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The Nest is UVic’s independent newspaper the Martlet’s podcast, established in November 2024. The Nest features Martlet Editor-in-Chief Sydney Lobe interviewing UVic and greater Victoria community members about what they’re doing, why they’re doing it, and how you can get involved. It is recorded CFUV 101.9FM’s studios and airs biweekly at 10:00 Saturday morning on CFUV 101.9 FM. Find out more about the Martlet and our volunteer and staff opportunities at martlet.ca.
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Rae Dawson: Thanks for tuning into the Nest, a podcast by the Martlet, the University of Victoria's independent newspaper. Settle in as we talk with UVic and Greater Victoria community members about what they're doing, why they're doing it, and how you can get involved. The Nest is produced in the studios of 101.9 FM CFUV radio, on the unceded lands of the Lekwungen peoples and the Songhees, Esquimalt and W̱SÁNEĆ peoples, whose relationship with the land continues to this day.
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Rae Dawson: Hello everyone, and welcome back to the Nest. My name is Rae Dawson, I'm the Operations Manager at the Martlet, and today I'm in CFUV studios with Anahita Seraji and Sara Sunderji, who are both part of AccessBC’s campaign.
Anahita is a reproductive justice advocate and campaign coordinator with AccessBC, where she has been involved since 2022, including during British Columbia’s free prescription contraception campaign. She currently helps coordinate AccessBC’s pain-management advocacy, leading a multi-pronged campaign that combines research, collaboration with physician and clinical partners, and policy advocacy to address systemic barriers in reproductive healthcare. Anahita’s broader interests include reproductive health and gender equity, which she advances through research, education, media production, and systems-level advocacy — both within and beyond AccessBC.
Sara graduated from the University of Alberta with a Bachelor of Science with distinction and is pursuing a Master of Applied Health Sciences. She has an interest in maternal and fetal medicine, and joined AccessBC for the pain management campaign, serving as research lead and stakeholder liaison. Passionate about equitable reproductive access, she advocates against policies and systemic barriers affecting marginalized communities.
Thank you so much both for being here, and welcome to the Nest.
Anahita Seraji: It's our pleasure. Thank you so much for having us.
Rae Dawson: So, what is AccessBC, for those who might not know, and what needs do you guys seek to address?
Anahita Seraji: AccessBC is an organization with groups of people that are across British Columbia and beyond who want to remove barriers that people face when trying to access prescription contraception. So examples of barriers that we have targeted through our campaigns is something like cost and what our current campaign is focused on, which would be pain.
Rae Dawson: I'm so curious, how did AccessBC begin?
Sara Sunderji: So AccessBC began when a group of individuals, comprised of physicians, allied health and legal professionals, desired to enact change in reproductive medicine for individuals who have uteruses. We have a variety of professionals who provide different perspectives on the issue of universal accessibility. And in essence, our goal is to avoid any barriers or means tests, so if you want prescription contraception, you can get it.
Rae Dawson: That's super exciting to hear. I know you guys just completed a successful campaign for free contraception in B.C. — which, congratulations, that's fantastic. Can you tell me a little bit more about that campaign?
Anahita Seraji: So one of our primary inspirations for that campaign was, as Sara mentioned, recognizing that there's a lot of people who want access to contraception, and having access to contraception is a good policy, no matter how you think about it. It's a good economic policy, it is a good healthcare policy, it involves people having the right to make empowered choices about their own body, and yet this very basic thing was inaccessible for people because of something such as cost. It goes against gender equity standards.
So what we tried to do, we wrote letters, we did some lobbying, we did tabling, we talked to a lot of people to ensure that people would have access to free prescription contraception. When it comes to something such as oral contraception, because the cost would be something that is routine along a certain period of time, it may come off as a little bit more accessible. However, when there's bigger costs, such as the IUD, which could sometimes cost as much as $500, there was a lot of barriers in terms of people who wanted the IUD, which is recommended to be one of the most effective forms of contraception, but were basically gate-kept from having access to this because of the cost factor.
Sara Sunderji: So I was just going to add on to that, that a lot of the time, some context is missed when we think about our success with free contraception. And it really comes down to, well, did we need to have to advocate for something that is so basic and seems like basic health care and is so fundamentally needed, to not have a cost associated with it? And I think that's where we came from, when it came to that campaign, and we advocated on the basis of common sense. We used common sense to get the success that we did, and we were really successful because B.C. became the first province to make all prescription contraception free. And we even saw that after the policy was enacted, that there was a significant uptake in IUD usage. So I believe around 49 per cent of people increased in their use of an IUD since the policy was implemented, which is incredibly successful.
