As Indigenous women, Dr. Adriann Begay, MD and Dr. Cristina Rivera Carpenter, PhD, MSN, RN-BC of the HEAL (Health, Equity, Action & Leadership) Initiative recognize an important element to reaching their goals in healthcare including increasing accessibility in healthcare for the community of people around them who have had similar cultural experiences as them. For both Dr. Begay and Dr. Rivera Carpenter, the relational support they have received drives their approach within HEAL to center and bring Indigenous perspectives and people into healthcare.
Dr. Begay, who is Navajo–from the Tábaahii (Edge of the Water) clan–knows the exact moment she decided to become a doctor. As a teenager, she shadowed Dr. Taylor McKenzie, the first Navajo medical doctor in the country. “I remember [Dr. McKenzie] walking over to a grandpa who had recently had surgery and saying ‘Yáʼátʼééh shicheii,’ which means ‘hello grandpa’ in Navajo,” says Dr. Begay. “It just struck this chord in me and I thought, ‘he’s Navajo, he’s a doctor, I could do this.’ And from then on, that’s what I wanted to do.” The experience also showed her the value of the Indigenous relational approach to medicine.
Dr. Begay experienced an academic detour after becoming a mother and started her medical school journey at 32 years-old at the University of North Dakota School of Medicine and Health Sciences’ Indians Into Medicine (INMED) program in Grand Forks. “I probably would not have completed medical school had it not been for the other Native students in the medicine program,” she says. “The relationships I had with other people who came from a similar background was so vital for the support and to share so many things that we go through.”
Dr. Rivera Carpenter echoes this sentiment. As a single mother of five, her path to becoming a nurse and then a PhD was not straight and narrow. “It was really the support of my family and other women that helped with getting through,” she says. Joining the HEAL fellowship for the 2016-2018 cohort and connecting with people like Dr. Michelle Kahn John and Dr. Begay (who was a 2019-2021 HEAL fellow) helped set her course. “Dr. Begay was so instrumental in getting me through [the PhD]. Not only having her as a role model, but also having her as a support,” she says. Additionally, HEAL’s role in the global equity movement and commitment to providing care for the resource-denied gave her opportunities such as leading to her pursuing a PhD as a Robert Wood Johnson Future of Nursing Scholar. Now, as HEAL’s Navajo Nation Program Officer, Dr. Rivera Carpenter brings that relational support system to her work by facilitating mentorship circles within the global health fellow programs and the health equity curriculum.
As the closing speakers for the 2022 UC Global Health Day at UC Santa Cruz, both Dr. Begay and Dr. Rivera Carpenter will bring their identities and core beliefs as Indigenous women and healthcare providers to their closing plenary. “There’s a term that we have in our language that says K’é. It’s what we call our relationships,” says Dr. Begay. “Within the Navajo people, K’é really comes down to love and respect for one another.” And part of honoring those relationships comes with reframing the way healthcare providers do and see their work.
“In healthcare, we’ve had a paternalistic approach,” says Dr. Rivera Carpenter. “But when we think about the people around our community, we think of them as our relations...Recentering us to that Indigenous world view, instead of ‘being responsible for my patient,’ we are accountable to them.”
This relational approach also aims to redefine the meaning and perception of “global health,” which has traditionally implied the problematic approach of “getting on a plane and going to the ‘Global South,’ and doing things to and for people who look different from you…which makes them separate from yourself,” says Dr. Rivera Carpenter. Instead, she advocates for bringing in an Indigenous perspective of global health which can transform that approach because “Indigenous health is global health.”