Healthy Living in the North

Aboriginal/Indigenous Health Improvement Committees: what are they and how do they impact health care in the North?

The Local Cultural Guide guide is pictured. The cover features a stunning image of a totem, as well as a wood building with Indigenous art on it.

The Local Cultural Resources Guide, created by the A/IHICs, supports health practitioners’ understanding of Indigenous community cultures, histories, and contexts.

Aboriginal/Indigenous Health Improvement Committees (A/IHICs) are action oriented groups of people who work together to support health and wellness for Indigenous people, families, and communities in Northern BC.

The A/IHICs began in 2005 and there are now eight across the Northern Health (NH) region:

NH is committed to partnering with Indigenous peoples and communities, and to building a health care system that honours diversity and provides culturally safe services.

The A/IHICs are made up of many different types of people, including local representation from Indigenous communities and organizations, the First Nations Health Authority, Northern Health, and other sectors.

A/IHICs provide opportunities for new connections and stronger relationships and cultural understandings between diverse communities and sectors working for the health and well-being of Indigenous people and communities.

The members of each A/IHIC bring perspectives and experiences from people who live in their communities and access health care. Through the A/IHICs, Indigenous peoples’ perspectives inform local priorities and solutions!

The work of the A/IHICs is driven by three key questions:

  1. If I was a new practitioner coming to your community, what would you like me to know about you so that I could serve you better?
  2. What is it that you need to know so that you can be the best practitioner that you can be?
  3. What is it that we need to know to be the very best partner that we can be to communities and other organizations?

The A/IHICs operate with the principle that Indigenous health is holistic and seeks balance. At the heart of this view is an understanding that all things – land, water, air, animals, individuals, families, and communities – are connected and in relation to one another. Holistic health is a process that demands a broad and inclusive perspective for addressing health issues.

Over the years, the A/IHICs have undertaken many different projects, including mapping patient journeys across Northern BC. Patient journey and process maps are an opportunity for communities to bring their voice into the health care system and identify opportunities for change in health services, as well as to identity local solutions and concrete actions that can be taken at the local level. The gaps and challenges that were identified can be collaboratively addressed through local strategies and solutions.  If you want more information on this project, you can read the full Mapping Summary Report.

Each A/IHIC has also worked to create local cultural resources that support health practitioners’ understanding of Indigenous community cultures, histories, and contexts. Check out the Local Cultural Resources booklet (produced by NH’s Indigenous Health department) for more details.

Shelby Petersen

About Shelby Petersen

Shelby is the Web Services Coordinator with Indigenous Health. Shelby has over five years of experience working in content development and digital marketing. After graduating with a degree in Political Science from UNBC, Shelby moved to Vancouver where she pursued a career in digital marketing. Most recently, Shelby was the Senior Content Developer and Project Manager with a digital advertising agency in Vancouver, British Columbia. Born and raised in Prince George, Shelby is thrilled to be back in the community and spending time outside enjoying everything that the North has to offer.

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One year later: the journey to create the UHNBC welcome sign and beyond

A picture of the welcome sign, which reads, "We welcome you to our traditional territory." The Lheidli T'enneh logo is in the bottom right. The image is of faceless-yet-friendly people, painted with bright, vibrant colours.

The Welcome Sign, first unveiled at UHNBC, recognizes and acknowledges that the hospital is on the traditional land of the Lheidli T’enneh, and welcomes people to it.

The winter of 2018 saw the unveiling of a special work of art that acknowledges the traditional territory of Lheidli T’enneh and welcomes Indigenous and non-Indigenous people to the University Hospital of Northern BC (UHNBC).

The vision for a welcome sign/art installation for UHNBC was born in 2015. UHNBC is located on Indian Reservation #1 (IR#1) and on the territory of the Lheidli T’enneh. So, it was decided that the sign should be an acknowledgement and welcoming to the Lheidli T’enneh territory, and that the sign would be in Carrier (the traditional language of the Lheidli T’enneh).

To begin this project, the PG and Area Aboriginal Health Improvement Committee (AHIC) created a sub-committee to lead and guide the project. With guidance from Lheidli T’enneh chief and council, the sub-committee began planning the steps to create an art installation that would be placed prominently in the hospital.