So more people are using IUDs, which is fantastic. But what that also means is that now we have to have this conversation about pain management and IUD insertions, because of this uptake in IUD use.
Rae Dawson: I’m glad to hear you guys are continuing your campaigning. So was that progression the inspiration behind tackling IUD pain management?
Anahita Seraji: Yes, so I joined the campaign towards the very end of our pain management campaign, and it was a huge victory. I was on the front lines at the tabling events, and I would talk to people and hearing their stories — I really felt that once we were able to pass free prescription contraception, that people would have the choice to access the type of contraception that they wanted to.
But then I was very surprised that after the success of the campaign, I learned that was not necessarily the case. Every time I've talked to a person, the first thing that came up was, “I'm so happy about the success you guys have had. I've been wanting to get an IUD, but it has been super expensive, but I'm still not sure if I want to get it, because I've heard it's very painful.” And so, that kind of started the conversation about pain being a barrier to people getting IUDs. And we initially started off as — again, just a group of people that were having a conversation about it, thinking, “Okay, what can we do to make sure that IUDs are accessible?” And it was a little bit of a wild goose chase initially because we didn't know how we could tackle the issue. But we initially started by trying to tackle physician training, seeing that if physicians have the training to provide pain management, whether then the problem would have been resolved. But slowly, as we start to investigate what was the source of pain and how we could tackle that problem, we realized that there are a lot more factors behind the scenes that inhibit pain management being accessible for patients who are seeking it.
Rae Dawson: Absolutely, I know that pain has been a huge discussion amongst myself and my peers when we're discussing IUDs, and it definitely, in the past, has made people I know hesitate to pursue that option. I know this campaign has four key actions you are asking of the B.C. government when it comes to standardized care for IUD pain management. What are those key actions, and what is your suspected timeline for those to be implemented?
Sara Sunderji: Well, I'd love to share what the four key actions are. In terms of the suspected timeline — I want to say that right now it's incredibly unpredictable. So the current political landscape is really unpredictable, and it would be a little premature to give a timeline. However, we have had some really promising conversations with members of the Legislative Assembly and national PharmaCare, so we are optimistic that change will be seen soon. But in terms of timeline, it would be a little premature. We are optimistic again, because B.C. has been such a national leader in reproductive justice, that we will see change in an accelerated timeline.
In terms of the four key actions — so, we are asking for four things. And our four key asks are mapped to different stakeholders, which is really important to note. So we will be advocating to different organizations or to different levels for each of those key asks. Our first ask is for billing, so we want for physicians to be compensated for the training that they undergo in order to provide effective and standardized pain management, as well as that they are compensated for providing the pain management itself.
So, the B.C. government did include an MSP billing code — so that's the way that physicians get reimbursed for cervical blocks, which is one pain management mechanism. But there are so many other pain management mechanisms. So these include inhaled analgesics like Penthrox, which is really heavily used based on our conversations with physicians who provide IUD insertions routinely, like on a daily basis, as well as other sorts of pharmacologic and non-pharmacologic pain management options. So we're asking for the B.C. government to make a comprehensive list of billing codes that align with every single option –– commonly used options for pain management.
Anahita Seraji: So one of our other asks is to set clear provincial standards. So this was one of the first things that came up where we were trying to understand what is the determining factor for whether or not a physician is providing pain management. We've noticed that the provision of pain management is quite inconsistent across the province, and there are a variety of reasons for that, and that is all embedded into the four asks that we have.
So one of them is the fact that if you do not have the training for providing pain management, you're likely not going to be able to provide it. So one of our asks is to improve training and education, and this ties into the clear provincial standards, where there should be a standard procedure for what the procedure of getting an IUD looks like. When you walk into a clinic, you should have all the information that you need about what an IUD is, how it's going to feel throughout the insertion process, and the options that you have in terms of pain management, so that patients are able to choose whatever method that's going to work the best for them. So we need some clear provincial standards that guide these so that everyone, when you walk into a clinic, you have an ideal standard for the way that your care should look like, and it's not so much dependent on the provider, their preferences, and things like that.
