Indigenous and Northern Affairs Committee on May 31st, 2022

[Martin Shields, Conservative, Bow River, AB]

Right.

Thank you.

[The Chair, Liberal, Marc Garneau]

Thank you, Mr. Shields.

We're now going to Mrs. Atwin.

Just before we do that, Chief, apparently the interpreters had a bit of trouble hearing you. Could you check that your selected mike is the microphone for your headset? Just check that while we're waiting.

I'll turn it over to Mrs. Atwin, for six minutes.

[Jenica Atwin, Liberal, Fredericton, NB]

Thank you, Mr. Chair, and thank you to our witnesses for joining us today.

Most of my questions will be for Ms. Clark from the Native Women's Association of Canada.

I'm a firm believer that NWAC has institutional knowledge, traditional knowledge, and the lived experience needed in order to bring women's voices into this conversation more and more.

In a general sense, you're here today to testify, but are there other ways that NWAC is engaged on improvements around policy regarding the NIHB program?

[Lee Allison Clark]

Not on NIHB specifically, although I feel like we definitely have the capacity to be doing that. As you were saying, we have really great knowledge embedded within the association. We have really great leaders, and we're always grounded in culturally relevant gender-based analysis. Everything is always trauma-informed, so that would be something we would welcome; however, currently, we are not.

[Jenica Atwin, Liberal, Fredericton, NB]

Thank you.

You highlighted something that's really important to me as regards birthing services. You highlighted an example of that with respect to not being able to have an escort, or additional family members outside of the escort, which I couldn't imagine from a woman's perspective. Are there other specific barriers for women, in particular?

Also, perhaps for gender-diverse individuals, are there difficulties in accessing gender-affirming care, trans care? Is there expertise that's lacking in the NIHB system?

I'd love to hear more about that as well.

[Lee Allison Clark]

Unfortunately, it is rife with layers of issues. Being someone who would be two-spirit, transgender, gender-diverse, or part of the 2SLGBTQQIA+ community is already difficult. If you then layer on being indigenous, that's only going to become more difficult. The indigenous experience in health care has traditionally been extremely difficult. Combining that with something that's already difficult, as well, would make it, unimaginably, almost impossible.

The idea of being two-spirit is something that is very foreign to most health care providers. They often associate that with being gay, bisexual, or something, and it's just a totally different thing. It's sacred; it's spiritual, and an understanding of that would probably increase the ability to seek gender-affirming care. However, especially if you're in a rural or remote community, it's going to be almost impossible to do that.

In regard to your first comment about having access to birthing services, yeah, it's a decision between bringing your midwife, your doula, or your child, and which child do you choose if you have several? Do you bring your partner, or does your partner look after them? Hopefully, there are elders in the community. There are just layers of having to decide who to have with you.

Mr. Shields was speaking about having a navigator with you. Having a navigator is great, but so is having family, and having just one person is not enough when.... I'm sure many folks here have been around people who have given birth. You're allowed to go to the hospital. It's easy. You drive over, you go, and you get to see the baby. It's incredible.

That doesn't happen for the majority of indigenous people who give birth and have family members. They have to wait until they fly home. Flying is already traumatic for some folks, but never mind with a newborn, so the layers and layers of barriers just continually keep coming up.

[Jenica Atwin, Liberal, Fredericton, NB]

I looked at NWAC's website just recently to brush up on some of the services, and I really like the section on knowing your rights and informing people about what that looks like, particularly accessing services. I'm just wondering about the other ways you communicate with indigenous people across the country.

[Lee Allison Clark]

Obviously, I'm really glad you've seen that. We have several websites that tell you what your rights are and what you're entitled to. Often, when folks go looking for services specifically related to NIHB, it's completely overwhelming. Typically, they'll tell you to reach out to your local organization or association. Those are the people who are able to navigate it, because it's so complex. When you're already facing lots of other issues at home, or layers of discrimination, it becomes impossible to try to figure out without someone to walk you through it.

In terms of what else we're doing at NWAC, again, we have a really great team, as you pointed out earlier. It's not my team, but I have great co-workers who are working on how to know your rights, especially those related to youth and gender equality. We have an initiative right now with.... What does gender equality look like? That is ultimately a health issue. I can't speak to what my colleagues do.

[Jenica Atwin, Liberal, Fredericton, NB]

Thanks.

In my remaining time, I'd love to focus on mental health, and access to mental health care in particular. I also noticed that you were part of creating a “heal the healers” workshop, as well. That's another critical piece: ensuring that those giving help are also looking after their well-being.

Could you speak to mental health initiatives in particular?

