Anishinabek Health Transformation: the journey continues
By Lynne Brown
GARDEN RIVER FIRST NATION—At the Anishinabek Health Conference in January, Anishinabek Nation Health Director, Jamie Restoule and Grand Council Chief Patrick Madahbee shared insight with attendees into movement forward on Anishinaabe health transformation. It is without doubt a monumental journey to be on.
“We work in an area that is a vast geographical territory and when we get the chance to see the different levels of advancement and capacity around the territories in health care delivery, I have to say that we have some astounding and fantastic people working on the frontline. We have made incredible advancements around the territories.”
“There’s never been more of a time in our history to work together and be united,” stated Grand Council Chief Madahbee. “What we need to do is look at best practices. When we began the process, I asked five chiefs to lead the charge on this—all folks that have been involved in health portfolios in various capacities. Those five chiefs, along with our staff, have begun the engagement process. We are not predetermining anything.”
“We need to get some foundational work done before the next round of provincial and federal elections,” added Grand Council Chief Madahbee. “Foundational elements that would prevent any change in government at the provincial or federal level from impeding progress. We presently have willing partners at the table.”
Grand Council Chief Madahbee shared that discussions around health transformation began in British Columbia (B.C.).
“We looked at many different models. We do not need to reinvent the wheel, nor do we need to follow B.C.’s model. We need to do things in ways that work for us – in ways that are flexible and accommodate the needs of the different regions. Access to services, facilities, economies of scale – building realistic networks that service a particular catchment area without having to travel hours and hours.”
“We need to look at what makes the most sense. Let’s look at this from a First Nations perspective. We have people who are working on the frontlines of health. We have people at different stages including at high levels working on health delivery…We have Anishinaabe doctors and professionals working right now in all levels of health services. Nothing is written in stone – we don’t have the perfect model now – so why not try and create something that we can tweak and mold that works for us…Our people are creative and intelligent, they find solutions and when we empower our people to do something we can create a health system that works better for us. By creating and building upon regional networks, we can continue to build capacity as we go along.”
“I see dynamic young people coming along. I have no fear about what our people are capable of. The community level is where this needs to start. The people in those communities can determine what their needs are. The answers lie in the community.”
Jamie Restoule shared a presentation on some of the initial steps that are underway.
“Through this process, we will be looking at the whole of our geography at each of the communities we have. There are already health systems – health models— in place in communities across the Anishinabek Nation.”
First Nations have been advocating for many years for increased control over their health and wellness, consistent with the inherent right to self-determination.
In December 2015, then provincial Minister of Health Dr. Eric Hoskins wrote to Ontario Regional Chief Day committing to meaningfully engage Indigenous partners through parallel bi-lateral processes and that, through collaboration, would identify the changes needed.
Cathy Bellefeuille, Legal Policy Analyst at the Anishinabek Nation, is facilitating regional sessions to begin the dive deep into health transformation.
Regional sessions began in February with Sudbury, Munsee Delaware Nation, Chippewas of Rama and Garden River First Nation. The initial round of engagement is for health professionals, with broader community outreach sessions taking place over the next several months.
“We’re trying to capture information on what First Nation people see as their idea of what First Nation Health means. We aren’t just taking a health care system that is maintained in the mainstream and then bringing it into our communities – It’s creating our own healthcare models,” said Bellefeuille at a recent session in Garden River.
“It could be a community model supported by a regional model supported by an Anishinabek Nation model. First Nation designed, delivered and administered. In all aspects of health, we want to be able to control health care,” continued Bellefeuille. “We’ve started our regional discussions with health directors, care providers – to begin looking at what is being done across the Anishinabek Nation.”
Bellefeuille said that capturing as much of the Anishinabek Nation as possible and generating discussion across the Nation is very important. Outreach will be key to pulling information together.
“It’s going to be our system, so it’s important that we reach as many individuals as possible,” stated Bellefeuille. “Some communities have very little programming and services. They don’t have the resources and so they may not see this as realistic. By creating a web of services that are all encompassing and far-reaching, we may be able to mobilize communities that feel that they don’t have anything.”
Bellefeuille said that by bridging the gap between those communities that are underserviced in health care programming and delivery with regional networks that do have a more fulsome capacity for health care, the potential exists for a more equitable system across the entire nation.
“We are looking at other models that are working, including the BC First Nations Health Authority, North Shore Tribal Council Health Services, and Sioux Lookout Health Authority. There are models that are already working and we hope to be able to create a system that can be built upon strengths.”
Bellefeuille further shared that, by identifying capacity and lack of capacity, gaps in service, the Anishinabek Nation can create a health care delivery model that works across the entirety of the Nation.
“It’s difficult to put a timeline on how long this will take. With these community sessions, we can generate the discussion around what people need. It’s going to be a lot of outreach, and for the next year, leading up to April 2019, there will be ongoing consultations, information gathering, and reports generated that continue to pull the pieces together,” noted Bellefeuille. “We want to capture as much of the Anishinabek Nation population as possible. We want to make sure that everyone has a voice on this issue.”
Nokomis Elsie Bissaillion of Serpent River First Nation attended the regional session held in Garden River on Feb. 20 and 21. She said that gathering stories and incorporating traditional teachings will be important.
“Ceremony is important. We need to invite our Ancestors to come in and offer guidance. Our health affects all aspects of our body, mind and spirit,” expressed Grandmother Bissaillion. “We often don’t know what services we need until something happens and then we find out that we have to travel great distances to get those services. We want a good future for our kids. I am 100% supportive of this initiative.”
Bellefeuille said that technology can play a role in gleaning information; however, grassroots community engagement will be key.
Bellefeuille added that ultimately it will be the communities that decide what it is that they need in health care programming and delivery.
“Empowering communities, thereby ensuring that health care delivery truly reflects what First Nation people need. Our own health care authority and health care laws.”
A historical signing ceremony of an Memorandum of Understanding (MOU) will take place sometime this Spring between the Anishinabek Nation and the provincial and federal governments.
The Anishinaabe way is one that seeks to – as one participant at the recent regional health transformation session in Garden River First Nation stated – “move like fluid through a dream catcher.”
Upcoming dates for Regional engagement sessions include:
March 7-8, 2018, in Ottawa at the Les Suites (downtown Ottawa);
March 13-14, 2018, at the Hershey Centre in Mississauga for Little NHL participants (this will not be a full engagement session, but an opportunity for information);
March 19-20, 2018, in Thunder Bay at the Victoria Inn;
March 27, 2018, Sudbury at Shkagamiik-Kwe Health.
Cathy Bellefeuille shares insight into the initiative on health transformation during her recent stop in Garden River First Nation.