Acknowledgement and dedication

The Alberta Medical Association acknowledges that we are located on Treaty 6, 7, and 8 Territory, traditional lands of diverse Indigenous peoples including the Cree, Métis, Nakoda Sioux, Iroquois, Dene, Inuit, Blackfoot Confederacy, the Tsuut’ina First Nation, the Stoney Nakoda and many others whose histories, languages and cultures continue to influence our vibrant community. We respect the histories, languages, and cultures of First Nations, Metis, Inuit, and all First Peoples of Canada, whose presence continues to enrich our vibrant community.

An initiative of the AMA Indigenous Health Committee, this issue of Alberta Doctors’ Digest has a focus on Indigenous health. The articles in this issue are written by Indigenous physicians, knowledge keepers, and academic leaders of Indigenous health initiatives and education in Alberta. To ensure that this issue thoughtfully, respectfully and authentically represents the experiences and perspectives of its contributors, we employed the services of Indigenous editor, Alicia Hibbert.

We dedicate this issue to Joyce Echaquan, as in her dying moments she turned the nation’s attention to the ugly existence and lasting costs to humanity of anti-Indigenous systemic racism in health care in this country. In Joyce’s memory, and for all Indigenous people who continue to experience discrimination in their experiences with the health care system, we CAN do better. We MUST do better.

Feature video. Indigenous health in Alberta: Trust, knowledge and relationships. (Video produced by Marvin Polis)

Reflections on our history and the path to health equity

My name is Dr. Cara Bablitz and I am a Métis physician, raised in Treaty 8 Territory, and currently reside in Treaty 6 Territory. I thank the Alberta Medical Association for asking me to write a guest editorial for our special Indigenous health edition of Alberta Doctors’ Digest

The year 2020 was one for pause and internal reflection. There have been many challenges we have been forced to confront, although we may not have wished to. We are still in a pandemic, learning a new way of life. Among health care workers, there has been a sense of being under-valued despite working harder than ever, and we feel an urgency for a vaccine we are hoping will bring back some normalcy. 

One might ask if this is the right time to put out an edition of ADD focused on Indigenous health, trying to shine a spotlight on this area while so much else is occurring. My argument for moving forward is that systemic racism and the impact of colonization is a top issue that our country is facing. Although much more silent than the pandemic, this is killing Indigenous people on a similar scale. We can no longer allow Indigenous people, like Joyce Echaquan, to die due to a system that was built to defeat Indigenous peoples. 

The following quote by Canada’s first Prime Minister, John A. Macdonald, shows the intention of the government to develop policies for Indigenous people, including residential schools, the last of which closed in 1996: 

John A. Macdonald quote.jpg
Prime Minister John A. Macdonald

This edition of ADD will discuss in more detail the historic impacts of colonization and residential schools on our people. I thank Mrs. Brenda Reynolds, an Indigenous knowledge keeper, for her contribution of an article to discuss this topic in more depth. Brenda was rightfully awarded the AMA Medal of Honor and is one of the bravest people I know. She faced persecution after uncovering multi-generation sexual abuse at Gordon’s Indian Residential School. Brenda ran an after-school program where she supported young Indigenous students and brought them to safety after years of abuse. In her article she shares her wealth of life experience. 

The authors in this edition are my mentors and my teachers. I strive to be a better person and a better physician every day, guided by the path they have carved out. 

In Tibetha Kemble (Stonechild)’s story, The (dis)honor of the Crown, we will further explore the failure of Canada to implement the treaty (“keep its side of the street”) and the impacts we see in the health outcomes of Indigenous peoples. Tibetha is a former director at the Indigenous Health Initiative Program at the University of Alberta and won a teaching award educating medical students on Indigenous health. I thank her for adding her voice. Her personal reflection is honest and eye-opening.    

There is a network of amazing Indigenous physicians across this province working to make a difference in Indigenous health. Three physicians leading the way are Dr. Cassandra Felske-Durksen, Dr. Esther Tailfeathers and Dr. Alika Lafontaine. In her poignant piece, Dr. Cassandra Felske-Durksen reflects on Indian hospitals. Dr. Esther Tailfeathers, with the help of our ally Dr. Amy Gausvik, updates us on the changes in Indigenous health at Alberta Health Services. They have led a team working to eliminate barriers and offer Virtual Care Clinics to Indigenous patients across Alberta. Further, Dr. Alika Lafontaine eloquently speaks to the doctors of Alberta. He offers encouragement that is needed, as it is so critical that physicians find and use their voice to bring deeper awareness to these issues.  

This edition includes a contribution from a team of national leading researchers, Dr. Lindsay Crowshoe, Dr. Cheryl Barnabe, Dr. Rita Henderson and Anika Sehgal. I encourage you to look further into the amazing work from this team, including a research network for improving primary health care that is shifting the landscape for Indigenous peoples. 

When I feel overwhelmed by the magnitude of the challenges before us, I find hope in working with students such as Nicole Labine. Her contribution is an eye-opening article from a medical student’s perspective. We must continue to advocate for increasing the numbers of Indigenous peoples in health care careers. 

In their co-written article, Indigenous Nurse Navigator Arrow Big Smoke and Community Health Coordinator Patricia Yellow Horn describe how rising rates of late-stage cancer in Indigenous patients led to their collaboration on a new, in-community information session. Through this and similar creative health service adaptations, Arrow and Patricia are seeing the beginnings of an evolution in health care for Inuit, Métis and First Nations people.

If this edition is a springboard and you want to learn more, then we have achieved our goal. There is further information included in an article about Indigenous Cultural Competency for health care providers by Simon Ross at Alberta Health Services. All physicians in Alberta are required to complete the AHS training on Indigenous Cultural Competency and we encourage you to do so. We have also provided a recommended reading list

I would like to express my gratitude to the AMA for supporting the Indigenous Health Committee in the development of this Indigenous health edition of ADD. The IHC is working on many initiatives to improve the health of our people; a timeline of our committee’s and the AMA’s work has been included. For more information, you can visit the IHC website  and read the AMA Policy Statement on Indigenous health, the basis of our guiding principles. Thank you as well to Alicia Hibbert (Edified Projects), our Indigenous editor, for her knowledge and support. 

In this Indigenous health issue of ADD, the AMA is officially releasing a video filmed at Saddle Lake Cree Nation. Dr. Nicole Cardinal is a physician from Saddle Lake who imparts knowledge on building relationships with Indigenous peoples. Thank you to Dr. Cardinal and Eric Large, a former Saddle Lake Cree Nation Chief and Band Counsellor, for sharing their stories and insight.

I hope you will read this issue of ADD and go forward knowing more than when you started. When we know more, we can no longer live our lives as if we have not heard the story of our first people. With this knowledge, we can move past systemic racism and systemic oppression to health equity and well-being.

Hiy Hiy.

Banner image: Community Health Coordinator, Patricia Yellow Horn (L) Indigenous Nurse Navigator, Arrow Big Smoke (R) from their story about Indigenous cancer care: How Times Have Changed