Evidence of meeting #141 for Indigenous and Northern Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was training.
A recording is available from Parliament.
9:35 a.m.
Calgary Confederation, CPC
Yes.
I would imagine your job is quite secure, though, because you're basically the only professional land manager in your community.
9:35 a.m.
Director, National Aboriginal Lands Managers Association
No. As I said, I serve at the whim of whoever happens to be in power.
9:35 a.m.
Calgary Confederation, CPC
I see, so they have an option to choose someone else in the community.
9:35 a.m.
Director, National Aboriginal Lands Managers Association
Yes, they do—or nobody.
9:35 a.m.
Liberal
The Chair Liberal MaryAnn Mihychuk
Thank you. We're out of time. That was very quick, but it was the full five minutes.
Now we're going to wrap up with MP Mike Bossio.
9:35 a.m.
Liberal
Mike Bossio Liberal Hastings—Lennox and Addington, ON
Thank you for being here today. I really appreciate the testimony.
If I read things correctly, on the land management side, as we see from so many witnesses who have come forward, there isn't a one-size-fits-all here when it comes to land management, or even to the engineering and the Technical Services Corporation. When you're dealing with each community, there really needs to be a lens applied to each one to find out what is the best way to serve that community.
Can you give me, though, a sense of some of the best practices you've seen out there as to what can be accomplished within the communities?
Albert, you and I were talking, just from the standpoint of Nova Scotia, about the great success you've had with graduation rates there, because it is indigenous-driven, indigenous-led and indigenous-created. Maybe you can give us a sense of how you can translate that success into the land management side, some of the best practices you've seen across the country and how we can improve it in other communities.
9:40 a.m.
Director, National Aboriginal Lands Managers Association
We're a close-knit community. We're a family at NALMA.
9:40 a.m.
Liberal
Mike Bossio Liberal Hastings—Lennox and Addington, ON
Yes, I see you guys are very close friends, even though you're at opposite ends of the country.
9:40 a.m.
Director, National Aboriginal Lands Managers Association
If I have a problem or an issue with my department, whatever the problem may be, I can always reach out to my colleagues throughout the country via NALMA. The network and opportunities are phenomenal.
If there is a plan that Ted's community developed, they're more than willing to share that plan with me, in order for me, my department or my community to excel. We don't have to reinvent the wheel.
9:40 a.m.
Liberal
Mike Bossio Liberal Hastings—Lennox and Addington, ON
Have you seen any other best practices from other communities as to how they're managing their land?
9:40 a.m.
Director, National Aboriginal Lands Managers Association
Yes, there are best practices out there, everywhere. For instance, in our community we don't have a written rule saying that this is your land, that you're allotted this land. Most of our land is held in custom. People respect that. They don't make big homes, big yards. They're very mindful of the little land base we have. For instance, in my community we occupy only 13% of our whole 8,600 acres. The rest of it is practically unusable.
The way I get around to managing these lands is by asking my colleagues throughout the country how they go about setting these rules.
9:40 a.m.
Liberal
Mike Bossio Liberal Hastings—Lennox and Addington, ON
We had another witness come forward, from the First Nations Land Management Resource Centre. They were going on reserves and training land management on site.
What is the relationship between you and the Land Management Resource Centre? I know you said that in a lot of cases people have to leave the community to get that training. Are they a completely different entity? Are they training in a different aspect of land management than you do?
9:40 a.m.
Director, National Aboriginal Lands Managers Association
Yes, it's a different organization altogether. Personally, I've never dealt with them.
Just to go back to NALMA, with regard to its services provided across the country, I'll allude to what Albert was saying earlier. NALMA is a great entity because it serves every first nation in the whole country to the best of its capacity. A lot of training happens: a matrimonial real property act training, land-use planning. There's survey help and whatnot.
To allude to what he was talking about with regard to contacting all our old classmates whom we trained with all over the country, that's probably one of the greater aspects of the NALMA program. If it weren't for that, I wouldn't have friends across the country whom I could phone and ask how they went about leasing land to this entity here. The information is free-flowing. It's not being hoarded by each first nation. It's quite nice to see that they're open and honest about sharing their situations with other first nations, because—
9:40 a.m.
Liberal
Mike Bossio Liberal Hastings—Lennox and Addington, ON
I apologize, but my time is running out.
