Crystal John has made it her life’s work to create safe spaces for Black women to receive health care and share resources.
John earned her master’s in social work in 2020, but her activism began decades before.
“My whole work for the last 20 years has been about really empowering women, using my voice and my profession to inspire women to create their own space and have their own voice,” says John, who works as a clinical therapist at the Nova Scotia Sisterhood.
She says it’s challenging to navigate the health care system as a woman already — but there’s added barriers for women of colour.
“There just isn’t enough research on the issues that are specific to women. And then the intersection of being a Black woman means that although we want to include Black women, there isn’t a specific lens on the things that medically happen with us, right?” John says.
“I think of endometriosis and PCOS — you know, those numbers are disproportionately higher in the African Nova Scotian communities, but we are not addressing them because research just does not allow for that.”
John’s family is from the African Nova Scotian community of Cherry Brook, but despite her deep connections to the Preston Township area, she grew up in Mulgrave Park — a neighbourhood in Halifax’s North End.
John’s community has historically been isolated from provincial health services. Growing up, she would see women going around to homes in the community, but wouldn’t discover they were social workers until she was older.
“They were always white women… I didn’t ever see a Black social worker,” John recalls. “And so, making those connections as a child growing up in the education system, if you don’t see somebody who represents a profession we just don’t think of it, because it’s like, ‘Oh that’s not something we do,’ and so representation matters.”
It’s something that drove her to eventually pursue social work as a profession.
Due to racial discrimination systemically embedded in health care systems across Canada, John says it wasn’t routine for the women she knew to go for health check-ups.
In her 30s, John created a community group that brought together North End mothers to discuss their health and that of their children.
“And we talked about, have you gone to get your cancer screenings? Have you had your mammogram? Have you, like, have had your Pap smear?” John says.
“And it was a way for me to check in on my friends to ensure that they didn’t repeat the historical trauma that their mothers and aunts and grandmothers have experienced by not going to medical facilities.”
But today, in 2025, this historical racism across health care systems still discourages Canadian women from seeking care.
According to a November report, Voices Unheard, by The Black Women’s Institute for Health, a survey of nearly 2,000 Black women found about 42 per cent have delayed or avoided seeking care due to concerns about how they’d be treated.
In addition, 67 per cent said they have felt dismissed or not taken seriously by a health care provider.
Dr. Toni Sappong is a family physician at the Nova Scotia Sisterhood. She says these findings, while concerning, aren’t surprising to Black women.
“They (the Black Women’s Institute for Health) not only identified the problems that Black women face in the health care system, but they also identified some solutions,” Sappong says.
And one of those spaces is the Dr. Maria Angwin Memorial clinic in Dartmouth, which houses the Nova Scotia Sisterhood, an all-Black female team of health care professionals.
The Sisterhood has been active since 2022, but recently moved into their new home at the clinic on Wyse Road.
It’s an initiative under Nova Scotia Health’s primary care division that aims to provide culturally adaptive health services to Nova Scotians of African descent.
In a statement, Nova Scotia Health says, “these dedicated services help address the impacts of institutionalized discrimination and racism …by reducing barriers that have historically prevented communities from seeking or receiving equitable treatment and strengthening trust in the health system.”
When a job posting at the Nova Scotia Sisterhood came across John’s desk in early 2023, she jumped at the chance to apply.
“I thought, this is my next chapter,” John says. “This is what I can do to really help support Black women in this province manage wellness in their lives.”
She says the feedback her team gets for the work they do is overwhelmingly positive.
“I well up when I think about, you know, the women saying, ‘You guys have saved my life. Literally saved my life,’ right? And I think, that’s a big responsibility,” John says.
“But it is simply because we’re doing what we’re supposed to be doing — we’re making sure that we’re giving them well-rounded primary care.”
John says when women walk into their clinic space, they often breathe a sigh of relief.
“They are experts in their own lives. They know their bodies. They know what they feel, and they just have not had space,” John says.
As the health authority continues to expand and make improvements, John would like to see it look to the Nova Scotia Sisterhood for inspiration and investment.
“I am excited for when the Nova Scotia Sisterhood Initiative becomes a Nova Scotia Sisterhood Clinic with a full-time doctor,” John says. “We have one clinical therapist, that is me… I’m building a case for a second because there is that much need.”
And beyond the Sisterhood, John envisions an African Nova Scotian health care centre, built to serve Black patients from a place of cultural understanding and acceptance.
Nova Scotia Health adds it’s “committed to continuing its work with African Nova Scotian communities and partners to improve culturally safe care across the province.”
Besides John’s role as the program’s clinical therapist, the Nova Scotia Sisterhood team consists of a family practice nurse, family doctors, a nurse practitioner, a wellness navigator, a registered dietitian, and a community liaison.
John says mental health is heavily stigmatized in society, including in African Nova Scotian communities, despite it being an essential component of everyday wellness.
“You might go for your pap smear, but you would never tell your doctor that you’re seeing visions or hearing voices, right?” John says. “You just wouldn’t do it because you’re so afraid that they might just lock you up as opposed to investigating what’s really happening.”
But John says the Sisterhood program has allowed women to take care of their mental health, without fear.
“I have a wait-list of 20 women who are waiting to see me, because… they would rather wait to see me than go to our Mental Health and Addictions system and see somebody who they have to explain to who they are — their culture,” John says.
“I love the clinical piece, but I also have resources for them,” she says. “So, ‘Oh, this is going on here? Let me refer you to this person.’ ‘Give this person a call.’ ‘We have our wellness navigator who can attend that appointment with you if you’d like.’ Those kinds of things are really important for women.”
And with many deaths in the community over the past decade, John says it’s important for African Nova Scotian women to have an outlet for their grief.
“I can name a number of young men who have died violently, and that impacts our whole community, right?” John says. “Most people say in life, there’s six degrees of separation. In our Black community, it is zero degrees of separation.”
“So, that kind of pain and loss and suffering — PTSD — those kinds of things don’t get addressed a lot of times in a culturally adaptive way.”
Which makes the work of the Nova Scotia Sisterhood so unique.
“I still think, ‘Oh, pinch me.’ I’m doing the best work of my life, really,” John says. “I’m so honoured that women allow me to support them.”
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