Meet the people trying to improve Indigenous patients’ experiences

Funding to address racism in Canadian healthcare is supporting research on Stanton Hospital’s Indigenous wellness program – a service some patients have never heard of.

Anastassia Judas, a senior Indigenous patient advocate at Yellowknife’s Stanton Territorial Hospital, says she’s excited to work on the research because of the potential it has to change the way Indigenous patients experience healthcare.

“As an Indigenous person growing up in the community of Yellowknife and the small community of Dettah, I often think of my grandmothers when they used to go to Stanton to access care and how uncomfortable they felt when they went there,” said Judas.

“I hope to see other grandmothers and grandfathers and people – my people, Indigenous people, Inuit people, Métis people – just feel comfortable and safe when they’re going to receive healthcare services. Everybody should be treated equally and we know that racism is in our healthcare system. We know that, we hear it.”

The research is a result of a project initiated by Healthcare Excellence Canada, a non-profit backed by federal funding that has established a cultural safety design collaborative.

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Healthcare Excellence Canada says that means “a two-year quality improvement and patient safety initiative that brings together teams from across the country to develop and implement a project to address racism experienced by First Nations, Inuit and Métis in the health system and foster cultural safety.”

In the NWT, a steering committee comprised of mostly Indigenous staff working in healthcare decided that collaborative’s work could best be targeted locally at Stanton’s Indigenous wellness program.

The overarching goal is “to address the racism that’s felt by our Indigenous patient clients and resident population,” said project manager Preet Dhillon.

Dhillon says the committee selected the Indigenous wellness program because its reform would have a widespread effect on patients from all 33 communities in the Northwest Territories.

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Further, Judas says the program is not well-known among patients at the hospital.

An NWT health authority video about the Indigenous wellness program.

The Indigenous wellness program offers services and supports to Indigenous patients receiving treatment at Stanton, including translation and communication help, access to traditional food and cultural programming.

“The work that they do is helpful to our Indigenous people, but there’s so much more they can be doing to help serve our Indigenous residents,” said Judas.

“We’ve also heard a lot of good things about the care they receive from the staff, the nurses, the physicians and the Indigenous wellness program. But I think there’s a lot of work to do to improve the care and experience for patients.”

Canada has a long history of anti-Indigenous racism. The North is no exception.

“Over the years, any time we had our people going to the health centres, they’d just turn them away and gave them pills,” said Dehcho First Nations Grand Chief Herb Norwegian.

“So what’s become of these centres? They’ve become kind-of like Tylenol centres – that’s what they’re calling them.

“The horror stories you hear from people in the communities. People are really shy to go to the doctor, they’re scared to go but they still go because they’re really in bad shape. They’re misdiagnosed, they’re given the wrong kind of treatment, and of course the travel is such a big one.”

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Meaningful change

Judas says she is working on this research in the hope that its findings will be implemented in and adapted to health service centres across the territories.

In February and March, the project heard from patients and staff at Stanton and elsewhere. The majority of hospital residents attending sessions were Elders, Dhillon said, adding sessions in communities were also an important part of the work.

Łı́ı́dlı̨ı̨ Kų́ę́ First Nation Chief Kele Antoine said he spoke with residents who attended a session held in Fort Simpson, which he said addressed topics like racism, issues with medical travel, language barriers and the resulting stress and anxiety.

“In terms of PTSD and residential school-type trauma, it’s very difficult for people in that state to constantly have to go and see new doctors and relive their problems every time they see a new doctor,” Antoine explained, referring to the high turnover among northern healthcare staff and reliance on short-term locum doctors and nurses.

One researcher on the project, Glenda Simon, had a background in nursing before she became a senior Indigenous patient advocate.

Simon helps residents, some of whom are Elders and residential school survivors, to navigate the healthcare system and advocates for them.

“I have experienced racism myself and it hurts. It makes me cry when I see other people who have experienced racism,” said Simon.

“They have to be seen as an equal in the healthcare system. When our Indigenous people walk into the health centre, they shouldn’t feel scared. That door is open for a reason, it’s to provide care.”

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Researchers are now analyzing the data collected to create “actionable items” to include in a quality improvement plan, according to Dhillon. That phase will conclude in March 2025.

“I’m confident the changes we’ll make will be meaningful for our Indigenous patients, whether it be tomorrow or a year from now,” said Dhillon, “taking that information and translating it into tangible changes that our clients eventually experience.”

‘We have a voice’

Health minister Lesa Semmler said this work is in line with her office’s vision for a more “holistic approach” to healthcare.

“Making sure that there’s equitable access for everybody, we’re trying to model that,” said Semmler. “Where you feel like you’re being seen and your issues are being recognized and you’re feeling safe and respected in this planned care.”

Even so, Norwegian said barriers to healthcare for Indigenous residents run deep.

He recalled in his lifetime seeing residents living on the land less and less, and noted the consequences for their health and well-being.

“As soon as people left their trap lines and cabins and moved into communities, their diet and everything else, life, has changed. Their body has taken a toll,” said Norwegian. “It’s a shock to the community as well as to the body.”

Norwegian said leaders needs to help Indigenous residents access the land to meaningfully address racism and improve access to healthcare. He said communication with the territorial government is another factor affecting successful healthcare experiences for Indigenous residents.

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“There needs to be a direct relationship with the First Nations,” said Norwegian. “The First Nation there should know what members are going to need some treatment and what they’re going to require… it’s all about preparation.”

Antoine said he’s been hearing about issues with healthcare for years.

“Medical travel, pains and headaches, and also just the lack of aftercare, which I think is the biggest factor contributing to the ongoing healthcare crisis in the North,” he said.

“Our people aren’t getting the care that you would in a bigger centre, so a lot of issues tend to build up and become bigger issues.”

Semmler says she has heard Indigenous leaders voice their concerns.

To better manage complaints, the department has established an Office of Client Experience.

“If people are feeling like they’re not getting the care that they need, they need to go bring it forward to the Office of Client Experience,” said Semmler. “They can look at any issue you bring forward.”

Semmler said it’s important that residents know they need to contact the office directly to have issues investigated. Stories circulating on social media or communicated through word of mouth won’t be looked into.

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Another advantage of the office is its potential for data collection, the minister said.

All complaints are documented and compiled into statistics, which Semmler said will be used as evidence to direct change in her department.

Simon wants to promote the Indigenous wellness program as much as possible, because she says it’s there to help Indigenous people and “guide them safely through the healthcare system”.

With this new research under way, Simon said she believes residents will have more of a say in how healthcare services are delivered.

“This project may not seem like a big thing, but to us Indigenous people it is,” said Simon.

“We have a voice and we need our voice to be heard loud and clear.”

Correction: May 29, 2024 – 13:38 MT. Originally, this article stated a steering committee that decided how to spend funding for this project was convened nationally. In fact, that specific committee was NWT-based.

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