Coast Salish Territory – The First Nations Health Authority (FNHA) is marking the second anniversary of the In Plain Sight Report on Wednesday, Nov. 30, 2022 by publicly announcing the completion of work on a first-of-its-kind Cultural Safety and Humility Standard (CSHS) for First Nations in British Columbia (BC).
Driven by a First Nations-led technical committee, supported by the FNHA, with input from Métis Nation BC and in partnership with Health Standards Organization (HSO), this new standard is a significant milestone event along the path toward ending systemic racism in BC's healthcare system.
Work on the CSHS began in October 2018, two years prior to release of In Plain Sight, the review of Indigenous-specific racism in the provincial health care system commissioned by the BC Health Minister. One of the recommendations in that report was that BC should adopt an accreditation standard for achieving Cultural Safety and Humility (CSH).
The existence of Indigenous-specific racism in BC's healthcare system is long-standing and pervasive and its ongoing presence continues to have harmful impacts on the overall health and wellbeing of BC First Nations people today. For this reason, it was important that First Nations health professionals, with input from community Chiefs, health leaders, and First Nations people across the province, led the development of the new standard.
During the public consultation phase, a technical committee co-chaired by the FNHA's Deputy Chief Medical Officer Dr. Nel Wieman and St'at'imc Nation Elder Gerry Oleman, received and reviewed over 1,100 comments from First Nations people, other Indigenous groups, health organizations and health professionals. This information provided crucial insight used to inform the standard.
The FNHA, alongside its governance partners, First Nations Health Council (FNHC) and First Nations Health Directors Association (FNHDA), held multiple sessions with First Nations in BC to keep the work grounded in First Nations needs and priorities, as expressed by Chiefs and Health Directors, including ongoing evaluations of progress.
Publication by HSO on June 14, 2022 was the first of several steps required in moving the CSHS from a reference standard to an assessment standard. The shift to an assessment standard is important as it means that those organizations currently accredited by Accreditation Canada will be able to perform self-assessments against the criteria referenced in the standard.
Going forward, the FNHA will continue its work to implement an anti-Indigenous racism, CSH framework and action plan, jointly developed with the FNHC and the FNHDA, focused on First Nations-led responses, regionally driven innovation and continuous improvement.
Dr. Nel Wieman, FNHA Deputy Chief Medical Officer, CSHS Technical Committee co-Chair
“What motivates me in this work is knowing that somewhere today in BC, a First Nations person is seeking medical attention and is being treated in a racist, discriminatory manner. This CSH standard is signaling to the BC health system that racism is no longer acceptable and there is a way forward to making the system safer for First Nations and other Indigenous people. We can be justifiably proud of the work that went into creating the CSH standard and know that we at FNHA are leading systemic change across the country."
Gerry Oleman, St'at'imc Nation Elder, CSHS Technical Committee co-Chair
“We can do this. In our lifetime, we can do this if we work together and are committed. There is justice in Canada. When we say justice, we mean justice and absolute fairness for all. Today I can say there is a Standard. We set a high bar about dealing with cruelty and fairness. We're talking about accountability. How do we make people accountable? I'm going to say with words. We transform people with words. I just want to thank the committee and the HSO for that hard work. Hard work is good work. You do not say no. You keep going."
Richard Jock, FNHA CEO
“Our organization is committed to continuing the journey of increasing CSH to eliminate anti-Indigenous racism in BC, thereby creating a safer health system leading to better health outcomes for First Nations people. We celebrate the creation of this first-of-its-kind standard, and are extremely proud of the hard work, dedication and commitment of those who contributed to its development."
Colleen Erickson, FNHA Chair
“This first-of-its kind standard was developed by and for BC First Nations by community health leaders, medical health professionals and healthcare partners with a singular focus on designing culturally safe systems and services at the organizational and institutional level, with the ultimate goal of removing systemic racism from BC's healthcare system. While we applaud this very important step, our communities know that there is still much more work to be done."
Wade Grant, Chair, FNHC
“We honour the leaders and health professionals who created this framework grounded in First Nations knowledge, traditions and culture. Only through Indigenous-owned and led approaches can we set standards for trauma-informed and culturally-relevant care to improve health and wellness for First Nations people."
Keith Marshall, President, FNHDA
“This CSHS is an important tool for Health Directors working across First Nations in BC. As an Indigenous-led process, this framework sets a clear standard of care in our ongoing work to ensure all residents of BC are treated with dignity and respect and have access to culturally grounded health care services."
Janene Erickson, FNHA, Manager Partnerships & Projects
“I am so proud of our people and the work. I am proud of you all as survivors, recognizing our governance and our ways, and seeing our FNHA family working behind the scenes to do everything they can to get this right. We are here to do this work the way we are supposed to do this work. Not some colonial signing of some document, but our way. I am really looking forward to the implementation and the passion of our people to ensure that this new standard aligns with our laws, teachings, and protocols and remains grounded in ceremony. This is history in the making right now."
Learn more about cultural safety and humility
For mental health counselling and cultural supports, please visit the FNHA Mental Health and Wellness Support page.