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Building trust and improving health services for Indigenous People
At Community Conversations suppers, Indigenous community members are invited to share their experiences with the health system in a safe and open space. (photo credit: N’Mninoeyaa Aboriginal Health Access Centre)
By Jason Rehel, story producer and editor, AOHC
Decades of colonialism and oppression have taken a terrible toll on the health and wellbeing of Indigenous people. Many struggle with depression and anxiety or suffer from chronic disease; in some communities, Type 2 diabetes has reached epidemic proportions. Another serious problem is that because of the racism they’ve encountered in health care institutions, Indigenous people often distrust health providers and therefore don’t always access the services they need to promote good health.
On the north shore of Lake Huron, N’Mninoeyaa Aboriginal Health Access Centre is rebuilding that trust with a simple solution: creating a space and a place where everyone feels comfortable speaking frankly about their health and wellbeing experiences and needs.
Several times a year, at different locations along the north shore, the centre organizes community conversations along with suppers, complete with gas cards for those who’ve travelled. Based on what they hear during these intimate community conversations, the centre’s staff adjust their efforts to ensure they’re meeting community needs in the best possible way.
“It’s better than any survey we could design,” says Gloria Daybutch, Executive Director of the centre. “Because we’ve had supper with them, and sat around a table, people know themselves as equal participants. That’s when answers come more easily about what we need to do differently.”
The evening begins with centre’s management and program coordinators introducing themselves and their families. “That creates of feeling of ‘OK, now I know who you are’ … and the conversation becomes one between friends and family,” says Daybutch.
As a result of what they’ve heard during these conversations, N’Mninoeyaa’s staff have made many changes at their eight sites: more highchairs have been purchased to accommodate young families in one community; a female traditional healer will soon be hired to support women who have suffered sexual abuse. Staff are also working to address service gaps flagged by community members: the need for more education and supports for autism, hearing loss and seniors inquiring about shingles.
After the suppers, the centre’s staff follow up with participants through whatever communication method they request. “That way people have a record of the questions that were raised and comments made,” Daybutch says. “Even though actions may come much later down the road, there’s a knowledge that an open dialogue exists, and that their voices are being heard.”
In coming months, Daybutch and her staff at N’Mninoeyaa will conduct a suppertime community conversation with Indigenous young men living in poverty, a population who rarely access the centre’s services, but who would benefit from an array of health promotion services. To issue invitations to these young Indigenous men, coordinators are partnering with local outreach workers at Ontario Works.
N’Mninoeyaa is one of 10 Aboriginal Health Access Centres (AHACs) across the province that are represented by the Association of Ontario Health Centres (AOHC). For Gertie Mai Muise, AOHC’s Director of AHAC Strategy and Transformation, N’Mninoeyaa’s Community Conversations are about restoring a sense of self-determination for Indigenous peoples, as well as trust.
“Trust is really foundational for any service provider coming into a community,” she says. “So it’s critical that we create safe spaces where the people can find solutions for themselves. That’s the whole reason why Community Health Centres and AHACs were born: to recognize that communities have the answers for the issues that they’re dealing with.”
She explains that N’Mninoeyaa’s Community Conversations also demonstrate accountability to Indigenous patients and communities, and respect for treaty rights regarding health services. Delivering that promise on the ground is something all Aboriginal Health Access Centres and Aboriginal CHCs strive for.
“People who are marginalized, people who suffer the impacts of racism – there’s still very little place for their stories when we talk about health care,” Muise says. “Community Conversations bring patient experience knowledge to a brand new level. If we could actually scale this across the system, I think we would be a lot more intelligent in our understanding of what people are actually experiencing, not just in health care, but in society as a whole.”