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Rupa Marya – Health and Justice: The Path of Liberation through Medicine | Bioneers

February 9, 2020

Please welcome the executive director
of the Justice Teams Network, Cat Brooks. [APPLAUSE] Well good morning. I am going to start this the
way I always start my talks, by saying their names.
Repeat after me please. Tamir Rice.
[AUDIENCE RESPONDS] Yuvette Henderson.
[AUDIENCE RESPONDS] And so many more.
[AUDIENCE RESPONDS] My name is Cat Brooks. I am the executive director of
the Justice Teams Network and the cofounder of the
Anti Police-Terror Project. [CHEERS]
[APPLAUSE] 1,129 people were killed by
law enforcement in 2017, and 778 have been killed
so far in 2018. Police violence in America
is an epidemic, a genocide. A genocide that many of
us are complacent to. Complacent by not responding
with the fervor that matches the scale of
the inhumanity. Hundreds and hundreds of people
are gunned down every year, many of them unarmed,
almost all of them of color, and the majority of them in
the throes of mental health crisis. As a black woman
in America, and as someone who has been
doing this work for over a decade, working intimately with
survivors of state violence, I’ve known for a long time
that the devastating impacts of these deaths do not just land on the
family and friends of the victim, they land on the entire community,
whether you knew the victim or not, and whether it happened in
your neighborhood or not, or in a city you never heard of on the
other side of the nation. For people of color, every time we hear a sibling was shot and killed by law enforcement, it lands like an
uppercut to the gut – that could have been me, my partner,
my child, my friend. But in today’s America there’s
no time to deal with that uppercut. Onward we must go
to school, to work, raising our children and taking
care of our families, surviving by burying the trauma
as deeply as we can. We live with it. We give our
children the talk. We are extraordinarily polite when we are
pulled over, even when it’s unjust. We do everything in our power
to avoid and evade contact with police. In America, every day,
there are entire swathes of human beings that take
precautions just to not get killed by a group of people who took
an oath to protect and to serve. In Anti Police-Terror Project’s
rapid response model, we have developed and incorporated
practices for healing in community – vigils,
support groups. We also believe that unapologetically
telling our truth is healing. That is why we call it police terror
and not police violence. The definition of terrorism is the unlawful
use of violence and intimidation, especially against civilians in the
pursuit of political aims. Police have a
political aim, which is to enforce the status quo of race-
based capitalism in this country. [APPLAUSE] It is terrorism to know that you could be killed
at any moment just for being in your skin. It is terrorism to have your neighborhood
infiltrated by an occupying army. It is terrorism when you get
pulled over for failing to signal, and though you may have
all of your paperwork straight, you are clear you may not make
it out of the situation alive. Despite this daily-lived reality,
we are told often and consistently that it’s not that bad,
that it’s not a genocide, and a little more training for
police should do the trick. For survivors of
any kind of violence, having your reality denied is compounding
trauma on top of trauma. That is why Rupa’s work,
Dr. Rupa’s work is so important. She has used her positionality
as a doctor and health worker to be not an ally
but an accomplice, to expand the work that
so many of us are doing by framing police violence
as a public health issue, to explore the ripple effect
of our daily lived lives, and how it intersects and
exacerbates inequities that people of color
in this country face daily. It is groundbreaking work.