Given that the resource centre is providing that training on reserve within the communities, would it not be beneficial for you to work much more closely together to build on each other's strengths?
9:45 a.m.
Director, National Aboriginal Lands Managers Association
Yes, I would imagine, if that were the case, but a one-size-fits-all approach doesn't work for everybody. You have to look at us as.... In Saskatchewan, there are 74 first nations. We're not 74 of one tribe, but many tribes with many languages, many customs and traditions and what have you, encompassing the whole province of Saskatchewan. Across Canada, there are 632 first nations. Somebody in B.C. isn't going to be the same as somebody in Nova Scotia, so you have to approach it with that mindset, not a one-size-fits-all approach. You have to design something that's going to fit as many people as possible, but not necessarily everybody.
9:45 a.m.
Director, National Aboriginal Lands Managers Association
NALMA is very good at using that approach because it's all-encompassing and it changes where it needs to change and runs with it where it's running smoothly.
9:45 a.m.
Liberal
The Chair Liberal MaryAnn Mihychuk
I'm so sorry, but we have to cut off this session because we have other presenters anxious to get started.
I want to thank you all for coming and presenting to our committee. Meegwetch.
We'll suspend and the other presenters can come forward.
9:50 a.m.
Liberal
The Chair Liberal MaryAnn Mihychuk
We're going to get started.
We have a guest who got up early to be with us all the way from B.C. We appreciate that. It's a morning session, and for you the time difference is pretty tough.
I understand that Ms. Jessie Hemphill is ready to go on now, on video conference. She is with Alderhill Planning Inc.
Welcome, and thank you again for participating. You have up to 10 minutes to present.
9:50 a.m.
Jessie Hemphill Partner and Senior Planner, Alderhill Planning Inc.
Thank you. Gilakasla.
[Witness spoke in Kwakwala]
[English]
I'm Jessie Hemphill. I'm from the Gwa'sala-'Nakwaxda'xw Nations, located on the north bend of Vancouver Island, British Columbia. I'm coming to you today from Nanaimo, B.C., in Snuneymuxw territory, and I'm really happy to have been invited. I also want to acknowledge MP Blaney, whom I see at the side of the room there.
And yes, it is very early here.
I want to keep my comments brief this morning and make a couple of key points. I believe I've been invited to speak to the role of planning, particularly indigenous planning, in capacity-building and talent retention. The first key point I would make is that planning, in particular a style of planning called comprehensive community planning, which I'll describe in a moment, is key to capacity-building beyond economic development. We often think of economic development as the key initiative when it comes to capacity-building, but I'd argue that planning has its role as well, because if it's done properly, it builds capacity at all levels within indigenous communities—in leadership, administration and within the community itself.
I'll share a tiny bit of my background on this topic with you. I have been working in indigenous planning for more than a decade, beginning with my own community, Gwa'sala-'Nakwaxda'xw Nations. I have since gone on to lead planning workshops and have worked with hundreds of communities across Canada. I've probably worked directly as a mentor planner with a couple of dozen first nations in Canada, from coast to coast to coast, on their community planning initiatives, and I've been the facilitator for indigenous planning workshops in many of the provinces and in both of the national comprehensive community planning workshops, one held in Charlottetown and one held in Winnipeg in previous years.
I am a trained planner, and last year I was also recognized at the Canadian Institute of Planners with the young planners award for Canada.
There hasn't been a large-scale study to date on the role of planning in capacity-building, so I'm speaking anecdotally and from personal experience, but I'd just like to convey that it's a pretty extensive personal experience in a field where there are not a lot of people working nationally.
In terms of comprehensive community planning, as I said, this is one of the keys to building up capacity and the structural integrity to do economic development and job training, education, health and all of these things. Comprehensive community planning is a form of planning that was named and developed by indigenous communities in British Columbia in the mid-2000s. It is a form of planning that is long-range. Typically, these plans are for 50 to 100 years, maybe 25 years on the short-term end, and they encompass everything.
You could almost compare it to official community planning for local government, but the scope is even broader than that. Typically, in CCPs we see economic development, lands and resources management, governance, health, culture, social issues, education, infrastructure, housing—all of these things are included in this type of planning.