But it's a little bit easier said than done, because there are a lot of providers that want to provide pain management. However, it is an inaccessible ask for them. So Sara already talked about billing codes, so when pain management — you're not able to bill for it. That means that doctors are not going to be compensated for providing pain management. This means that there is a financial disincentive to providing equitable care for people. Other things are, for example, if you are a sexual or reproductive health care provider, the way that you are compensated for the care that you provide is different than the way that family physicians are compensated. So what this means is that because you are going to be paid for every service that you provide, and only the billable services, not only are you not being compensated for the medication itself, but you're also not going to be compensated for the time that it takes to provide the pain management. So the billing codes, having a standard where people are incentivized to actually be able to provide pain management. We talked about training a little bit earlier, so having a guideline for what training should look like, and the fact that training shouldn't just be about providing the IUD, but also recognizing that pain management should be recognized as part of providing the IUD, and also to ensure regional equity.
So all the barriers that we have talked about, and whether it's access to resources, access to facilities, having access to providers that have the training and have the time to provide IUDs, all of that is going to be exacerbated if you're not within the urban center. So what we want to do is we want to come up with solutions that are going to be applicable and practical for people who are not necessarily near hospitals and near urban centers. So that could include something like mobile clinics, ensuring that the options for pain management are going to just be you need to get an OR visit if you want to have access to pain management, which, again, is not always accessible, or you just have to tough out the pain. There's a lot of other options in between that are available and should be used, that are just not accessible at this point.
Rae Dawson: I'm so curious. What would it actually look like if I were to walk into a B.C. clinic today looking to get an IUD inserted without the standards that AccessBC wants to be put in place?
Sara Sunderji: Well right now, it would entail a lot of patient advocacy. So as a patient, you would have to be educated, incredibly educated about the different pain management options. You would have to be very proactive in asking whether my medical history would make me vulnerable to bleeding afterwards, or to excessive pain. A big part of that is trauma-informed care, so if you have previous trauma, you would have to carry that burden of advocating and saying, “Hey, I had this trauma. How will that impact my response — my pain scores when it comes to the procedure itself?”
So there's a lot of patient advocacy needed. You would also have to go to a medical professional, if you are educated, that is known for providing these sort of pain management options. The wait time for those appointments I'm not entirely sure, but I do know that there's a select few — there's a very small amount of providers who actually are specialized in sexual and reproductive health care, and would be the ones who are able to provide you with comprehensive pain management. Otherwise, if you go to your family doctor or to another practitioner who doesn't necessarily have that expertise, they may not know about those pain management options, and they may refer you to a gynecologist or a specialist if they're prompted with the questions that you are asking.
Now this is all assuming that you as a patient, have done the research, you are well informed, you are educated, and you're asking the questions that need to be asked, but a large subset of the population just doesn't know that pain management needs to be provided, or that self advocacy is a thing that is required because it seems like a no brainer that a doctor should know what they're doing. So not a lot of people think that, okay, well, I need to advocate for myself. I need to sit for two hours at the desk and do my research before I go in and get this IUD.
Anahita Seraji: I will add that — huge disclaimer, is that it is very, very variable, as we mentioned, it definitely depends on the provider. Some of the doctors that we work with, they are incredible. So they have a whole conversation or consultation that is trauma-informed, it's very patient-centered. They try to get to know the person, their needs, and they tailor their care towards that. However, there are others, as we mentioned, who might not have the time, the capacity, the education, to be able to provide care like that, and like Sara said, it really does fall on the patient to be able to advocate for themselves.
That should not be the case, but I could tell you, I have gotten the IUD myself, and that was the case for me. I essentially went in with full arms, like “I refuse to get the IUD if you're not going to offer pain management.” Because of that, I was basically hopping from physician to physician for a while, trying to find someone who was actually going to pay attention to my concerns and validate them.
Rae Dawson: It's so frustrating to me that you can't just walk into any doctor's office in B.C. and expect to receive the same standard of care, especially for pain management, and especially too when, as most students who might be listening know, just getting a doctor's appointment in BC can be a huge struggle if you don't have a family doctor, and even if you do have a family doctor.
