The FNHA Office of the Chief Medical Officer (CMO) draws on the richness of First Nations knowledge and teachings as well as mainstream population and public health approaches to support community health and wellness.
Totem pole in Tla'amin Nation.
In many BC First Nations cultures, the traditional role of the Watchmon is to watch over, protect and guide their people by standing guard, observing and warning of impending danger or challenges. Because of the Watchmon’s importance, they are depicted in carvings and atop poles in many communities.
Inspired by these teachings, the FNHA’s CMO holds an important role as a Watchmon who monitors and acts as a guardian and champion of the health and wellness of First Nations people, province-wide.As Watchmon, the CMO’s key roles are to:
• SEE AND HEAR, by observing, monitoring and gathering information and data from various sources to capture the story of health and wellness of First Nations.• REPORT, by sharing the story of health and wellness of First Nations people in BC to improve health and wellness.• GUIDE (or Guard), by providing two-eyed seeing* leadership to contribute to a strategic response at various levels.
*Inspired by the teaching of Mi’kmaq Elder Albert Marshall, two-eyed seeing refers to learning to see from one eye of Indigenous ways of knowing and from the other eye of Western ways of knowing, and using the strengths, gifts and insights from both to gain well-rounded perspective.
Between 2006 and 2014, First Nations in BC established a clear mandate for health data governance and information management through a series of health plans and agreements, consensus papers, and the 7 Directives. This mandate directed the FNHA to create a First Nations leadership position responsible for monitoring and reporting on the health of First Nations people in BC, and tracking progress against health and wellness indicators.
In 2014, the FNHA appointed the first-ever – and so far, only -- Chief Medical Officer (CMO) in Canada who advances First Nations self-determination and self-governance. The CMO was given authority by the BC First Nations governance structure to implement health and wellness actions in partnership with provincial and federal Medical Health Officers.
Prior to the establishment of the FNHA, BC's Provincial Health Officer (PHO) held the sole responsibility for reporting on the health of Indigenous peoples living in BC. Following the establishment of the FNHA's Office of the CMO, the FNHA and the Province of BC assumed shared responsibility for First Nations population health reporting. Since then, the two offices have formed a unique partnership built on mutual respect and collaboration that reflects reconciliation in action.
Together they produce reports that provide evidence-informed analyses to support, inform, and catalyze action throughout the health system and other sectors, and to monitor and support the wellness of the First Nations population.
The CMO's role as Watchmon (see above) is to share the story of health and wellness of First Nations people in BC, illuminating First Nations' roots of wellness (determinants of health), supportive systems and structures, approaches to wellness, and health status.
The FNHA's Office of the CMO and the Office of the Provincial Health Officer work in partnership to develop regular reports as well as special, in-depth reports, including:
• The First Nations Population Health and Wellness Agenda: Executive Summary (full report coming soon)• The Indigenous Women's Health Report (full report coming soon)• Indigenous Health and Well-Being: Final Update (2018)• First Nations Health and Well-Being: Interim Update (2015)• The Health and Well-Being of the Aboriginal Population: Interim Update (2012)• Pathways to Health and Healing, 2nd Report on the Health and Well-Being of Aboriginal People in BC: Provincial Health Officer's Annual Report 2007• The Health and Well-being of the Aboriginal Population in British Columbia: Interim Update (2007)
• The First Nations Population Health and Wellness Agenda: Executive Summary (full report coming soon)
• The Indigenous Women's Health Report (full report coming soon)
• Indigenous Health and Well-Being: Final Update (2018)
• First Nations Health and Well-Being: Interim Update (2015)
• The Health and Well-Being of the Aboriginal Population: Interim Update (2012)
• Pathways to Health and Healing, 2nd Report on the Health and Well-Being of Aboriginal People in BC: Provincial Health Officer's Annual Report 2007
• The Health and Well-being of the Aboriginal Population in British Columbia: Interim Update (2007)
Other FNHA public health reports and joint reports:
• Regional Health Survey Phase 3: Provincial and Regional Reports• BC Coroners Service and First Nations Health Authority Death Review Panel: A Review of First Nation Youth and Young Adult injury Deaths (2010-2015)• Overdose Data and First Nations in BC Preliminary Findings (2017)• Tripartite Data Quality and Sharing Agreement - Annual Report on Progress (2016/2017)
• Regional Health Survey Phase 3: Provincial and Regional Reports
• BC Coroners Service and First Nations Health Authority Death Review Panel: A Review of First Nation Youth and Young Adult injury Deaths (2010-2015)
• Overdose Data and First Nations in BC Preliminary Findings (2017)
• Tripartite Data Quality and Sharing Agreement - Annual Report on Progress (2016/2017)
The Office of the CMO includes seven Medical Officers; they are physicians who provide clinical and public health leadership in their areas of specialization.
Dr. Shannon McDonald, Acting Chief Medical Officer, is Métis/Anishinaabe with deep roots in the Red River Valley of Manitoba. Dr. McDonald completed her medical training at the University of Manitoba. She leads the operational, day-to-day functions for the OCMO, including providing supervisory and human resource management to the OCMO team; represents the OCMO at external meetings and events; and works to strengthen internal relationships and functions across FNHA units. She also leads the OCMO's involvement in substance use work, as well as surveillance and data initiatives within the FNHA; the OCMO's relationship with the BC Coroners' Service and the Chief Coroner's Office, including convening Death Review Panels; and participates in Infant Mortality Review committees. Prior to joining the FNHA, Dr. McDonald was Executive Director of the Aboriginal Health Directorate, BC Ministry of Health, where she was a close partner in the evolution of the FNHA's work, and a Regional Medical Officer with FNIHB Health Canada. She also worked for several years in Winnipeg on community health programs, especially mental health and chronic disease programs.
