Thank you very much. I am Marilee Nowgesic, the executive director of the Canadian Indigenous Nurses Association. I'm joined by my colleague Isabelle Wallace, who is also one of the registered nurses across the country whom we rely on for their expertise.
At this time, I want to recognize the unceded land of the Algonquin territory on which we meet. I want to pay my respect to the traditional custodians across the lands in which we work, and especially to my ancestors and elders who have guided my journey here today. I want to acknowledge the other knowledge keepers in this room who have prepared comments based on their expertise and experience.
I'm going to skip over a lot of my notes just to make this shorter. There is one typo: while I'd like to say I have 97,000 indigenous nurses across this country, I have to remove one of those zeros; I only have 9,700.
In 2018 we have extended the authentic partnerships developed with external stakeholders who have a shared vision. We continue to work alongside our national indigenous leadership, such as the AFN, ITK, and others such as the First Nations Health Managers Association and the Canadian Association of Schools of Nursing. Each of these partners has made a commitment to advance indigenous nursing.
Lifestyle over the past 50 years has had a great deal of impact, and serious impact, on the health of indigenous people. Our elders have expressed their sadness, because diabetes is killing our people. This is what it is, a killer.
We have seen an ongoing opportunity for this government to support the request to work with your respective caucuses to call on the government to provide funding to explore the establishment and administration of diabetes strategies for indigenous people, using indigenous knowledge-based healing models such as the Four Directions. This would include terms for renewable funding and evaluation for success that is mutually agreed upon by the federal government and national indigenous health professional associations.
As is most times the case, indigenous nurses are the primary care providers at the community level. It is and will be through their diligent efforts that fundamental changes in the design, development, and implementation of health services that will be more responsive to community needs become the reality. These are the health care providers who will utilize whatever tools they have available to adjust food security, manage medication, and give people in these communities the information necessary to make informed decisions about their illness.
Investment in diabetes strategies through regional and national indigenous-based organizations will begin to connect the health gaps between indigenous and non-indigenous groups. Although there are currently several promising practices, they tend to be operated as one-offs. It is necessary to scale up, so that the benefits of these programs can be shared with more communities.
Indigenous knowledge and healing practices must be incorporated into the service delivery framework and the management of such chronic diseases as diabetes, recovery from stroke, and end of life care. Support for programs that will address all aspects of the continuum of care and the overall health status of indigenous people will require partnerships with other health stakeholders, such as the new working relationship that CINA has with Diabetes Canada to develop the diabetes 360 strategy..
We also want to note that communities and health care organizations alike recognize a discrepancy in funding in relation to coverage, standard practices, and requirements for care.
Examples of this discrepancy include the non-insured health benefits program, which is a national program, but one that is too rigid and inconsistent across Canada.
This situation is further complicated by the rising costs of prescription medications. In a recent report released by the Canadian Federation of Nurses Unions called “Body Count: The human cost of financial barriers to prescription medications”, 57% of Canadians with diabetes reported failing to adhere to their prescribed therapies because of affordability issues related to medications, devices, and supplies. This is a phenomenon otherwise known as cost-related non-adherence.
The establishment of indigenous health centres in urban centres would improve access to quality health care in a culturally based setting. These centres could provide provincial health facilities with the training and resources to improve delivery in a culturally competent and safe manner.
We see value in focusing on this issue and we call on this government to encourage Indigenous Services Canada, in collaboration with provincial governments, to establish indigenous health centres in urban areas where there are high indigenous populations.
I would now like to turn to Isabelle Wallace.