MEET ARUNA DHARA
She’s a mother, committed social justice advocate and family doctor at the Sipekne’katik Health Centre in the Sipekne’katik First Nation (Indian Brook) community and at Dartmouth General Hospital.
She’s a provider of medical assistance in dying, a voice at the table on how Dalhousie University’s Medical School can better serve Indigenous people and move forward with truth and reconciliation and is an outspoken advocate for a national pharmacare program.
“I’m a jack-of-all trades,” jokes Dr. Aruna Dhara. “With family medicine I get to do lots of different things.”
“I’m one heck of a lucky girl. Sometimes I have to pinch myself because I get to do what I do.”
Change is brewing
“The year 2019 offers us an amazing opportunity to finish the work of Medicare. The missing piece is pharmacare.”
Dr. Dhara was part of roundtables and discussions organized by the Advisory Council on the Implementation of National Pharmacare, which recently led a national consultation on how to implement national pharmacare for Canadians and what a national drug plan could look like.
She anxiously awaits the council’s report, expected in the spring, and is hopeful the Trudeau government will seize the opportunity to implement a national program.
Driving Dr. Dhara
“I see it all the time — folks that come in, folks in diabetic crisis because they are rationing their insulin,” she says
“Your diabetes doesn’t care if you have a job or not.”
A national pharamacare program, Dr. Dhara believes, would most help the working poor. These are people who have little or no drug coverage and are often choosing between buying food and paying rent or buying their medications.
“Things like access to medication is really about people with income issues,” she says.
It’s one of the big social determinants of health. According to the World Health Organization, these are the conditions in which people are born, work and live, and the wider set of economic policies and systems, social norms and political systems that shape the conditions of their lives.
“For people who have chronic diseases in the community, (national pharmacare) would be huge. It would literally be life-changing for them.”
A big challenge
“Remembering where I am supposed to be on any given day or time,” she laughs.
On a more serious note, she refers to the emotional toll delivering primary care in today’s world has on her and other family physicians.
“We do a lot more emotional labour,” she says. “Family doctors need to be good listeners, involve their patients in shared decision-making and often have to literally hold a patient’s hand through some of the most difficult moments in their lives.”
Recognizing that structural and institutional change is slow — and then summoning patience — is another challenge for Dhara.
But there are rewards
“I am so lucky to have such energizing work.”
How does being in Atlantic Canada shape your perspective?
Dr. Dhara moved to Nova Scotia in 2011 from Toronto where she went to medical school and worked at St. Michael’s Hospital, in the heart of the city. She now calls Halifax home.“Being somewhere that is a little bit smaller and has a strong sense of community ,” she said, “makes finding connections and allies you can make changes with easier.”
Looking ahead to 2019, what are you focusing on?
“I know pharmacare is the right thing to do,” she says. “The challenges are really about how do we do it in a way that is responsive to the changing needs of Canadians?”
What do you want to continue working at and getting better at?
One of the tenets of family medicine is that you are a resource to a community. You have to understand the community you serve.
“I consider it a great privilege to work there (Sipekne’katik First Nation). I work with an incredible group of people. The community has done amazing work.”
Dr. Dhara points to a community-based opioid replacement program that started about a year ago after the community identified the need and worked to implement it.
What is one book on your reading list?
Vincent Lam’s biography, Tommy Douglas. Also, Good and Mad: The Revolutionary Power of Women’s Anger by Rebecca Traister.
What message would you share with everyone in Atlantic Canada?
“If pharmacare is something we value as Canadians, Atlantic Canadians need to step up and have their voices heard. This is a national effort.
“It is possible to do this. We can do this.”
What advice do you have for readers who are in the first decade of their career?
“When an opportunity comes along say ‘yes.’”If something is important to you, the first thing to do, according to Dr. Dhara, is say ‘yes,’ then find someone who will work with you to make positive change.