‘You send an Elder to the concrete jungle and expect them to survive’

A need for more Indigenous language supports was brought up repeatedly during a Monday briefing on systemic racism in the NWT’s healthcare system.

Led by health minister Lesa Semmler, the briefing – for a committee of regular MLAs – went through work done over the past couple of years and future plans.

“Indigenous language support is a challenge in our system,” said Fraser Lennie, the NWT health authority’s director of quality, risk and client experience, whose job includes supervising the new Indigenous Patient Advocate program.

“Language supports are not always readily available throughout many Indigenous clients’ care journey. This includes from when they begin their care journey until the end, including when on medical travel. The system is very reliant on family members for interpretation and this is not always ideal.”

Though interpreters are available in all facilities, most interpreters work regular business hours, said Department of Health and Social Services deputy minister Jo-Anne Cecchetto.

“There are times when we don’t have all interpreters for NWT languages available at all times.”

Relying on family members for interpretation doesn’t always result in effective communication. Lennie pointed to instances when informed consent is required for medical treatment and procedures, and family members are not trained in medical terminology.   

“We also know that Indigenous clients are refused escorts for interpretation when on medical travel,” Lennie said. “There is no standardized way to access language supports when needed throughout the client’s care journey.”

Minister Semmler said there are some supports in place, such as the GNWT’s contracts with Larga, which provides boarding and meals for some patients travelling to Edmonton for care. But she acknowledged that those staff don’t offer a service that helps people navigate their healthcare.

Mackenzie Delta MLA George Nerysoo, speaking at Monday’s briefing, described meeting an elderly woman at Larga Edmonton several years ago. He believed she had travelled from the Sahtu.

The woman was sitting in a yard crying after losing a grandchild to cancer, Nerysoo recalled, and could barely speak English.

“There was no advocate there to help her on what the process was,” he said. “What should she do? How will she get her child home?”

Nerysoo said sending people on their own for medical travel, without a language escort, remains an issue and creates a barrier to healthcare, whether they’re being sent to Edmonton or Yellowknife.

“My constituency is saying that they’re not given the opportunity to have a person go with an Elder,” Nerysoo said.

“You send an Elder down into the concrete jungle and expect them to survive … it is still hard to hear that people are being sent without escorts.”

Semmler acknowledged the need for a review of medical travel, including how non-medical escorts are provided and the criteria that determine who needs an escort.

She said she understood that going from a smaller community to navigating a large hospital can be intimidating.

“That can impact care. And so we have to be looking at these things,” the minister said.

“Not every senior or Elder needs an escort … but the ones that do, we need to ensure that they are getting the services that they need.”

Monday’s briefing also covered the impact of the first year of the Office of Client Experience.

That office, established early last year, was billed at the time as a “centralized point of contact for individuals to provide feedback, make a complaint, or ask any questions they have regarding the health and social services system.”

In its first year, according to Lennie, the office supported more than 1,000 patients and families across the NWT. Approximately 65 percent of those identified as either First Nations, Inuit or Métis.

The office heard approximately 500 complaints in the first year and is looking to identify themes and trends in those complaints to guide future efforts.

Since 2021-22, a Cultural Safety and Anti-Racism division has delivered training to 600 individuals, including Health and Social Services staff, senior bureaucrats and 17 MLAs.   

The training aims to provide people with a common language and basis to understand the root causes of anti-Indigenous racism, and to identify action required at individual and organizational levels to dismantle it.

One of the challenges of delivering this training is that the work requires high emotional labour and can be very taxing on the training staff, said Karen Blondin Hall, the division’s director.

“The training staff, who are majority Indigenous, are frequently exposed to and expected to respond to white participants’ denial of racism, and the ongoing blatant racist beliefs,” Hall said.

“We are still learning how to build, make adjustments … and deliver this training without burning Indigenous staff out, and protecting them from the very racism we are trying to eliminate for Indigenous patients.”

Range Lake MLA Kieron Testart raised concern that short-term or temporary staff do not receive this training as part of their onboarding and may not receive it during brief periods in a role.

Blondin Hall also noted that much of the work’s recent growth was initiated through federal and third-party cash, meaning the programs and units are vulnerable and “susceptible to changes in funding.”   

Sahtu MLA Danny McNeely said while he thinks people will “respect the advocacy group,” and he sees in it “huge value to the system,” he doesn’t think enough people yet know about these new supports, and more needs to be done to share what’s available.

“If I went downtown and I asked somebody, ‘Do you know what the advocacy group is?’ They will probably say ‘no,’” McNeely said.

“The messages aren’t really going to the people that matter.”