Indigenous health unit at Maniwaki Hospital building trust, community says

A health unit at the hospital in Maniwaki, Que., has been supporting the region's Indigenous population by making those patients feel more secure in the health-care system — something community members say is desperately needed following the death last year of Joyce Echaquan.

The Integrated First Nations Health Service, or Anishinaabe service, was created by the Outaouais health authority in 2016 and opened at the Maniwaki Hospital in 2018.

It provides personalized social and health services adapted to the realities and customs of the urban Indigenous community of Maniwaki and the on-reserve communities of Kitigan Zibi and Lac Barrière. 

"It's making sure that everybody gets the services that they deserve to get and in a good way," said Monique Chabot, one of the social workers with the program who is herself Anishinaabe from Kitigan Zibi.

The service employs a doctor and a nurse who spend a certain amount of time each week caring for Indigenous patients. Social workers from the health authority liaise with patients and relay information from doctors to family members who can't visit because of COVID-19 precautions.

The service also offers supports like translation and transportation, and integrates traditional Indigenous medicine with modern medical methods.

Communication is key

One of the main benefits of the program is improved communication between community members and health workers, according to Chabot.

Maniwaki is a mostly French-speaking town, but most Indigenous people in the area speak either English or Anishinaabemowin as their first language. 

"The translation is very important," she said.

"Building that and bringing that here and providing a sense of belonging, also with the traditional medicine, with a better understanding of our culture and our history, with the staff, with the people that work here — I think that brings more trust."

Death of Joyce Echaquan 'affected us all'

That trust is especially important, community members say, in the wake of the death of Echaquan, an Atikamekw woman who died in September at a hospital in Joliette, Que.

In the moments preceding her death, Echaquan filmed health care staff who were treating her uttering slurs and insults in what was widely seen as a shocking example of racism in Quebec's health-care system.

Echaquan's death still haunts people's minds, especially in Indigenous communities.

"It affected us all, because we have all experienced some type of systematic racism at one point — the majority of the time because of the language barrier," said Charlotte Commanda of the Maniwaki Native Friendship Center.

Commanda, whose centre works closely with the Anishinaabe service at the Maniwaki Hospital, said Indigenous people have a great deal of mistrust of the health system because of a history of mistreatment.

She said the service at the hospital helps Indigenous patients feel secure, particularly when the staff they meet are of similar backgrounds.

"Being Indigenous makes them feel comfortable because one part of the judgment is gone," said Commanda.

More work to be done

Despite the program's success, there's still work to be done in other health-care settings in the Outaouais and across Quebec, said Kitigan Zibi Chief Dylan Whiteduck. 

"Sometimes we have to go to hospitals in Hull, Gatineau or even Montreal for treatment," said Whiteduck. "From what I've heard, [from] some stories — a lot of systemic racism exists in these places."

Whiteduck said the first step to combat systemic racism in health care is to admit that it exists — something Quebec Premier Francois Legault has refused to do. 

It's also necessary to improve education so that more Canadians understand the history and culture of First Nations, Whiteduck added.