After a call for Indigenous artists was issued, Carla Joseph, a Métis artist, born in Prince George, with Cree roots in Green Lake, Saskatchewan, was selected to create the sign. Carla created the design with Darlene McIntosh and Mary Gouchie, two Lheidli T’enneh Elders.

“Painting the sign was a great opportunity for me,” says Carla. “I wanted to do a piece that represented community and family. [The people on the sign] have no faces to show that it can be anybody. Making time for each other is so very important. Being an artist, I know art can be healing and inspirational.”

The sign is intended to recognize and acknowledge Indigenous peoples in health care facilities and to acknowledge the traditional territory of the Lheidli T’enneh. It’s also an opportunity to offer a learning experience to non-Indigenous peoples entering the hospital.

The welcome sign was officially unveiled on February 23, 2018.

Over a year later, the sign has had a tremendous impact on patients and health care providers alike. Shortly after the unveiling, the PG and Area AHIC voted to purchase additional signs to be distributed in health care facilities across the city.

For patients who access multiple health care facilities in Prince George, the signs acknowledge Lheidli T’enneh territory, provide continuity, and prioritize cultural safety.

Here are some of the locations where you can find a welcome sign, along with community members’ thoughts about the impact they’ve had on each facility:

Positive Living North

“When I go to a location that has one of the welcome signs, I immediately feel more comfortable walking in as a stranger to provide presentations.” – Kyla Turner

The Welcome Sign hangs on a white wall that also features Northern BC locations written in an inter-linking pattern.

The Welcome Sign hangs at the BC Cancer Centre for the North.

BC Cancer Prince George Centre for the North

“The welcome sign helps to set the tone when you walk into the facility and shows that cultural safety is a priority. The sign also provides a sense of continuity of care as BC Cancer Centre is linked to the University Hospital of Northern BC, where the larger presentation of this artwork originates.” – Carolyn Jacob, practice leader, patient and family counselling, and Laura Nordin, Indigenous cancer care counsellor.

Aboriginal Housing Society

“The sign is a symbol of our relationship, acknowledging Lheidli T’enneh traditional territory, and that we are thankful as visitors that we can live in and do our work on Lheidli T’enneh territory.” – Christos Vardacostas

Two women are posing with the Welcome Sign.

Erin Anderlini and Maria Rossi pose with the welcome sign at Prince George Native Friendship Centre.

Prince George Native Friendship Centre

“This sign is very meaningful to us, as it represents our working relationship with Lheidli T’enneh, which, for me, has been fostered by being part of the AHIC.” – Erin Anderini

PG Divisions of Family Practice & Blue Pine Primary Health Care Clinic

“We have had many comments on how beautiful the ‘Welcome’ picture is. When I think of the meaning it brings to our clinic, the theme of beauty comes to mind. We are fortunate to walk on the land of the Lheidli T’enneh. The welcome is a reminder to be mindful and respectful of the people and land of this territory.” – Submitted as a group quote.

Foundry Prince George

“The sign speaks to the importance of holding, in the work that we do, the history of this community and honoring territory. It brings forward agendas that bring healing. There is also a continuity from the bigger sign in the hospital – and people recognize that.” – Toni Carlton

Shelby Petersen

About Shelby Petersen

Shelby is the Web Services Coordinator with Indigenous Health. Shelby has over five years of experience working in content development and digital marketing. After graduating with a degree in Political Science from UNBC, Shelby moved to Vancouver where she pursued a career in digital marketing. Most recently, Shelby was the Senior Content Developer and Project Manager with a digital advertising agency in Vancouver, British Columbia. Born and raised in Prince George, Shelby is thrilled to be back in the community and spending time outside enjoying everything that the North has to offer.

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What are Aboriginal Patient Liaisons and what do they do?

Lloyd McDames smiles at the camera. Text highlights what Llyod, an Aboriginal Patient Liason at Mills Memorial does and provides his phone number: 250-638-4085.

Llyod McDames is the APL for Terrace and Kitimat at Mills Memorial Hospital. The contact information for your community’s APL is available on the Indigenous Health website. It’s also on posters and screens at your local hospital.

Maybe you’ve seen their smiling faces on a TV screen at one of our hospitals or maybe you’ve heard the term “APL,” but you’re still not sure what exactly Aboriginal Patient Liaisons are, much less what they do. Let’s find out!

