have reasonable amelioration anyway. And so the right point is that we have to be very careful of our perspective when we go look back on history. So you know I want to thank you for that because you're assuming I'm younger than I am and I'm good with that. You know during the ladies and the naïve what was happening the piece I didn't actually talk a lot about in this talk and I do in other places was the ways in which the profound sex phobia ends up dictating the conversations that we're having. So if you watch Angels in America and the band played on mostly and the band played on there's a really great scene and the band played on. I think it's on Netflix now trying Netflix Prime Crave TV, YouTube but there's a great scene in that where the doctor says to a white older white gentleman he's in the hospital they're like oh yes you have AIDS and his wife is sitting there and the doctor says you know has your husband had sex with another man and she's like well have a man have sex with another man right this little tiny clip so the piece about the 80s which is really interesting is one of the ways that people started to take notice of AIDS at the time was when it started to make its way to perceive healthy heterosexual white populations and people are like what is this we can't have this so like gay men, black folks black gay men, indigenous gay men right let's understand that these are not separate isolated communities right that we're black gay people we're struggling with this disease we're struggling with the disease dying from the disease and pretty much not being taken really seriously people are interested in doing that kind of research why are they doing this it must be a gay thing it must be a gay thing because at the time and still today to have the same sex relationships and same sex, sexing continues to be perceived as unnatural unhealthy and not normal right but when it was showing up predominantly previously perceived healthy heterosexual communities then people are like oh no something's going on you're having normal sex so it can't possibly be a sexually transmitted disease it has to be something else it just came out of gay and black communities the piece that had this disease being as deadly as it was I would argue was in the inability to have a conversation around anal intercourse vaginal intercourse and other kinds of sexual practices and the belief that heterosexual people have anal intercourse heterosexual people have more than one partner being married but they may be in a trouble they may be swingers they are having a protected intercourse they were doing all of these things but nobody was having that conversation because the overriding assumption was that if you're married or monogamous you're only having sex with your partner and you're only having sex with your partner because you're trying to have children and when you're done having children you're not having sex with your partner the other piece that made that disease so deadly was the idea that the general population did not include gay people did not include black people did not include sex workers that they were the disposable those are the folks living on the fringes that they were not our sisters that they were not our mothers that they were not our fathers that they were not our sons and if there was a way that we could have disrupted the deadliness of that homophobia the deadliness of that racism then the deadliness of the disease would have taken a different trajectory and this is the argument that I have with Canadian blood services because the creeper commission set to the Canadian blood services in South Canada to educate the Canadian community on what people need to do to make sure we have a safe blood supply and if in 1998 Canadian blood services started that work with saying are you having unprotected amement of course are you having unprotected baguette amement of course have you met with any of the various ways of safer sex pieces then in 2019 we wouldn't be having this conversation in 2019 we would be having different conversations around the abundance of blood supply so there was a job for Canadian blood services to do around educating the public on what practices people were engaged in as opposed to what people needed to be part and you know the Canadian blood services actually did a research study where they asked people who came in to donate blood to fill out the questionnaire of who last you went to get unprotected baguette amement of course and who last you went to get unprotected amement of course so they went through all these sexual health questions on the door of the questionnaire have you had sex with somebody who is sexual background have you had sex with more than one person in the last few months and so they asked these questions and they found the questions to be really effective but they felt that it excluded too many people and therefore it wouldn't be good for the blood supply so there are lots of folks who are giving blood who are unprotected amement of course but they're not asking that question about HIV transmission they're still asking whether or not you're a man who said sex with a man or if you're a woman who said sex with a man who said sex with a man and that is profoundly deeply deeply situated in colonialist sex phobic frameworks and there was a way that the 80s didn't need to be that way but you know being out in the street in the 80s protesting police violence protesting getting fired from your job you know protesting cops who are arresting you and you know saying oh don't worry I'll let you go as long as you serve us free protesting we were protesting those things and people were like people were saying to us in the 80s and 90s your lives don't matter you don't matter it's unnatural let's go to gay conversion camps let's do this let's do that and that's what was expanding and exasperating the disease and that's what my responsibility was so thank you for the spot it's really interesting on many levels I'm wondering that I mean you talked about black exceptionalism I guess I'm wrong no I'm talking about sexual exceptionalism sexual exceptionalism so I'm kind of thinking though that you've been to this book on sexual HIV exceptionalism and development development of basically through disease in West Africa you're now located in an epidemiology department in a community health and epidemiology department and I'm wondering really the target here isn't really an epistemological colonial epidemiology that has been pervasive in medicine really since chronically Typhoid Mary before typhoid Mary absolutely I'm kind of curious what we're going to do yeah so yeah I was talking about sexual exceptionalism because part of the arguments that happen with gay blood activists which is like we're just like everybody else we're gay married we're gay married we have children we barely have sex with each other and unlike those people over there which continues to perpetuate farmers position around how Asian people are perceived to have this wild