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Health care discrimination against Inuit studied

If you've experienced discrimination or racism through the health-care system in Ottawa, researchers want to hear your story.

Two Ottawa-based organizations have joined forces to conduct research into possible discrimination against Inuit in the Ottawa health-care system. Pixabay photo

The Wabano Centre for Aboriginal Health and the Ottawa Aboriginal Coalition began interviews in late November and will schedule more through February as they aim to document ways in which Inuit are not treated properly by health care staff.

"We actually want to engage specifically with community members who can tell us what their experiences are, good or bad, with the City of Ottawa health. That could be anything from pharmacies to emergency rooms, private doctor clinics, anything like that," said Elena Abel, community developer with the Ottawa Aboriginal Coalition. "It may be an incident where it would mean the person was less likely to want to access care or less likely to go to a clinic to present with issues because they've had a poor experience previously. It's a burden... they worry about being discriminated against or being labelled."

Inuktitut interpreters can be made available for interviews.

Approximately 5,000 Nunavummiut patients and escorts were sent to Ottawa for medical treatment in 2017-18, according to the Nunavut Department of Health.

NTI president Aluki Kotierk encourages Nunavut Inuit to participate in a study on health care discrimination conducted by Ottawa researchers.
NNSL file photo

Aluki Kotierk, president of land claims organization Nunavut Tunngavik Incorporated, said she applauds the research because quantifying such data can be a catalyst for change and advocacy. Kotierk said she encourages Inuit to make their voices heard through the initiative.

"Among ourselves... people speak about how they're not getting the right type of treatment or they question whether or not they're getting treatment that's equitable to other people," said Kotierk, who added that she believes few formal complaints are filed.

She's correct. The Nunavut Department of Health said its Office of Patient Relations received no complaints related to discrimination against Inuit in the Ottawa health care system in 2017-18.

"Inuit need to be able to trust that they're getting good service, but they also need to feel comfortable to get it and see themselves in that system. The delivery – the approach to health services – is crucially important," Kotierk said.

In worst-case scenarios, health-care discrimination can lead to death, she noted.

An example of that came to light during a coroner's inquest in August 2017. Victor Kaludjak, a Rankin Inlet resident, was treated for alcohol poisoning at the Rankin Inlet health centre in March 2013 based on his symptoms. He hadn't been drinking. He suffered a heart attack a short while later and died soon after being medevaced to Winnipeg.

"Assumptions are very dangerous," Kotierk said.

The coroner's inquest jury made 24 recommendations following the Kaludjak tragedy, which the Department of Health is still addressing, according to the GN's chief nursing officer, Jennifer Berry. Twenty-four Indigenous cultural competency training sessions – inclusive of 473 Health employees – have been held since 2017-18, with another 13 workshops scheduled before the end of this fiscal year, Berry stated.

Cultural training is essential, Kotierk asserted.

"I think with the power control relationships, historically speaking and probably presently speaking, where authority figures were always white people that came into our communities and created the communities, there's already an intimidation factor, I think, that many people don't realize they have just by the mere fact of being white in our communities," said Kotierk.

Early responders

Close to 40 people had already responded in the first several days since the Ottawa-based research was first advertised, Abel noted.

Nunavummiut patients with complaints about health care in Ottawa should be made aware of how to contact the GN Department Health's Nunavut Patient Relations by Ottawa Health Services Network Inc., which has a team of Inuktitut language interpreters.

The patient relations division fully investigates complaints and reports back to clients, according to the Department of Health.

Complaints about specific hospitals or clinics are forwarded to those facilities and are also reviewed by the executive director of Ottawa Health Services Network Inc.

Meanwhile, Ottawa Public Health (OPH) has already taken action to improve patient relations and outcomes, according to an OPH spokesperson.

The Ottawa Board of Health approved OPH's Reconcili-ACTION Plan in June, noted Donna Casey, program and project management officer with OPH. That plan outlines OPH's commitment to "enhance cultural safety for clients, including Indigenous cultural safety training for staff and strengthening our relationships with Inuit and other Indigenous partners and service providers," according to Casey.

In addition, the Wabano Centre is preparing cultural competency training that will be made available to health care providers, Abel said, adding that increasing the number of Indigenous people as front-line service workers will be encouraged.

As well, video resources will be created – including some of the lessons from the stories shared by Inuit – to share with administrators at the hospitals.

"We want to be able to highlight some of their concerns and also provide recommendations to the patients themselves," said Abel, adding that the videos will be available through the Ottawa Aboriginal Coalition's website.


Policies identified in Ottawa Public Health's Reconcili-ACTION Plan

  • Encourage employees to apply/promote Indigenous knowledge, languages and cultural teachings as appropriate
  • Raise awareness about historical injustices against First Nations, Inuit and Métis peoples and the direct/indirect impacts on Indigenous health
  • Acknowledge (and address) the underlying causes: past & present policies; ideologies of racism and colonization
  • Develop and implement culturally-appropriate data collection methods and analysis related to Indigenous health in Ottawa
  • Continue to support Indigenous partners, as requested, in their efforts to establish culturally safe health & wellness treatment and support services in Ottawa
  • Tailor Ottawa Public Health (OPH) programs and services to incorporate Indigenous knowledge and the principles of trauma-informed care (i.e. when feasible and appropriate to do so)
  • Collaborate with traditional knowledge keepers, Indigenous interpreters and system navigators (i.e. when appropriate and feasible to do so)
  • Establish a mechanism to facilitate annual reporting on reconciliation progress related to closing the gaps between Indigenous and non-Indigenous community members on health indicators that are relevant to public health in Ottawa
  • In consultation with Indigenous Works employment services, develop and implement an evidence-informed Indigenous employment equity and inclusion strategy at OPH
    Source: Ottawa Public Health's Reconcili-ACTION Plan