So, what are Aboriginal Patient Liaisons (APLs) and what do they do?

There are 10 APLs across the North. They work to make sure Indigenous patients, clients, residents, and their families have access to high quality, culturally safe care. They also help close gaps between Western and traditional medicine, ensuring a holistic health approach.

Lloyd McDames is the APL for Mills Memorial Hospital, which serves communities in and around the Terrace and Kitimat areas. In Lloyd’s role, no two days are the same.

“When I reflect on my role as an APL at Mills Memorial Hospital I find my role is that of: a travel coordinator, a comforter, a family researcher, a cultural awareness educator, a support person, an advocate, an outreach worker, a facilitator, a mediator, a problem solver, a community liaison, a social worker, and my favourite: a telephone-tag player,” says Lloyd.

Lloyd and the other APLs across the region work with a diverse group of community members and health care providers. They must learn to adapt quickly to make sure each unique individual receives culturally safe care.

Northern Health created the APL program because we are committed to:

  • Partnering with Indigenous peoples.
  • Building a health care system that honours diversity and provides services in a culturally relevant manner.

The program runs in partnership with community agencies in Prince George and Smithers (Carrier Sekani Family Services and the Dze L K’ant Friendship Centre Society respectively).

Northern Health’s Indigenous Health team supports the APL program by:

  • Providing training opportunities and mentoring.
  • Supporting a community of practice.
  • Developing communications materials and resources.
  • Collaboratively planning, developing and evaluating the program.

What can an APL assist you with?

Indigenous health is holistic and seeks balance. At the heart of this view is an understanding that all things are connected and in relationship to one another – land, water, air, animals, individuals, families, and communities. Holistic health is a process that demands a broad and inclusive perspective for addressing health issues.

Here are some of the ways that APLs can work to make sure your health care experience is holistic:

  • Arrange for translation services.
  • Help patients understand the health care process, procedures, and terminology.
  • Help to ensure admission and discharge planning goes according to patient needs.
  • Assist with advanced health care planning.
  • Facilitate communication and cultural understanding between patient and care providers.
  • Assist patient with end-of-life resources.
  • Coordinate spiritual/cultural advisors.
  • Support and comfort family and friends.
  • Assist with referrals within Northern Health and to community agencies.
  • Help link patients to non-insured health benefits.
  • Assist with transition to and within long-term care.

How can you get in contact with an APL in your community?

There are 10 APLs throughout Northern Health in the following communities:

Contact information for each area can be found on the Indigenous Health website. Patients are invited to reach out to their APL directly or ask their health care provider for a referral.

Whether you are a health care provider or a patient seeking care, the team of APLs is here for you.

Shelby Petersen

About Shelby Petersen

Shelby is the Web Services Coordinator with Indigenous Health. Shelby has over five years of experience working in content development and digital marketing. After graduating with a degree in Political Science from UNBC, Shelby moved to Vancouver where she pursued a career in digital marketing. Most recently, Shelby was the Senior Content Developer and Project Manager with a digital advertising agency in Vancouver, British Columbia. Born and raised in Prince George, Shelby is thrilled to be back in the community and spending time outside enjoying everything that the North has to offer.

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Foodie Friday: Supporting culturally safe environments with traditional First Nations foods

As a member of the Aboriginal Health team at Northern Health, it’s really important to me to support culturally safe health care environments. When health care settings are inclusive of Indigenous cultures and traditions, they become more culturally safe for Indigenous people. That is why I was excited to learn how Northern Health staff are making traditional First Nations foods available to patients and residents!

Cook with Hugwiljum (fish soup)

Offering traditional First Nations foods in health care environments is an important step in creating an inclusive, welcoming, and culturally safe health system for Indigenous peoples.

In Hazelton, cooks Anita Lattie and Armin Wesley are excited to make traditional First Nations foods available to residents and patients at Wrinch Memorial Hospital. Both Armin and Anita are Gitxsan; Anita is from Gitanmaax and Armin is from Sik-E-Dakh.

“When patients and residents see foods they are familiar with, they enjoy it more,” said Anita about the response to the menu additions.

