We call upon those who can effect change within the Canadian health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients.
Indigenous Watchdog Status Update
|Current Status||June 14, 2021||IN PROGRESS|
|Previous Status||March 31, 2021||IN PROGRESS|
Why “In Progress?”
The federal government response focuses on specific programs and services as opposed to the broader strategy and policy recommendations adopted by national health advocacy organizations: HealthCareCAN, Canadian Medical Association, Royal College of Physicians and Surgeons, Indigenous Health Alliance, Canadian Partners Against Cancer, Dalla Lana School of Public Health Waakebiness-Bryce Institute for Indigenous Health.
United Nations Declaration on the Rights of Indigenous Peoples. (2007)
1. Indigenous Peoples have the right to maintain, control, protect and develop their cultural heritage, traditional knowledge and traditional cultural expressions, as well as the manifestations of their sciences, technologies and cultures, including human and genetic resources, seeds, medicines, knowledge of the properties of fauna and flora, oral traditions, literatures, designs, sports and traditional games and visual and performing arts. They also have the right to maintain, control, protect and develop their intellectual property over such cultural heritage, traditional knowledge, and traditional cultural expressions.
2. In conjunction with Indigenous Peoples, States shall take effective measures to recognize and protect the exercise of these rights.
Medical Organization Commitments to Indigenous Health and Healing
Canadian Public Health Association
The Canadian Public Health Association is the independent national voice and trusted advocate for public health, speaking up for people and populations to all levels of government.
Policy Statement: Indigenous Relations and Reconciliation, October, 2019
CPHA acknowledges that health is a basic human right and the Association takes a public health approach to achieve health for all. A public health approach aligns with the need to adopt culturally appropriate practices for meaningful relationship- building with Indigenous Peoples…When building relationships with Indigenous partners, CPHA recognizes and respects the diverse knowledge systems of Indigenous Peoples. Indigenous ways will be equally valued and interwoven with public health approaches.
The 2015 final report of the Truth and Reconciliation Commission (TRC) put forward 94 Calls to Action that frame the national processes of reconciliation.1 These Calls to Action directly impact many pathways for improved health of Indigenous Peoples in Canada, including land, economy, culture, health, education, law, and governance.
CPHA envisions a future when reconciliation is meaningfully embedded in all aspects of its work and the Association establishes and maintains relationships with Indigenous Peoples based on mutual respect, trust, and dialogue.
In support of its policy goal, CPHA upholds the following principles:
- Public health is based on respect for the well-
- being of all people and their intricate links to the natural environment.
- The realization of TRC Calls to Action and the implementation of the articles of UNDRIP are essential to the health and well-being of Indigenous Peoples.
- The jurisdictional and legal context of treaties and the rights of Indigenous Peoples are relevant to the implementation of effective public health services.
- Indigenous law and governance systems are recognized and upheld.
- The rights, knowledge, protocols, and traditions of Indigenous Peoples are respected.
- Indigenous Peoples are encouraged and supported to train for and work in public health, and celebrate the strengths, skills, and knowledge they bring to the profession.
- The diversity of Indigenous Peoples and their right to self-determination are inviolable.
Indigenous Health Alliance
The Indigenous Health Alliance was a 3-year project that arose in response to the Truth and Reconciliation Commission calls to action for health. It has a mission to eliminate the differences in quality of care between indigenous and non-indigenous patients. Most important, it is through a process led by indigenous peoples. In addition to many other first nations and territorial organizations, our members and supporters include:
- The Royal College of Physicians and Surgeons of Canada
- The College of Family Physicians Canada
- The Canadian Medical Association
- The Assembly of First Nations, and the
- The National Indian Residential School Survivor Society
Canadian Medical Association
Feb. 27, 2021: Toronto Star – Dr. Alika Fontaine from Treaty 4 territory in southern Saskatchewan is the new President of the Canadian Medical Association. The CMA unites the medical profession in Canada to improve the health of Canadians and strengthen the health care system. Lafontaine co-led the Indigenous Health Alliance from 2013 to 2017, a “health transformation project” involving 150 First Nations and several national health organizations. Once Lafontaine’s nomination is ratified at the August meeting, he will officially become president-elect. His presidency is set to begin in August 2022.
CMA Sir Charles Tupper Award for Political Advocacy — 2019 Recipient
Dr. Alika Lafontaine is receiving the Sir Charles Tupper Award for Political Advocacy for demonstrating recent leadership, commitment and dedication in advancing CMA goals and policies through grassroots advocacy.
