Transforming Indigenous healthcare, one person at a time

Indigenous communities in Kingston imagine paths to change

Expanding Indigenous peoples’ access to healthcare requires a community-centred approach.
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This article discusses anti-Indigenous racism and the atrocities committed in Residential Schools and may be triggering for some readers. Those seeking support may contact the Office of Indigenous Initiatives and Reconciliation or Four Directions. For immediate assistance, the National Indian Residential School Crisis Hotline can be reached at 1-866-925-4419.

When Dionne Nolan (Zoogipon Ikwe) visits her patients, she brings her medicine bundle containing her drum, pipe, feathers, shaker, and plant medicines.

Every day, Nolan, an Indigenous cancer care navigator at the Southeast Regional Cancer Program, travels throughout an area extending from Prescott to Bancroft to Trenton to connect Indigenous peoples living with cancer with the care and advocacy they need.

“My medicine bundle is kind of like a doctor’s satchel, and I have all my tools in there. My spiritual sacred items are in there, my medicines are in there, and I share that with my patients,” Nolan told The Journal in an interview.

The process of being diagnosed and treated for cancer can be disorienting for anyone, but it’s especially so for Indigenous patients who face an increased risk of cancer while also lacking access to key cancer care or screening services, Nolan said.

For Indigenous peoples, the typical instability that comes with illness is further exacerbated by a complex, long-standing web of colonial biases embedded in a healthcare system that was never designed to meet their needs.

To Nolan, who is mixed-blood Algonquin from Bear Clan living in Katarokwi, these issues have gone unaddressed for too long.

Her job is to provide comprehensive support for Indigenous patients from the start of their cancer journey to the end, from attending appointments with doctors, to performing ceremonies and smudging, to going grocery shopping with her clients.

In the process, she provides her clients with the opportunity to reconnect with traditional healing practices—a process she sums up as “culture is cure.”

“To go out on the land, and work my land and pick medicines, that's healing in action, that's culture, and that really helps,” she said.

Nolan sees her services as caring for the spirit, elevating the voices and wishes of her patients in ways that are specifically attuned to Indigenous experiences.

“We were taught that when we aren't well, to put our hands in the dirt and get back to Mother Earth. When it comes to First Nations patients, we really need to get back to those cultural teachings, cultural ceremonies, the ways of life and the life passages that we have.”

Across Kingston, Indigenous community members, learners, and health professionals are working one by one to build a more inclusive healthcare system in the ways they know how.

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Prior to the arrival of European settlers, Indigenous peoples across Turtle Island developed their own successful and long-standing methods of healing over millennia. With colonization, Indigenous communities were stripped of their self-determination and dispossessed of the land, resources, and traditions that kept them healthy. 

Those assimilationist policies were institutionalized in the Indian Actof 1876.

Alongside bringing Indigenous communities under the control of the Canadian government, the act excluded Indigenous women from certain benefits and protections, forced Indigenous nations off their lands, increased their dependence on the government, and mandated that Indigenous children attend Residential Schools where they were exposed to abuse, racism, and disease in ways that affected the health of generations to come.

The Indian Act also established the concept of ‘status and non-status Indians,’ which stratified federal benefits, responsibilities, and services unequally between those who were registered with the act and those who were not.

Status remains a significant determinant of Indigenous peoples’ health to this day according to Josée Sunday, the Indigenous transition facilitator at Providence Care.

To her, providing support to Indigenous patients regardless of status is key to combatting colonial attempts to define Indigenous identity.

“For non-status First Nations, it's more difficult [to receive healthcare] because they have had a lot of the same kind of experiences with colonialism and cultural genocide in very similar ways to status First Nations people, but non-status communities tend to be not recognized by the government,” Sunday explained in an interview with The Journal.

This tiered healthcare system creates an atmosphere of ambiguity and fragmentation that results in delays to care. According to Sunday, many non-Indigenous healthcare providers are unfamiliar with the hurdles involved in navigating federal healthcare benefits, as well as the regional resources available to Indigenous peoples.