“I have been waiting for this,” said a resident about the Hugwiljum fish soup and bannock he was eating for lunch.

The process of adding new foods to the Northern Health menu repertoire involves putting the recipe in a consistent format, testing it with ten people, and then submitting it for approval and further testing. Support services coordinator Deana Hawkins explained to me that once the recipes are approved, they are added to the core menu across Northern Health so other sites can also serve them.

In the northwest, Mills Memorial Hospital, Terraceview Lodge, and Kitimat General Hospital now offer the Hugwiljum fish soup and bannock. Anita has just finished testing a salmon patty recipe to send for approval this week. “All the staff in the Wrinch Memorial kitchen are Aboriginal and it makes us feel good about our jobs to be able to do this,” said Armin. According to BC Stats, in Hazelton, 56.5% of the urban population is Aboriginal.

In Prince Rupert, dietitian Arlene Carlson works with Elders at the Gitmaxmak’ay Nisga’a Society and Friendship House to organize traditional feasts twice a year for residents of Acropolis Manor, the local long term care facility. The feasts include locally prepared, seasonal foods such as fish chowder, moose soup, and kelp on roe. Local First Nations cultural entertainment is a highlight of the feasts. “These feasts are really popular with First Nations and non-First Nations residents alike,” said Arlene. This work has helped create a policy within our organization of bringing in food for social functions and cultural events. Other policies are in place to support families to bring in food for their loved ones in long term care.

On Haida Gwaii, traditional foods are offered in both hospitals. In the south, the Haida Gwaii Hospital and Health Centre – Xaayda Gwaay Ngaaysdll Naay serves local fish regularly on the menu and the Meals on Wheels program brings traditional food to Elders in the hospital on a weekly basis. In Masset, Northern Haida Gwaii Hospital & Health Centre residents are offered a special occasion meal once per month. Meals feature local and traditional ingredients such as fish, clams, deer, and locally grown vegetables. On Haida Gwaii, Shelly Crack and Tessie Harris are part of a national movement to incorporate sustainable food into the health care system; including more traditional foods.

Cultural safety is a priority for Northern Health. In July 2015, all BC Health Authority CEOs signed a declaration demonstrating their commitment to advancing cultural humility and cultural safety with their organizations. The goal of cultural safety is for all people to feel respected and safe when they interact with the health system. Culturally safe health services are free of racism and discrimination. People are supported to draw strengths from their identity, culture, and community. One of the features of a culturally safe health system is ensuring physical environments reflect local Indigenous communities and cultures.

Offering traditional First Nations foods in health care environments is an important step in creating an inclusive, welcoming and culturally safe health system for Indigenous peoples.

Hugwiljum (fish soup)

Makes 4-5 portions

Ingredients

  • 2 cups potatoes
  • 1 medium onion (diced)
  • 3 salmon loins
  • 1 tbsp curry
  • 1 tsp salt
  • 1 litre water

Instructions

  1. Bring all ingredients to boil. Reduce heat and simmer until potatoes are tender and salmon cooked.

 

Victoria Carter

About Victoria Carter

Victoria works in Northern Health's Aboriginal health program as the lead for engagement and integration. She is an adopted member of the Nisga’a nation and was given the name “Nox Aama Goot” which means “mother of good heart.” In her work she sees herself as an ally working together with Aboriginal people across the north to improve access to quality health care. She keeps herself well by honouring the mental, emotional, physical and spiritual aspects of her life through spending time with her friends and family, being in nature and working on her own personal growth.

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Orange Shirt Day

Two women dressed in orange

Marking Orange Shirt Day in Kitsumkalum.

I was honoured to be invited to Kitsumkalum’s Orange Shirt Day by Charlene Webb, the community health director. Although I got to wear a beautiful locally designed orange shirt, enjoy yummy orange food, and visit with many people, this event has a sad undertone.

What is Orange Shirt Day?

September 29th is Orange Shirt Day – a day of remembrance and recognition of residential school survivors and those who did not survive.

It is a day each year to acknowledge the harm done by the residential school system to children’s self-esteem and well-being and to remember that every child matters. Orange Shirt Day grew out of Phyllis’ story. In 1973, when she was 6 years old, Phyllis attended the Mission school. On her first day of school, her clothes (including a special, brand new, shiny orange shirt) were taken from her and replaced with a uniform. Orange Shirt Day is an annual opportunity to engage in a discussion on all aspects of the residential school system.