Sara Sunderji: Yeah. And I just wanted to echo some of the conversations that we had with people who have been on the receiving end of an IUD. As Anahita mentioned, it's very varied, very varied. That's a fun choice of two words, but it varies a lot. So, people have extremely positive experiences, and people also have extremely negative experiences. But the common thing that connects all of these individuals is that they're choosing the birth control option, which is the most efficacious. So it has a 99 per cent, greater than, success rate, and the failure rate is even less than 1 per cent. On top of that, it lasts extended periods of time. So there's so many benefits when it comes to getting an IUD, which outweigh a lot of the concerns that people have.
That said, it shouldn't be a balance between the two. You shouldn't have to pick a not as efficacious option because you are worried about pain management, or you are worried about the timeline to actually get that procedure, or there's a long wait with this one physician that you really want to get it done by, so you go to someone who maybe doesn't have the expertise. That's my experience, that it's extremely efficacious. So I don't want to scare anyone and say “don't get an IUD,” because there's so many benefits to getting an IUD, but there is a lot of systemic barriers which make that process, the procedure, kind of daunting and not as comprehensive and holistic as other procedures. Like when I go to get my wisdom teeth pulled out, I know I'm going to have pain management. It's kind of — I booked my appointment, it's not a concern in the back of my head that, will I have pain management? Whereas in IUDs, the landscape is a little different, and we're hopeful that the landscape will change in the future.
But for patients, for any listeners who right now are considering an IUD, because I do know we're dealing with the student base, and a lot of them are at reproductive age, and probably considering getting an IUD. Talk to your doctor or medical professional, allied medical professionals, about the options. Ask for pain management options. Bring a support person, if it helps, to your appointment. Ask what pain relief is available and what step — what will each step in the procedure be like, starting from the speculum to actually inserting the IUD, to the swelling you might experience afterwards. Everyone's symptoms are different, so just ask what each step will feel like in your case. And that's kind of the way to be proactive at the moment.
Rae Dawson: For sure, yeah. Asking questions is so daunting, but I've definitely found as I've gotten older that it's typically the best way to meet these systems that are in place, because, as you mentioned, the pain management options exist. They just need to be implemented in these spaces. So, currently, AccessBC is running a letter-writing campaign to bring about these changes to IUD pain management. Have you guys been successful before running a letter-writing campaign?
Anahita Seraji: Our founder, Teale, and Devon, they're kind of at the front lines of the strategy. They have a lot of experience, and they've been incredible mentors for people like Sara and I that are joining the campaign later, and we're kind of earlier in our career in terms of knowing how to run a campaign, what to do, the strategies, things like that. So I'm not 100 per cent sure if they got their inspiration for how they wanted to approach the work that AccessBC has done by looking at another campaign and the way that they approach their letter writing. However, I can tell you based off of our success with the free prescription being accessible in B.C., letter-writing campaigns definitely do make a difference. It's not just about letting decision makers know exactly what our expectations are from them, but a lot of the times they are conversation starters.
So we do have a lot of tabling events where we take our letters, and we encourage people to go on our website and send a letter to their MLAs, for example.
A lot of the times these people don't exactly know what the problem is, or they're not fully informed, and this letter writing campaign is an entry way for them to learn more about it and to be able to advocate for something that they do care about, they just didn't know there was a way for them to utilize their capacity, their powers, to actually do something about it. So it's also not just about changing the decision-making process and letting people know what our expectations are, but also a public engagement process.
Rae Dawson: That's so exciting to hear that you've found a way to involve people in policy decisions that will affect them and give them the tools they need to be educated on the issues they're talking about. I think it's insanely easy to feel intimidated in such a busy world and to feel like you don't have the knowledge to actually make a change or make a difference.
Sara Sunderji: Oftentimes, I find a lot of decisions are made due to a lack of knowledge. So, you know, sometimes it's easy to villainize all these stakeholders and think that they're sitting there and they're making this awful situation for a lot of individuals who want to get an IUD, but it really boils down to a lack of knowledge. They just don't know, or I'd like to assume that a lot of them just don't know. So it's really important to educate them, but also just get to know your MLA too. Get to know who the decision maker in your community is, and this is a great starting point for a lot of people. If they send a letter to their MLA through AccessBC and ask for our asks to be met when it comes to pain management for IUD insertions, not only are you raising awareness about a topic which is of interest or which directly implicates someone in your life. You are also having that conversation starter with your MLA, and you are learning about who they are. When I started this letter-writing campaign, or when I first submitted a letter, I had no idea who my MLA was. And just submitting it, I was like, “Okay, that's interesting. Now I kind of know who's making the decisions,” and you have that comfort in knowing that individual, and also being able to have that line of communication open.
