Dr. Lisa Richardson
Making Women’s College Hospital a safe place for Indigenous patients
By: Liz Beddall
We spoke with Dr. Lisa Richardson, strategic lead in Indigenous Health at Women’s College and co-lead in Indigenous Medical Education at the University of Toronto, who is helping to create a comprehensive program for Indigenous Health
What would you say is the biggest challenge with regard to the delivery of healthcare services to Indigenous communities in Canada?
One of the biggest ongoing health inequities in Canada is related to the health of Indigenous peoples. What we know from research is that health outcomes for Indigenous people across the country are poor. Broadly, we know this is partly because of what we refer to as the social determinants of health – the things that impact a person’s health but are not directly related to healthcare like employment status, access to safe housing and equal opportunities to education.
We also need to acknowledge that there is a deeply rooted history of systemic racism in Canada that is impacting healthcare delivery for Indigenous peoples. Part of my job is to make sure there is an understanding of the specific histories and healthcare needs that must be considered when caring for Indigenous patients. This helps ensure Indigenous peoples have a safe and equitable experience within our healthcare system. I also see my role as a chance to educate healthcare providers about the resilience and strengths of Indigenous peoples.
These are factors that need to be addressed across all sectors but healthcare is where I think my experience and expertise can have the biggest impact.
Why is cultural safety important?
Cultural safety is a concept that first emerged out of the work of Irihapeti Ramsden, a Maori nurse educator and scientist. She found that the basic teachings around cultural awareness and competence were not adequate, in terms of caring for Indigenous peoples. Cultural safety considers the history of colonization, ongoing colonial practices and the specific power dynamics that exist in the relationship between a healthcare provider and a patient.
We all have histories and stories that influence how we interact with each other. Cultural safety encourages an understanding of those experiences and how, as healthcare providers, they may impact how we care for our patients. The concept of cultural safety reminds us to always be mindful of the power dynamic. Being a patient, even if you are relatively healthy, is a vulnerable place to be. That vulnerability is heightened when you are a member of a community that has been marginalized for so long.
How will your work at Women’s College Hospital help to create a hospital environment that is welcoming to Indigenous patients?
A first step to providing care to Indigenous people is acknowledging that everyone has a role to play in response to the Truth and Reconciliation Commission. Healthcare providers need to understand the history and experience of Indigenous peoples in Canada so they proactively work to create safe spaces where healing can happen.
Women’s College is already creating a foundation for meaningful change. It has included Indigenous people on the hospital board and it’s my plan to have more Indigenous people actively advising the hospital on what services are required and how to implement them to best serve Indigenous patients. Community involvement is paramount to creating an inclusive, meaningful care program, including incorporating Indigenous approaches to healthcare like traditional healers and Elders within the hospital.
We are also planning to provide training opportunities for people across the hospital – not only healthcare providers – on how to deliver culturally appropriate care to Indigenous patients and visitors to Women’s College.
Another important signal to the Indigenous community is the physical space. For example, does the hospital have a place where people can participate in a smudge? Seemingly small features are a big signal to the community that they are being considered and that their traditions, values and practices are seen to be equally important. It is imperative that we are caring for the mind, body and spirit in a very holistic way. We are working to create this type of space at Women’s and I think it’s going to be really effective.
What do you hope the Indigenous healthcare program at Women’s College achieves?
I would love for Indigenous peoples across the GTA, and Indigenous women in particular, to know if they have a concern related to their health they can go to Women’s College Hospital and they will be treated with respect and receive the highest level of care that also considers their specific needs as Indigenous people.