Health centre embarks on a cultural safety project

One of the more visible aspects of the Manitoulin Health Centre’s cultural safety project is the addition of signs in Anishinaabemown such as this one on the emergency room restroom. photo by Michael Erskine

MANITOULIN – Manitoulin Health Centre’s (MHC) odyssey to become a culturally safe, inclusive and welcoming environment began in 2017 with an initiative from the Northeast Local Health Initiative Network and is now starting to come into fruition, following a careful path. The result is Maamweziwining (togetherness), First Nations engagement through learning circles and one-on-one sessions, and an enterprise-wide inclusion in helping to reshape the health care institution away from colonial and towards reconciliation.

“The MHC’s Cultural Safety, Engagement and Inclusion Committee, an internal working committee of the hospital, has been reconstituted and is working on things we can do to advance cultural awareness and ways we can make the health centre a more welcoming and safe environment,” said Tim Vine, MHC co-CEO and vice president corporate support services. This has included learning from elders on National Indigenous Peoples Day and the National Day of Truth and Reconciliation. “We had Every Child Matters buttons created for our staff,” said Mr. Vine.

“It is very important we recognize and promote areas that make everybody comfortable in a satisfactory and appropriate manner,” said Mr. Vine. To that end, the health centre embarked on a careful and in-depth study of where and how they could take the steps necessary to build such a space.

MHC recognized early on in the process that it was important to distance its own administration from that study in order to elicit frank and fulsome discussion, so in the interests of creating that buffer, the health centre brought on a third party consultant, Mariette McGregor-Sutherland, an experienced and highly credentialed Indigenous health policy specialist to support the effort.

“We felt better having a third party,” said Mr. Vine. That being said, the process has involved MHC senior management and its chief of staff.

Much of the effort to create the Maamweziwining environment has been spearheaded by Melanie Stephens, manager of clinical innovation and partnerships, but Ms. Stephens was quick to point out the project could not have advanced the way it has without the help of many people. “I really can’t reiterate enough how happy we are to have the guidance of Rosella (Kinoshemeg), Geraldine (Ense-McGregor) and Mariette (McGregor-Sutherland) on this project,” she said. “We are very fortunate for their partnership in making this happen. Our wayfinding signage was completed with the support of the Kenjegewin Teg Language Program.”

“Maamweziwining (which translates to togetherness) is the name we as a working group have collectively determined was an excellent fit in naming this project,” she said. “These sessions are going to be occurring in each community via our consultant and we are really encouraging people to register and participate so that we may learn from their feedback and build on these efforts to ensure a safe and inclusive space for all.”

One of the first activities undertaken by MHC was to have its staff take part in the San’yas Indigenous Cultural Training Program. “That was where it all started really,” said Ms. Stephens. She noted the six domains (or voices) in which MHC is engaging: patient, caregiver, community, leadership/partnership, employee and medical staff, as well as the original ICS training brochure where it all started. To date, 65 percent of staff have taken the program and the reviews have been outstanding.

“It was a real eye-opener for many of our staff,” said Ms. Stephens. “So many of them have said that they did not know a lot of what they learned through the program.” That knowledge has gone a long way toward assisting doctors and other health professionals in engaging more effectively.

As a health organization with a very large and diverse staff, MHC decided it would be effective to canvas its own. To that end a survey has been sent out to all of the organization’s staff, said Mr. Vine. That survey will explore the experiences the staff themselves have had in accessing the health centre’s services.

“We have had a lot of information provided to us anecdotally,” said Mr. Vine, “but it is difficult to make changes based on anecdotal evidence. We want to make sure we are not just solving ad hoc issues.”

The outside consultant will be helping to conduct interviews as well, providing a more structured dataset than what can be gleaned from anecdotal experiences. Interviews will be conducted in person, or by Zoom, with an emphasis on making things as easy for respondents as possible.

“We want to make it as accessible as possible,” said Mr. Vine. “We don’t want financial or technical issues getting in the way.” So the process will be flexible to the respondents’ needs.

The result, they are determined, will be building relationships with people. “Saying what we will do, and then doing it,” said Mr. Vine. “We want to create a space that is safe and inclusive.”

As an organization that is made up of human beings, MHC recognizes that not everyone’s experience will be positive. “People have off days, we get that,” said Mr. Vine. But it is important, he stresses, that as an organization that those negative interactions are the result of a staff member’s own bad day, not a systemic issue that impacts an individual because of the group they belong to.

Mr. Vine stressed that it would be a mistake to label Maamweziwining as a “program.” “It is an engagement process,” he said.

While much of what will come about through the Maamweziwining engagement process will by its nature be “invisible” to the eye, a tangible example is MHC’s Wayfinding signage. With the support of the Kenjgewin Teg language program, signs in the travelled portion of the health centre’s Little Current site are now written in both English and Anishinabemowin. 

That, in itself, presented some challenges as there are three dialects present on Manitoulin: Odawa, Ojibwe and Potawatamie. MHC worked with Kenjgewin Teg to simplify and create signs that would be accessible to speakers of any of those dialects.

“So something like physio-cardiology becomes “the place where you go to work on your heart and physical stress,” said Mr. Vine. “Doing this was not only something that needed to be done, but it was a lot of fun.”

Signage at the Mindemoya site will also be changing, once the current renovation project has been completed.