Residential schools

September is when children go back to school and it is therefore timely to remember the Indigenous children in Canada who were taken from their families and travelled long distances to attend residential schools. Instead of being nurtured and supported, many suffered emotional, physical, and sexual abuse there.

Residential schools are a dark part of Canadian history that make me very sad. As a 6th generation Canadian white woman with First Nations children, I have struggled with this part of Canada’s history. I first learned about residential schools when I was pregnant with my first child. I was devastated that such a thing could happen. As a parent, I cannot imagine a more heart wrenching and devastating experience than having my children forcibly removed and taken far away where I cannot protect them or care for them.

Woman wearing "Every Child Matters" shirt

Orange Shirt Day is a day each year to acknowledge the harm done by the residential school system to children’s self-esteem and well-being and to remember that every child matters.

Learning more

As hard as it is, we need to acknowledge that this tragedy occurred and learn more about it so that it never happens again. I encourage you to explore several resources:

Cultural humility

Part of healing from this difficult history in Canada involves all of us developing our cultural humility – our ability to be respectful, self-aware, and lifelong learners when it comes to the experiences of others.

I encourage you to join me and participate in the First Nations Health Authority social media campaign to engage all of us in advancing cultural safety and humility in the health system. In my daily life, I strive to do my part to help create an environment in Northern Health where people feel safe from racism and discrimination. Make a pledge today and share it on social media. Together we can make a difference.

Victoria Carter

About Victoria Carter

Victoria works in Northern Health's Aboriginal health program as the lead for engagement and integration. She is an adopted member of the Nisga’a nation and was given the name “Nox Aama Goot” which means “mother of good heart.” In her work she sees herself as an ally working together with Aboriginal people across the north to improve access to quality health care. She keeps herself well by honouring the mental, emotional, physical and spiritual aspects of her life through spending time with her friends and family, being in nature and working on her own personal growth.

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Sharing of cultural practices in health care transitions

“I can’t emphasize how important it is for health care professionals to take the lead in asking these questions (about cultural practices), in peeling back the layers of assumptions, and finding out specifically how we can assist and make any transition smoother. Things will go better if those questions are asked right away and then I’ve always found when that happens, those questions are met with relief almost and answers are immediate” -Coco Miller, Kitselas, Tsimshian Nation

Young boy carrying drum

A young drummer at a video launch event in Kitselas.

The Terrace/Kitimat and Area Aboriginal Health Improvement Committee (AHIC) is pleased to launch two videos that share information for health care providers about the Tsimshian, Tahltan, Haisla, Gitxsan, and Nisga’a peoples’ cultural practices and how they impact their health care needs.

In 2014-2016, Aboriginal Health provided financial support for each of the eight AHICs in the north to develop local cultural resources. Development of these resources was guided by the question: “If I were a new health care provider in Northern Health, what you would want me to know?”

The Terrace/Kitimat and Area AHIC produced the following videos which focus on cultural practices for important life transitions:

These videos cover important topics relevant for life events that often take place in the health system including:

  • the importance of families gathering and being together,
  • the cultural roles of the family,
  • the diversity of practices among families and Nations,
  • how Northern Health staff can support families and their cultural practices, and
  • the importance of communication between the patient/family and care providers.

“I think it’s very important to have family there and friends to be around us to support us, pray for us. They are there to feed us. Especially for the young ones to be there to witness what we have to go through during the time of a death. It’s very important for them to know how we feel and see the experience.” -Roberta Grant, Haisla Nation

Group of six adults with gift bags.

Celebrating the launch of the AHIC videos in Kitselas.

“The Grandmother comes to visit and is in the delivery room also. She will take the baby and examine the baby to look for any recognizable birth marks on the baby because, in our belief, our family comes back through reincarnation. An aunt of the father also needs to be in the delivery room because we have her role to be to cut the umbilical cord because this signifies their role as the father clan. The child is no longer just belonging to the mother’s family (the maternal family) but the child also belongs to the paternal family.” -Verna Howard, Gitxsan/Wet’suwet’en Nation

I encourage you to take a few minutes to watch these videos and share them with others. The information contained in these videos is an amazing gift from the Tsimshian, Tahltan, Haisla, Gitxsan and Nisǥa’a peoples.

