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Influencing the Frontlines of Health

On the Frontlines

During her residency at hospitals and clinics in northern B.C., family physician Dr. Catherine Elliott found that optimal health for many of her Aboriginal patients meant more than addressing immediate symptoms.

“It is important for improved care that we understand the historical complexities and social context that Aboriginal patients bring with them to encounters with family doctors,” said Elliott, who shared her perspectives in the Canadian Family Physician Journal.

In isolating an elderly First Nations woman for tuberculosis testing, for instance, Elliott learned that a routine procedure from her perspective could be a frightening experience for her patient. That’s in part because TB treatment in many Aboriginal communities has been linked to residential schools, sanatoriums, and “lonely deaths far from families and home communities.”

Education Module for Paediatric Residents Across Canada

January 2013 – New curriculum to support paediatric residents in the care of Aboriginal children was launched in 2011 at universities across Canada. Developed by the Canadian Paediatric Society with the support of the NCCAH and nearly a dozen national organizations in the Many Hands, One Dream partnership, the curriculum provides not only medical information but also historical context in the care of Aboriginal children and youth. The project came out of a December 2005 summit on the health of First Nations, Inuit, and Métis children and youth and the NCCAH provided funding for the development, delivery, and evaluation of the curriculum.

The curriculum was piloted in a day-and-a-half workshop at Queen’s University. “Most of the students in the pilot felt there was a very strong need for this information,” said Dr. Kent Saylor of the Montreal Children’s Hospital, McGill University Health Centre.  “Many were not familiar with the data presented to them, and even basic information was new, such as the difference between First Nations, Inuit and Métis peoples; who is considered an Aboriginal person; who the Indian Act applies to; how housing works in different jurisdictions; and who supplies basic medications in which jurisdictions. A lot of this is eye-opening.”

Saylor, who has played a central role in developing the curriculum, said most paediatric residents will serve in tertiary centres and teaching hospitals, and are therefore likely to be involved in the care of Aboriginal children and youth from relevant regions. “It’s hard to see how this program will not help improve outcomes.”

The project is expected to be a significant step in addressing the questions Elliott has raised in support of meaningful and therapeutic relationships between physicians and their Aboriginal patients. An online training module is in development to facilitate increased access and uptake by other health professionals.