Indigenous representation in health care improving – but ‘enormous gaps’ remain – National

Ever since she was a little girl, Kelsey Allen dreamed of being a doctor.

But the 25-year-old medical student from the Qalipu Mi’kmaq First Nation in Newfoundland knows her journey comes with barriers – including racism – as she tries to navigate a health-care system where inequities and a lack of Indigenous representation are still a concern.

“As an Indigenous woman, I’m very aware that every day that I’m in medical school, I’m working in a system that was not made for me,” said Allen, who is in her second year of medical school at McMaster University in Ontario.

Her goal is to eventually serve her community back home.

“It’s very important to me that as an Indigenous doctor, getting my medical education, that I do not come out on the other side of a medical conveyor belt as another western doctor who is Indigenous,” she told Global News in an interview.

“I want to be an Indigenous doctor who practises holistic medicine and who acknowledges that someone is more than just their symptoms or their disease.”

As Canada marks its third National Day for Truth and Reconciliation Saturday to honour lost children and survivors of residential schools, Indigenous doctors say progress has been made in the health-care field, but more work needs to be done.

In 2015, the Truth and Reconciliation Commission made 94 calls to action – of which seven are focused specifically on health care.

In particular, number 23 demands an increase in the number of Indigenous professionals working in the health-care field.

Dr. Alika Lafontaine, past president of the Canadian Medical Association, says Indigenous representation is improving and “it’s an exciting time” to see that happen.

“I’m seeing more and more folks go into specialties that are needed within Indigenous communities across the country … moving into policy positions and also leadership within health-care systems,” he told Global News in an interview.

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Indigenous medical student shares experiences of racism in studies: ‘It’s about what’s not being said’

The federal government, as part of last year’s Fall Economic Statement, earmarked $250 million over five years to support the recruitment and retention of health professionals on First Nations reserves.

To boost nursing employment, Ottawa says Indigenous Services Canada has conducted job fairs and social media outreach, paid for advertising and worked with educational institutions to help Indigenous students access and participate in health-care programs.

Besides better representation, Lafontaine said he’s also seeing advancements on the infrastructure side, with a shift toward building clinics in places where Indigenous people live.

“There still are enormous gaps between where we need to be and where we are right now, but we should celebrate those wins on our way to that end state,” he said.

This is a good start, says Dr. Michael Dumont, vice-president of the Indigenous Physicians Association of Canada and medical director of the Lu’ma Medical Centre in Vancouver, adding that Indigenous health-care workers still remain “really underrepresented” in Canada. 

“First Nations, Inuit and Métis people make up roughly five per cent of the population of Canada, but we only make up a small fraction of one per cent of all the physicians in Canada as Indigenous doctors. So we have a really long way to go to reach parity.”

Seeing more Indigenous health professionals provide care and in leadership positions will also help build trust among patients as they navigate a system that is “inherently unsafe” for them, Dumont said.

“We need to transform the system from within to make it safer for all of us and for Indigenous communities.”

One of the many challenges Indigenous students face, along with the lack of financial resources and other supports, is the constant struggle with their identity and the fear of not being accepted in urban settings, Dumont and Lafontaine said.

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Indigenous medical student talks about challenges of being ‘white passing’

For Allen, who does not have any distinguishable Indigenous features, being “white-passing” has been both a blessing and a curse, she said.

“If I don’t wish to share my identity with people if I sense that the environment is hostile or it’s not safe, in that sense, it’s great, it’s an asset. But the other part of it is, especially when I’m not known to community here, it’s a risk of … not being accepted because I don’t look the part.”

Lafontaine, who is Métis from Saskatchewan, said it’s a “confusing journey” for many aspiring to get medical training and help their communities.

“I think that there’s definitely unique challenges for Indigenous youth. One is self-confidence and just not having that long history of folks who’ve been in the system.”

Efforts should also be made to make sure students feel well-prepared when they are done with training and go back into their communities, Dumont added.

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Indigenous doctor reflects on how to make medical system safer for communities

The recognition of Indigenous healing practices — that have been passed on through generations — in the Canadian health-care system is also among the TRC’s calls to action.

Ottawa says it recognizes the value of Indigenous healing practices “as an important element in the provision of high quality and culturally-relevant health services for Indigenous Peoples and is providing support for these practices in a number of ways.”

In many parts of the country, these practices are “experiencing a revival,” Dumont said.

At the Lu’ma Medical Centre in the unceded Musqueam, Squamish and Tsleil-Waututh territory in B.C., where Dumont serves as a medical director, they partner with elders and traditional healers to try to improve the quality and scope of care, he says.

“Many of us grow up with a sense of shame in our identity and having access to traditional healing methods and elders really helps to foster a more positive cultural identity and ultimately better mental and emotional and spiritual health,” Dumont told Global News.

An increasing exchange of knowledge of traditional healing practices with western medicine bodes well for Canadian health-care systems, Lafontaine said.

“There’s a lot of different opinions on how you make the two work together, but at the end of the day, what we want is really for people to feel healthy.”