Rae Dawson: Absolutely. I'm so glad you guys have been so successful engaging people in those conversations. So, is this campaign intended as a one-off issue, or is it more of the beginning of a larger AccessBC campaign for all reproductive health issues in B.C. or across Canada?
Anahita Seraji: I want to say that it's going to be the beginning of a larger AccessBC campaign. There –– we are still working across Canada to make sure that contraception is free and accessible to the public. So while we're not based in other provinces, we're pretty B.C. localized. We're supporting a lot of sister campaigns across Canada to try and ensure that they can also have access to pre-contraception.
It's kind of a value that we stand for, as I mentioned earlier, we want everyone to have access to the choice for what they want to do with their body and how they want to go about it. So this is just one issue that — it's only the beginning. That's the way that I want to say it. And because the pain management campaign is just so new, it's so young, I don't know what our next campaign might look like, but I can tell you just based off of the way that this campaign was formed, a lot of the times it's, “Okay. So we heard the public telling us there's a barrier to something within reproductive health care. What can we do about it?” And then, for example, we were able to make contraception free, but there's still another barrier, that being pain. And then perhaps when we are able to accomplish this goal, they're going to come and tell us, “Hey, there's something else.” So I think a lot of our campaigns are going to be informed as landscapes change, as people's needs change, as the economy changes, and just trying to be able to address the concerns that our communities actually have.
Rae Dawson: I think it's so exciting that B.C. is potentially going to be a leader in reproductive care across the country, and also set the standard going forward. What methods beyond just letter-writing does AccessBC mobilize?
Sara Sunderji: So we do use a bunch of methods when it comes to advocacy. So, for making pain management accessible and achieving each of those four asks, we have lobbying. So we have almost 100 volunteers from so many different walks of life, all walks of life, who support us in our efforts. And they help with lobbying, they help with speaking to the general public, and to also speaking with change makers and other stakeholders and decision makers across the country, there's so many different methods. I'll kind of leave it up to Anahita to elaborate on more, but we use a lot. Obviously, it changes based on the landscape at the time.
So right now we're prioritizing media communications, speaking with our MLAs, speaking with decision makers, like I mentioned, we have a lot — we've had a lot of promising conversations with individuals at the national and the provincial level. And we also work with our sister campaigns to kind of help give more weight to our asks and to our efforts.
Anahita Seraji: And to add to that, there's definitely a very big educational component of it. So whether it's with our briefing paper, the research that we do, the things that we post on our social media, one of the major goals is education. Like I mentioned, oftentimes, the people in our community, just the average everyday person, they know there is something that's missing, they just don't know the full story why it's missing, and they don't know that they have the right to be demanding care that is going to be tailored to what they want, care that does not have to be painful, and be able to make decisions –– like I've said before, it's actually based on what they see for themselves, what is ideal for them, their lifestyles, their beliefs, and their choices.
So there's a huge educational component, and I think that has got to be one of the most impactful things that we could do. Because when we mobilize as a community, as a whole, and we're able to all be advocating for the same thing, the same rights, that is going to be very, very impactful while we are sitting with decision makers. Because we have a whole community of support behind us that are helping us make these changes actually possible.
And we're not only focusing on our own goals, the four asks, but we're also, as Sara mentioned, we have a lot of sister campaigns and just partners. So we could have physicians that write us a letter and they tell us, “Hey, this is what's going on. This is a barrier for me to be able to provide the care that I want. Could you help me?” And so we do also try to amplify the voices of people who are facing barriers when it comes to providing equitable care.
Sara Sunderji: Something that was really incredible, and me and Anahita, I believe we spoke about it a little bit, was when we actually had a person who was awaiting an IUD email us and say, “How do I go about this?” So it really goes to show that our briefing paper and the research that we do helps build capacity in both patients and providers. So building that knowledge and allowing and enabling and empowering them to be able to provide this comprehensive care, and that's the underlying principle, I think, in our campaign, is capacity building.
Rae Dawson: I'm sure it's very encouraging for young people and students to hear that there is a resource to turn to with those questions you might have if you're pursuing having an IUD, especially when you're entering into the medical world for the first time as an adult, often, for a lot of students. There's a word that I'm hearing us use a lot in this conversation, which is reproductive justice. Can you tell me a little bit of what reproductive justice actually means?
