This past week has been a remarkable one. I believe I have grown in my understanding of the responsibilities of the CoM with regards to Aboriginal communities.
On Wednesday and Thursday, I had the good fortune of participating in Building Reconciliation: Universities Answering the TRC’s Calls to Action. Our chancellor Blaine Favel and our new president Peter Stoicheff demonstrated great leadership in initiating this important national forum at the University of Saskatchewan. Representatives from more than 50 universities in Canada—including 14 presidents—were here to learn, exchange ideas and set collective goals for responding to the recommendations of the TRC. There were also Aboriginal student leaders, faculty and staff from the University of Saskatchewan who contributed valuable local knowledge to the TRC conversations.
In fact, three of those recommendations are specifically directed at medical schools.
- 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.
- We call upon all levels of government to:
- Increase the number of Aboriginal professionals working in the health-care field.
- Ensure the retention of Aboriginal health-care providers in Aboriginal communities.
- Provide cultural competency training for all health- care professionals.
- 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, human rights, and anti-racism.
Saturday night I attended the meeting of the Indigenous Physicians Association of Canada (IPAC) and brought greetings on behalf of the CoM. The president of IPAC is Dr. Alika Lafontaine, an alumnus of the CoM and anesthetist in Edmonton. I also had the pleasure of listening to the keynote speech by Dr. James Makosis, a family doctor from Alberta who also has a Master’s degree in Public Health. Dr. Makosis spoke eloquently about issues of reconciliation, aboriginal history and aboriginal health.
I learned many things from Aboriginal and university leaders this week. In the summation on Thursday at noon, a panel of university presidents and an active audience developed some great take-home messages. Dr. Ralph Nilson of Vancouver Island University emphasized the importance of seeing each other as equals and learning to respect different ways of knowing. Dr. William Robins of University of Victoria at University of Toronto said that he learned: stories matter, naming the problem matters, and relationships matter. An Aboriginal leader, Leroy Little Bear, stated that presidents can help change the conversation, and Dr. Vianne Timmons of University Regina extended that responsibility to all leaders at universities.
Peter Stoicheff emphasized again if not here, where and if not now, when? He also stressed that we all should feel a sense of urgency and impatience but should set a tone of hope and enthusiasm. In terms of our obligation to do research that benefits Aboriginal communities, he reiterated the principal that Aboriginal people stress: nothing about us, without us.
Aboriginal leaders included our students, Chancellor Blaine Favel, Chief Perry Bellegarde, National Chief of the Assembly of First Nations (and from Saskatchewan) and Honourable Justice Murray Sinclair, Commissioner of the Truth and Reconciliation Commission of Canada. Justice Sinclair had, for me, the most important insight for the College of Medicine: education is the key to reconciliation. Justice Sinclair also said: “By including teaching around residential schools in Canadian curriculum, we are not only opening the door to having Aboriginal people become part of the circle, we are also opening the eyes of Canadians to the fact that they have been educated in the public schools about Aboriginals historically, and even today, in (a way) that is simply wrong and doesn’t contain accurate information.”
With 63 self-identified Aboriginal graduates and 31 Aboriginal students here at the College of Medicine, it could be easy to sit back and say we’re doing pretty good. I came away from this week learning we have so much more to do. Demographic projections for Saskatchewan now show the population is more than 15 per cent Aboriginal people and suggest that by 2030 this number will be more than 25 per cent. Our current enrolment target of 10 seats for Aboriginal students is inadequate.
I ask what our collective responsibility is in ensuring Aboriginal communities, families, and students feel comfortable to bring their cultures and traditions into our University and College of Medicine environment? How do we continue to work with Aboriginal students so they feel they don’t have to hide their identity and ways of being in order to fit into the “culture of Medicine”?
While visiting Île-à-la-Crosse this summer, I saw the abandoned building that formally housed sequentially both the residential school and the drug and alcohol treatment facility. I’m sure we fail to teach all of our students the health legacies of colonization, residential schools and current inequities faced by our Aboriginal people and communities.
Yes, we have much work still to do but to paraphrase President Stoicheff: what medical school in Canada is better poised to lead in responding to the TRC recommendations 20, 21 and 22? And if so, why not now?
