Those are really important questions. Thank you for thinking more broadly about the many issues that impact this.
First of all, accountability on the part of our health systems needs to be better understood and articulated. Often, as has been stated, their decisions rely on data and the availability of data, but there also needs to be a recognition—I know Juliet talked about anecdotal stories—of stories from indigenous perspectives. When these stories are repeated time and time again, they are not anecdotal; they are actually evidence. There needs to be some harmonized data and perspectives on the experiences of indigenous women.
Indigenous women at the age of 40 are experiencing lifestyle challenges and issues that are often very exacerbated when compared to other groups in Canada. They include the raising of their grandchildren, which many of them do due to overdoses and what's happening with their grandchildren's parents.
The other thing that is really important is what Dr. Caron referred to, and that is the development of resources. Many of the mammograms in different provinces are very.... The buses are really old, so the capacity of the system to have up-to-date and really good equipment so we can make it to the remote and isolated regions where we find many of our indigenous people has to be significant.
We also need to look at putting more energy, funding and research into building community capacity. When we build community capacity, we engage provincial screening services at a more meaningful level. With respect to many of the things you talked about and we've been talking about, such as raising knowledge and information, there needs to be a recognition that when a lot of these resources go into communities, they anticipate and expect that communities will pull together all of the engagement and will take capacity from their own centres and primary health care providers to set all of it up.
The level of evaluation and sharing of data is such that it's not very acceptable to communities. We'd be able to build the capacity of communities if health systems were more willing to share data and work towards shared capacity in having these services available.