It is game-changing work. It is the next phase of the fight to eradicate
state violence from communities of color, and help to forge a pathway
of healing for us all. Please join me in
welcoming my friend, my comrade,
my family, Dr. Rupa Marya. [APPLAUSE] Give it up for the future mayor of
Oakland, Cat Brooks. [APPLAUSE]
Yeah! That’s right. Well, I first want to acknowledge
the Coastal Miwok and the beings on whose land
we are meeting today, and to acknowledge all the
Indigenous People who have trusted me and
shared deep conversations with me, and influenced my understanding of
what it means to be a healer, and what exactly is the
scope of my work. I want to acknowledge those killed by police, and
their families still fighting for justice, and the UCSF division of
hospital medicine for supporting me in shaping
a path that defines health and healing as broadly
as I can imagine. And finally, I want to acknowledge
my husband, Benjamin Fahrer, revolution farmer, whose love for the Earth
creates delicious bounty, and whose daily support creates the
space I need to do this work. [APPLAUSE] Can I get my
slides up? Alright. Today we are going to talk
about decolonizing medicine. [APPLAUSE] But first I’m going to tell you
a bit about who I am so you have an idea about
where my thoughts are coming from. This image is by
artist Mona Caron, from our forthcoming album
Growing Upwards. And it captures a good
deal of who I am. I am the daughter
of Punjabi immigrants who came to this
country in 1973, with little money but plenty
of caste privilege. We grew up with family vacations driving
around a VW van around the Western lands. And my father would stop
at the reservations where he would make us get out
and listen and learn and look, and see what had happened
to the original people of this land. He would talk to me
about colonization, because we are also a people
who had been colonized by Europeans. I am a mother of two
beautiful mixed heritage boys, and I am a
farmer’s wife. I’m a physician who works
in adult medicine, and who witnesses society’s ills
manifest in my patients’ bodies, and a doctor who sees racism and state violence
as an urgent public health issue. I’m a touring musician who
has played in 29 different countries, singing in five different languages
with the band Rupa and the April Fishes. [APPLAUSE] And to use a phrase taught
to me by Miwok elder, Wounded Knee, I am an Earth person. What I’m going to describe for you today is a
system of domination in which we live, and what I believe are the direct health
consequences of that system for all of us. We begin with a description of how we come to understand disease in a modern
post-industrial context. In the 1850s, the germ
theory was developed, which described how organisms
such as bacteria and viruses and such made us sick, which led to the development
of antibiotics and vaccines, and systems to prevent the— to limit the spread
of infectious disease. And then in the 1960s,
with the elucidation of DNA, we entered the molecular genetic era,
where we are today. Here the gene creates a protein
that can cause or protect from disease. How sick or well you are was thought to be
preordained somehow by your genetics. This understanding has led to
many powerful diagnostic tools and targeted therapies
for specific diseases. And in 2004, with the discovery of the RAS gene mutation’s role
in the development of colon cancer, exactly 2,000 years after
Roman physician Celsus described the cardinal signs
of inflammation, we are entering the
era of inflammation, where instead of a reductionist approach
to understanding disease, we are seeing how many pathways
lead to chronic inflammation, which in turn creates the
conditions for illness. Today we will be talking about
the impact of social stressors, which have been shown to
cause chronic inflammation. These diseases require
more systemic approaches, not simply focusing
on the individual, but rather moving our gaze
to the structures of society, helping us see how the
individual pursuit of health is actually futile in a system
that makes health impossible. [APPLAUSE] To understand the root causes
of pathologies we see today, which impact all of us but affect black, brown,
and poor people more intensely, we have to examine the foundations of this society,
which began with colonization. To me, to be colonized means
to be disconnected and dis-integrated from our ancestry, from our Earth,
from our indigeneity, our Earth-connected
selves. We all come from
Earth-connected peoples, people who once lived in deep connections
with the rhythms of nature, and I believe that it is not
a coincidence that the colonization of this land
happened at the same time Europeans were burning hundreds
of thousands of witches, those women who carried the traditional indigenous
knowledge of the tribes of Europe. [APPLAUSE]
Colonization… it’s true. Colonization is the way the extractive economic
system of capitalism came to this land, supported by systems of
supremacy and domination, which are a necessary part
to keep the wealth and power accumulated in the hands of the colonizers
and ultimately their financiers. In what we now know
as the United States, this system of supremacy is expressed in many ways
and with many outcomes, but today we will focus on specific ones
for the sake of time. First, white supremacy, which created a framework that
legitimized slavery and genocide. Slavery created
cheap labor, which is necessary for a
functioning capitalist system. And genocide created
unlimited access to resources in the form of land, animal parts,
minerals, and raw materials, which are also necessary for
a fully functioning capitalist economy. As capitalism functions, it further entrenches
these systems of supremacy. Now we all know that white
supremacy is the scary guy with the swastika and
the hood. Right? But it can also look like
any place where there is an abundance of white people
in exclusive contexts, where power and access
is not readily ceded to others. [AUDIENCE RESPONDS] Yeah, you know what I’m talking about.
