The Importance of Indigenous knowledge in healthcare
For many Canadians, our healthcare system is seen as a point of national pride. However, knowledge gaps in health education means that not all among us experience an equal standard of care. Anti-Indigenous racism in healthcare has existed throughout Canadian history, with recent events, such as the deaths of Joyce Echaquan and Brian Sinclair, and recent publications outlining striking examples of prejudice and discrimination that is still experienced today. As Canada continues to learn and grow, it is important that healthcare professional education does the same. One important path forward is to listen and learn from Indigenous knowledge, in order to transform the healthcare system for all patients who we serve. As our country works towards a national goal of reconciliation, this is one example of Indigenous worldviews on health and wellness, and the Western-paradigm of health coming together.
Kiowa Bernhardt is a recent Queen’s University graduate from the School of Nursing. After spending the last four years earning her Bachelor of Nursing Science (BNSc) degree, Kiowa has gone on to find success in Kenhtè:ke (English Translation: Tyendinaga Mohawk Territory), as a member of their new Indigenous Interprofessional Primary Care Team. From Kenhtè:ke herself, Kiowa has been able to combine her own cultural knowledge with the knowledge that she gained during her time at Queen’s. As she’s beginning her career, Kiowa feels as though both of these things have given her the confidence and skills to help her community in these unprecedented times. “My time at Queen’s definitely prepared me well, by ensuring I had all of the competencies that a new nurse should have in order to succeed,” says Kiowa.
The Indigenous Interprofessional Primary Care Team in Kenhtè:ke offers holistic healthcare to Indigenous people and their families within the South East LHIN by providing primary medical care and mental health services with a strong culture-based approach. Kiowa’s role, which consists of a mix of virtual and in person care, includes triaging, comprehensive health assessments, health promotion and prevention of illness, and health education. Kiowa often works with patients to perform therapeutic interventions such as chronic disease management, immunizations, lifestyle counselling and wound treatment. However, her responsibilities also include tasks outside of direct client care, like involvement in vaccine management, procurement and inventory management of medical supplies, and necessary Infection Prevention and Control (IPAC) measures.
Reflecting on her time at Queen’s – and how it has prepared her for her career - Kiowa had many positives to share. She also sees an opportunity to strengthen the classroom setting by becoming more culturally responsive and relevant. She sees opportunities for leaders at the school to honour community and strengthen relationships with these surrounding communities, to build authentic collaborative approaches to health education and services. Another area with the potential for growth is the curriculum, which may be addressed through the integration of cultural knowledge. Growing up in Kenhtè:ke, Kiowa understands the importance of cultural knowledge when it comes to healthcare delivery and has the lived experience to inform her practice as a nurse. Her non-Indigenous classmates don’t have the same foundational knowledge, and their undergraduate degree could be an ideal place to develop competencies in cultural knowledge and safety.
As the nursing representative for the Indigenous health education working group at Queen’s, Kiowa was able to use her voice to talk about these concerns. She is supportive of the positive changes that the Faculty of Health Sciences (FHS), and other organizations such as the Canadian Association of Schools of Nursing (CASN), are striving to create with respect to curricular change. However, she believes that racism in healthcare will persist until forms of oppression faced by cultural groups are fully addressed and combatted by our education systems. “Learning about the culture of others is an important part of this but it’s not the entire solution,” says Kiowa. “Schools like Queen’s need to address the fact that racism and oppression already exists within our healthcare systems.”
The FHS recently committed to increasing the integration of cultural care knowledge into existing curricula. Currently in the process of developing its next Strategic Report, the School of Nursing has also highlighted cultural care, diversity, and anti-racism as key pillars within current and future planning for its programs. “We have a responsibility to ensure that everyone who graduates from our programs possess a high level of cultural safety,” says Dr. Jane Philpott, Dean, Faculty of Health Sciences. “This fall, the Faculty of Health Sciences launched the Dean’s Action Table on Equity, Diversity and Inclusion. One of its priorities is to implement curricular change across our three schools. In tandem, the faculty’s new Office of Equity, Diversity and Inclusion is investing in recruitment efforts to diversify our student body; Indigenous students are still significantly underrepresented in health professions education.”
The faculty has also prioritized building a culture of belonging so that students from all backgrounds not only feel welcome and safe while studying at Queen’s, but can flourish during their time here. “One piece of advice I would give to current and future students is not to think that you don't have much to offer,” says Kiowa. “Every student has a new set of eyes and brings forward a new understanding. Do not underestimate your value and try not to be scared to use your voice. It’s easy as a student in a competitive field in a large institution to feel small, but when you’re able to really succeed is when you realize that you have something to bring to the table.”