The Indigenous Health Alliance is one example of Dr. Lafontaine’s advocacy work. In 2013, he was helping Saskatchewan First Nations figure out why its residents were so sick and uncovered a gap in the quality improvement approach between Indigenous and non-Indigenous patients. Committed to eliminating these differences across Canada, Dr. Lafontaine drafted and co-led a national strategy with territorial organizations representing 150 First Nations and several national health organizations. That proposal was then submitted to the federal government on behalf of those First Nations — the Indigenous Health Alliance — to advance health transformation.
HealthCareCAN, the national voice of action for health organizations and hospitals across Canada – was formed from the merger of the Canadian Healthcare Association and the Association of Canadian Academic Healthcare Organizations in January 2014.
Bringing Reconciliation to Healthcare in Canada: Wise Practices for Healthcare leaders”. April 2018
The 10 identified Wise Practices includes the following within Indigenous Client Care and Outcomes:
- Enhance the journey of Indigenous clients through the practice of trauma-informed care and programs such as Indigenous navigators, access to traditional foods and healing practices, support from Elders, and land- based healing; the specific initiatives should emerge from the recommendations made by local Indigenous communities, advisors, and clients.
HealthcareCAN Issues Brief, 2016 Suggested Recommendations:
- Advocating for parallel support of Indigenous traditional medicine approaches to healing;
- Working with traditional healers to develop respectful ways to teach learners as well as practicing health care providers on how to work with traditional healers or people who are using traditional healing methods – this may include accreditation
- Developing community partnerships between First Nations communities and health organizations to ensure inclusion of traditional healing in the primary care models in ways that are respectful, responsive, and directed by First Nations communities and traditional healers.
The Canadian Partnership Against Cancer
June 21, 2018 – Committed $24 million in funding until 2022 to support improved cancer outcomes by supporting action on self-determined priorities of First Nations, Inuit and Métis leaders, organizations and communities. The investment of the Partnership will result in large-scale changes that deliver high-quality, culturally respectful cancer services and programs in all provinces and territories. the Partnership and our partners are focused on the following areas:
- Increasing access to, and use of, screening services especially in rural and remote areas of Canada;
- Promoting wellness and preventing cancer (e.g., smoking cessation);
- Improving cultural supports through Indigenous patient navigation; and
- Led by Indigenous partners, exploring opportunities to better gather and analyze Indigenous-specific cancer data through data linkage.
The Partnership has invested $15 million to date in building respectful, impactful and collaborative relations with Indigenous communities across Canada.
June 4, 2019 – The Canadian Partnership Against Cancer’s “Canadian Strategy for Cancer Control 2019-2029 identifies three priorities for First Nations, Inuit and Métis. For each of these priorities, Peoples-specific actions were identified that help drive needed changes in outcomes and experience for all First Nations, Inuit and Métis.
- Priority 1 – Culturally appropriate care closer to home
- Priority 2 – People’s specific, self-determined cancer care
- Priority 3. – First Nations-, Inuit -, or Métis-governed research and data systems
Dalla Lana School of Public Health’s Waakebiness-Bryce Institute for Indigenous Health
Aug. 2, 2019 – Dalla Lana School of Public Health’s Waakebiness-Bryce Institute for Indigenous Health offers five days learning about Indigenous health in one of Canada’s first land-based learning courses. The move to land-based learning is an attempt to truly Indigenize the educational experience so that public health workers can begin to gain the kind of understanding they’ve been missing, said Suzanne Stewart, director of the Waakebiness-Bryce Institute. She hopes this shift in thinking will address the root reasons for many of the failures of public health institution programs to improve Indigenous health.
“The Western paradigm has privileged the mind. In Indigenous culture, it’s the spirit and the heart that makes decisions and guides our lifestyle and behaviours,” she said. “Everything to do with Indigenous health is tied to spirituality, and spirituality is based in the land and in the relationship between land and people.”
Royal College of Physicians and Surgeons of Canada 2019
The Royal College is the national professional association that oversees the medical education of specialists in Canada, accredits the residency programs at 17 universities across Canada and also accredits the learning activities that physicians pursue in their continuing professional development programs.
Indigenous Health Primer:
- Legislation and policies related to Indigenous people in Canada were created with the intention to assimilate Indigenous people.
