One of the top architects of Nova Scotia’s COVID-19 response leaves her public health post and goes to Dal to promote anti-oppression, advance health equity, and improve public health

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decade ago, the notion of taking on a full-time job around improving race relations and inequities in health care would have been too draining for Dr. Gaynor Watson-Creed to contemplate.

“There’s a level if exhaustion that’s been described by some … as racial battle fatigue,” the long-time public health physician and deputy to Dr. Robert Strang tells Halifax Magazine. “You live the experience of battling racism, even if it’s in subtle ways, every single day. Having to also do it in a formal and public way just becomes, ‘Why would I take that on because I’m already tired from dealing with it?'”

The brutal death of Black American George Floyd in police custody in Minnesota last year helped change her view.

“It’s that sense that we’re grieving collectively, both racialized and non-racialized communities, so it feels far less lonely,” she says. “Some of what critical theorists, scholars and anti-racism activists have been saying for decades is actually being heard now. I love that.”

She’s made what she describes as a difficult decision—”My kids cried, I cried”—to step down as Nova Scotia’s deputy chief medical officer and exit a career in public health for an expanded, full-time job in Dalhousie University’s faculty of medicine.

She will head up a portfolio that promotes public health as a career path and examines inequities in the health and well-being of long-marginalized communities, including the region’s Black, Indigenous, and immigrant populations, as well as the LGBTQ community, rural areas, and seniors.

It’s a role she started part-time in 2018. Since then, she’s worked at Dal one day a week, even while serving full-time on Nova Scotia’s response to the COVID-19 pandemic as second-in-command to Dr. Strang. She became the deputy chief medical officer of health in 2017, after serving about 12 years as medical officer for Nova Scotia’s Central Zone.

“Nova Scotians are no strangers to the issues on race relations, both anti-Black racism and anti-Indigenous racism,” says Watson-Creed. “All of the events of 2020 have really brought a laser focus to the need for that work. Even the past three months has just been insane in terms of the demand for content related to anti-oppression and the faculty’s appetite for looking at their curriculum differently.”

The “serving and engaging society” portfolio that Dal introduced a couple of years ago, with Watson-Creed as assistant dean, is part of an effort by Dean of Medicine Dr. David Anderson to bolster diversity and foster community outreach as a priority in the med school’s strategic plan.

Anderson wasn’t available for an interview, but provided a statement to Halifax Magazine.

“Her experience as a leader in public health and a visionary change maker in Nova Scotia is an asset to the medical school and will provide a great opportunity to enhance our commitment to equity, diversity, and inclusion,” says Anderson, a hematologist and medical school dean since 2015. “The COVID-19 pandemic has reminded us how important the delivery of equitable health care is in communities across the Maritimes and Dr. Watson-Creed’s role will lend service to catalyzing much needed change in the health care system.”

Dr. Theresa Tam

Canada’s chief public health officer, Dr. Theresa Tam, whose 2019 annual report on the state of the country’s public health focussed on addressing stigma, says she looks forward to learning more about the work Dal and Watson-Creed will do.

 “I applaud her continued efforts to address health inequities and racism in her new role,” says Tam in an email. “Reducing stigma and discrimination in the health system is vital to increasing access to the health information and care people need to protect and maintain their wellness.”

EDI (short for equity, diversity, and inclusion) is part of Watson-Creed’s new job and is being rebranded by Dal as “anti-oppression,” says Watson-Creed, who’s returning full-time to the medical school she graduated from in 1999.

She says Dal’s faculty of medicine already has EDI work well underway, but “so much more needs to be done here … as we explore the deeper and more lasting impacts that might be brought to bear by anti-oppression as an approach.” 

A big part of her work throughout her years in public health has been taking advantage of opportunities “when people and systems wake up. You can be aware of something, but still be kind of asleep to it. It’s a useful metaphor. There’s been such reluctance to wake up to the reality.”

The Black Lives Matter movement puts the many injustices facing marginalized communities in the spotlight, while COVID-19 has highlighted the disproportionate impact and health inequities for racialized communities. Recent data from Statistics Canada, for instance, confirms anecdotal evidence that Black people are far more likely to die from COVID-19 than whites and other groups.

