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Interview with Sarah Elshahat

📷 Sarah Elshahat

Journalist: Yumnah Jafri

Yumnah Jafri: Welcome to SciSection. My name is Yumnah Jafri and I am the journalist for the SciSection radio show, broadcasted on CFMU 93.3 FM Radio station. We are here today with Sarah Elshahat. Thank you so much for taking the time to meet with me today, Sarah.

Sarah Elshahat: Thank you so much. It was very nice seeing you today.

Yumnah: I'm going to start off by asking you a very general question. Who are you?

Sarah: Thank you so much, Yumnah. My name is Sarah Elshahat and my initial, or my primary background is as a clinical pharmacist. So, I'm a clinical pharmacist but also a public health professional. I'm going to share some of my life journey today. I'm also working as a researcher at McMaster University. I have a BPharm degree in pharmacy and MPh from Queens University (the UK not here). Now, I'm working, or I'm leading the National CAN HEAL research project in Canada as a primary investigator at McMaster University.

Yumnah: And that's so great to hear. So, you did mention your research project CAN HEAL, so what are your inspirations in creating this initiative?

Sarah: I can provide an overview. CAN HEAL stands for the Canadian Arab Nutrition Health Education Active Living Project. So as the primary investigator, this project aims to address the health needs of the Arab community in Canada. The inspiration–maybe I can provide some insight.

The project employs a holistic bio-psycho-sociocultural perspective, which thoroughly and comprehensively and deeply investigates all the relationships between human biology, psychology, and the wider physical and social environment.

While this lens is crucial to effectively address health needs of any human being, this can be particularly critical for marginalized groups such as immigrants, refugees, or ethnic minorities as a whole, because they face much challenges and the stressors than the general population. This actually was the inspiration because there is a need for research that uses a holistic approach to ensure equitable, dignified, and efficient health and social care to all vulnerable communities and minorities. So, our study is a bitter one as most of the health issues our community actually faces today are a product of the societal issues and failures. This can range from discrimination, lack of education, and/or underemployment, inaccessible resources, healthcare professional shortages because of the systemic barriers. These are just a few examples. And of course, the list is so long. So, yeah, a little bit about the inspirations that led to creating this project on this initiative.

Yumnah: You mentioned something really important, being the holistic approach to research. So, that definitely does tie in with your focus on immigrant Arab and AIR populations in Canada. Is that correct?

Sarah: Yeah, Arab immigrants. AIR stands for Arab Immigrants and Refugees. Back in the UK before moving to Canada, I could see how Arab immigrants face unique issues that really require a holistic approach to address. They have specific beliefs and values that need to be taken into account and respected throughout any research, or also delivery of health and social care service.

So, cultural and linguistic sensitivity is critically needed throughout the entire process from research to practice. Otherwise, their needs or this population's needs would not be properly addressed, which unfortunately is the case.

And also, the research among this population is very limited. So, during my time in the UK as a public health professional, I could discuss and cooperate with colleagues from North America, and I was able to see that the Arab community in Canada face the same issues like those in the UK. Unfortunately, the situation is even worse in Canada due to issues within the healthcare system, as well as discrimination. More hate crimes are on the rise here in Canada, much more than the UK which is super concerning and eye-opening. Talking about the health system, for example, here, the medications are not covered by the government as part of the OHIP, for example, talking about Ontario. In the UK, in contrast there is coverage. People would just go to the pharmacy and collect their medications without having to think of insurance and those stuff. So, an additional barrier for this population and other populations as well. Here also you have the terrible so-called Canadian experience, like discrimination within the job market. Nothing like this exists in the UK, unfortunately. Things are much better. So, lots of issues here. I decided eventually to do this research here in Canada with their community because of the high need for this research. Also, this research would be to some extent applicable to support other ethnic minorities who have the same struggles. It's not just in Canada but would help also inform other research projects and practice in other western countries as well.

Yumnah: That’s so great to hear that you saw these systemic issues within Canada, and decide to do something about it, especially regarding a very vulnerable group of people. You already briefly went over this, but if you wanted to specifically talk about what you expect to see by the end of CAN HEAL. What are your long-term goals for CAN HEAL or your final, end goals for this initiative?

