Cancer Care Ontario renews Aboriginal strategy
By Bonnie Kogos
The coincidence and blessings of Northern Ontario caused me to sit next to a bright and charming young fellow, Usman Aslam, on my last Air Canada flight from Sudbury to Toronto. An employee with Cancer Care Ontario, Usman is group manager with the Aboriginal Cancer Control Unit. He was fresh from attending meetings on Manitoulin Island with health professionals.
As a grateful breast cancer survivor for 20 years, I eagerly listened that Cancer Care Ontario renews, this week, its commitment to aboriginal cancer care with the launch of a new three-year plan that will leverage local networks and partnerships to improve health equity.
This comprehensive plan that will guide how the organization works with partners to improve the performance of the cancer system and reduce the burden of cancer for First Nations, Inuit and Metis people from 2015-19.
Inuit and Metis have higher mortality rates from preventable cancers, show higher rates of some modifiable risk factors and tend to present with later-stage cancers at the time of diagnosis.
Aboriginal Cancer Strategy III builds on the progress in the second strategy (2012-15) and focuses on the same six strategic priorities to improve health equity. Cancer Care Ontario works with aboriginal groups to formalize relationships based on trust and mutual respect, and develops data to inform and monitor progress in programming initiatives.
The strategy is to focus on smoking cessation efforts and begin to address other modifiable risk factors. To increase participation in cancer screening across the province. And to offer palliative and end-of-life care.
“Through our work the past 11 years, we’ve developed a thorough understanding of the unique needs within First Nations, Inuit and Metis communities,” Alethea Kewayosh, director of the Aboriginal Cancer Control Unit, told me on the phone. “This plan demonstrates our unified commitment to staying on the path we’ve paved together with our partners and building on the success that’s already been achieved. Working together, we want to reduce the risk of aboriginal people developing cancer, while improving the quality of life for current and future patients.
“While many successes has been achieved since the launch of the second strategy, one of the most impactful accomplishments has been the creation of an Aboriginal Navigator network across the province,” Alethea explained. “Ten Aboriginal Navigator roles have been established to help guide patients through the cancer system and provide personalized support for families and caregivers.”
“There is fear associated with health issues and this is related to the increased number of community members who are dying,” said Leah Borgstrome, Aboriginal Navigator, Simcoe Muskoka Regional Cancer Program. “This is a double-edged issue because people may decide to ignore their health concerns, afraid they’ll learn of bad news.”
“I know about that,” I said.
“I understand, Bonnie. You’ve been through it. However, when we’re able to provide education regarding the importance of early detection, people begin to understand why ignoring the issue isn’t in their best interest.”
Funded by the Ministry of Health and Long-Term Care, the strategy was developed jointly by key stakeholders, including aboriginal leadership, healthcare providers, cancer survivors, aboriginal health networks and the Joint Ontario Aboriginal Cancer Committee.
“Part of our government’s Patients First strategy is about ensuring that the highest quality care is delivered in a way that puts patients’ needs at the centre of everything we do as health care workers,” said Dr. Eric Hoskins, minister of Health and Long-Term Care. “The Aboriginal Cancer Strategy is a wonderful example in providing care tailored to the unique circumstances of a community that has traditionally been under-serviced and overburdened with complex health issues.”
Over the next four years, Cancer Care Ontario’s Regional Cancer Programs will continue to play a key role in supporting the delivery of the program at local levels. Priorities include enhancing community relationships, expanding cancer support services and implementing additional cancer control initiatives.
I tell Usman that I’m privileged to learn and write, for 24 years about my First Nation friends on Manitoulin and in Sudbury –and their accomplishment. Besides bestowing the name of Hummingbird in Ojibwe upon me. One of my columns was included in Trent Prof. Rhonda Paulsen’s well-received book, its purpose to assist in revitalizing Indigenous Languages. It is “Spirit of the Island: Manitoulin’s People Discuss First-Person Histories on Manitoulin Island in Both English and Ojibway.”
Usman knew the book. Prof. Paulsen told me, “Manitoulin is an excellent place to discover the diversity of indigenous languages, and is a microcosm of all the issues that affect aboriginal groups in Canada: I am inspired endlessly.”
And Cancer Care Ontario work is so important. I talked to Usman in Toronto, and he introduced me to Tony Jocko, health policy analyst for the Union of Ontario Indians, who tells me “Our First Nations stretch from Lake Nipigon to Sarnia. Bonnie, to learn more go to our website, www.anishinabek.ca.” And I do.
The background on this is Cancer Care Ontario’s Aboriginal Cancer Strategy, which has identified improvements to palliative and end-of-life care as a key area of focus. The strategic priority includes a goal to expand the availability of pain and symptom management tools for First Nation, Inuit and Metis health-care providers. They also support use of pain any symptom management tools, like the Edmonton Symptom Assessment Scoring system.
The expansion of pain and symptom management tools to remote and settings will be enabled through deployment and integration of a newly developed mobile application that aims to support aboriginals serving community health centres.
I learn about the process flow: the patient completes questions on a tablet and the data is received by the provider, who is able to review the answers or scores via a web-based portal, while the patient is receiving treatment in the cancer centre. This integration to health-care providers through the portal provides access to trends to enable and support integrated, interdisciplinary care and management of cancer clients.
Scores collected in the community setting for clients who are still in active treatment will be made available to cancer centre providers, which will help support coordination across the care continuum.
These benefits that will improve patient experience by empowering cancer patients to better understand and manage their pain and symptoms with support. This improves the delivery of and access to health services and palliative care to Ontario’s remote communities, improve health outcomes, coordination of care; and support community-led services.
Providers can track patient symptoms and support integrated care through the provision of patient scores across the entire cancer journey.
Union of Ontario Indians Grand Council Chief Patrick Madahbee spoke at the launch: “Today marks another milestone in our collective journey to address cancer control for First Nations people. Cancer Care Ontario Aboriginal Cancer Strategy 111 provides an opportunity to reflect on this partnership that we have entered in, and re-affirms our commitment to work together to ensure that our people are not dying prematurely from preventable and treatable cancers.”
Wonderful. Stay well. Stay tuned.
— Our Bonnie applauds these important initiatives, grateful that she is well. Please find her novel, Manhattan, Manitoulin, at Chapters in Sudbury and Turners in Little Current. Find her at BonniKogos@aol.com.