“I feel like folks have been jolted awake and they’re not going back to sleep,” says Watson-Creed.

She and her sister (Halifax family practitioner Dr. Adrienne Watson) were well versed in topics around race growing up on Charlottetown. Their parents are Jamaican immigrants. Their father was a sociologist at the University of Prince Edward Island whose area of study was the Black diaspora and critical race theory.

“It’s probably the reason I became a public health physician, looking at inequities broadly,” says Watson-Creed, who was born in England and moved to P.E.I. in the 1970s at six weeks old.

Charlottetown was “a lovely place to have a childhood,” she says. “But as a racialized woman, a young Black girl, it was also lonely. I had a lot of friends, but I always knew I’d be stared at when I walked down the street. Thankfully, it was none of the grossly violent racism that exists.”

Watson-Creed starts full-time at Dal on April 15. She’s hoping to use up some vacation time, but isn’t holding her breath. The three weeks she tried to take off last summer didn’t pan out. Trips home to P.E.I. with her two children from her first marriage, a 17-year old son and a 15-year old daughter, are on hold due to the pandemic.

Waston-Creed says the decision to close Nova Scotia’s borders is the main reason the province has an enviably low COVID-19 case count.

“In a federated nation like Canada, it’s a heck of a move to say other Canadians can’t come into your province,” she says. “To be clear, we’ve never said they can’t come in. What said is they have to do a 14-day quarantine to make sure they don’t have COVID before they enjoy the province.”

Nova Scotia, the other Atlantic Provinces, and the northern territories were able to take the tough stance on borders because of the recognition they lacked the health-care capacity of larger provinces to cope with widespread outbreaks. “We’re not Sunnybrook or Sinai in Toronto,” she says. “So we made a decision early on not allow COVID to get in. And it’s served us well and, strangely, allowed us to be more open than the other province as a result. We’ve been criticized for it by our colleagues across the country. Maybe some of it’s jealousy.”

Watson-Creed also gives credit to Nova Scotians for taking up the message and the cause of not transmitting COVID-19.

“My partner was remarking that he was at a grocery store on the Eastern Shore and he’d see people who would normally hug take a step back and say, ‘I don’t want in infect you,'” she says. “This was before grocery stores even got organized about COVID. Very early on, Nova Scotians got the message … My clinical colleagues will talk about autonomy of the patient being one of the highest ethical principals that they adhere to. In public health, ours is the greater good. We’re often in the position of having to sacrifice individual autonomy if the greater good will prevail.”

Public health wasn’t Watson-Creed’s first choice when she went into medicine.

She was considering specializing in pediatrics, family medicine ,or psychiatry when her sister, who was a year ahead in medical school, suggested public health.

Dr. Gaynor Watson-Creed. Photo: Janet Whitman

“I was offended,” Watson-Creed recalls. “I had no understanding of what they did. I said, ‘I want to be a real doctor. Aren’t they just bureaucrats?'” she recalls. “She said, ‘Look at the training programs and tell me that’s not you.’ I realized, ‘Oh my god, you can do a whole career as a physician in health equity.'”

While leaving public health “was never going to be an easy decision,” Watson-Creed says she’s “moving over to pull along something else that’s really important if our systems are going to succeed.”

Public health authorities have been preparing for the next pandemic since the early 2000s, but didn’t anticipate COVID-19’s persistence , says Wastson-Creed, who, even as an introvert, has been finding working from her home in Dartmouth to be tight quarters.

“COVID will find every opportunity,” she says. “The constancy of attention was already going to be exhausting, but then you layer on an entire year. I don’t think any of us was ready for that.”

It’s left little time or energy to plan for future pandemics.

“It’s hard to impress upon people how flat out we are still dealing with the current one, and that’s without having many cases in Nova Scotia,” she says. “We’re as much preparing for the next day as the next weeks and months. I’m hopeful if there is a next one, there will be some lessons learned.”

And the next public-health emergency might be something equally unexpected.

“In particular, with sea levels rising, we will lose habitats,” Watson-Creed says. “That land loss is no small event. It impacts the capacity to manage food supply, the density of population, and the proximity of animals,” she says. “It sets of ripples that I’m not sure we’re thinking about.”

Halifax Magazine