Fostering Transformative Change

Racism and discrimination are two factors that have negative impacts on the health and wellness of Indigenous communities in Ontario. The health sector in Ontario is moving forward with advancing transformative change within its system through two initiatives: Southwest Ontario Aboriginal Health Access Centre (SOAHAC)’s online Indigenous Cultural Safety (ICS) training and Our Health Counts Urban Aboriginal Health Database Project.

The SOAHAC online Indigenous Cultural Safety (ICS) training is aimed at uprooting systemic Indigenous-specific racism within the health care system.The ICS training supports Indigenous Health transformation by addressing the need for increased Indigenous cultural safety within the health care system. Transformative change occurs when service providers are able to examine their biases, increase awareness of how colonialism is embedded in health care practices, as well as learn about the unique history and current realities of Indigenous populations that affect service accessibility and health outcomes for that population. This training program challenges people with influence within the healthcare system to address anti-Indigenous racial discrimination.

The Our Health Counts Urban Aboriginal Health Database Project contributes to transformative change through the creation of a baseline population health database for urban Aboriginal people living in Ontario that is accessible, useful, and culturally appropriate for policy makers to improve health planning. Ontario’s current health care information system is unable to identify urban Aboriginal individuals in its health datasets for a couple of reasons: health assessment data is often program or non-random survey based and is not population based; and census data for urban Aboriginal people cannot be disaggregated from First Nations, Inuit, and Métis data. The near absence of population based health assessment data is concerning because it makes it difficult to do any effective health policy, planning, program/service delivery or performance measurement without proper baseline information. The Our Health Counts Urban Aboriginal Health Database Project involves Aboriginal Health Access Centres in Hamilton, Toronto, Ottawa and London is an Indigenous-informed, innovative population health survey project aimed at improving health outcomes for urban Indigenous communities in a self determined, culturally safe manner (Southwest Ontario Aboriginal Health Access Centre, 2014).

The movement towards transformative change is also occurring within the educational system. Earlier in this chapter, we read about the shared values employed by Laurentian University in their strategic plan that address aspects of the TRC’s ‘Calls to Action.’ While this is a movement in the right direction, there needs to be more action taken if true reconciliation is to occur.  Mawhiney (2018), in her article “Reaching true reconciliation at our universities,” talks about the roles that universities must play in making meaningful changes to the academy’s structures, decision-making practices and funding, if true reconciliation is to occur. As a start, Mawhiney identifies three questions that institutions must address in responding honourably to the TRC’s ‘Calls to Action.’ These are:

• Who makes decisions about Indigenous education?

• Who are the knowledge experts on Indigenous education?

• How can universities decolonize structures and decision making processes?

These questions challenge academic institutions to take a hard look at their structures, traditions and practices and take the necessary steps to create space for Indigenous representation on their boards, senates and senior decision-making committees. Further, universities must seek guidance from Indigenous scholars on Indigenous education and research needs as well as work to transfer programs and resources to Indigenous Institutes. Of course, all of this will take time to accomplish but it will be possible provided that Western academic institutions are willing to relinquish control over to Indigenous academic institutions and accept that there are many forms of knowledge that are equally as valid as Western forms of knowledge.

Learning Activities

1. Why is learning about cultural safety important to creating transformation within the health care system?
2. Describe how true reconciliation of the educational system is reminiscent of the two-row wampum?
3. What needs to happen if true reconciliation is to occur in the health care setting? in the educational setting?

Expanding Your Knowledge

1. For more information about the Ontario Indigenous Cultural Safety Training, take some time to explore the following links:
   Ontario Indigenous Cultural Safety Training
   SOAHAC Ontario Indigenous Cultural Safety Program
2. For more information on the Urban Aboriginal Health Database Research Project, visit the following link:
   Our Health Counts: Urban Aboriginal Health Database Research Project
3. The following link contains the article by Dr. Anne-Marie Mawhiney:
   Reaching True Reconciliation at our Universities