Qey, hello, bonjour.
N'toliwis [My name is] Isabelle Wallace and I am a community health nurse in the Madawaska Maliseet First Nation, which is where I come from and of which I am a member. I am a proud Wolastoqey nurse who has had the opportunity to practise in a number of First Nations, Métis and Inuit communities, including in New Brunswick on my traditional unceded land, and in northern Quebec, Ontario and Manitoba.
I have Indian status, and have had since I was born. I believe that my master's thesis on Indigenous cultural competence, my professional career, and my experience as a Wolastoqey woman equip me to make a considered judgment of the NIHB or Non-Insured Health Benefit Program. I am honoured to be able to share my opinion and suggestions in connection with this study. Thank you for inviting me to appear before the committee.
To put my testimony in its proper context, I'd like to tell you about the profile of my community. The Madawaska Maliseet First Nation is located in northwestern New Brunswick, on the Quebec border and the border with Maine, in the United States. We represent 196 members who live on the reserve land and 404 members who live off the reserve.
Ours is the only First Nations reserve where French is the majority language spoken and English is the minority. However, because of the violent assimilation measures imposed by successive governments over the years, no one in our community speaks Wolastoqiyik, our ancestral language.
In 2021, we won a victory in our land claim, after which we had a large part of the city of Edmundston recognized as being located on our "reserve" lands. So you can see that we are close to Edmundston and the members of our community have access to the regional hospital and various health professionals in the private sector.
As a community health nurse, my role is to provide care in various sectors of health care, including public health, community health, home care, and primary health care. Before the pandemic, we were already asking for a nurse to deal with a complex and flawed health care system. Now, we also have to do crisis management, plan numerous vaccination and testing clinics, educate the members of our community, and find innovative solutions to respond to health care needs.
The additional complexities generated by the NIHB program are therefore quite simply an unnecessary burden for a community health nurse. I am even prepared to say that the numerous flaws in the program fuel racism in our region.
A recent example was last week, when I contacted a private sector health care provider to facilitate communication between that professional and a client.
When we were discussing a member of my family, the person not being aware of that relationship and so that I am part of the community myself, the person said: "Personally, Indians, I don't deal with that."
After I asked for clarification so I could determine whether she was refusing to provide services only to First Nations, she told me that all clients had to pay in advance, but that, she said, she was going to have trouble getting paid by an "Indian".
I think my role, as a community health nurse, is to advocate for my clients and my family so they get access to equitable health care, while, at the same time, I also have to deal with racist remarks on a daily basis.
Because of a lack of training on the program, my role is to educate providers about navigating the system and to act as a facilitator.
Unfortunately, I have several other examples where I was able to feel and observe, concretely, the consequences of these failures and of the closed and unacceptable attitude on the part of health care providers, whether as a client or as a colleague.
I could say more about the laborious administrative duties that come with the program or the hours spent on following the appeal process. However, I think the essence of my testimony would get lost.
In my opinion, the lack of sensitivity and of rigorous, continuous training on the part of health care professionals in all sectors has extremely harmful consequences for the health of members of the First Nations and on Métis and Inuit.
Instead of looking after their welfare, the NIHB program contributes to widening the gulf between its clients and non-Indigenous people.
Woliwon. Thank you.
Thank you for giving me the opportunity to speak on this important subject and to represent the members of my community.
I will be happy to answer your questions.