A Vancouver single father says he and his three First Nations sons faced discrimination at a non-profit dental clinic serving Vancouver’s Downtown Eastside neighbourhood.
Despite all three boys having years of medical history at Strathcona Community Dental on Keefer Street, Ajantha (Sam) Dharmapala says the receptionist refused their First Nations status cards for coverage or to serve him unless he paid in cash.
The receptionist did not seek help from another staff member and said Dharmapala would not be able make appointments for the boys unless he agreed to pay for them in cash, he recalls.
“I tried to explain things to her very kindly, but she very rudely told me not to come back to this place without money,” said Dharmapala in an Aug. 24 Facebook post.
“It was horrible,” he said in a Friday interview with The Tyee. “I don’t want anyone treated that way. I don’t need that happening to another person.”
Dharmapala says operators of the clinic have since apologized to him. An explanation by the clinic posted online blames in part a computer error.
Dharmapala and his former partner, who was status First Nations and a member of the Waywayseecappo First Nation in Manitoba, share a 12-year-old son. After her recent sudden passing, Dharmapala was asked to foster her two other sons, aged seven and three. All three boys are status First Nations through their mother.
“I’m dealing with three kids who lost their mom, I’m trying to keep the younger two out of foster care,” said Dharmapala.
“It’s not easy because I have to think about their mental health,” he said. “I didn’t want them to have to experience that kind of treatment.”
Status First Nations people who reside in B.C. are entitled to many dental services free of charge through the First Nations Health Authority and Pacific Blue Cross.
Indigenous people in Canada experience nearly twice the rate of dental disease compared to non-Indigenous people, in part because of limited access to dental care and nutritious foods, as well as higher smoking rates.
Poor dental health can result in heart disease and other serious health challenges throughout an individual’s life.
A 2020 report into anti-Indigenous racism in health care also found that widespread and insidious racism in all corners of B.C.’s health-care system deter Indigenous people from seeking care, causing more health issues to go untreated and resulting in more severe outcomes.
On its website, Strathcona Community Dental Clinic acknowledges that “First Nations people who are status have up to 100 per cent coverage on some procedures.”
But Dharmapala says he and his sons faced treatment from the front desk receptionist at Strathcona Community Dental that was inhumane and could completely deter someone else from seeking dental care.
He took the three boys to the clinic on Friday, Aug. 19. He chose that clinic because it was familiar and staff knew their dental history.
When he was three years old, the middle son fell down and knocked out about five baby teeth. Now seven, the boy’s adult molars had started to appear and Dharmapala wanted to make sure they were growing properly. He brought the other boys along for checkups at the same time.
The receptionist said they could only take his middle son. And when she asked how Dharmapala would pay, he explained that his son was covered under his status card and Pacific Blue Cross.
The receptionist ran the status card number and said it wasn’t working. She asked Dharmapala to pay in cash, which he said seemed odd given credit or debit are much easier.
He then explained that the boys’ mother had just died so he did not have all the details of their dental history himself, but that they had come here for many years and their status card had always worked.
“She said, ‘That’s your problem,’” recalls Dharmapala. He could afford to pay, he said, but shouldn’t have to.
The family left and went to Cambie Village Dental, where Dharmapala says they accepted the boys’ status cards without issue and gave them excellent care. He even called the First Nations Health Authority, which confirmed their cards were active and conferred dental coverage.
On Wednesday, Dharmapala said another staffer at the clinic reached out to apologize, but did not say what accountability or steps would be taken with the receptionist.
In a response to a one-star Google review of the clinic Dharmapala posted on Aug. 26, the clinic said it takes these complaints seriously.
“We always accept Native Health and are up to date about insurance’s changes. Having said that, we are limited by what the computer system tells us when we verify coverage,” read the reply, posted late Thursday evening.
“The people running the place need to fix it,” said Dharmapala. “They have to know about the workers and make sure they’re being thoughtful. But that receptionist is not good for that job and dealing with low-income, vulnerable people.”
Strathcona Community Dental Clinic is a non-profit providing reduced-cost dental care to low-income and marginalized people, many of whom are Indigenous.
In an emailed statement to The Tyee, clinic executive director Erin Riddell declined to comment further on the specific allegations or any actions that have been taken with the staff member in question, citing privacy concerns.
She said issues confirming status First Nations health coverage are not common, and that clinic staff have taken part in cultural sensitivity training through the BC Dental Association.
Asking a patient to contact the ministry to confirm coverage or pay out of pocket and claim back those costs is standard practice if there is confusion around coverage, Riddell said. She did not respond to a question about why cash payment would be insisted upon.
“Unfortunately, we cannot take the risk of giving out free service as we do not have the means to recoup these funds,” she wrote. “As a not-for-profit dental clinic, we rely on government grants and donations for our clinic to keep operating and stay open.”
Dharmapala said no assistance with a claim was offered. The only solution offered by the receptionist was to demand he pay for the services in cash.
Dharmapala has experience speaking up for others as a housing and anti-poverty advocate in the Downtown Eastside, which helped him navigate the situation at the clinic.
But he says his heart breaks for his grieving sons and other vulnerable and Indigenous people who may face similar behavior.
“The history of Canada’s treatment of Indigenous people is dark. It is still in society,” said Dharmapala. “How do these little kids have to face this, especially First Nations kids? Kids can get very mad and deal with this poorly. It is sad.”
“And I really want to give them a good future.”