- The policies and laws, based entirely on race alone, resulted in cultural, social and economic disruption.
- Jurisdiction regarding health care delivery for Indigenous people is complex and often misunderstood.
- Current inequities in health and well-being experienced by Indigenous people are the result of these dismissive and oppressive policies and laws, which continue in some forms in our present day.
Understanding legislation and policies can be overwhelming but, put simply, there are two fundamental areas of legislation and policies that affect the lives of all Indigenous Peoples in Canada:
1. the set of laws and policies that were originally designed to assimilate Indigenous people, and
2. a second set of laws that dictate the level of government that is responsible for health care delivery to Indigenous people.
Indigenous science is a form of Indigenous knowledge. It refers to the science of Indigenous cultures. It is a way of seeing and knowing that is dynamic, holistic, intergenerational and time-tested. Indigenous science has existed for thousands of years, thus developing sophisticated modes of knowledge-transfer that have enabled its survivance (more than mere survival — it is a way of life that nourishes Indigenous ways of knowing).
Despite this survivance, Indigenous Science has been devalued in the past by a Eurocentric worldview and institutions that have deemed it to be simplistic or primitive. Indigenous Science is place-based and therefore dependent on a deep connection and relationship to traditional lands and the natural world.
Anishinaabe Historian Brenda Child states “In Ojibwemowin, our language, the term for medicine is mashkiki or ‘strength of the earth.’ Medicine people approached the plant and medicinal knowledge in a meticulously systematic way, according to Frances Densmore, always emphasizing experiment and study. Like artists in their work, they were masterful observers of the natural world. They knew the exact time to harvest a multiplicity of plants, many of which had the most ephemeral season…Their work sustained the Ojibwe goal of mino bimaddizi [”the philosophy of a good life]” (Densmore, 2005).
Although Indigenous Nations in what is now referred to as Canada are incredibly diverse, they all share a common, earth-centred worldview. They also share a sense of deep interconnection and relationship with the land that differs from the dominant Eurocentric understanding.
“To the settler mind, land was property, real estate, or natural resources. But to our people, it was everything: identity, our connections to our ancestors, the home of non-human kinfolk, our pharmacy, our grocery store, our library, the source of everything that sustained us. Our lands were where our responsibility to the word was enacted, sacred ground. It belonged to itself; it was a gift, not a commodity, so it could never be bought or sold” (Kimmerer, 2013
Indigenous Health Values and Principles Statement: June 21, 2019
As in the first edition, the second edition examines the values pertaining to Indigenous health and bridges these values to the CanMEDS framework with actionable principles to guide the delivery of culturally safe health care. The culturally safe physician is a complete health care practitioner who:
- embraces Indigenous knowledge/science….
- practicing with cultural humility, fostering an environment of cultural safety and proactively pursuing anti-racism interventions.
- Understands that Indigenous health is an integral component of medical research, education, training and practice, and that this research is based on evidence from empirical sources, critical appraisal of relevant material beneficial to patients, leading Indigenous and non-Indigenous practices and lifelong learning that can be adapted to serve Indigenous patients.
The culturally safe physician also embraces the following Indigenous values:
|Openness: traditional Indigenous medicine reinforces the holistic approach to health and wellness embraced in Indigenous cultures. Indigenous healing practices, spiritual well-being and natural therapies are recognized by the patient, and he or she decides whether western medical practices are comprehensive, complimentary, beneficial, holistic or integrative.|
Evidence: health care decisions and healthy life choices are based on qualitative and quantitative information that is readily available, focused and whose limitations are clear. This includes Indigenous knowledge in traditional Indigenous medicine and its value in the education of medical students, residents and practicing physicians.
Government Responses to Aboriginal Healing practices
Budget 2017 and 2018 provided $86 million over 5 years and $490 million over 2 years respectively, to preserve access to medically necessary health benefits and services through the Non-Insured Health Benefits. Non-Insured Health Benefits medical transportation benefit provides coverage to enable clients to access medically necessary health services, including services provided by traditional healers.
The Indian Residential Schools Resolution Health Support Program secured a 2 year renewal for fiscal year 2016 to 2017 and 2017 to 2018 ($116 million total) that provides access to mental health, emotional and cultural support services for eligible former residential school students and their families. The services provided are based on the specific needs of individuals, families and communities, and may be provided by Elders, traditional healers, Indigenous community health workers, psychologists and social workers.
