Anti-Indigenous racism has long been recognized as a serious problem across Canada’s healthcare systems. So how is the NWT, where Indigenous people represent at least half of the population, working to address the issue?
Last week, NWT health minister Julie Green attended a national meeting on anti-Indigenous racism in healthcare alongside federal, territorial, provincial and Indigenous leaders.
Green told Cabin Radio the meeting built on an initial discussion in October, and focused on potential solutions alongside actions being taken by jurisdictions across the country.
“I took away that this process needs to be led by Indigenous people. There are many very knowledgeable and competent Indigenous people who are involved in this discussion,” she said. “I think there’s a lot of potential here.”
Green said the federal government was prompted to hold the meetings following the death of Joyce Echaquan. In September, Echaquan, a 37-year-old Atikamekw woman, died in a hospital in Quebec after filming mistreatment – including openly racist comments – from healthcare staff.
Indigenous patients have complained about misdiagnosis, discrimination and neglect in the NWT’s healthcare system.
In the Legislative Assembly on Thursday, Inuvik Boot Lake MLA Lesa Semmler said youth, Elders and residents from small communities in particular have said they don’t feel heard when trying to access medical care, or they don’t understand the questions they are being asked.
“We do have a history of not trusting the healthcare system in this country, Indigneous people,” she noted.
Semmler, who is Indigenous and has a background in nursing, said she and her children were mistreated during two of three hospital visits since she became an MLA.
“All I can say is the way that we were treated was unacceptable and I am unsure as to why we were treated that way,” she said.
“I am bringing this to this floor so that everyone out there can hear. People need to be responsible for their actions and we need to hold them to account to that, even as co-workers,” she added. “The only way things will change is if we make the change.”
Green said patients who feel they’re not getting the help they need can speak to their patient representative. If they’re still not satisfied, she said, they should reach out to their MLA, who can direct them to other resources.
“So next time I will make sure when I’m treated badly, I’ll call myself,” Semmler responded.
Anti-Indigenous racism in NWT healthcare came to the fore in 2016, following the death of Aklavik Elder Hugh Papik. Papik died of a stroke after healthcare workers in the community mistook his symptoms for drunkenness, delaying his treatment.
Shortly afterward, the territorial government ordered an external investigation into Papik’s death. Findings from that investigation have never been made public, but the government did release 16 recommendations. Those included reviewing and monitoring community health centres to ensure they are properly staffed, recruiting and training Indigenous staff in communities to decrease turnover, and creating mandatory cultural safety training for all healthcare workers.
In 2019, the Department of Health and Social Services released a cultural safety action plan to improve the quality of care for Indigenous people in the territory.
According to the latest annual report on the territory’s health and social services system, 157 staff attended nine cultural competency training sessions between March 2019 and February 2020. Those included content around Indigenous medicine teaching, the effects of residential schools – including intergenerational trauma, colonialism and privilege – and racism at interpersonal and systemic levels.
The territory also developed a toolkit for staff on respectful engagement with Indigenous people, alongside an Indigenous advisory group tasked with providing guidance and advice on Indigenous cultural and healing practices.
Yet a report from the Tłı̨chǫ Community Services Agency found that one in five patients in the region had concerns about being treated with dignity and respect in the healthcare system. They requested professionalism and training among staff with a focus on the Tłı̨chǫ language, cultural competency, community participation, and risk management.
Green told Cabin Radio her department was now moving from a short-term action plan to a cultural competency framework, which will start to roll out this summer.
“We’re kind-of moving on from thinking about what we could do to spending more time doing it,” Green said, characterizing that switch.
“We’re very committed to this cultural competency approach. We see that it’s important for us to make the healthcare system inclusive in every way of Indigenous experience and that we also need to make sure that people don’t find racism a reason to not engage in the healthcare system.”
‘People are still going to be afraid’
On Thursday, Semmler questioned how effective training would be at addressing the issues in the healthcare system.
“There’s no course in the world that’s going to change somebody who doesn’t want to take it and that’s the issue,” she said. “People are still going to be afraid of the healthcare system so they’re not going to speak up, they’re not going to advocate for themselves.”
Semmler called on the territory to install a patient advocate at healthcare facilities in each region to help people navigate the system.
She noted that despite goals for Aurora College’s nursing program to increase the number of local, Indigenous staff at healthcare facilities in communities, that hasn’t happened.
Green said she felt every staff member at a healthcare facility is a navigator, adding patients are able to access services in their language, but said she would look into Semmler’s request.