By Maggie Macintosh | Winnipeg Free Press
New made-in-Manitoba training on “culturally safe care” will educate current and future doctors, nurses and their colleagues on anti-Indigenous racism with a goal of improving treatment for all patients.
Health-care workers will be able to register for Giga Mino Ganawenimaag Anishinaabeg — an Ojibwa phrase that translates to “We will take good care of the people” — as of Monday.
Ongomiizwin-Indigenous Institute of Health and Healing, based out of the University of Manitoba, announced the imminent rollout of its 10-module training program on Tuesday.
Participants will be assigned case studies and reflection questions to increase their understanding of historical injustices and persistent prejudices that affect the health outcomes of First Nations, Métis and Inuit people.
“A lot of times, racism is almost subterranean,” said Lee Sanderson, one of five Indigenous coach-facilitators hired to help registrants, including post-secondary students and their professors, work through the online course and a final in-person workshop.
“It could be a small, nuanced facial expression or an inflection, a tone of voice or the way something is said and anybody who has identified with carrying trauma will know that the smallest of things can be triggering.”
While on the job as a trauma worker serving homeless people in the Winnipeg Regional Health Authority, Sanderson said he often heard from clients who did not feel safe entering a clinic and expected to be turned away, judged or disregarded entirely.
The coach-facilitator, who is a member of Sagkeeng First Nation, said his hope is that new training will morph into “emotional recognition” and awareness of the biases that health-care providers bring to work.
The goal is to train 3,000 people annually, with each health employer nominating different teams to participate.
Topics range from the impact of colonization on Indigenous health to how the residences of patients, be they in urban, rural or on-reserve communities, affect medical treatment.
The online lessons are anticipated to take 10.5 hours to complete, in addition to a culminating workshop to consolidate learning over two to three hours.
Darlene Jackson, president of the Manitoba Nurses Union, called the initiative “a good start to making our health-care system more accessible and comfortable for everyone,” and indicated she intends to look into completing it herself.
Jackson said she has questions about how employers will support the rollout and if overworked nurses will be asked to do the training on their own time.
“They need some down time. They need a mental health break and so, I’m not sure how much uptake there will be on this,” she said.
The Truth and Reconciliation Commission of Canada’s 94 calls to action, especially those singling out health care, are central to the curriculum.
“Now, we are the Canadians being called upon to make those changes, so we ask you to do that with your heart, your mind and your hands. We need all. We need your will. We need your willingness,” Shared Health’s Charlene Lafreniere told a crowd gathered on U of M’s Bannatyne campus.
Lafreniere, provincial lead of Indigenous health, asked that all participants practise humility during this exercise so they can acknowledge missteps and respond accordingly.
Roughly 100 people attended the launch event inside the Brodie Centre Atrium that began with a pipe ceremony and ended with a feast.
Dr. Lisa Monkman, an Anishinaabe family physician and faculty lead in post-graduate medical education, performed an honour song about gratitude and giving thanks to the Creator to mark the occasion.
Ongomiizwin received nearly $1 million to develop and deliver the courses in partnership with local health regions through a Health Canada fund that supports anti-racism work.
While similar training has been offered to health-care workers since 2015, this project is unique in that it was created locally with input from elders and personalized coaching is available.
It will bolster and standardize anti-Indigenous racism education across the Rady Faculty of Health Sciences.
The vice-dean of Indigenous health, social justice and anti-racism said she wants to see First Nations, Métis and Inuit students and members of the workforce start to experience safer environments as a result of this work.
Dr. Marcia Anderson noted that 56 per cent of Indigenous, Black and other racialized employees in a 2023 Shared Health survey disclosed they had directly experienced one or more forms of racism within the last year.
“That increases the risk of burnout, of mental health distress and of leaving the health workforce and so (anti-racism training programs) are critical to also stabilizing the health workforce,” the Cree-Anishinaabe physician added.
Everyone involved in the new initiative is encouraged to seek guidance through personalized, one-on-one coaching available throughout their studies.
The initial cohort of coaches, hailing from various health-care areas ranging from medicine to rehabilitation services, will provide 20-minute sessions and host wrap-up seminars.
Coach-facilitator Kaitlin Hogue said one striking element of the curriculum is its analysis of tragedies involving real patients, such as Brian Sinclair and Jordan River Anderson.
As they study how these patients were mistreated, the Métis pediatrician said she wants people to “lean into the discomfort” of understanding how systemic and interpersonal racism presents itself in health care.
Sinclair died of septic shock after a 34-hour wait in his wheelchair in an emergency room at Health Sciences Centre in 2008.
The namesake of Jordan’s Principle was five when he died in hospital in 2005 amid a two-year dispute between the Manitoba and Canadian government over who should pay for the boy’s at-home care.
Indigenous people, representing about 18 per cent of the overall population in the province, have a significantly lower life expectancy than their non-Indigenous neighbours.
Manitoba’s latest health status report shows First Nations women and men are expected to live to 72 and 68, both of which are almost 11 years younger than average.