Each year, staff at Health Quality Ontario read the Quality Improvement Plans (QIPs) submitted by Ontario hospitals, primary care organizations, long-term care homes, and local health integration networks (which administer home care). We identified some stand-out examples from the 2017/18 QIPs showcasing what some organizations have done to address health equity in the populations they serve, and reached out to the people involved to find out more about their experiences.
The Weeneebayko Area Health Authority (WAHA) submitted an exemplary response that described their Traditional Healing Program.
We had the opportunity to talk to Caroline Lidstone-Jones, MIR, BA, Chief Quality Officer, Executive Team, and Robert Gagnon, Organizational Quality Coordinator, to discuss this program in more depth.
Can you tell us about the Weeneebayko Area Health AuthorityTraditional Healing Program (THP)?
The Program offers a variety of services with traditional and cultural healing options, focusing on the mind, body, and spirit of the person. The THP exists to support WAHA community members and their families, with emphasis on serving those who are surviving residential school members, or family members of survivors.
WAHA’s Traditional Healing Program is offered to the following communities located within the James and Hudson Bay region: Moose Factory, Moosonee, Fort Albany, Kashechewan, Attawapiskat, and Peawanuck. The regional hospital, Weeneebayko General Hospital (WGH), is located on an island. There are no roadways in to the community, except during winter when there are ice roads. The approximately 12000 residents depend on planes, trains, boats and helicopters to navigate the territory.
Traditional Healers, along with Traditional Counselors, travel throughout all of the six communities, conducting ceremonies and providing counseling services for the people.
The key programs and services of the THP are:
- Providing counseling to individuals, youth, couples, families, and community groups
- Counseling services for addictions, grief, sense of cultural loss, personal crisis situations, and suicidal ideations
- Healing for residential school survivors and family members
- Various ceremonies which include the rites of passage, sweatlodges, shaketents, and seasonal ceremonies
- Traditional Cree knowledge recovery through traditional medicines
WAHA cultural day 2017 – Goose cooking
What types of inequities is your population facing?
The major inequities in our region are jurisdictional barriers, service accessibility, and priority setting.
- Jurisdictional barriers related to federal vs provincial responsibility, services covered by OHIP, and non-insured benefits cause a tremendous waste of energy as leaders try to navigate these barriers for the First Nations people and their health providers.
- Issues with service accessibility are often related to the need for transportation to major cities to obtain care. Residents are challenged by having to leave work and family members they are caring for if they are required to leave their community to obtain care. Furthermore, in some cases, the patient only is provided with funded transportation and is required to leave the community without family support. Many patients are fearful to leave their community for care.
- Priorities are not driven by First Nations. For example, the region is interested in focusing on land-based activities, learning family roles (who collects the water, starts the fire, cooks, skins the animals, cleans up, navigates the land, etc.) and family bonding (re-learning or creating stronger bonds as a family unit). The people want to focus on traditional diets and foods (learning how to hunt, cook, sustain yourself through natural diets), which has to be fostered at a young age.
How did you engage the community in this work?
Leadership from within the communities is key. Our traditional healing advisory committee, made up of representatives from each of the six communities, provides advice and guidance to WAHA about the program. Membership includes traditional healers and counsellors and medical staff committed to working together, despite differing models of care.
Teepee at WGH - Moose Factory, Ontario
What type of advice/support do you feel health care organizations require to become more equitable?
You need to be willing to redesign models of care, ensure cultural sensitivity, recognize the Truth and Reconciliation recommendations, and generate motivation to become more equitable.
Models of care need to be inclusive of the First Nations values and the medical model. Care needs to be designed beyond physical walls or geographies. Models need to establish linkages between all needs (physical/mental/emotional and spiritual components). Partnerships are required to support the social determinants of health, for example between child welfare, education, income security programs, justice, and health care. Nothing in life happens in silos or in a vacuum – we need to work together for overall wellness.
Front-line staff should complete mandatory cultural sensitivity training, recognize the Truth and Reconciliation recommendations, and be able to apply the knowledge at the site of care to improve patients’ experience.
Finally, it’s important to maintain motivation. Tackling the low hanging fruit does not always motivate the impetus for change. You need to be prepared to listen, and deal with anger, grief, and trauma. Many stories need to be told, which will provide insight and help to build trusting relationships. This work takes time.
WAHA’s
Traditional Healing Room
You may also be interested in:
Quorum’s Indicators & Change Ideas page. Find more information about QIP indicators and related change ideas.