Quebec Indigenous Emotional Training Inadequate, Health Workers Say

As the two years since Joyce Echaquan’s death approach this week, the measures taken by the Quebec government to address racism and discrimination in health facilities are inadequate, indigenous medical experts say.

Echaquan, 37-year-old Atikamekw’s mother of seven, died in 2020 at a hospital in Joliet, Quebec, after filming herself being subjected to insulting comments from staff.

Quebec’s Ministry of Health and Social Services (MSSS) developed compulsory training for all health workers after a coroner’s report found that racism and discrimination contributed to her death.

But Glenda Sandy, a Naskapi Cree nurse in Kawachikamachi, Quebec, says the training does little to combat racism, prejudice, or harmful misconceptions in the state’s health care system.

“This is more bad than good,” Sandy said of the workout.

The family wants to know exactly how and why Joyce Echaquan (right) died while in the hospital. (Facebook)

Originally developed for civil servants, the 90-minute online awareness training on Indigenous realities will be promoted by MSSS in June 2021 as “Access to Culturally Safe and Relevant Services for Indigenous Peoples and Inuit.” It is now available for the purpose of “improving continuity.”

CBC News has received access to training from MSSS. The first module on history and settlement focuses on creation stories, the fur trade, treaties, assimilation policy, Indian law, and boarding schools.

It also delves into the Bering Strait theory, questioned by recent research, that migration to North America occurred thousands of years ago when people crossed a land bridge from Asia.

“Honestly, it felt like a history class in high school,” said Sandy, who works as a nursing adviser in the public health division of the Nunavik Community Health and Social Welfare Board.

She noted the lack of indigenous perspectives and voices compared to the Quebec professors, and described the content as disgustingly superficial.

Glenda Sandy is a Naskapi and Cree nurse from Kawatikamak, Que State. (Marika Wheeler/CBC)

“When I timed it, the story of creation lasted less than two minutes, while non-indigenous archaeologists were talking about the migration of people thousands of years ago for more than five minutes,” Sandy said. I was.

“Having non-Indigenous experts tell our stories continues to undermine and marginalize Indigenous peoples.”

The second module focuses on best practices for adopting vocabulary and place names, and includes a video montage of testimonials on how to improve relations with indigenous peoples.

The Best Practices module incorrectly lists an indigenous word for “thank you”. (MSSS)

It also contains a factual error in the section on how to say hello and thank you in Quebec’s 11 indigenous languages. The training incorrectly states that “migwech” is the Inuktitut way of saying “thank you”. It also uses older terms like “Malecite” and “Micmac”.

lack of cultural safety

Dr. Darlene Kitty, a Cree family physician in Chisasibi, Kay, said she was disappointed with the way she was training.

She wrote to the board of directors of the McGill University Health Center expressing concern about the lack of reference to the Truth and Reconciliation Commission, the Wiens Commission, and the national investigation into missing and murdered Indigenous women. Did. girl.

“I think they have good intentions, but you can’t learn everything about indigenous people in one module,” Kitty said.

“It has to be a continuous journey, it has to be more interactive. It’s not just listening to videos and watching slides.”

She said there are two big aspects of training that are missing. Cultural safety and cultural humility. It is a principle that transcends consciousness, sensitivity and capacity by incorporating the political, social and historical context of culture.

Dr. Darlene Kitty is a Family Physician from Chisasibi, Que Province. (T. Filipchenko)

Cultural humility, she said, is an introspective process about the relationship between Indigenous patients and professionals.

The Biens Commission, which has investigated the treatment of First Nations and Inuit in Quebec by public services, has established a health and social services network agency to work with indigenous peoples to develop services and programs based on cultural safeguard principles. I asked for

This is also enshrined in the Joyce’s Principle, a document prepared by the Atikamekw Nation Council and the Atikamekw Council of Manawan to ensure that indigenous peoples have equitable access to health and social services without discrimination.

The training does not mention Echaquan at all.

58% of employees completed training

As of September 21, 183,844 healthcare workers have completed training, representing approximately 58% of the network.

At a provincial election debate hosted by the Indigenous Quebec and Labrador Congress (AFNQL) last week, outgoing CAQ Indigenous Affairs Minister Ian Lafrenière expressed pride in the “good progress” his party had made in training. did.

“We weren’t waiting. We weren’t just sitting. We made some changes on the spot to a cultural safety guide written with indigenous people,” he said. .

In an emailed statement to CBC News and Radio-Canada, MSSS said the training was the result of more than two years of work, and that it “recruited several prominent members of the indigenous community, university researchers, and a It was developed with the involvement of civil servants.” .”

“Their work was submitted to an interdepartmental working committee responsible for verifying the accuracy of facts and completeness of information, and then to the Indigenous Peoples Advisory Committee,” said Marie in MSSS Media Relations. – said Hélène Émond.

“Check the box”

Dr. Samir Shaheen Hussain, a doctor in Montreal, wrote this book Fighting to Hold Hands: Confronting Medical Colonialism Against Indigenous Children in Canada.

He questions the relevance and effectiveness of training without acknowledging the history of colonialism that created inequalities and injustices in health care.

“There’s a huge generational baggage of medical colonialism that we’ve brought with us as people in healthcare that has to be undone,” Shaheen-Hussain said.

Dr. Samir Shaheen-Hussain is a pediatric emergency physician in Montreal and an assistant professor at McGill University School of Medicine. He was one of the co-founders of the #aHand2Hold campaign. (submitted by MUHC)

Boarding schools, for example, were discussed in training but omitted how medical institutions, scientists and providers played a role in the system, he said.

Training must address that history and be specific to the healthcare context, he said.

“The danger is basically checking boxes,” said Shaheen-Hussain.

“People are going to come out of this government-approved training and think that the knowledge being conveyed is capital ‘T’ truth, so it’s actually going to be harmful. ”

For Sandy, she hopes the training will be revised so that indigenous peoples will voice their perspectives and experiences in the health care system.

“I’m a nurse. I know how to navigate that system. That doesn’t mean I’m not afraid,” she said.

“When I walk into the hospital, there is fear.

Quebec Indigenous Emotional Training Inadequate, Health Workers Say

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