I hope the videos inspire all of us to continue collaborating and learning and that you find them helpful in your life and your work.

If you have any questions or would like to learn more, I encourage you to contact Lloyd McDames, the Aboriginal Patient Liaison in Terrace.

Another way to develop your understanding of First Nations and Aboriginal peoples is the San’yas Indigenous Cultural Safety Training, an online course by the Provincial Health Services Authority.

Find more work done by the AHICs from across the north in this booklet of local cultural resources.

 

Cultural practices around birth

Cultural practices around illness and death

Jonathan Cooper

About Jonathan Cooper

Jonathan Cooper is the Health Service Administrator for Kitimat. His role includes many aspects of health care responsibilities for acute, complex care and community services in Kitimat. Jonathan has been in this role approaching 8 years, during which time he has been actively participating in many health committees, including the Terrace, Kitimat & Region Aboriginal Health Improvement Committee. Jonathan immigrated to Canada from the United Kingdom where he worked for the National Health Service. Jonathan enjoys outdoor pursuits, cooking, reading, and spending time with his family and children.

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A video from North Coast First Nations for health care providers

Man in First Nations regalia

A still frame from the opening of Honouring our Journey, a newly released video that provides information for health care providers about the Haida and Tsimshian Nations culture, history, and how these impact their health care needs.


“The door is open for you to learn,” says Kitkatla Councillor, Timothy Innes. “Learn how our culture is and what it entails … and who we are, then (you) can work with us more comfortably … you’re not intruding.”

The North Coast Aboriginal Health Improvement Committee (AHIC) is pleased to launch a video, Honouring Our Journey, that provides information for health care providers about the Haida and Tsimshian Nations culture, history, and how these impact their health care needs.

“If doctors and nurses come with an open mind and are genuine, lots will be returned to them as our people are kind and generous,” says Elizabeth Moore, an Elder in Old Masset.

In 2014-2015, Aboriginal Health provided financial support to each of the nine AHICs in the north to develop local cultural resources. These resources were guided by the question, “If I were a new health care practitioner in your community, what would you want me to know?”

In the video, Lauren Brown, the Health Director in Skidegate, encourages health care providers to consider “the whole person, including their beliefs and traditions.” Cindy Ignas, the Health Director in Kitkatla advises,

“You have to really listen and be very careful to not make any judgements and to understand the cultural lens that you bring as a non-First Nations person … step back from your biases, assumptions, and judgements and try to really learn, be curious and ask lots of questions.”

Betty Reece, the Health Director in Lax Kw’alaams, says, “Come out and meet the people apart from your workplace.”

This impactful video covers important and relevant topics such as:

  • the present day impacts of Residential School experiences on health care interactions,
  • the current role of traditional medicines and the importance of health care providers asking about their use to prevent possible negative interactions with prescribed medications,
  • the importance of using plain language, including family and/or translators in the appointment, and
  • learning about the gathering and use of traditional foods in health and well-being.

I highly encourage you to watch this 25 minute video and share it with others. If you have any questions or would like to learn more, Mary Wesley, video producer and the Aboriginal Patient Liaison in Prince Rupert and for the North Coast, would be happy to connect and even to facilitate group discussions following a screening.

This video is a beautiful gift from the North Coast First Nations in hopes that we all are inspired to continue our learning journeys towards a culturally safe health care system for all First Nations and Aboriginal people. Another way to develop your understanding of First Nations and Aboriginal peoples is the San’yas Indigenous Cultural Safety Training, an online course by the Provincial Health Services Authority.

A booklet summarizes the cultural resources developed by AHICs across the north.

Victoria Carter

About Victoria Carter

Victoria works in Northern Health's Aboriginal health program as the lead for engagement and integration. She is an adopted member of the Nisga’a nation and was given the name “Nox Aama Goot” which means “mother of good heart.” In her work she sees herself as an ally working together with Aboriginal people across the north to improve access to quality health care. She keeps herself well by honouring the mental, emotional, physical and spiritual aspects of her life through spending time with her friends and family, being in nature and working on her own personal growth.

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