Another key feature of CCPs is that they are developed by the community according to a process that the community itself determines. The previous speaker, Mr. Marshall Jr., I believe, spoke to challenges around the lack of continuity between the elected leadership. This form of planning, because it's long-range and is created by the community itself, has really done wonders in communities to address this challenge and help ensure some continuity of vision and action.
These plans do not necessarily resemble one another. Another one of the previous speakers, whose name I missed, was asking about best practices and the efficacy of nations building on each other's successes. The response was that our nations have such different needs and contexts that we need flexible solutions. In my opinion, planning, particularly when the community is allowed to define the parameters of the planning process and outcome on its own terms, enables that kind of flexibility.
I would also agree with the previous speaker that balancing that out with mentorship—networks or communities of practice at provincial and national levels—really helps to bring ideas together from various communities and to create those support networks, and it also allows each community to pursue the planning process in its own unique way.
That's just a tiny bit of background. Just for your information, there is a website called comprehensivecommunityplanning.org, if any members of the committee would like to read more about that style of planning.
I think that is the key point.
I wanted to leave most of the time for questions today. I'm happy to take any questions now, through the chair.
9:55 a.m.
Liberal
The Chair Liberal MaryAnn Mihychuk
Thank you very much.
All right. We're moving to the Northern Ontario School of Medicine. Thank you for coming out. We have Roger Strasser, Catherine Cervin and Sarita Verma. You have up to 10 minutes for your presentation, any time that you're ready.
9:55 a.m.
Dr. Roger Strasser Dean and Chief Executive Offier, Northern Ontario School of Medicine
Thank you very much, Madam Chair and members of the committee.
I'm Roger Strasser, dean and CEO of the Northern Ontario School of Medicine. It is my pleasure to share with you NOSM's experience in improving the recruitment and retention of health care professionals in rural, remote and indigenous communities.
With me today are Dr. Catherine Cervin, vice-dean, academic, and Dr. Sarita Verma, who will take over from me as the dean and CEO on July 1, so she's dean and CEO designate for the school.
I'm going to read the prepared remarks, but I also have some slides to show. The prepared remarks are not completely in sync with the slides, so I'm going to refer to the slides quickly as we go through.
Let me say that since its inception, NOSM has proudly defied traditional health professional education. The school was born of a grassroots movement. First of all, I have a slide to show you of Ontario's population distribution. As you can see, northern Ontario is geographically vast and very sparsely populated, with many indigenous communities, first nations and Métis communities.
Northern Ontario School of Medicine opened officially in 2005. It serves as the faculty of medicine at Lakehead University in Thunder Bay and Laurentian University in Sudbury, 1,000 kilometres apart. We have a social accountability mandate, which is a commitment to be responsive to the health needs of the people and the communities of northern Ontario, with a focus on improving the health of the people of northern Ontario.
In sum, I would say that the Northern Ontario School of Medicine is an Ontario government strategy to address the health needs of northern Ontarians, improve access to quality care and contribute to the economic development of northern Ontario.
Essentially, the school was founded on this research evidence, that is, the three factors most strongly associated with going into rural practice after education and training. First is a rural upbringing: having grown up in a rural area. The second factor is positive clinical and educational experiences at the undergraduate level—that's the basic training—in the rural setting: learning in rural clinical settings and community settings. Then, after graduation, the third is the training that prepares the graduates to practise in the rural setting. That's really the evidence base for all activities of the school.
I'll go through the slides quickly.
First, distributed community-engaged learning is our distinctive model of medical education and health research, and this slide shows what it looks like, with over 90 sites in northern Ontario where our students, residents and other learners may undertake part of their clinical learning. Next is community engagement, the centrepiece—that is, the interdependent partnerships that we have with communities right across northern Ontario.
In relation to indigenous communities, we regularly hold what we call indigenous community partnership gatherings. We've had five of them. In the top left-hand corner of this slide you can see that “Follow Your Dreams” was held at Wauzhushk Onigum First Nation in June 2003, and in September 2018, so just recently, we were back at the same first nation for the number five, “Gathering Together for Life and Well-being”.
Also, the bottom left-hand side of that slide shows a series of gatherings that were held specifically with a focus on research, the first one in 2008 in Thunder Bay on partnership opportunities in research gathering, and then, in 2016, an indigenous health research gathering that led into the 2017 “Pathways to Well-being” workshop, which was really about involving indigenous youth and looking to a future that doesn't include suicide.