Indigenous Services Canada (ISC) is working with the National Aboriginal Council of Midwives to implement the Budget 2017 midwifery investment of $6 million over five years. ISC also continues to support the development of Indigenous Service Delivery Models for crisis planning, prevention, response and recovery and land-based programming, which incorporate Indigenous healing practices.
Budget 2018announced $248.6 million over 3 years, starting in fiscal year 2018 to 2019, for services, including mental health and emotional supports to survivors and their families for the duration of the Indian Residential School Settlement.
Mar. 1, 2017 – The BC Health Regulators (BCHR) representing 23 regulatory colleges governed by the Health Professions Act and the Social Workers Act declared their commitment to making the health system more culturally safe for First Nations and Aboriginal People through actions and processes which will ultimately embed culturally safe practices within all levels of health professional regulation.
Follow-up: Annual reports outlining strategic activities which demonstrate how each organization is meeting their commitment to cultural safety.
Oct. 2, 2018 – Release of “Indigenous Health Transformation Roadmap: 2018-2020” through the Population, Public and Indigenous Health Strategic Clinical Network of Alberta Health Services. Specific projects identified are:
- Recognize the value of Indigenous healing practices, establish policies to guide the implementation and administration of practices within AHS
- Expand access to Indigenous healing practices in the treatment protocols with Indigenous peoples within AHS
- Work with other SCNs to ensure Indigenous priorities, perspectives and healing practices are considered in their care pathways and system innovations
March 28, 2018 – Dr. JoLee Sasakamoose has assumed leadership of the Indigenous Peoples’ Health Research Centre (IPHRC) as the new director. Sasakamoose’s research explores the intergenerational effects of historical trauma with Indigenous Peoples and the use of traditional healing methods in the promotion of health and wellbeing. In partnership with the First Nations communities of Saskatchewan, she co-authored the Indigenous Cultural Responsiveness Theory, a theoretical framework to improve wellbeing of Indigenous Peoples.
Budget 2020 – 2020 ($800K) and 2021 ($1.5M) funding to enable Neecheewam Inc. to expand its Winnipeg facility and improve access to Indigenous-led healing, care and treatment services to sexually exploited youth. Neecheewam operates the Strong Hearted Buffalo Women Crisis Stabilization Unit, a four-bed crisis intervention program for female and transgender youth who are at high risk of sexual exploitation. With new provincial funding, Neecheewam will undergo renovations to pilot a new, longer-term four-bed addition to its treatment facility.
June 3, 2018 – Aboriginal elders currently visit Winnipeg emergency rooms to work with patients and help ER staff to provide culturally appropriate care (CBC).
Sept. 20, 2017 – First Nations Health and Social Secretariat of Manitoba (Nanaandawewigamig) and the First Nations Diabetes Leadership Council in Manitoba have developed the First Nation Basic Foot Care Program. This innovative foot care service will help clients in all 63 Manitoba First Nations communities to maintain their health and lower their risks from diabetes- related foot complications. Patients living with diabetes who have foot ulcers are at risk for hospitalizations, lower extremity infections, and amputations. First Nations populations experience diabetes at a rate more than four times higher than the general Canadian population.
May 30, 2016 – With funding support from five ministries, Indigenous partners and service providers will continue to support the Aboriginal Healing and Wellness Strategy. The strategy supports culturally appropriate solutions to improve healing, health and wellness in communities across Ontario.
Oct. 25, 2019 – Tungasuvvingat Inuit with the support of the Government of Ontario announce the re-opening of Mamisarvik Healing Centre in Ottawa to serve and offer delivery of Inuit specific trauma informed healing and address substance abuse disorders. Mamisarvik will offer extensive counselling sessions, culturally-specific healing, time with Elders and a world class team of health experts.
Nov. 16, 2020: Toronto Star – Centre for Addiction and Mental Health (CAMH) in Toronto launches an Indigenous-led centre dedicated to improving health-care services for First Nation, Inuit and Métis communities. Shkaabe Makwa, Anishinaabe for “Spirit Bear helper”, “plans to meld Indigenous knowledge and traditions with medical research, training and healing models for caregivers serving Indigenous communities”. Dr. James Makokis, Shkaabe Makwa’s first medical director said, ”He’s excited about the chance to focus on Indigenous ceremony, medicine and thought, especially in developing new research that addresses Indigenous needs. Renee Linklater, PhD Senior Director said, ”Culture is central to healing and wellness for many Indigenous people and that’s too often ignored.