Thank you. Please remember, lest you get caught up in
a tsunami of guilty feelings, that as I talk
about these things, I’m talking about systems
of oppression that we are actually all a part of
and that we all recreate, and these systems are what
need to be dismantled. Back to colonization
and its impact. There’s white supremacy and
then there’s male supremacy, aka patriarchy, which leads to the
invisiblizing of women’s labor, like creating the entire human
race out of our bodies. [APPLAUSE] Yay-o. Or in this context, reproducing the entire
workforce and suppressing our wages, which further supports capitalism. Patriarchy also leads to femicide,
domestic violence and child abuse, which we see across
all groups here. We also see
human supremacy, where people feel superior to
the rest of living entities, thereby subjecting—
[APPLAUSE] —Yep— Thereby subjecting living soils,
seeds, animals, plants, and water to horrific treatment
in the name of exploiting resources, which in turn feeds the capitalist
need for ever-increasing profits. Now while this wheel of domination,
exploitation, generation, and sequestration of wealth continues, we experience as the byproduct
and common pathway – trauma. And many studies show us
that chronic stress and trauma create chronic
inflammation. When we look at the top 10 causes of
death in occupied Turtle Island, we see diseases that have been
described to us as diseases of lifestyle or ones that come about
because of our poor choices. Maybe we eat too
much fried food. Maybe we don’t
exercise enough. Maybe we have a
genetic predisposition. What these diseases have in
common in their pathogenesis is a component
of inflammation, and we are just starting
to parse out how the social stressors and the
very structures of society contribute to and exacerbate
this chronic inflammatory state. Now it is short-sighted to see
these diseases as caused by individual poor choices in the context
of a genetic predisposition. I see them as diseases that are
virtually impossible to avoid because of the system
in which we live, which generates a biological
milieu of inflammation through trauma, chronic stress, environmental degradation, and damaged food systems. I see these as diseases
of colonization. [APPLAUSE] Now if you’re a Native person here,
you’re like, Duh. [LAUGHTER] You know, it takes science and medicine a long time
to catch up with Native knowledge. So this is not news
to Native people. When I met Oglala Lakota elder,
Candace Ducheneaux, out in Standing Rock, she talked to me about how these diseases
that are so common in modern society and more heavily so in
Indian Country are diseases that were
brought by the colonizers. We talked
about diabetes, which I had been taught
in medical school is a disease of
insulin resistance. Either your pancreas
doesn’t make enough insulin or your body’s cells are
not sensitive to the insulin, both ways of seeing things
that are based in a sense of individualism and
predetermination. On the Standing Rock
reservation, before the damming
of Mni Sose or the Missouri River, diabetes was rare. Actually across
Turtle Island, diabetes was
virtually nonexistent. Once the river was dammed
and the cottonwood tree forests where people would forage for their food
and medicines were destroyed— Sorry, once the river was dammed,
it ended up flooding these cottonwood forests. By shifting the ecology
through a colonizing force, the people became more dependent on the cash
economy for their food and medicine, and lost the essential cultural
connection to their traditional ways. This tragic loss of the commons is a
hallmark of capitalist society, and the impact is felt
in the individual body. After the damming of the river,
rates of diabetes skyrocketed, and this story is similar for all tribes
all over Turtle Island. It is important to recognize this didn’t happen simply because
people became more sedentary and consequently
more obese, this happened because
of colonization, not by changing the
indigenous body, but by changing the social
structures around that body, which in turn
creates disease. [APPLAUSE] One powerful study from
Alberta demonstrated that First Nations tribes that had
maintained their cultural continuity specifically through language
had lower rates of diabetes. So here you see the
prevalence of diabetes, here you see the percentage of people
who had indigenous language knowledge. Basically if you spoke
your language, you didn’t have diabetes. Just imagine that. Just imagine that. So this is what
is protective. It’s not the low carb,
paleo diet. It’s not exercise. It’s not the
latest fad or trend. This study also showed
that self-determinism has a powerful protective effect
from diabetes for Indigenous People. [APPLAUSE] These same factors had a protective effect
against suicide for Indigenous People in Canada, who experience rates two to
five times the national average. This example to me
demonstrates how disease is a complex manifestation
of social and biological influences on groups of individuals that results
in a common expression – here, diabetes. While we can understand this clearly
from a Native American experience, we must be aware that
these social structures of domination produce trauma
and inflammation for all of us. We are all affected. So what can we do in
the face of this knowledge that can seem
so overwhelming? That the system in which
we live is actually making health impossible for
most of us. Like the example before, simple things can
have huge effects. To heal the diseases that are caused by the
trauma of colonization, we must decolonize. If colonization represents a
dis-integration and a disconnection, we must reconnect. And our work
is two-pronged – to reintegrate and
to dismantle. We must reintegrate what
has been divided and conquered in our societies, between our peoples, between us and the
natural world around us, and within ourselves. And we can do this
in many ways, by promoting acts that increase local
autonomy and self-determinism, by exposing the myth
of treating the individual as limited in its ability to actually address
root causes of diseases, by reconnecting to who we were
before our respective colonization – through songs,
