Doctors say their concerns over racist email, papal visit request dismissed by Alberta Health Services

Two Indigenous doctors say Alberta Health Services dismissed their concerns about a manager who sent racist and inappropriate emails to physicians, including about the upcoming visit to Alberta by Pope Francis.

Emails obtained by CBC News show that in March, a locum doctor applied to the health authority's Indigenous Wellness Core program to fill in for Dr. James Makokis at a clinic on the Kehewin Cree Nation, 240 kilometres northeast of Edmonton.

Dr. Ellen Toth, the AHS administrator in charge of ensuring Indigenous communities have physician coverage, shared the application form with colleagues with this comment:

"Pretty impressive CV.. U of A grad… prolly brown…"

Toth added about the doctor, who is male: "I will talk to her, essentially to get a sense if there is a bad accent (I doubt it if she went through U of A)..."

Makokis, who is Kehewin Cree Nation's only family doctor, said Toth's words were included in a response to the applying doctor.

Makokis said he was "shocked and embarrassed and angry" when he saw the email. He apologized to the locum doctor, and replied to Toth and other recipients that the message was racist.

In response, Toth wrote to a group of people who had received the email: "I take full responsibility for my innate racism … which should not be a surprise given my blue eyes and origins…"

She also said she regards a doctor being "brown" as a positive attribute, and that any heavy accent can be a problem with patients.

During the next two months, Makokis tried to elevate his concerns to AHS senior leaders. He said it eroded his confidence in the organization's ability to respond appropriately to racist incidents when Toth remained in a leadership role for a program that delivers health care to Indigenous people.

In a June 24 email to Makokis and several others, Dr. Mark Joffe, an AHS vice-president, called Toth's message "highly inappropriate and racist" but said "appropriate steps have been taken."

On Friday, AHS spokesperson Kerry Williamson told CBC News the organization conducted an internal investigation and told Toth her message was unacceptable. He wouldn't say if Toth faced any discipline, saying it was a private human resources matter.

Toth has not responded to requests for comment.

CBC showed the emails to psychologist Helen Ofosu, president of Ottawa-based I/O Advisory Services, a company that specializes in helping organizations improve equity, diversity and inclusion.

Ofosu said such intolerant messages hurt not only the subject of the racist comments, but any colleagues who also worry they will be discriminated against.

That's a problem, because workers who are anxious and preoccupied with feeling like they have to protect themselves at work will have more difficulty with productivity and accomplishing goals, she said.

Request for volunteers 'triggering'

Makokis said his concerns persisted when Toth sent another email on June 24 — an "urgent" request for doctors to volunteer during Pope Francis's Alberta visit, July 24-27.

The email went to roughly 60 physicians who work in Indigenous health services across the province.

Ten of thousands of people are expected to flock to a mass at Commonwealth Stadium, a pilgrimage at Lac Ste. Anne, and to a gathering at the site of a former residential school in Maskwacis, 100 km south of Edmonton.

The Pope's visit was prompted by public pressure on the Catholic Church to make amends for its role in the legacy of residential schools across Canada.

AHS wants to be prepared for participants overwhelmed by crowds, the heat, potentially with COVID-19, medical emergencies and whose trauma is exacerbated by the events.

"So today's request," Toth wrote to the doctors. "If U are not already committed, what can U comit (sic)?"

Makokis said it was a disturbing and inappropriate request to send to this group of doctors, some of whom are Indigenous, when the church has a violent history toward them.

"It is very triggering that you would request Indigenous doctors — and I'll speak for myself (perhaps there are others who find this problematic) to come and 'volunteer' for the Pope's visit," Makokis replied to Toth.

Family physician Dr. Lana Potts, who works at the Siksika Health Centre on the Siksika Nation reserve, 95 km east of Calgary, said she was appalled and rattled by the request.

Potts attended a residential school in Saskatchewan, and her family members are also survivors.

"I am harmed by those policies still to this day," Potts said. "I don't go home at night and forget about this. I live it."

Worse yet, Potts said, was Joffe's reaction after several doctors said the request was inappropriate.

In a June 25 email, Joffe said AHS must prepare for all large gatherings — including Garth Brooks concerts and the Calgary Stampede. He said the doctors can choose whether or not to participate.

"But this is ultimately about being prepared and supporting the participants, not about your personal views of any of this," Joffe wrote.

Potts and Makokis said they felt leaders had no insight into why the request was harmful.

Joffe did not respond to an email request for an interview. Williamson's statement from AHS said the organization apologizes to doctors who found the request triggering.

Six doctors have volunteered so far to be on hand for the events and will be paid for their work, Williamson said.

"We are very aware of the trauma this emotional event may cause, and we believe that having Indigenous health-care professionals providing help and support to Indigenous peoples at what could be a difficult time may help," the statement said.

Ofosu said AHS's "callous" response to the doctors' concerns shows they don't sufficiently understand the history and traumatic effects of residential schools.

"If the leadership doesn't believe in equity, doesn't believe in [being] trauma-informed, doesn't believe in being trauma-sensitive, maybe they're not the right people to be in leadership in this organization," she said.

Zakeana Reid, COO of Calgary-based CCDI Consulting, said these kinds of missteps are common.

Reid said it's important for leaders to take ownership of their mistakes and give employees as much information as possible about what happened and how the organization is taking steps to prevent it happening again.

"Every time an organization brushes something under the rug, there is a potential that you are impacting the trust that your staff have in you," said Reid, who has also seen the emails.

One hopeful sign is that some doctors felt safe enough to bring the concerns to the attention of managers, she said.

Both consultants said AHS leaders should have asked Indigenous people how to request the doctors' help for such a sensitive event.

AHS adopts anti-racism position after other incidents

In 2020, CBC News revealed that a Grande Prairie surgeon had in 2016 taped a noose to the door of a surgical theatre that he said was intended to send a message to a Black surgical assistant.

Last year, an Indigenous nurse, who was the subject of racist abuse from colleagues at the Edmonton Remand Centre, was granted a human rights tribunal hearing after AHS assigned her to different work instead of dealing with the problem.

In 2017, AHS fired two employees after one worker sent a text message calling an Indigenous school principal a racist slur.

Last summer, AHS, which is the province's largest employer, released an anti-racism position statement. It acknowledges that racism and discrimination exist within the health-care system, and commits the organization to combating them.

An anti-racism advisory council also gave AHS a list of 36 recommendations to improve equity and inclusion, from amending hiring practices to training leaders to making it safer to file a complaint.

AHS has accepted all the recommendations but doesn't have a timeline for putting them all in place.

Employees can also report racist incidents or behaviour through an online portal or an anonymous telephone "safe disclosure line," Williamson said.