The National Day for Truth and Reconciliation recognizes the shameful history, ongoing trauma, and legacy of colonization. Our history of colonization includes the Indian Act, residential schools, unmarked graves and missing children, the generational impact on the families left behind and the survivors of these institutions, the 60’s scoop, and loss of language and culture, to name but a few.
The National Day for Truth and Reconciliation is Monday, September 30, 2024.
The NOHT-ÉSON is marking the day by highlighting the calls to action under Health from the Truth and Reconciliation Commission’s Final Report and the NOHT-ÉSON’s efforts to address these specific seven calls to action. Not all calls to action have been undertaken thus far, and there is still much work to do in furthering the reconciliation process.
The NOHT-ÉSON is committed to increasing Indigenous voices and presence at the Planning Table and its many working groups, actively building collaborative, community-engaged partnerships, and supporting its partner organizations to be leaders in de-colonizing health and social service practices.
18. We call upon the federal, provincial, territorial, and Aboriginal governments to acknowledge that the current state of Aboriginal health in Canada is a direct result of previous Canadian government policies, including residential schools, and to recognize and implement the health care rights of Aboriginal people as identified in international law, constitutional law, and under the Treaties.
Since its inception in 2019, the NOHT-ÉSON has identified Indigenous peoples as a priority population in its work. It is of the utmost importance to ensure that Indigenous peoples have timely access to the care they choose, be it Western or Indigenous traditional medicine, and receive their care through practices grounded in identity-affirming approaches and cultural humility. The NOHT-ÉSON has made it a priority to build and strengthen trusting relationships with Indigenous peoples in Niagara.
NEW for 2024 – Over the course of 2023 and 2024, an Indigenous Health pillar for the NOHT-ÉSON’s strategic plan was developed entirely by community members over several engagement sessions, including with the Indigenous Advisory Council. The community-driven process, facilitated by the Manager of Indigenous Health Care Relations with support from the NOHT-ÉSON, was endorsed by the NOHT-ÉSON’s Planning Table at its meeting on September 5, 2024.
The strategic goal and objectives of the Indigenous Health pillar are as follows:
Strategic Goal: To ensure that our health and social care services reflect Indigenous values, prioritize Indigenous voices in decision-making, and integrate Community perspectives into all levels of planning.
Objectives:
- People-First Priority: Ensure that people are the first priority in all aspects of health and social care services. Strive for optimal fulfillment of Indigenous individuals’ needs, aspirations, and rights, placing their well-being at the forefront of decision-making and resource allocation.
- Eliminate Mistreatment and Premature Death: Enhance cultural competency, practices, and policies within health and social care services to reduce the risk of mistreatment and premature death among Indigenous peoples.
- Prioritize Optimal Care: Redirect funds to prioritize optimal care that aligns with Indigenous values and preferences, ensuring that services are tailored to the unique needs and inherent rights of Indigenous peoples.
- Build Partnerships and Community Outreach: Foster partnerships with Indigenous communities, organizations, and leaders to actively involve them in decision-making processes, strategic planning, and service delivery. Conduct Community outreach and education initiatives to enhance understanding of disparities and promote culturally sensitive care.
- Create Integrated Community Services: Develop integrated health, social and community services that address the holistic needs of Indigenous peoples, considering factors such as cultural traditions, language, and spirituality. Ensure that services are accessible, responsive, and respectful of Indigenous identities and experiences. This may involve the creation of new agents.
- Prioritize Indigenous Data Sovereignty: Acknowledge the paramount importance of Indigenous data sovereignty across all phases of data collection, utilization, storage, and interpretation. Commit to supporting Indigenous individuals and communities in asserting control over their data, ensuring that data practices honor Indigenous rights, knowledge systems, and self-determination. Ensure that asserting control over data does not impede Indigenous participation in health and social care programs and services.
19. We call upon the federal government, in consultation with Aboriginal peoples, to establish measurable goals to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities, and to publish annual progress reports and assess long term trends. Such efforts would focus on indicators such as: infant mortality, maternal health, suicide, mental health, addictions, life expectancy, birth rates, infant and child health issues, chronic diseases, illness and injury incidence, and the availability of appropriate health services.
In consultation with Indigenous health and social service providers and the community, the NOHT-ÉSON continues to work on its Measuring Health Equity Project that will inform the transformation of services by listening to the voices of Indigenous peoples and how the health care system is experienced in Niagara. By developing a set of standard demographic questions to be collected, ideally, by all service providers, the NOHT-ÉSON aims to establish baseline demographic information. It can then identify gaps and improve the health care experience of Indigenous peoples.
NEW for 2024 – Three partner organizations have agreed to pilot the collection of this data and are planning a launch over the coming months.
20. In order to address the jurisdictional disputes concerning Aboriginal people who do not reside on reserves, we call upon the federal government to recognize, respect, and address the distinct health needs of the Métis, Inuit, and off-reserve Aboriginal peoples.
21. We call upon the federal government to provide sustainable funding for existing and new Aboriginal healing centres to address the physical, mental, emotional, and spiritual harms caused by residential schools, and to ensure that the funding of healing centres in Nunavut and the Northwest Territories is a priority.
22. We call upon those who can effect change within the Canadian health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients.
NEW for 2024 – In May 2023, Ontario Health (OH) identified a critical opportunity to enhance care for people with diabetes and peripheral vascular disease. Specifically, the focus was on lowering the rates of avoidable, non-traumatic lower-limb amputations.
The Niagara region has the second highest loss of lower limbs in Ontario, and it is estimated that 85 per cent of lower-limb amputations are preventable.
The NOHT-ÉSON and its partners identified significant gaps in care in the Niagara region, especially in providing culturally safe and appropriate diabetes education and management services for Indigenous peoples.
