A week of ups and downs

Last week was of tremendous importance in Canadian history with the release of the recommendations of Chief Justice Murray Sinclair, Chair of the Truth and Reconciliation Commission. It was also a great week at the CoM, as we celebrated convocation for the Class of 2015 – a class which included 10 First Nations and Metis graduates.

Further context for me was my first visit to the northern village of Ile-a la-Crosse. As a week, it was both a moment to take pride in what we have accomplished, and a painfully stark reminder of how much further we have to go.

First, I must congratulate the Class of 2015!  They celebrated a remarkable set of accomplishments and I was honoured to celebrate with them. They have great pride in their class and in the college, and clearly have great ambition to make the world a better place. This class has contributed greatly to the CoM as we have gone through a major period of transition.

As I said, this class of 84 students had 10 Aboriginal graduates. This is the highest number of Aboriginal graduates in our history – maybe the highest in Canada – in absolute terms; and surely the highest in relative terms.  My comments on this at the Graduation  Banquet received great applause, and lots of Tweets.

Yes we have come a long way, but our population is 16% Aboriginal, and growing at a fast rate.  We still have a long way to come before we can truly say we have a representative faculty and staff. It is also worth noting that despite our efforts, we have failed to recruit a Chair in Aboriginal Health, even after 4+ years of trying.  So lots more to do – we must commit to a collective effort to ensure we have better representation of Aboriginal people in all parts of our CoM.

Justice Sinclair has two recommendations specifically directed at medical schools. Recommendation 23 focuses on increasing the number of Aboriginal healthcare providers, and Recommendation 24 calls for education on Aboriginal health, the legacy of the residential schools, and cultural competency for all of our learners.

Justice Sinclair said “A knowledge of history leads to understanding, and understanding leads to respect. Reconciliation follows.”  Another powerful statement he made was: “We are the best, we are the brightest, we are the future, we are the change…”

Clearly, our curriculum, and our policies should be informed by all of the recommendations in the full report when it becomes available.

Our Making the Links program is the envy of many medical schools, as are our inner-city student-run clinics. But these do not reach all students.  Val Arnault-Pelletier (our Aboriginal Student Coordinator in the CoM) does a fabulous job in supporting and advocating for our Aboriginal students, but we do not yet have Aboriginal space in our Health Sciences Building.

Go to the Northern Ontario School of Medicine, and you’ll see all signs represented in English, French and Ojibway.  Every NOSM student spends a month in an Aboriginal community in first year.

We have great efforts in Aboriginal health research by people like Caroline Tait, Mark Fenton, Vivian Ramsden and others, but our placement of Aboriginal Health as one of our three research priorities is more aspirational than real. Lots more to do!  Remembering we must work together collectively and collaboratively to support Aboriginal Health initiatives in our college and asking ourselves what our collective responsibility is.

So how do I tie in Ile-a la-Crosse? Well, so far I have visited 10 of 13 health regions, and as of last Friday, all three Northern Health Regions. In all, I have seen beautiful landscapes, people who love their homes and take great pride in their community.  And yet, I hear painful stories of social and health inequity, and injustice.

I was invited to Ile-a la-Crosse by MLA Buckley Belanger and Mayor Duane Favel. I spent the day with them as they proudly showed me their community, and their considerable efforts to improve the health and socioeconomic status of their people. I met with Elders; two of our graduates, Drs. Reid and Darcy McGonigle,  who live and work there; some of our students; Keewatin Yatthe Health Region personnel – including CEO, Jean-Marc Desmeules; an RCMP officer; and many community members.  I toured the Integrated Services Centre – an incredibly beautiful new building that houses the hospital, ER, Primary Care Clinic, community health services, long term care facility, daycare, community employment agency and high school!  It was an amazing facility.

We talked at length of their aspirations of having all of their doctors living in their community; the desperate need for mental health services; the number of people struggling to manage their diabetes and other chronic illnesses in the absence of full services; and poignantly, the challenges of driving five hours to Saskatoon for dialysis three time a week.

But the moment that really brought me up short, was our discussion about the challenges with alcohol and drug addiction, and access to care. We toured their four-bed detox unit, and discussed the challenges faced by patients in immediately returning to their often even more remote community, without on-going care. They told me there was once a 28-day treatment program – I would see where it had been housed when we finished the tour of the town.

We later drove by a boarded up old building which had housed that alcohol and addiction treatment program. They said with grim irony: “Yeah, before that it was the residential school.”

Well it felt like I had been punched in the stomach!

It illustrated for me, in an instant, all that Justice Sinclair has had to say in the last week.  That residential school only closed in 1971, which is not that long ago.

Not all of the North is Aboriginal, and we need to be cognizant that Aboriginal people throughout the province need a CoM that meets their needs.

We are doing some great things in the North. We have great student placements, a family medicine residency program in La Ronge, and have done some outstanding public health research led by Dr. James Irvine.

Dr. Ivar Mendez and Dr. Lorna Butler of the College of Nursing are pioneers on the use of robots in providing remote-presence care, and are doing the research to back that up. This year, Dr. Mendez will represent the only medical school in the world – USask – to be invited to a World Health Organization conference on remote health care.

Dr. Tanya Holt in paediatrics is doing innovative work providing remote consultation and care using the robot in Pelican Narrows  and will soon start using Nursing’s robot to do the same in Ile-a la-Crosse. For years the CoM has operated Northern Medical Services, ably now led by Dr. Veronica McKinney, who provide doctors for the North.

The visit has certainly inspired me to ask: how can we leverage NMS, the interests of our faculty and our learners, our focus on Aboriginal Health research, and our immense and beautiful North to be national and world leaders in Northern and Aboriginal healthcare?  I believe we must commit to delivering on Justice Sinclair’s TRC Recommendations, always mindful of what the community needs and resources are. As always, I am interested in your ideas and opinions.

The trip to Ile-a la-Crosse was great in other ways too. I got to bring along my new camera and lens to do some aerial photography on the way (don’t be looking in National Geographic anytime soon), and in the afternoon they took me fishing. So, I got to cap off my first year in Saskatchewan catching my first Walleye and Northern Pike (but don’t look for any prize winning fish just yet as well!).

So I learned in the week of the release of the TRC Recommendations that we still have a long way to go at the CoM in serving our Aboriginal partners.  We must commit to resources, dialogue and initiatives that make a difference for our collective good, but most certainly for our Aboriginal demographic, youth, leadership and those yet to come.

And through Convocation, I saw the results of all the great work all of you do. Congratulations again to the Class of 2015.

Preston

 

3 thoughts on “A week of ups and downs

  1. Great blog post. I would ask for some clarification about the Chair of Indigenous Health at the U of S and the urgent need for an Indigenous Physician to fill the role and help implement the recommendations of the TRC in meaningful ways. It’s been years since the position was posted and several Indigenous Physician scholars have applied for the position with no hiring.

    What is the COMs plan for the Chair? This is one of the areas the COM must follow through on. Proud that the Indigenous programs have continued to grow since I graduated in 2006.

  2. I’m so glad to see our Dean taking such an interest and getting involved with so many different communities in our province and sharing these with the rest of us.

  3. Thank you for another onsite full newsletter.
    Long ago in northern Ontario, I was the education coordinator for an aboriginal addiction treatment program that was 28 days hospital, followed by a year of residential where participants attended my upgrading classes during the day. It was very successful but after 10 years a change in government ended the program.

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