As such, she works to advocate for patients within the hospital environment so they can receive safe, culturally appropriate care while also linking clients to resources in their community, so they continue receiving treatment even after being discharged.

Sunday believes truly expanding Indigenous peoples’ access to healthcare requires a community-centred approach—one that recognizes how larger systems of exclusion affect Indigenous communities beyond the individual.

Although her role involves working with individual patients, she also sits on a committee on Indigenous palliative care where she works to address gaps in palliative care resources for Métis people across the region based on disparities she’s witnessed.

“When I come across a patient who has a barrier to health care in some way, I don't just treat it for that one patient,” Sunday said. “I would treat it as if the whole community needs that [support], so that the next time I have a patient with the same kind of issues, they wouldn't have the same barriers because they've already been addressed.”

Still, a lack of awareness and knowledge about Indigenous peoples in Canada presents difficulties for Indigenous peoples seeking healthcare, Sunday said—particularly because that information often isn’t a standard part of curriculums and training for healthcare professionals.

Dr. Sarah Minwanimad Funnell, director of Indigenous health within the Queen’s department of family medicine, believes educating medical professionals on how to serve Indigenous patients is a project that must begin early.

As an instructor in the Faculty of Health Sciences, Dr. Funnell, who is Algonquin and Tuscarora from Alderville First Nation, takes learners through what she calls a “root cause analysis” to reveal the causes behind the health inequalities Indigenous peoples face.

Starting with a health disparity—such as the presence of higher tuberculosis rates in Indigenous communities—Dr. Funnell continually asks students “why” to uncover the contributing factors behind this outcome, tracing the inadequacies and deficiencies experienced by Indigenous communities to one common cause: racism.

“Racism is about power and control over people of different races, and it's very specific in what we now call as Canada,” Dr. Funnell told The Journal in an interview.

“We understand that racism is about power and control over people, and in this context—Indigenous people—it's not historical. And so what is that about? What purpose does [racism] serve, for the more powerful in our society, to exert control over Indigenous people?”

Understanding that the health inequities Indigenous communities face is inextricably linked to the way those in power benefit from their oppression is crucial to combatting the discrimination that pervades Canada’s healthcare system, Dr. Funnell said.

Importantly, it places the injustice Indigenous peoples face into a historical context, combatting the stigma they face in the healthcare system by revealing where the problem really lies.

“As a system, we put a lot of judgment and blame on people that develop type 2 diabetes, because we know that there's a lot of evidence that is preventable,” Dr. Funnell said.

“So, when someone shows us slides on diabetes rates in Indigenous people and they're much higher than non-Indigenous people, or tuberculosis, or other things, without an adequate explanation of why that is, it further stigmatizes Indigenous people. There’s a narrative [of Indigenous people] perhaps being lazy, or uneducated, or making poor choices.”

Dr. Funnell said educating healthcare professionals about why Indigenous people experience the health problems they do can prevent the perpetuated of those stereotypes.

As a researcher herself, Dr. Funnell knows how data on health conditions can be skewed to construct narratives and uphold stereotypes about Indigenous peoples. It’s why she believes this data must be collected carefully and in partnership with the populations being studied.

Like mining or logging, she explained, research is also an extractive industry—conducting research that doesn’t better the community isn’t ethical.

“Your academic career is promoted [by] the more grants you get, or the more papers [that] are published, but with research [on Indigenous communities], those may not necessarily be the important things,” she said.

“The type of research that Indigenous people want in the community doesn't translate into number of papers published.”

Like Nolan, Dr. Funnell believes the future of Indigenous healthcare in Canada lies in building upon their strength: their culture. Whereas the mainstream model of medicine tends to break down a person’s health into discrete organs, systems, and illnesses, she explained, Indigenous practitioners take a more holistic view.

According to Dr. Funnell, integrating Indigenous and non-Indigenous worldviews could greatly serve our healthcare system in all domains—including addressing the primary care practitioner crisis Canada is experiencing by placing greater emphasis on team-based, whole-person health in accordance with traditional Indigenous models.