Several barriers prevent Indigenous peoples from accessing high-quality diabetes and lower-limb preservation services in Niagara. Given these gaps, the NOHT-ÉSON and its partners adopted a holistic approach to diabetes management, focusing on prevention, early intervention, and providing culturally safe care.
The NOHT-ÉSON successfully secured approval for the initiative, and work is now underway. In the first year, the Indigenous Primary Health Care Council (IPHCC) played a pivotal role in shaping the initiative to ensure it followed an Indigenous-led approach to service planning. In the second year, leadership transitioned to the Indigenous Diabetes Health Circle (IDHC), with continued support from the Fort Erie Native Friendship Centre and De dwa da dehs nye>s Aboriginal Health Centre. The IPHCC remains an active partner in the initiative. Together, through community engagement, they developed and implemented a comprehensive Lower-Limb Preservation Strategy (LLPS), focused on the following key goals:
- Reduce avoidable, non-traumatic major lower-limb amputations in the Niagara region
- Link community members with additional local community-based programs and services to assist with the management of overall health
- Improve equitable access to culturally safe, holistic, high quality, trauma-informed best practices for:
- Early screening for foot care, diabetic retinopathy screening (eye health), and vascular health
- Integrated lower-limb wound care
The priority for the LLPS is to ensure the work undertaken is relevant and culturally competent to the Indigenous peoples living in the Niagara region. The IDHC currently offers a foot care program (assessment by a nurse, education, and self-care resources) at the centre’s head office in Thorold and at the FENFC. Through the initiative, the foot care room at the FENFC will be renovated. Diabetic retinopathy eye health screening, vascular health screening, and wellness sessions with a traditional healer/practitioner at the FENFC will be offered. Equipment will also be purchased to provide Doppler ultrasonography, and an evaluation of the initiative will be conducted using a holistic model of health.
Additional outcomes include the creation of a referral pathway for unattached clients from the IDHC and the FENFC to the DAHAC and Bridges Community Health Centre (CHC) to connect clients with a primary care physician. A similar referral pathway will be created from the DAHAC and Bridges CHC to the IDHC or the FENFC to connect clients with preventative and holistic care.
Lastly, the initiative will discover and address any gaps Indigenous clients may encounter when experiencing foot ailments while navigating the health care system utilizing data from needs assessments (engagement sessions).
By focusing on culturally safe, holistic, and trauma-informed care, the Lower-Limb Preservation initiative tackles existing barriers. It strengthens partnerships and referral pathways to improve access to essential diabetes and foot care services. Through ongoing collaboration with Indigenous-led organizations and health care providers, the LLPS is poised to significantly enhance health outcomes, ensuring that Indigenous community members receive the high-quality, integrated care.
An overview of the Lower Limb Preservation Project can be found here.
Click here to read an article from the St. Catharines Standard regarding Lower Limb Preservation Project.
23. We call upon all levels of government to:
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Increase the number of Aboriginal professionals working in the health-care field;
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Ensure the retention of Aboriginal health-care providers in Aboriginal communities; and
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Provide cultural competency training for all healthcare professionals.
San’yas Indigenous Cultural Safety Training has been offered to NOHT-ÉSON members and employees. The training challenges anti-Indigenous racism while discussing how to begin to provide identity-affirming care grounded in cultural humility. The NOHT-ÉSON recognizes the training is a foundational piece in its allyship.
The Bystander to Ally course enables people to enhance their skills in speaking out and advocating for the social justice of Indigenous peoples. The course is offered to people who have completed the initial Indigenous Cultural Safety Training offered through San’yas.
NEW for 2024 – Five full and half day training sessions were organized by the Manager of Indigenous Health Care Relations at the Fort Erie Native Friendship Centre throughout the year. In total, approximately 300 people participated in the sessions and included representatives of the NOHT-ÉSON, its partners, Community, and the public.
24. We call upon medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous peoples, Treaties and Aboriginal rights, and Indigenous teachings and practices. This will require skills-based training in intercultural competency, conflict resolution, human rights, and anti-racism.
The NOHT-ÉSON remains committed to ensuring regular learning and growth opportunities take place. These include the use of the Indigenous Allyship Toolkit and the Mno Bmaadziwin Report as part of our commitment to learning and understanding the barriers to health and well-being outcomes of Indigenous peoples due to systemic racism and the legacies of colonization, and the NOHT-ÉSON encourages its partners to do the same.
The Hamilton Niagara Haldimand Brant Indigenous Health Network, in partnership with the former Hamilton Niagara Haldimand Brant Local Health Integration Network, developed the Indigenous Allyship Toolkit.
The toolkit is intended to support health care providers in addressing inequities. The document includes many helpful resources on advocating for social justice and addressing anti-Indigenous racism.
Click here to download a copy of the toolkit.
Orange Shirt Day
The National Day for Truth and Reconciliation also coincides with Orange Shirt Day, inspired by Phyllis Webstad, who had her favourite orange shirt taken from her on her first day at a residential school when she was six. In addition to signifying when Indigenous children were sent to residential schools, Orange Shirt Day reminds us of the assimilation practices towards Indigenous peoples, that “Every Child Matters”, and encourages us all to wear an orange shirt on September 30.
Learn more about Phyllis’ story here.
Indigenous Mental Health and Community Services
The NOHT-ÉSON recognizes the National Day for Truth and Reconciliation may be a distressing time for Indigenous peoples. Hope for Wellness Helpline is available 24/7 to all Indigenous people across Canada – call 1-855-242-3310 or visit www.hopeforwellness.ca. The helpline is operated by Donna Cona, an Indigenous organization funded by the Government of Canada.
The NOHT-ÉSON’s Resource Navigator features many Indigenous-led health and community services in the Niagara region. They can be accessed here.