Specializations: First Nations Data Governance, Research, Surveillance, Population and Public Health, Public Health Emergency Response (e.g., COVID-19 and Opioid Overdose Crises).
Dr. Cornelia (Nel) Wieman, Acting Deputy Chief Medical Officer, is Anishnawbe (Little Grand Rapids First Nation, Manitoba). Dr. Wieman completed her medical degree and psychiatry specialty training at McMaster University. Canada's first female Indigenous psychiatrist, Dr. Wieman has 20+ years' clinical experience, working with Indigenous people in both rural/reserve and urban settings. Her previous activities include co-directing an Indigenous health research program in the Dalla Lana School of Public Health at the University of Toronto and the National Network for Indigenous Mental Health Research, being Deputy Chair of Health Canada's Research Ethics Board, and serving on CIHR's Governing Council. She has also worked and taught in many academic settings, has chaired national advisory groups within First Nations Inuit Health Branch - Health Canada, and has served on many boards and committees, including the Indspire Foundation's Board of Directors. She is an Adjunct Professor in the Faculty of Health Sciences at Simon Fraser University and an Assistant Clinical Professor at McMaster University. She was recently re-elected to a second three-year term as President of the Indigenous Physicians Association in Canada.
Specializations: Mental Health and Wellness / Addictions, Trauma-Informed Practice, Cannabis, Communications and Wellness Initiatives.
Dr. Kelsey Louie, Medical Officer, is Coast Salish from the Tla'Amin First Nation in Powell River, BC. He has the traditional name Men'ahl'elten, that of an inherited Chief. Dr. Louie recently completed residency in UBC's Indigenous Family Practice program. He is passionate about supporting the FNHA's work to address and improve health and wellness outcomes in BC First Nations communities. In addition to his work at FNHA, he is a family physician based in Victoria, BC.
Specializations: Primary Care, Injury Prevention, Missing and Murdered Indigenous Women and Girls, Family Violence, Men's Health, Cultural Safety and Humility.
Dr. Unjali Malhotra, Medical Officer, Women's Health, completed her residency in Winnipeg, Manitoba, where she created and completed a women's health residency program after family residency. She is the Founder and Program Director of the UBC Women's Health Residency Program (for training family doctors in advanced women's health skills for delivery in rural and remote communities). She is the outgoing Medical Director of Options for Sexual Health BC (five years) and the outgoing Chair of the Society of Obstetricians and Gynaecologists of Canada's Canadian Foundation for Women's Health (two years). She also previously served on the Board of the Federation for Medical Women. She is an author and speaker for Continuing Medical Education both provincially and nationally, and has a multidisciplinary women's health clinic in Kelowna. In her various roles, Dr. Malhotra has co-created provincial programs that are focused on advocacy, community support, and education as much as clinical services.
Specializations: Women's Health, Menopause, HPV, Contraception.
Dr. Helena Swinkels, Senior Medical Officer, Public Health, is proud to work with the First Nations Health Authority in a part-time role. Throughout her career, she has worked collaboratively with other physicians, individuals and community partners to promote healthy environments in which people can thrive in their work, communities and lives. She developed a spirit for adventure growing up in beautiful Ktunaxa territory and has since travelled the world seeking new perspectives, insights and ways to contribute. Dr. Swinkels worked as a family doctor in the Yukon, rural BC, Nepal and Vancouver before entering specialty training in Public Health and Preventive Medicine in 2005. Prior to joining the FNHA, Dr. Swinkels worked for nine years with the Fraser Health Authority in the role of Medical Health Officer. She has a passion for transforming health care systems through diversity and inclusion. She has developed and fostered strategic partnerships at the regional, provincial and national levels, and has broad experience across multiple disciplines within public health. She has a Master of Health Science from UBC, Undergraduate Medicine from UBC, and a Bachelor of Science in Biochemistry from Simon Fraser University.
Specializations: Health Protection, Communicable Disease, Environmental Public Health, Crisis Response.
Dr. Sean Wachtel, Medical Director COO/CMO, grew up in the UK and qualified in Medicine at the University of Leicester after studying biochemistry and physiology. Dr. Wachtel undertook post-graduate training in Internal Medicine and Family Practice in Newcastle and Dorset, and moved to Canada in 2009 after a commission in the Royal Air Force, during which he deployed to Iraq, Afghanistan, the Sudan, and Central America. Initially working in family practice and emergency medicine upon arrival in BC, Dr. Watchel undertook additional training in Public Health and Preventive Medicine (PHPM) at UBC along with a Master's degree in Public Health, and is currently fellowship- and college-certified and licensed to practise both Family Medicine -- in which he remains active in a rural clinic with ER -- and PHPM. Dr. Watchel's portfolio at the FNHA includes acting as Medical Director for primary care and health system and primary care redesign. He also provides clinical and public health expertise to the FNHA's health benefits team and alcohol working group, leads the cannabis file with Dr. Nel Wieman, and advocates for First Nations interests on several provincial committees. Dr. Watchel is an elected board member of the College of Family Physician of BC.
Specializations: Primary Care and Physician's Services, Family Medicine, Health Benefits, Clinical Quality/Standards, Jordan's Principle, Cancer, Clinical Quality Improvement.
Note: Dr. Evan Adams is currently on a two-year appointment with Indigenous Services Canada