blood thirsty voodoo type sexual whatever black people continue to be positioned in this hyper sexual framework which is why we can get away with putting a tree up for a question around sexual contact and I meant to say that in all of the questions that they ask the only time they use the phrase sexual contact is when they're talking about Africa so they ask if you've had sex with a sex worker they ask if you've had sex with someone who's taking money or drugs for sex they ask if you've had sex with someone who's sexual background you don't know if you've had sex with another man or if you've women had sex with another man but when it comes to Africa they ask if you've had sexual contact and now we're in there so again the person whose entire job was to word the questions couldn't tell me why they chose wouldn't tell me why they use different language for Africa around sex and I would argue it is around this colonial and paternal object which does population studies it's so interesting doing this work population studies where it's like okay we're going to look at the population and then we're going to ask the people of visible minorities and then we're just going to treat this small percentage of people but we're asking for visible minorities but then we're not going to jewel down and be like are the indigenous people of visible minorities but we're not going to jewel down and be like are you black are you after Nova Scotia they're not going to do that piece they're going to say well out of the population of people who identify as visible minorities they don't have the same issue and it's therefore outside the scope of our research so then you apply for a research grant you're like hi I want to study the ways in which anti-black racism undecured this work that we're doing at ABCD&E and then you get a response that says are you seeing all black people experience anti-black racism that is a bad methodological position we can't give you fighting for that where's the evidence that you can demonstrate that black people experience anti-black racism so it is a conundrum it is a bit of a challenge but you know African Nova Scotians are badass for some of you from Toronto let me just say y'all badass so even before I got here the kind of work the kind of work that African Nova Scotians have been doing around health community interventions these kinds of pieces as a way, as workarounds right? in order to receive the services that need to be received that's a master class right then and there so the fact that I get to be the James R. Johnson chair in the faculty of medicine and I get to go I get to be with African Nova Scotians and be like listen I understand workarounds work together to get the so we can make the workarounds the mainstream kind of walk into the front door getting the services that we need that to me is brilliant for my own research I'll continue to Nancy Criker does some of this work around racism and epidemiological practices I'm actually eventually when I teach community health and epidemiology that will be the course that I offer in terms of you know you want to be an epidemiologist you want to be a public health worker how do you contend with the ways in which this field is deeply situated in colonial and anti-black frameworks how do you contend with that and if we go back to Priscilla Wall's work on Typhoid Mary and one of the early social text collections it's a brilliant text and I continue to go back to it in terms of the ways in which people are racialized who sign to racism in order to make sure in order to be used as the basis of all things full responsibility for this deadly disease that is finding its way to the world so yeah it's a load that I do not carry on my own and it's the work that if we are actually committed if we are actually committed to the well-being of our the well-being of our neighbors then we must begin with acknowledging and disrupting the colonialism and anti-black racism that undergirds so much in this research yeah that's what I was going to say hi thank you so much I'm sorry about that I was just wondering about the last piece when you make your critique to the language of diversity because coming from outside Canada you know like people look at Canada and it looks like a model for other places where you know like people don't even talk about diversity and at the same time I completely agree with you with all the shortcomings and the problems with the language of diversity as if you are just adding more people to the general public but not really questioning what is the general public and how it's made after all and then I was wondering like what would be the best way to go and try to do something about it yeah thank you that's great yeah I think I know I'm being I often get flamed on Twitter when I make these positions um lately rebel media seems to have taken an interest in Black Canadian Studies Association so um Sarah Ahmet does some really great work on being included where she talks about the window dressing of diversity, humanity, and the dark side dark side of the nation I believe it is and of course Melinda Smith's work on who equity, diversity, inclusion policies benefit so Melinda Smith did this fantastic work where she like went through I think employment record, not employment record accessible employment data in terms of who was benefiting employment equity, diversity, inclusion, and hiring so what she discovered was that white women predominantly benefit of the mechanic growing women, white LGBTQ folks predominantly benefit out of the category LGBTQ, white people with disabilities predominantly benefit from people with disabilities and that white people predominantly benefit from the visible minority category and so the thing with the diversity framework is you can look at Stats Canada Stats Canada will tell you 2.8 of the population are Black people and they'll say in Nova Scotia 3.2, 3.6 people in Nova Scotia are Black people that staff can be one so a diversity framework would say we need to give 2.8% of our attention to Black people across the country and 3. whatever percent of our attention to Black people in Nova Scotia, that's what a diversity framework would say but a transgressive framework, one that understands the ways in which colonialism and anti-Black racism work would say you don't start you don't start with the majority you start with the minority of the minority right, so you censure the experiences that Indigenous people have Indigenous people, Indigenous Black people and Black people have and then you work out from there right, so the other way is kind of trickle down for those who do it right that's not work for anybody at least of all us but if you start with and this is bell hooked right, if you start if you put the margin into the center and you start with the experiences of the center then you're actually doing something much more transgressive right, and so then you're starting with the experiences of Black Afro-Norway stations, started with Indigenous Black people