Why Indigenous health professionals matter
Turning Evidence Into Action
for Women’s Leadership
The challenge
Since March 29, Six Nations of the Grand River has been limiting access to their reserve through an initiative called Project Protect Our Elders. Nations across the country, such as the Haida Nation on Haida Gwaii, have similar restrictions.
Now more than ever, it’s time to think about the critical role health professionals play in rural and remote Indigenous communities.
1 In 2014, when the 2019 target was set by Status of Women Canada, women’s representation on boards across Canada sat at about 10 per cent. Status of Women Canada, “Increasing the Representation of Women on Canadian Boards,” last modified November 28, 2016, accessed December 18, 2019, https://cfc-swc.gc.ca/abu-ans/wwad-cqnf/wldp/wb-ca/rep-rap-en.html; Melissa, Bennardo, “Women Hold Less Than 20% of Positions on Corporate Boards, StatsCan Finds.” CBC News, May 7, 2019, accessed December 20, 2019, https://www.cbc.ca/news/business/statistics-canada-women-corporate-boards-1.5125995.
2 Examples include Catalyst, Gender Diversity on Boards in Canada: Recommendations for Accelerating Progress (Toronto: Government of Ontario, 2016); Osler, Hoskin & Harcourt LLP, 2019 Diversity Disclosure Practices: Women in Leadership Roles at TSX-Listed Companies (Toronto: Osler, Hoskin, and Harcourt LLP, September 18, 2019); accessed January 24, 2020, https://www.osler.com/osler/media/Osler/reports/corporate-governance/2019-Diversity-Disclosure-Practices-Women-in-leadership-roles-at-TSX-listed-companies.pdf; Canadian Securities Administrators, CSA Multilateral Staff Notice 58-311: Report on Fifth Staff Review of Disclosure Regarding Women on Boards and in Executive Officer Positions (Montréal, CSA, October 2, 2019), accessed December 20, 2019, https://www.osc.gov.on.ca/documents/en
/SecuritiesCategory5/sn_20191002_58-311_staff-review-women-on-boards.pdf; Canadian Board Diversity Council, CBDC Annual Report Card: Advancing Diversity Leadership on Canada’s Corporate Boards (Toronto: CBDC, 2018), accessed December 20, 2019, https://phasenyne.com/wpcontent/uploads/2019
/03/ARC-Annual-Report-Card-2018.pdf.
The threat of COVID-19 looms large for many rural and remote Indigenous communities in Canada. These communities are especially concerned about the vulnerability of their Elders and the irreplaceable knowledge they hold.
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It would make a huge difference to have Indigenous health professionals because they know their own communities and know what the needs are, and they know their own network of communication.”
Darlene Sanderson
Messaging matters
At this stage of the COVID-19 crisis, containment of the virus is key. And containment relies on public health messaging for success.
Health professionals working in rural and remote Indigenous communities need to use a variety of communication networks. Whether the platform is Facebook, community posters, local radio and newspapers, or word of mouth, the messaging should reflect the social realities of remote communities and be sensitive to local perceptions of the health system and its colonial legacy. Local Indigenous health professionals and trained community members are better able to understand that community context and convey it to their colleagues across the health system.
During this crisis, Indigenous health professionals have wasted no time in creating support networks. On March 21, Idle No More and Indigenous Climate Action arranged an online fireside chat. This event brought together seven medically trained Indigenous health professionals from Canada, the U.S., and Australia. All seven were connected to Indigenous culture and community.
More than 400 people tuned in to the fireside chat. Discussion topics ranged from common questions about the virus, to the challenges of self-isolation in multi-family homes, to using traditional foods and medicines for wellness. Similar conversations are happening across the country as Indigenous families and communities seek trusted advice in uncertain times.
Indigenous communities have fewer health professionals
Our March 26 blog post pointed out that many Indigenous communities are served by far fewer medical professionals per capita than non-Indigenous communities across Canada. At the same time, First Nations, Inuit, and Métis people are under-represented in almost all science, technology, engineering, and mathematics (STEM) fields—and that includes the health sciences.
Culturally safe health practices
Indigenous COVID-19 patients who need to enter the hospital system will expect culturally safe health care. Cultural safety in medicine can mean offering patients complementary care options, including access to traditional Indigenous healers. It can include access to plants and foods that Indigenous communities have used for millennia in the face of disease. It can also mean taking a holistic approach that encompasses the spiritual dimension of healing. This presents an opportunity for Indigenous and non-Indigenous healthcare providers to collaborate and develop holistic approaches that could better serve all Canadians.
Strategies for the long term
COVID-19 is a wake-up call for increasing Indigenous representation in the health professions. Efforts to address the gap should not fall by the wayside as we ramp up into crisis mode.
Many Canadian universities now have access programs designed to help Indigenous students move into health careers. For example, Thompson Rivers University (TRU)’s Indigenous Pathways for Health Careers program has a suite of supports that help Indigenous learners in British Columbia move into nursing and other health careers.
In addition to doing outreach to high school students, TRU has upgrading and bridging programs for mature students who lack high school diplomas, along with bursaries, tutors, and social services designed for Indigenous learners on campus.
Indigenous professional associations play a role too. In 2009, the Canadian Indigenous Nurses Association helped draft the Framework for Cultural Competence and Cultural Safety in Nursing Education that has guided nursing curriculum reform in universities like TRU. Now, all TRU nursing students must complete a mandatory course about Indigenous approaches to health and wellness.
It is increasingly accepted that Indigenous cultural competency is an essential skill for all healthcare professionals who will practise in Canada. Indigenous student representatives
of the Canadian Federation of Medical Students work hard to help classmates and teachers increase their cultural awareness through guest speakers, panel discussions,
and cultural experiences. In these high-pressure roles, Indigenous students often have to be frank about their personal lives, their communities, and their experiences as Indigenous medical students—with the goal of reducing racism and broadening cultural awareness in medical school and, ultimately, in the medical profession.
Eye on the future
More Indigenous people in medical schools and healthcare professions will improve awareness, challenge assumptions, and change norms, ultimately creating a more culturally safe healthcare system.
In the short term, Indigenous communities are mobilizing to protect their members—especially their Elders—and their livelihoods. And for the long term, they’re working to provide culturally appropriate, improved healthcare within the context of current Indigenous realities.
Darlene Sanderson
The wider community needs to know that the space needs
to be provided—within the context of hospitals—for traditional medicines to be used.”
Yotakahron Jonathan
National Officer of Indigenous Health,
Canadian Federation of Medical Students
What’s important is that we have more Indigenous people in the field, because not only can the patient feel safer and can trust us a bit more, but we are role-modelling for future generations.”
Jane Cooper BA, MSc
Senior Research Associate
Erin Macpherson, MSc
Research Associate
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Darlene Sanderson
Coordinator, Indigenous Pathways to Health Careers,
Thompson Rivers University
Communities and the leadership are really stepping up to educate on how people’s actions will really protect the Elders.”
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