“The way we look at medicine now is, we'll see an obstetrician birth the baby, and then hand the baby off to the pediatrician or the family doctor. It’s really compartmentalised by body part,” she said.

However, many Indigenous communities see things differently.

Dr. Funnell recalls her great-grandmother, who grew up in Six Nations and later moved to Tuscarora Nation. She was a midwife, but patients simply called her the doctor.

“She didn't just birth babies; she took care of the whole family, in a holistic view of that person. [She took care of] the woman before her delivery, after her delivery.”

***

This Sept. 30, Queen’s observed the National Day for Truth and Reconciliation for the second time in history. Although the date has become a federally regulated statutory holiday, it’s not recognized as such at the provincial level. Here at Queen’s, students and faculty had a half-day off to commemorate the legacy of Residential Schools.

For Candice Martin, Meds ’25, one afternoon isn’t enough to address the gravity of the atrocities committed against Indigenous children in those schools.

Martin, who is Oji-Cree from Hornepayne First Nation and enfranchised into Fort Albany First Nation, is an executive member of the Queen’s Native Students Association (QNSA).

For almost a year leading up to the holiday, Martin and the QNSA participated in talks with the University around making the National Day for Truth and Reconciliation into a full-day holiday, but Queen’s turned them down.

“The reason why [the National Day for Truth and Reconciliation] is so important is so that people can acknowledge the deaths of the thousands of children in these residential schools that are basically going unacknowledged,” Martin said in an interview with The Journal.

“It’s so backwards that we're celebrating Thanksgiving, but we're not acknowledging the National Day of Truth and Reconciliation as a full day off.”

Martin, who overcame extensive barriers to even gain entrance to Queen’s, said that being an Indigenous medical student involves: “fighting for our rights—in every situation—to be seen as equal.”

They explained that when Indigenous communities are struggling to access education, clean water, and nutritious food, or even to be acknowledged as human beings, there are a whole host of issues that need confronted before even considering healthcare.

“Unfortunately, there's a lot of Indigenous people who don't feel comfortable accessing healthcare services because of racism in society,” they said. “You won't get people coming to get care, and until they get care, they won't be able to get fully treated.”

To truly address Indigenous health inequities, Martin believes health officials and institutions must commit to long-lasting action, consult more thoroughly with Indigenous groups themselves, and look to the rich history of Indigenous knowledge and healing for answers.

Although they say progress is being made, it’s coming at a “slow and painful” rate.

Martin thinks any movement towards reconciliation in healthcare must occur in collaboration, which is why they say the responsibility of making a change shouldn’t lie exclusively with Indigenous peoples.

Still, they remain committed to fighting for justice through their involvement with organizations like the Native People of Sudbury Development Corporation,the Queen’s Aesculapian Society, and the Canadian Federation of Medical Students. As a parent, Martin finds hope in working towards a future where Indigenous children can grow up safely.

“When the system is broken, or when there is a toxic environment, you change the environment, right? You don't change the plant if you're going to grow something there.”

***

When Nolan is asked to imagine a truly inclusive Indigenous healthcare system, she said she sees it as a “two row wampum style system.”

The Two Row Wampum belt is a symbol of the treaty signed between the Haudenosaunee and the Dutch government in 1613. It consists of two purple and three white stripes of wampum shells that extend the length of the belt: one purple stripe for Indigenous peoples, and the other purple stripe for non-Indigenous people.

It represents the two groups travelling into the future together—Indigenous peoples in their canoe, non-Indigenous people in their ship—and co-existing peacefully.

To Nolan, it represents her ideal vision for Indigenous healthcare: two systems and ways of knowing moving forwards in harmony without interference, with patients being given the option to select one or both streams of care.

“We're not interfering with one another; we're letting each other do what we need to do to look after our people and our resources, and to follow our original instructions that were given to us by Creator.”

Above all, she hopes mainstream medicine will begin to open up to Indigenous methods of healing, so both allies and Indigenous peoples can work hand in hand to build a better future for all.

“It's important as human beings, whether we're Indigenous or not, that we tried to do better today than we did yesterday. If we do that, we can put our heads down and rest at night.”

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