traditional knowledge, reawakening our food and
medicine ways, and reawakening our relationships
to each other, to the Earth around us,
and to other beings. And we must dismantle
those systems of domination that create and recreate cycles of
trauma and inflammation, those systems that work
in service of capitalism. This is my vision of
holistic healthcare. [APPLAUSE] What does that look
like for my work? How do I use my whitecoat privilege
to address things systemically? Aside from starting to address
diseases with my patients in the hospital as directly related to these phenomenon,
I’m doing these things: With regards to integration, I have been invited to help
create a clinic and farm to develop the practice of decolonizing
medicine at Standing Rock, together with tribal members
and healers, Linda Black Elk and Luke Black Elk, great-grandson of
Black Elk medicine man. We have been developing a framework on how to
offer care that centralizes Lakota cosmology, an understanding of
disease and health, and to create a model
that can be replicable to other places and in
other specific contexts. We have incredible partners, including Mass Design Group
and National Nurses United, as well as the Do No Harm
Coalition at UCSF, who are over 400
healthcare workers committed to ending systems
of oppression as a way of insuring
health for all. We have raised over a
million dollars so far, thanks to generous gifts from
the Jena & Michael King Foundation, Colin Kaepernick,
and Crowd Funding, and seek five million more to break ground
on this exciting project. [APPLAUSE] With regards to dismantling
systems of oppression, I have been working
on a national study of the health effects of
law enforcement violence, or terrorism, called the justice study. We were asked by
the community who was fighting for justice
for 26-year-old Mario Woods, who was gunned
down by SFPD in 2016, to create a study that would
answer this question: If the wound is police violence
and the medicine is justice, what happens to our health
when the medicine is not given? So we gathered a team together
of public health workers and researchers, and we are currently actively
compiling data. I encourage anyone to go
and fill out this survey online. It’s called the We especially want to hear more from
Indigenous, black and brown voices. So we are currently
assembling data, and it’s already
illuminating, showing how many areas of people’s lives
are affected by police violence. We know that Native Americans,
black and Latinx people experience disproportionate
rates of police violence, and can see that they are most impacted
by the long-standing traumatic effects of violence. How does this reality contribute
to the health disparities that we see? This slide also shows us how
we are all affected by that violence. Across all races we are
being traumatized with black, brown, and Indigenous
being affected more intensely. We are continuing
to collect data, and we’ll be offering it
to policy makers who wish to shape community
safety away from models that uphold white
supremacist frameworks into ones that create safety
and mitigate harm for all of us. What I want you to remember
from this talk is this: Health is impossible when
living in systems of oppression. We cannot effectively treat
diseases like diabetes with a drug without addressing
the systems that makes diabetes so prevalent. We must redefine the scope of healthcare
workers and the work of healthcare to include not only care at the
bedside of the individual, but dismantling the systems of oppression
that create the conditions for illness. And finally, we must reintegrate
with the Earth, with each other,
and within ourselves. We must decolonize. [APPLAUSE] So what’s next for me? I’m in the process of
flushing out these ideas in greater detail through
co-authoring a book on these issues with writer
and agroeconomist and die-hard anti-capitalist,
Raj Patel. I’m going to continue fundraising
and developing clinical methodologies in collaboration with Lakota Dakota people
at the Mni Wiconi clinic and farm, and I’ll be continuing data collection, analysis,
and reporting for the justice study, as well as fundraising
for those efforts. Like many here, I don’t get paid to do
any of this important work, and I hope I can receive the support
I need to do it to the best of my abilities. Finally, I will be finishing
our forthcoming album, Growing Upward, which is a look into these
issues from a musical perspective. [APPLAUSE]
Yeah. How do we… How do we heal from
genocide as a culture? How do we help our
Native community heal as we work to stop
ongoing colonial trauma? Because it is ongoing. How do we move forward in greater health
if we have not healed the past? I want to close with a song about these
questions called Stolen Land. It is my hope that perhaps one day
we will sing this song together, instead of the manifest
destiny jingle This Land Is Your Land,
This Land Is My Land, because it’s not. [LAUGHTER] I invite my band mate,
John Eichenseer, to join me. [APPLAUSE] [PIANO MUSIC] Take a walk with me, through the redwood trees. A thousand years or more,
oh what they have seen. Like grizzlies sitting here just taking in the view while the wind whispers songs the Ohlone knew. Watch the water come down now from the peaks to the bay carrying the memory of
another way. Everywhere I walk, everywhere I stand, everywhere I go, I’m
on stolen land. And my heart breaks to pieces. This is how I am whole, learning how to listen in this place I call home. Whose footsteps walked here? Whose words will I never hear? Whose baby was born through the blood and tears? Falling to the ground silent in the shadows of sound, waiting to be heard, waiting to be found. Watch the rain coming down now, as it has and it will, waking up the seas who remember still. Oh everywhere I walk, everywhere I go, everywhere I lay my head down, everywhere I roam, everywhere I sing now, everywhere I stand, everywhere I wake up
I’m on stolen land. I’m on stolen land. Yes, my heart breaks to pieces. This is how we are whole, uncovering the memory
in this place I call home. [APPLAUSE]

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