Sarah: Yeah. Thank you so much, Yumnah. This is a good question. So, basically just three main or big objectives, or hopefully, these hard outcomes. One of them is raising awareness and also advocating for health and social needs of ethnic minorities. This is a bigger goal because, for example, talking about the discrimination within the job market, this is not an issue for Arabs only, but also other ethnic minorities and immigrants overall. Raising awareness about all these issues, number one. Number two, informing policy change in the context of health and social care systems, as well as policy like politics and legislation. And number three, informing health and social care practices and how services are actually provided and delivered. So, every service, every resource is individual, and patient centered.

Yumnah: These are three aims and objectives, or outcomes for this project that the team hopes to achieve at the end. Considering you have such a hard-working team with such an amazing principal investigator as yourself, I have no doubts that you'll achieve exactly these three goals that you mentioned for CAN HEAL. Going back, what exactly do you think you did differently compared to your peers when you were an undergraduate student, that helped you become who you are today or reach where you are today?

Sarah: Actually, this is a sensitive question, but I'm happy to share a bit about it. So, one major thing was that I was always not satisfied with during my journey as a pharmacist, was the sole focus on the biomedical in the healthcare and delivery. So, the majority; most of my colleagues were focusing on the biomedical model, which I believe has proven to be a major global issue and reason for many unsolved health challenges that our communities face. So unfortunately, I can tell you, having worked in this field for many years, there is a high loyalty to pharma. They are educated to talk about medications instead of how we can address the root causes of all the health issues that we have in our communities. Of course, we can’t deny that pharma is a big business. Pharmaceutical businesses sell people's sickness. Unfortunately, this is the fact. So, they benefit. They take advantage of people's sickness. That's their job.

Sometimes, I really felt angry about this when I pursued pharmacy. I was hoping to help people, however, the system didn't allow. There’s always restrictions because profit is a key driver for the whole system.

You can't skip that. You can't just change people having a specific system to follow. So, this was the turning point for me. Then, I decided to find something else. It was just like, that's the turning point for me to pursue public health. I realized that I should consider an additional field to allow me to do what I'm not allowed to do. Public health is a bit different field. You can have the capacity, the room to criticize these issues. Cooperate for solutions, measures, to change the system and so on. So, this is mainly, the main turning point for me. I hope one day our system could see change. One day pharma and healthcare work to help and support people and be really patient centered by actions, networks, and promises, and fulfill the promises instead of just seeing them as a means for profit and increasing their sales, unfortunately.

Yumnah: Thank you so much for sharing that with me. I know that was probably a very sensitive point in your life, especially you mentioned “the turning point”. Very unfortunate to hear about the fact that root causes of many of these illnesses are never acknowledged or never wanting to be acknowledged.

Sarah: Because otherwise, they won't be able to make profits!

Yumnah: Yeah, exactly. It's very unfortunate. So, maybe for other students who may also be interested in tackling these issues at the root cause, what kind of advice would you have for them? For them pursuing research, maybe related to public health?

Sarah: That's a great point, thank you so much, Yumnah, So the first advice I would recommend is don't limit yourself to what you have in mind as a long-term goal. For example, even if talking about research, you have a goal to pursue research on public policy, for example, at the end, you can still join opportunities for health promotion research, health services, research, or even nutrition. So, don't limit yourself to what you have in mind as a long-term goal because what you will learn now or with any opportunity. This would allow you to learn many things. This would be applicable to many fields. I can assure that you can't imagine how different fields relate to each other. It's eye-opening. It's all interconnected as well, methodologies are so interconnected and applicable to too many disciplines. Gaining these different perspectives would definitely help you be a more experienced person. The second one is trying to join or work on interdisciplinary research projects. This is such a great opportunity to see how knowledge from different disciplines is all integrated, to address conflicts for such questions. And my last advice (I kept to the end because it's so important) always keep in mind or consider to adopt a holistic approach because we do need more integrated approach. We as human beings are all intertwined with the environment we live in. That significantly impacts our life.

So “human” is not just biology. This is like one minor part of it.

Like human bodies are super complicated. To be able to really help address any problems and issues we have in our super tough and complicated societies we are living in nowadays.

An integrated approach is much needed if we need to see change and improvement, and if you do really want to help people, you need to adopt a holistic approach.

Yumnah: Yeah, your point about biology being only a small part of your entire being as a human, as a human being is a very understated point in university. Thank you so much for that answer, Sarah. That was amazing. That's it for this week of SciSection. Make sure that you check out our podcast available on global platforms for our latest interviews. Thank you so much for meeting with me today, Sarah.

Sarah: Thank you so much, Yumnah.


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