Anahita Seraji: So reproductive justice, it can have different meanings for different people, but one of the ways that AccessBC defines it is that we want people to have full bodily autonomy and to be able to make that possible, we want to tackle barriers, whether it's religious, race based, medical based, identity based in any way, financial, economic, all of these factors. We want to tackle these barriers that keep people from being able to make decisions that align with who they are when it comes to accessing reproductive health care.
So that could be in terms of the front lines, as we've talked about, their interactions with a physician when trying to get access to an IUD or any other form of reproductive health care. It could be in that sense, or it could be a bit more systemic. So right now, again, we're facing a barrier where there are a lot of physicians who want to provide pain management, but they're not able to because of systemic barriers. There's a lot of people who have not gotten the care that they should have with the dignity and respect that they deserve because of these systemic barriers, because of all the barriers they're facing.
Sara Sunderji: Reproductive justice, at least to me, and I think in the context of AccessBC, is just ensuring that every individual is able to make decisions about their own body, their own reproductive health, and that they're not prevented from achieving whatever their goal is when it comes to their reproductive health. Whether it's a decision to conceive a child, or whether it's a decision to receive an IUD, the full spectrum of any sort of reproductive procedure, that they are able to get what they want out of that appointment, and that the individuals who are providing that care are also able, without barriers, to provide that care and to give the patient what it is that they need and what it is they deserve and what it is that they want.
Rae Dawson: Absolutely. I'm sure that success for this campaign means having those four legislative requests that we talked about met. But I'm curious about what you guys think full reproductive justice would actually look like in an ideal world in B.C.?
Sara Sunderji: I think it would look like — well, I mean, the vision is incredibly — is something that you work a really long time to achieve, but our goal is to see a B.C. where there are no rural health disparities, meaning your ability to achieve, at least in this context, pain management for an IUD insertion doesn't depend on your postal code, and that regardless of what physician or what provider you go to, in order to receive this healthcare service, you are receiving the exact same quality of care, meaning that the same options are provided. There are no barriers for a physician to provide those options in the sense of billing or training, and that each patient can walk away receiving comprehensive pain management and being satisfied with their IUD experience, not leaving with further trauma, which will then implicate them in their life going forward.
Rae Dawson: That definitely sounds ideal to me. Sign me up. I'm curious about what difficulties you guys have faced during this campaign?
Anahita Seraji: I think definitely as a starting point, knowing where to start, knowing how to tackle the issue, knowing who to talk to, has been very, very difficult. I definitely think, Sara and I — we’re not doctors. We're not physicians. We're basically the audience, we're students. We're around the same age, so we're starting with no background knowledge, and everything that we have learned has just been based on what is accessible to us through a Google search or the conversations that we've had with our connections, the physicians, the partners, and so on.
But there's definitely a lack of transparency when it comes to who is in charge of making what decisions, how to get in touch with them, how the decision-making process goes. So it has been kind of difficult for us to identify the groups to talk to and how to actually go about that, and it feels like every conversations that we had with again, our partners, we’re learning something new about all the barriers in the background.
Like, you go into a physician's office, you're getting an IUD, and it is perfectly understandable if you're walking out of that office, if you haven't been offered pain management, and you're upset, and you're like, “Gosh, I can't believe this is the care standard that — or the standard of care that we're getting today.” But when you learn that there's a lot of physicians who are losing money just because they want to provide the care that they want for you, the fact that they're people too, and a lot of them are willing to — that they're okay with that. They're okay to pay out of pocket for providing pain management because that is their ideal for the care that they want to provide for their patients.
A lot of the times, you're not hearing these conversations in public, and we didn't know about it until we had conversations with the physicians that are helping us. And so it has been very difficult, because –– from the patient perspective, from the outsider perspective, we're a little bit blind to what's going on systemically, what the barriers are, and just figuring out what leverages we have to be able to have meaningful change that has been really challenging.
Sara Sunderji: Yeah, and some other difficulties are definitely — it's a learning process. I think every successful campaign you consistently learn new things, and your campaign view and your approach shifts as you learn more and more and more. And in this case, as we've started our campaign, and now we're in — the campaign has been launched for, I would say, a couple months now. We're learning about more stakeholders, and identifying more stakeholders, and having to strategize on building their capacity. It really does come down to capacity building. So going into it when we hadn't done any research, I think our primary concern was, patients are not receiving pain management. But as you dig deeper, you learn that, okay, well, not only are patients not able to receive pain management, providers are unable to provide pain management due to a multitude of barriers. And then on the back end, the province is unable to provide expanded coverage because of x, y, and z.
