A non-profit launching in Edmonton says it aims to provide NWT residents on medical travel with “a familiar face” as they receive care in the city.
The organization, Goba Care, was created by Melinda Laboucan. She told Cabin Radio she wants to give “culturally safe healthcare navigation and support” to northern patients and their families.
Laboucan is from Fort Good Hope and a member of the K’ahsho Got’ine First Nation. She said the idea for Goba Care came from personal experience.
She lost her mother to cancer in 2011 and her sister to pneumonia less than two years later. She had served as the primary caregiver for both, accompanying them on medical travel across the territory and Alberta, then providing palliative care at home.
“I’ve seen, I’ve felt, and I went through all the gaps that we all fall through,” Laboucan said.
Helping her mother and sister while they travelled for treatment was a difficult experience, she said, describing little support for family members and escorts in Edmonton. So much of her time at home was spent caring for them that she felt unable to properly grieve her loss.
“It was just so devastating,” she said.
“I was always very passionate about what support we needed back then, and how I can help other people. If anybody has gone through what we’ve gone through as a family, I want to be able to help.”
Laboucan said she began working in Fort Good Hope to support residents diagnosed with cancer, hosting sharing circles for patients and survivors, fundraising to cover medical expenses, and taking people on the land to heal mentally and spiritually.
Now having moved with her family to Edmonton in 2018, Laboucan’s new venture will continue that work. Services will be free of charge, she said, with Goba Care funded through donations and support from NWT research support group Hotıì ts’eeda.
The word “goba” means light on the horizon in the K’ahsho Got’ine language. Laboucan said she sees her non-profit as “a light that helps guide through new places, services, and cultural differences.”
She will attend appointments with patients, serve as a point of contact for people travelling to the city, connect people to health services, and offer in-person and virtual support for families dealing with illness and end-of-life care.
“Once Covid restrictions lift, I’ll be able to be right beside them,” Laboucan said of her clients. “If anybody comes down here for cancer treatment, cancer diagnosis or results, or any other medical care that they need, I will be here.
“It’s not only for the patient, but for the medical escort, too. And this is not focused just on cancer, it’s for any other patient that’s coming down here, from diagnostics to surgery.”
Florence Burnaby is an Elder from Fort Good Hope. She has experiences of lymphoma – cancer of the lymph nodes – and received support from Laboucan, who would visit her and keep her company.
Burnaby said the sharing circles were the most helpful thing.
“You don’t feel alone,” she said. “There are other people out there that are going through what I’m going through. I couldn’t wait for them.”
Laboucan eventually hopes to host online sharing circles through Goba Care. She plans to develop resources in Indigenous languages and has been assembling free care kits with traditional Dene medicines.
“Research has shown that medical travel is an extremely stressful process,” Laboucan said. “Despite ongoing efforts to improve the experience, people still feel unprepared and overwhelmed.
“But you come down here, you see a familiar face – which is me – and right away, you feel … OK being in the big city. You have somebody who is from the North, who gets it, and who knows a lot of supports down here in Edmonton, so a lot of that stress is lifted off. It leads to good health outcomes.”
The NWT Health and Social Services Authority’s annual report states 15,141 patients travelled for medical purposes in the 2019-20 financial year, both within the NWT and down to Alberta.
Dr Sarah Cook has been a practising physician in the NWT for 13 years. Formerly the territory’s medical director, she also acts as the clinical lead for Choosing Wisely NWT, the local chapter of a national organization that aims to reduce unnecessary medical tests and treatments.
Over the years, Dr Cook has observed the challenges medical travel can present.
“Sometimes, it may be that someone needs an interpreter that may not be available,” she said.
“Sometimes, it’s just the challenge of going to an entirely new place without necessarily having a lot of comfort navigating that place and figuring out how to get to your appointment.”
Health authority ‘welcomes innovation’
David Maguire, a spokesperson for the territory’s authority, told Cabin Radio in an email the authority recognizes “there is room for innovation in the health and social services sector from private businesses and the not-for-profit sector.”
However, Maguire said that doesn’t necessarily point to a gap in the NWT’s healthcare system.
“We work very hard to layer our supports for patients throughout their care journey,” Maguire wrote, “but we also recognize that people may wish for a more individualized support experience than our programs are able to provide.
“There are external services that add value to the health and social services landscape … we welcome innovation and opportunities to understand and recognize successes of organizations that create services that may take a differing approach than our broad, system-level care and service offerings.”
For Cook, bringing care closer to home in the NWT communities is the best solution. It cuts costs and allows more holistic treatment.
However, when at-home care isn’t possible and medical travel is necessary, she said better supports are needed for travelling patients.
“It’s challenging for anyone living in rural Canada,” Cook said. “Having to travel to bigger centres, out of your comfort zone, away from the people who are supporting you is not just daunting, but can actually have an impact on your health, because it’s going to impact the decisions that you make.
“I have seen, in my practice, examples of this. People will have an experience where they feel very, very uncomfortable, and they will decide not to go back for necessary follow-up care because they either didn’t feel comfortable or it wasn’t culturally safe.
“Melinda has identified, through her own personal experience and her very close connection with communities in Northwest Territories, an opportunity to really improve the experience people have when they’re traveling to Edmonton for care. I think anything we can do to improve that experience is going to be positive.”