As always I look for your feedback, welcome your comments on the blog and invite face-to-face conversations. I’m happy to meet anyone anytime on this or any other issue of importance to you. My door is always open…
Related to advancing the initiatives related to the TRC’s call to action and specifically recommendations 21, 22, and 23, I look forward to advancing the work considering interprofessional and interdisciplinary approaches. These actions apply to all health science students, professionals and researchers. For more than 10 yrs the School of PT has collaborated with community and university partners on initiatives related to each of the 3 recommendations with some success. This call to action reinforces the importance and priority of our work with students, families, patients and communities.
Thank you for your thoughtful and challenging comments on this very important topic for our University and our College. This month, Saskatoon also hosted the Wicihitowin conference on Aboriginal engagement. It was equally informative and challenging to see intersectoral leaders, staff and community representatives discussing how to overcome the barriers to recruitment and retention of a representative workforce and make our services culturally safe in the various human service sectors. While we still have a long way to go, naming institutionalized racism and discrimination and working to incorporate cultural safety in our improvement initiatives is a good place to start.
Thanks Preston. A few years ago while I was involved in administrating the UGME program, Serene Smythe and I received funding to create an aboriginal health curriculum for medical students. This took close to 3 years to develope and Serene undertook a compreand we undertook an comprehensive approach that included consultation with elders (and other representatives of the 1st Nation community), broad review if existing curriculums, and systematic, evidence based module development. I’m not sure how much of this course has been incorporated into the 2+2 curriculum, but still represents a valuable resource that aligns with the COM direction to increasing awareness and that of our new President.
Dear Dean Smith,
Thank you for sharing your thoughts and reflections on your experiences with Building Reconciliation. We are at an important time in our nation, our province, our university and the College of Medicine, including the School of Physical Therapy. We, at the School of Physical Therapy, believe that there is much to do among all health care professional students at our university and we need to continue to come together to share in open and safe dialogue with one another. We must prioritize and maintain strong connection with First Nations, Métis and Inuit communities to ensure that community voice is included in these initiatives and collective dialogue. I am currently part of a program of research that includes a long-standing and respectful relationship with the community of Île-à-la-Crosse, where I continue to learn of the tremendous strength and resilience that community members bring to our collaborative work of promoting health across the lifespan, in ways that support Métis culture-based approaches to health and wellness. I continue to learn so much from the Métis community members I work with and value the concept of reciprocity that is critical to informing our way forward. We need to maintain avenues for continued integration of Indigenous community perspectives and voice to inform our actions in response to the TRC recommendations. In this way, we can continue to build on strong relationships, learn from one another, and move forward together, in a good way.
(This is being posted on behalf of Dr. P. R. Butt, MD, CCFP. FCFP)
Thank you for your thoughtful and informative blogs. Many universities struggle with making TRC recommendations walk. It needn’t be so difficult. We have well defined Tri-Council processes for conducting research in conjunction with (not on) Indigenous people. We need to make them overt, and ensure absolutely no research is conducted that does not reflect the spirit and content of those documents. Further, we can use them to inform the academy’s relationship in other domains as well: curriculum development, pedagogy, outreach and service. It should not be difficult to develop similar principles or guidelines that form the basis for ethical, respectful and reciprocal relationships.
“Nothing about them without them” seems fairly simple but we have many egregious examples in the Health Sciences – both large and small – of career advancements in Indigenous Health without due consultation and inclusion. Sometimes all one needs to do is monitor the flow of resources and acknowledgement; monitor the jobs created; monitor the level of consultation and inclusion; and ultimately monitor the willingness to step back and make way to appreciate the corrections we need to make. Reconciliation can be done in many practical ways. In fact it must because if we don’t make it happen we are left with empty rhetoric and a relationship grounded in tokenism and cynicism. We need to walk the talk. We are very fortunate at the U of S to have a plethora of well trained and engaged Indigenous students, staff and scholars to nurture and develop those conversations and relationships within their own communities. We are so fortunate, in fact, that one has to wonder what is wrong when they are not present. When they are not included. When they are absent or kept apart.
We have the ability and power to make the change happen. I agree with the Dean and President. Let’s get on with it.
Dr. P.R. Butt, MD, CCFP, FCFP
Assoc. Prof., Department of Family Medicine,
University of Saskatchewan