and and then you're saying okay how many of the population of Indigenous folks in African Nova Scotians have doctors because if that percentage is 0.1 then there is a problem because we can't do it the other way we're on CBC the other day they're like, oh only 50,000 people don't have doctors, are all 50,000 of those people, Indigenous people and you know, we want to get Indigenous Black folks to Black folks we don't know because they don't collect those stats right that is a transgressive piece but that's information that people don't you know, so when I arrived in May May 1st I got my desk yesterday let's not speak about it and in June there was a discussion on CBC with Portia Clark where a woman who lives in a rural community in Nova Scotia was sexually assaulted by her physician but she did not report that she was sexually assaulted by her physician because she was worried that her community would lose her doctor the Nova Scotia Health Authority person came onto the radio and said yes, we cannot guarantee that that community would not lose their doctor when I tell you I spit out my teeth right because the Nova Scotia Health Authority did not get all the radio and say that's egregious absolutely report that and we will make damn sure that there was a doctor in the community they didn't say that they said oh yeah, you're right we don't know, they might lose their doctor so if they're in a rural community who is the population in that rural community and what does it mean because we already have the stats we know that indigenous women missing and murdered indigenous women we know that indigenous black folks we have the stats are often more likely preyed upon less likely to report to police right what does that news story tell us about the experiences of indigenous women, black women and women of color in rural communities with doctors that's a diversity framework well they have a doctor we need to make sure we get our numbers out make sure the communities have doctors a transgressive activist framework would be like no giving that doctor, not only do we want doctors we want good doctors we want ethical doctors we want reliable doctors that's a different framework so that's what I would say I just think if there's anything that makes the health context different than like labor law in these instances so I'm thinking around informed consent I work in an area where we want to bring the patient perspective to health research the perspective is like wrong-headed, uneducated and like flat-out racist so like first of all how do we keep those perspectives from being dominant in terms of what you're talking about if they make up the majority either now or in 1940 or whatever but then also like maybe they're two separate questions but they're both to do with who's the general public so the second is around informed consent does that make this space different than labor law for example if you couldn't ask this questionnaire to see who gets hired at Canadian Blood Services but is there something about like even though they're flat-out wrong and uneducated and whatever does the general public get some higher level of the general public get some higher level of input on what blood gets donated to Canadian Blood Services because it's going in their body and they have a right to informed consent and to deny treatment even if that treatment is going to like it's the only way to say their life is there anything different or is it like this is unacceptable and we just can't tolerate this under any circumstances I don't know about labor law to be able to do but like a comparative analysis there's something about a substance that's going in your body that like I don't know I believe that this state of health is only ever measured by an absence of disease even though the World Health Organization says that's not the case, that health is more than just the absence of disease but when I'm teaching inter-women studies and we're talking about sexual health you see it when you're on Grindr back in the day it was Craigslist Prax, Tinder you know rest in peace Craigslist but you see in these ads where it's like you need to be drug and disease free you need to be clean you need to be this language around STBVIs and socially transmitted infections or viruses and diseases but the belief is when you have perfect health then you have perfect health in absence of herpes in absence of chlamydia in absence of HIV in absence of these things but our lives don't live that way you can have herpes and chlamydia and HIV and still have health now especially around HIV but you still have health so this belief that somehow our bodies are not leaking into one another that we don't I think overall we've become really nervous around bodily fluids and having them get on us in us, around us proximity to us and that's a framework that then when we think about blood is like I don't want to have a reaction to blood I think it's like 4-8% of people who get blood transfusions have a reaction to the blood transfusion I give blood transfusions because of various medical conditions that I have and I always find it curious and humorous when they come into the hospital room and they're like well here's your form that talks about how safe the blood system is and you know we just want to give this to you so you understand that the blood is perfectly safe and I was like you know I don't live in a life I don't live a life I don't live a life or in a world where I believe anything is perfectly safe and so if we understood that differently in the most intimate spaces of accepting blood into our bodies then we would have a different relationship with how we understand this donor questionnaire and how we understand the blood the blood process and policies and if we again started with an Indigenous perspective whether that's Turtle Island the Caribbean the African region an Indigenous perspective then we would understand the sharing of blood in a differently spiritual way and that too would give us a different relationship to what's happening with blood so you know yes I'm all about consent why would I believe in consent but I think the ways in which we are given information about the decisions that we're making that information is skewed to a point to make a different kind of decision because we don't have the conversations around blood we don't have the conversations about our experiences with other people's bodily fluids right? if we did then we wouldn't be so caught up with women with people breastfeeding at restaurants or in a classroom right? if we had those conversations we wouldn't be so caught up with having tampons and pads in all toilets regardless of the gender that's designated outside right? if we had a different conversation around our engagement with people other people's bodily fluids then we would have a different engagement with the donor questionnaire thanks very much I really apologize but what a wonderful seminar itself and also incredible introduction to the series as a whole so thank you again