So it's kind of this rolling effect, where you learn more and more and more, and there's so many different dimensions to it. And I think that is a difficulty that me, Anahita, and the entire team have kind of learned to expect and we're familiar with, but initially it was definitely daunting, and it kind of hindered our optimism a little bit. And also this idea of like — and I think this is really important for students to know, because a lot of individuals want to enact change, and you're kind of scared to start. But a difficulty that we experienced was, we're asking the province, we're asking these stakeholders, but we're going into these meetings not really knowing what that exactly looks like, because that is part of the conversation with the province and with training institutions and with different stakeholders.
So a difficulty would be being comfortable with uncertainty and being comfortable in unfamiliar territories. And I think that's something that we definitely learned over time, and we're continuing to learn, but that is a difficulty that a lot of individuals in advocacy will experience and encounter.
Rae Dawson: I love what you're saying about the work being building capacity and being okay with vulnerability and uncertainty. I think that both of those things are exactly what stops people from organizing or doing advocacy work, that feeling of not really knowing what you don't know, or not really knowing where to start. I'm glad that you guys at AccessBC have found ways to overcome that in your commitment to tackle these issues. On the flip side, can you share an anecdote of a time that you felt AccessBC was successful in its goals?
Anahita Seraji: I think definitely after the success of the prescription contraception campaign, having people tell us that, “Hey, I've been wanting this one form of contraception, and now I finally get to have it.” And a conversation that I always try to bring in is that contraceptives are not just used for contraceptive purposes. There are a lot of different reproductive health concerns that you can have, and contraceptives could be an adequate form of treatment for that. So we're not only helping people feel empowered to make their own choices when it comes to contraception, but also actually take care and treat a lot of other reproductive health concerns.
So hearing stories of people be like, “I had x condition, and now I could afford y contraceptive,” that is really, really impactful. And then also, even with our current campaign, with the IUD pain management, we had a rural family physician that has been working for 30 years in northern eastern B.C. write us a letter. And they kind of explained that it's very important the work that we're doing, and that this has been a barrier that they have been facing, and that the solution should be simple. We should be able to provide pain management, at least those that are available, in almost every clinic. And I think it's incredibly validating to hear that the work that we are doing is things that a lot of physicians across B.C., and probably beyond, have been wanting to do. And like you said, sometimes it's — there's one issue, and then you try to dig in, and there's so many other issues, it's very difficult to be able to tackle all of it and find the capacity. You really do need a village. And it's really nice to hear anecdotes like that from our supporters.
Sara Sunderji: And I think that in terms of this campaign, specifically, when we did some of our media, the reporter would come up to us and — came up to me specifically, and this is just my own personal memory and way that I measure success — and she said that, I'm incredibly happy that you guys are doing this, because for the longest time, I was so anxious about getting birth control, or even asking for birth control, because a lot of individuals just didn't know that it could be used for her condition, which was endometriosis. And she's — just hearing that, success isn't necessarily measured on the long — a wider picture, sometimes it can be just one person. And seeing that that one individual benefited from our campaign, in terms of knowledge, and was passionate about the future work that we're going to do was a measure of success for me, and I always reference that when I'm thinking about long term goals for AccessBC, because it just shows how even educating one person or empowering one person, she'll then go on and educate other individuals. So it's really, it's kind of a snowball effect.
Rae Dawson: Thank you. I'm curious for the two of you, what impact has working with AccessBC had on your own personal life?
Anahita Seraji: So, for me, personally –– first of all, I love this team. Everyone I have met has been so incredible. So, just the process of going through all the grunt work, reading through the research, and strategizing, I think it's a lot more fulfilling because the team of people that we work with, they're just so genuine. They're just such incredible people. And Teale, our co-founder, he is one of my greatest mentors, he's one of our greatest supporters. So it really is a village of incredibly supportive people that want access to basic care and to see how many people there are and how much support we have, it's incredibly fulfilling for me to do our work. It makes me feel good about just going out into the world, and also it has kind of made me the designated IUD person in my social circle.