At NOSM, several measures are in place to support physician recruitment and retention. High school students are encouraged to see a future for themselves that might include a health career and studying medicine. The next slide shows that every year at Lakehead University and at Laurentian University we have a week-long health careers camp, which we now call “Camp Med”. Then, three times in first nations, we had the “Walking in Two Worlds” health science camps, specifically for first nations young people, with our own indigenous physician graduates as the keynote speakers in each of the three first nations.
We have also been working in Nunavut, and I'll say more about this shortly. We held a health careers camp in February of last year with federal government support, and we're planning another one in May of this year, which brings together high school students from the communities across Nunavut, similar to the camps in northern Ontario. It's really about making the connection between what they're learning in high school and health careers.
These are some pictures from the health careers camp in Nunavut in February of last year.
We also have a partnership with Matawa First Nations Management and Eabametoong First Nation, so we have a remote first nation residency stream in our family medicine residency program. We are also active in a partnership with other agencies in northern Ontario and have developed a physician resource action plan for northern Ontario.
We have this international dimension, which I'm going to dwell on momentarily. Before I do, this slide shows some of the outcomes from the school. These are quotes from our students. I think the one that's highlighted, “you don't know it until you live it”, really sums up the value of our program.
With regard to this slide on career directions that are chosen by our graduates from our MD program, it's 62% family medicine—mostly rural. That's almost double the national average for Canada for those going into family medicine. You can see that 12% of our graduates are indigenous physicians. When you look at the graduates from the MD program who did their residency in northern Ontario, 94% are practising in northern Ontario, including about a third in the small or remote rural communities.
On this slide, you see that recruiting and retaining health care professionals for rural, remote and indigenous communities is an ongoing challenge in many parts of the world. The school has garnered an international reputation for its success in improving northern Ontario's ability to recruit and retain health professionals.
Since 2011, we've been partnering with countries in the north of Europe for European Union-funded projects. The most recent one started in 2015. It's the Recruit and Retain 2: Making it Work project, which is putting into practice in different jurisdictions in the northern periphery and Arctic region what we learned from the first project. NOSM is part of this because of our success, expertise and experience in transforming the northern Ontario health care landscape. As I said, most recently we've been working in Nunavut, as well, with the Government of Nunavut Department of Health and others in Nunavut.
In January of this year, we had a big forum—multi-site, multi-country video forum—where we presented the framework for remote rural stability. That's what's on the screen. I'm going to speak quite a bit more about that now. It's the result of that seven-year partnership, and the lead partners are now Sweden, Scotland, Norway, Iceland and us, for Canada. It's about stakeholders getting together and drawing on the evidence and lived experience of what works, what's successful in recruiting and retaining health and other public sectors in remote rural communities.
Let me quickly take you through this framework. You'll see that there are three components, and each of them has three elements.
There's planning. It's really important to start by looking at the health needs of the population, and then design a service model that meets the needs of that population and is attractive to physicians and other health care providers. Then it's targeting where you're going to find those particular providers to recruit them. That's the planning.
Recruiting, then, is about sharing the information and active community participation, community engagement, supporting and recognizing that when you recruit a physician or other health workforce into a community, it's a whole family. The family has to feel at home and wanting to be in the community.
Retaining is equally important. It's a workplace that's supportive, with continuous professional development and training the next generation. That's the retaining part.
This is the very last slide. In the centre of that circle are the essentials for success, recognizing that remote, rural, indigenous communities are each unique. They have their own perspective. The service models that work best in those communities are designed in those communities, for those communities.
That means active community participation. That means real investment, real money and resources to actually make this happen, to make this work, as well as having an annual cycle of activities, not just doing it once but on a regular basis, and ensuring that you're continuing to monitor that.
In summary, you have to set your goals and your vision, keep your eyes on the prize and stick to it, because there are plenty of naysayers, plenty of doubters. What I've learned is to smile and nod to them, and then just get on and do what I was planning to do in the first place, challenge conventional wisdom.
In a very short way, I've told you about the Northern Ontario School of Medicine, about our success in the recruitment and retention of our health workforce in northern Ontario and supporting work in Nunavut, in partnership with international partners—