[Lee Allison Clark]

I'm really glad you've seen “heal the healers”. That's something I'm quite proud of, to be honest. My team is incredible. We engaged with our elders, knowledge-keepers and traditional healers around the country and were able to develop a program that we delivered through our resiliency lodge model, which seeks to heal the people who are helping to heal others.

If you're having an issue, you might seek out the help of an elder, but who's helping that elder? Typically, it's not a lot of people. We created a two-hour virtual program and an in-person day program that scoots around NIHB, because you have predeterminations for most services. It takes forever to access them and there aren't maximum times for waiting. It allows healing to take place within the culture they are from instead of in an institution, which can be very scary.

We also did a training for community support workers, so they would know how to best deliver health care services to indigenous women and girls and two-spirit, transgender and gender-diverse folks.

[The Chair, Liberal, Marc Garneau]

Thank you.

Ms. Bérubé, go ahead first six minutes.

[Sylvie Bérubé, Bloc, Abitibi—Baie-James—Nunavik—Eeyou, QC]

Thank you, Mr. Chair.

I want to thank the witnesses for joining us today. I also thank the interpreters for the work they are doing in committee.

My question will be for the three witnesses.

In this study, as in previous studies this committee has carried out, including the one on housing, which we just completed, it has been mentioned several times that health is ubiquitous in a number of areas of life of first nations and Inuit. I also think that a healthy population essentially corresponds to healthy community living.

Could you talk to us about the connections between health and various indigenous and community areas of life?

[The Chair, Liberal, Marc Garneau]

Can you tell us to whom you are putting the question?

[Sylvie Bérubé, Bloc, Abitibi—Baie-James—Nunavik—Eeyou, QC]

My question is for the three witnesses.

[The Chair, Liberal, Marc Garneau]

Okay.

We'll start with Chief Jerry Daniels, then we'll go to Ms. Idlout and Ms. Clark to answer that question.

[Grand Chief Jerry Daniels]

It's quite simple, actually. If you're not healthy, you can't help people. You have to have a great deal of the mental capacity to provide direction and knowledge, and to transfer that knowledge on how to live healthy and to participate in activities in the community that are healthy. Those are all important in enabling people as individuals to help and mentor their families. The families that are very healthy in the community can support and are usually the foundation. The person or people provide a great deal of that secondary support outside of primary families to aunts and uncles who are suffering from health issues. We see it a lot with diabetes. The cancer rate is very high. It's a loss for us.

For example, my mother is in the hospital right now. She's in and out because she has liver disease. It really weighs not only on me, but on my brothers and my family. We're always thinking of her. She's still very young. She's not even 60 yet.

The livelihood and the inability for the health system to provide alternatives or that extra support for her to deal with the health issues...those are transferred as well. Diabetes is very much preventable in our communities, but we continue to see skyrocketing rates that lead to amputations and kidney failure. There's maybe not enough education around that. For her and others who are going through this, if they're able to overcome and manage, that's important for us, the younger population, to understand.

I think it's not something that should be isolated to the health system. It's something that needs to be part of the education system overall.

[The Chair, Liberal, Marc Garneau]

Ms. Idlout, would you like to answer that question?

[Joy Idlout]

I lost connection for a bit, so I did not hear the question.

[Sylvie Bérubé, Bloc, Abitibi—Baie-James—Nunavik—Eeyou, QC]

Could you talk to us about the connections between health and various indigenous and community areas of life?

[The Chair, Liberal, Marc Garneau]

Did you hear that translated into English, Ms. Idlout?

[Joy Idlout]

No. I just turned it on.

[The Chair, Liberal, Marc Garneau]

Okay.

What role does people's health play in the lives of indigenous communities? How important is it?

[Joy Idlout]

It really takes a toll on the whole family when someone is sick, because there are no hospitals in most northern communities, so most people have to fly out. We end up having to look for someone to be with that person out of town, which leaves families and kids behind. Being away for months at a time would be hard for everyone.

[The Chair, Liberal, Marc Garneau]

Thank you.

Ms. Clark, would you like to answer the question too?

[Lee Allison Clark]

Absolutely. I think it's impossible to speak about health without recognizing everything that goes into health. Health isn't just being healthy. It's having access to safe housing. It's having access to a safe environment. It's access to water. It's so many different things.

In relation to community, when a community doesn't have those things, how can its health possibly thrive? As Ms. Idlout was alluding to, when someone has to leave, that makes a big dent in the community. I was speaking before about how you have to leave your children at home sometimes when you're just having a baby. It's something that is pretty normal, but it disrupts not only your life, but the entire community's life.

I would also like to highlight that health typically isn't as individualized for indigenous folks. It's the community, and you thrive off of your community and what is going on in your community. When one person is ill, the community rallies around. It's not just that he, she or they have diabetes. The whole community comes around.

I would say health is absolutely critical to creating a well-woven community.