So this isn't — it's kind of become more of an identity, it's not even just a campaign. It's who I am as a person, it's what I stand for. I do a lot of women's rights and gender equity work, and it feels good to know that, at least the people in my immediate circle, they have someone that they could talk to about this and that there's a conversation being had about it.
I didn't grow up talking about these things. I think we're still — there's definitely a level of stigma. So I — it makes me feel very good that I'm part of this mission, and that I'm able to educate people and start a conversation and see a real impact in the communities. It's so, so fulfilling.
Sara Sunderji: Well, I will say, Anahita echoed everything that I was going to say, which is, we have such an amazing team. And I know everyone says that, but I really do mean it. We have forged a lot of connections, and I think that's influenced my personal life, because now I can say I have friends from the campaign, and some of the people that I work with on the campaign are my closest friends and confidants. So it has strengthened my own personal circle, my support circle.
And, like Anahita said, I also, I didn't grow up talking about this either, talking about reproductive justice and just women's reproductive health in my household was not spoken about. You know, periods, or having cramps, or puberty, even something that small wasn't really spoken about, because I came from a very conservative family. And, I mean — I come from a very conservative family, I haven't left them yet! But, I didn't grow up talking about this.
So now it's really interesting, because these conversations are being held in my own household. And I mean, yes, I am the one starting it, but it's not met with as much hesitation. Initially, when you bring up something that you really shouldn't bring up, you can see everyone get a little tensed, but it's more — it's become more and more normal, and we're normalizing something that for the longest time has been considered abnormal, or has been considered taboo. And I think that is something which is really remarkable to me, and just demonstrates how you can be a change maker at so many different levels, the community level, but also the personal level in your own household, and I think that was really informative and remarkable.
Rae Dawson: I'm so glad that you guys have both been able to meet that culture of shame with care and education. To be able to step into a world where information about reproductive health is easily available is definitely a long-overdue change, in my opinion. Just before we sign off, how can students get involved with you guys, if they want to?
Anahita Seraji: So you could look up our website, it's accessbc.org. At the top of the website, you're going to see a little bit of a banner, and one of the tabs is going to be “contact.” You click on that, you'll see a button on the bottom left-hand side that says volunteer intake form. Fill out the form, and then you could become part of the family!
The way that we're running things right now, whatever you want to do, we're happy to take the help. You don't have to be stuck to one role if you have any capacity, or even if you're looking to learn and expand your skill sets, AccessBC is a team where you could do that. So, for example, if you want to be more involved in the policy aspect of things, you don't have any experience, like I said, it's a very supportive team. There's a lot of mentors, and we can help onboard you [to] that and we teach you how to go about it. We are looking for people to help with social media, social media is a huge thing. I know our generation, we're very involved with social media. So that's definitely a capacity — and just a lot of leadership roles helping organize the campaign, mobilize teams to be able to actually deliver a lot of our campaign asks, the outreach work and things like that.
Sara Sunderji: And it's important to note that we have, we have no paid staff, so all our funds are donated, and they support our advocacy work. So there's also room for helping us secure small grants from allies, also communicating with the public, because we do rely on funding from generous members of the public, helping with lobbying, helping with developing the campaign, more and more and more, so creating merch. There's a lot of flexibility, but we really do rely on the help, because we are a group made of volunteers from across the province. So, more volunteers, the better.
Anahita Seraji: So, you could just go on our website, and that's accessbc.org on the contact page, at the banner, and just fill out the — if there is something that you want to share with us, any testimonials, you could definitely fill it out there, or you could fill out the volunteer intake form.
Rae Dawson: Awesome. Thank you guys so much, Sara and Anahita, for coming on the Nest today. I wish you nothing but the best on this campaign, and best of luck.
Sara Sunderji: Yeah, thank you so much for having us, and we really appreciate speaking with you today.
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Rae Dawson: Thanks for tuning into the Nest, a podcast by UVic’s independent newspaper, the Martlet. You can read the latest edition of the Martlet’s publication on martlet.ca or find us on Instagram as @humansofthemartlet, or on BlueSky, TikTok and LinkedIn as @theMartlet. Interested in getting involved? Email info@martlet.ca to learn more about volunteer writer, editor, and design positions.
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Rae Dawson: And now a note from the Martlet fact-checking team.
At 15:51, Sunderji says “there's a very small amount of providers who actually are specialized in sexual and reproductive health care, and would be the ones who are able to provide you with comprehensive pain management.” The Martlet could not verify this fact.