Indigenous History, health and Culture

Indigenous History, health and Culture

Kent Saylor, MD October 11, 2017 MUHC Health Equity Symposium INDIGENOUS HEALTH CARE ACCESS THE ROUTE AHEAD Recognition of territory Goals for today At the end of this session learners will:

Have a better understanding of the needs for more Indigenous health care providers Have a better understanding of the gap in the number of Indigenous health care providers Have a better understanding of what can be done in academic institutions Who am I?

Pediatrician Northern and Native Child Health Program MCH Director Indigenous Health Curriculum Director Indigenous Health Professions Program Mohawk Nation Definition

An Indigenous person is defined as a someone who is either: First Nations Inuit Mtis The terms Indigenous &

Aboriginal are synonymous

Indigenous Nations in Qubec Inuit Naskapi Cree Innu Attikamek

Algonquin Migmaq Malecite Huron-Wendat Abenaki Mohawk Numerous health discrepancies Lower life expectancy Higher infant mortality Medical conditions

Diabetes Cancer Infectious disease Bronchiolitis Many others Factors contributing health disparities to

A C C E S S T O C A R E , E V E N B A S I C P R I M A RY C A R E , I S D I F F I C U LT A N D A C C E S S T O S P E C I A L I S T C A R E V E R Y L I M I T E D M A N Y H E A LT H C A R E P R O F E S S I O N A L S W O R K S H O RT T E R M L E S S K N O W L E D G E O F I N D I G E N O U S P E O P L E S C U LT U R E , H E A LT H I S S U E S LANGUAGE BARRIERS WHICH OPTIMAL MAKES CARE LESS THAN S O C I A L D E T E R M I N A N T S O F H E A LT H

V E RY F E W I N D I G E N O U S H E A LT H C A R E P R O V I D E R S I N Q U E B E C : E S T. 1 2 O U T 2 0 , 0 0 0 D O C T O R S A R E INDIGENOUS Many solutions are beyond the reach of health care but . . . Health care professional training schools and health care institutions have a significant role to play

Until now we have not made significant efforts to address the health needs on Indigenous peoples 2016 Diversity Survey Data Report to the WPC Truth and Reconciliation Commission

Call to action #23 We call upon all levels of government to: Increase the number of Aboriginal professionals working in the health-care field ii. Ensure the retention of Aboriginal healthcare providers in Aboriginal communities iii. Provide cultural competency training for all healthcare professionals i. Truth and Reconciliation Commission of Canada: Calls to action; 2015

Truth and Reconciliation Commission Call to action #24 We call upon medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples,

Treaties and Aboriginal rights, and Indigenous teachings and practices. This will require skills-based training in intercultural competency, conflict resolution, Experience at McGill university INDIGENOUS POPULATION I N C A N A D A - E S T I M AT E D

1.4 MILLION (~4%) INDIGENOUS PEOPLE IN CANADA F I R S T N AT I O N S , M T I S AND INUIT ACCOUNT FOR 60%, 33%, AND 4 % , R E S P E C T I V E LY. 3 % MIXED BACKGROUNDS ( S TAT S C A N ) IN QUEBEC ~1.8% ARE INDIGENOUS

IN THE MCGILL RUIS - 4 LARGE INDIGENOUS P O P U L AT I O N S : ALGONQUIN, CREE, I N U I T A N D M O H AW K Message from Indigenous Partners We need more Indigenous health care providers not just doctors

Our children lose interest in science/math at an early age Mature students interested in health careers need help and guidance getting back to school All health care professionals need to learn about Indigenous peoples Realization We need a comprehensive program

to address the lack of Indigenous health care providers, not just physicians We need to address cultural safety training for all future health care providers A new program is born The Indigenous Health

Professions Program (IHPP) McGill Faculty of Medicine Partners McGill partners CSD, Medicine, Nursing, PT/OT Dentistry, Nutrition and SW Indigenous partners within our region Algonquin, Cree, Inuit and Mohawk

Current McGill students Indigenous and non-Indigenous IHPP Objectives 1. C R E AT E A C E N T R A L I Z E D L O C AT I O N F O R A L L M AT T E R S D E A L I N G W I T H I N D I G E N O U S P E O P L E S H E A LT H T R A I N I N G A N D T E A C H I N G AT M C G I L L 2. I N C R E A S E T H E N U M B E R O F I N D I G E N O U S H E A LT H C A R E P R O F E S S I O N A L S T U D E N T S AT M C G I L L 3. I N C R E A S E T H E T O TA L N U M B E R O F I N D I G E N O U S H E A LT H CARE PROFESSIONALS IN QUEBEC/CANADA

4. S T I M U L AT E T H E C R E AT I O N O F I N D I G E N O U S C U R R I C U L A AT A L L H E A LT H P R O F E S S I O N S S C H O O L S AT M C G I L L 5. C R E AT E A W E L C O M I N G E N V I R O N M E N T F O R I N D I G E N O U S S T U D E N T S I N T H E H E A LT H P R O F E S S I O N S AT M C G I L L IHPP Program Indigenous Student Education Trajectory Early Exposure

Transitioni ng Applying Retention & completion Professiona l Developme nt

Activities Outreach worker to visit communities, schools etc. Summer science camp Eagle Spirit Science Futures Bridge programs with CEGEPS and Universities

Pre-admission workshops For current Indigenous students Welcoming Dinner Elder in residence Tutoring and mentoring programs Informal gatherings Welcoming Dinner 2017

Future plans Plans to reach mature students Plans to introduce topics on Indigenous health at all the schools Establish trust with Indigenous partners 5-10 YEAR VISION

Long term Goals At least 2% of graduates from health professional programs will be Indigenous Indigenous health curriculum taught at all schools McGill is seen as a leader in Quebec in training Indigenous health care professionals Facilitate the hiring of more Indigenous staff Beyond students

How can we bring about positive change in our health care institutions? Everyone working in health care is part of the solution! Reception Maintenance Porter Technicians

Physician/Nurse Administrator Truth and Reconciliation Commission Call to action #23 We call upon all levels of government to: Increase the number of Aboriginal professionals working in the health-care field ii. Ensure the retention of Aboriginal healthcare providers in Aboriginal communities

iii. Provide cultural competency training for all healthcare professionals i. Truth and Reconciliation Commission of Canada: Calls to action; 2015 Cultural safety Cultural safety training Need to establish cultural safety

training for all staff who have contact with patients Important for all cultures but the needs for Indigenous clients are unique Historical factors Social determinants of health Stereotypes We are trying to avoid

this tragedy Conclusions We have a responsibility to actively recruit and train more Indigenous health care professionals We have a responsibility to train all future health care providers about the realities regarding the health of Indigenous peoples

We must do better at educating current health care providers regarding cultural safety Ni:wen Merci Thank you Questions?

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