June 18, 2020 – BMO Financial Group (BMO) and the Hewitt Foundation are partnering to maintain social pediatric services in Northern Quebec Indigenous communities. Their respective donations of $3 million and $2 million send a strong message to the business community about the importance of supporting the Montreal Children’s Hospital in changing the face of pediatrics in Quebec through innovative ways of healing. The Minnie’s Hope Social Pediatric Centre was established more than five years ago by and for members of the Cree community of Whapmagoostui and the Inuit community of Kuujjuaraapik, both located on the southern shore of Hudson’s Bay. In partnership with the Children’s and others, Minnie’s Hope provides pediatric care and evaluations as well as therapeutic, social and educational programs developed — with the involvement of community members including elders — to reflect the values and knowledge of both communities.
This unique partnership approach that focuses on combining their traditions, values and knowledge and dedicated experts has made Minnie’s Hope a Canadian leader in its field. The $5M in new funding will support the construction of a larger centre to accommodate the growing communities with more administrative, medical and paramedical staff and new services and programs—all offered in a way to ensure cultural safety. “This project was initiated, developed and managed by Indigenous communities.
Dec. 13, 2019 – Researchers at Nova Scotia’s Cape Breton University have received a $850,000 grant to develop a traditional Mi’kmaq medicine for potential future commercial production as a skin ointment. Maskwiomin is made from the oil of birch bark and is used to treat skin conditions such as rashes, eczema and psoriasis.
Sept. 18, 2017 – Yukon’s priority is to work with Yukon First Nations to develop more culturally relevant programming and alternative correctional therapeutic environments for individuals with disabilities, mental health and addiction issues, and to collaborate in order to reduce delays and improve outcomes.
July 20, 2017 – The Governments of Canada, the Northwest Territories and its partners signed an agreement with the Tlicho Government to provide $24.9 million in funding and in-kind contributions to establish a NWT Strategy for Patient-Oriented Research (SPOR) Support for People and Patient-Oriented Research and Trials (SUPPORT) Unit – Hotıì ts’eeda. This health research and training will be rooted in Dene, Inuvialuit and Métis knowledge and will encourage a better understanding of the importance of culture and community in the delivery of our health care
Aug. 20, 2019 – Improving mental wellness for Inuit in Nunavut means providing better access to care that is culturally appropriate, closer to home, effective, and sustainable. The Partnership Table on Health, the Government of Nunavut, Nunavut Tunngavik Incorporated and Government of Canada’s came together to sign a joint declaration of intent for the construction and operations of a Nunavut Recovery Centre which will provide treatment in Nunavut for addictions and trauma.
The Nunavut Recovery Centre will provide a range of treatment and healing interventions that will address both addictions and trauma, and will be founded on Inuit cultural practices and values.
Official Federal Government Response: Sept, 5, 2019
Sept. 5, 2019 – The Government of Canada recognizes the value and importance of Indigenous healing practices.
Through funding announced in Budget 2017 and 2018, it is providing $86 million over 5 years and $490 million over 2 years respectively, to preserve access to medically necessary health benefits and services through the Non-Insured Health Benefits. The Non-Insured Health Benefits program is working with partners to advance the implementation of these changes to benefit coverage. Non-Insured Health Benefits medical transportation benefit provides coverage to enable clients to access medically necessary health services, including services provided by traditional healers.
The Indian Residential Schools Resolution Health Support Program secured a 2-year renewal for fiscal year 2016 to 2017 and 2017 to 2018 ($116 million total) that provides access to mental health, emotional and cultural support services for eligible former residential school students and their families. The services provided are based on the specific needs of individuals, families and communities and may be provided by Elders, traditional healers, Indigenous community health workers, psychologists and social workers.
Indigenous Services Canada (ISC) is working with the National Aboriginal Council of Midwives to implement the Budget 2017 midwifery investment of $6 million over 5 years. ISC also continues to support the development of Indigenous Service Delivery Models for crisis planning, prevention, response and recovery and land-based programming, which incorporate Indigenous healing practices.
Budget 2018 announced $248.6 million over 3 years, starting in fiscal year 2018 to 2019, for services, including mental health and emotional supports to survivors and their families for the duration of the Indian Residential School Settlement.