Teem ah thit – "we are doing our best" in hən̓q̓əmin̓əm̓ language

COAST SALISH TERRITORIES – Doctors of BC and FNHA came together in ceremony to sign the most recent Declaration of Commitment to Cultural Safety and Humility in Health Services Delivery for First Nations and Indigenous people in BC on June 3, 2019.

Doctors of BC is a voluntary association of 14,000 physicians, residents and medical students in British Columbia. Their vision is to "promote a social, economic, and political climate in which members can provide the citizens of BC with the highest standard of health care, while achieving maximum professional satisfaction and fair economic reward."

The signing took place during a meeting of their Representative Assembly, which involves 106 physicians working throughout the province.

Two Families coming together

xʷməθkʷəy̓əm (Musqueam) Family Member and FNHA Knowledge Keeper Te'ta-in Shane Pointe led the protocols. He shared that the ceremony and signing represented two great Families or Houses coming together as one – nə́c̓aʔmat ('we are one').

"I'd like to start by saying it is a great honour and privilege for me to be here at this moment. This moment for me is historic. It is historic because what it's going to do is bring together two Families. Two Families that are making a commitment to partnership," said Te'ta-in.

Later he added, "Pre-contact, we didn't have surnames but we came from houses. So, when I'd identify myself to my relatives, I'd let my relatives know this is the House I belong to. In my thinking, I belong to the First Nations Health Authority House. You wonderful people belong to the House of Physicians. So, my terminology today is that we're Houses. Houses mean that we come from Families. Today these two great Families, these two great Houses, are combining their strength. On an emotional spiritual intellectual level, we're coming together."

Te'ta-in emphasized that the work being done that day was not just for the benefit of BC First Nations but also all new British Columbians who bring their own languages and cultures when they come to live in this province.

Calling the witnesses

As the ceremony took place at the Robert H Lee Alumni Centre at the University of British Columbia, honouring protocols of the territory of xʷməθkʷəy̓əm people was essential.

Te'ta-in explained that, "Following with Coast Salish tradition, if we do not have witnesses, then the work didn't happen…It's the responsibility of the witness to see, hear, and feel the work that's happening. Their responsibility is to move into the future and to relay the message of the work. Today, there's going to be a stronger bond between two great Families. The witnesses' responsibility is to relay that message to their Houses, their homes, and their work so, everyone knows what happens here today."

Four witnesses were called: FNHA Deputy Chief Medical Officer Dr. Shannon McDonald (Métis & Anishinaabe); and three Voting Representatives from Doctors of BC, Dr. Jason Wong, Dr. Warda Toma and Dr. George Watson. Each was offered a kwa sun a tun ('anchor', represented by a coin) by four members of the FNHA Family. The kwa sun a tun is a gift to acknowledge appreciation for the witnesses, and help them to remain in the present moment.

From Left: Witnesses Dr. Warda Toma, Dr. George Watson, Dr. Shannon McDonald, (Te'ta-in Shane Pointe), Dr. Jason Wong

Blanketing leaders from the two Families

Leaders from the two Houses were wrapped in blankets and head wraps. Doctors of BC President Dr. Eric Cadesky and CEO Allan Seckel were called, as well as FNHA Chief Medical Officer Dr. Evan Tlesla II Adams (Tla'amin Nation). Each representative spoke, and then sat to add their signatures to the Declaration documents. FNHA CEO Joe Gallagher, k̓ʷunəmɛn (Tla'amin Nation) was absent due to illness and has since added his signature as well.

Te'ta-in explained that, "The blanket signifies that the House acknowledges and respects that individual's station. It also signifies to the person being blanketed that the host supports them 100% in who they are in the moment and into the future. The headband historically, and as it is now, is to protect the individual's mind from negative energy so that they're clear in the moment the work that they are doing."

Dr. Adams reflected that he has "feet in both Houses". He shared that, "Today is an important milestone in our relationship with Doctors of BC. The signing of this Declaration of Commitment to Cultural Safety and Humility in Health Services Delivery for First Nations and Indigenous people in BC with Doctors of BC acknowledges the meaningful impact that physicians have on the care and wellness of our people. With this Declaration, we also recognize that we can do better, and that each of our organizations has reciprocal accountability in this important work."

Dr. Evan Tlesla II Adams (Tla'amin Nation), FNHA Chief Medical Officer

The witnesses had the opportunity to reflect on what they had seen, heard, and felt. Again, they were given kwa sun a tun by the FNHA Family.

From Left: Dr. Warda Toma, Dr. George Watson, Dr. Shannon McDonald, Dr. Jason Wong, Te'ta-in Shane Pointe, Dr. Evan Tlesla II Adams, Allan Seckel, Dr. Eric Cadesky

Several members of the physician Family – both leaders and witnesses – spoke from the heart about coming to Canada as immigrants and navigating cultural differences, and how these experiences shape the commitment they were making that day.

We are all sacred medicine       

Once the work of signing was complete, Te'ta-in shared his Family's history and relationship with Dr. Baldwin, who was their family doctor in "every sense of the word".

"Personally, I was spared Indian Residential School because my mother went to Dr. Baldwin. My mother knew that in the 1950s, everyone, regardless of station in life, listened to doctors. So, she went to him and she asked him, please Dr. Baldwin, write a letter to the Indian Agent saying that my son cannot go to Indian Residential Schools. I do not want him to go there. Dr. Baldwin did exactly that. Beyond medicine, beyond healing. For my mother he said yes, Dimples, I will write the letter. And he did. Kept a copy for himself, kept a copy for the Indian Agent, kept a copy for the people who were going to come and get me from my home. When they got to the house, my mother presented the letter from Dr. Baldwin, signed by the Indian Agent that I was not to go to residential school. Beautiful moment for the men who came through the door: they were disarmed from their negativity and their violence in the moment because they saw Dr. Baldwin's signature as well as the Indian Agent's. That is cultural safety and humility from another time. Always constantly saying prayers myself for that very fine gentleman, not for what he did for me but for his relationship with my mother – the kindness and respect that he showed her as a human being."

Te'ta-in used this piece of his history to highlight the role of doctors to support the health and wellness of First Nations and Indigenous people, beyond healing. He closed by sharing a teaching about how each of us is sacred medicine:

"My old people said to me that medicine, in our language, slax'in, is xa-xa, is 'sacred'. Xa-xa slax-in is 'sacred medicine'. We as human beings are xa-xa slax-in. We are sacred medicine for each other. We are sacred medicine for each other. I am medicine for all of you. You are, in turn, medicine for me. I'm grateful for this powerful moment, for children, First Nations children first and foremost, and the generations of children that are going to follow after this moment. You wonderful people have demonstrated today that you are indeed xa-xa (sacred), xa-xa slax-in, that you are sacred medicine for other human beings."

Part of a Cultural Safety & Humility Movement

In signing on to the Declaration, Doctors of BC joins other partners in BC's health and wellness ecosystem who have made this important commitment.

This First Nations-led movement began with the experience of one BC First Nations family who encountered cultural un-safety following the death of a loved one. It was the spark that prompted FNHA to seek cultural safety and humility commitments with its partners in the health system.

Cultural safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the health care system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care.

Cultural humility is a process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust. Cultural humility involves humbly acknowledging oneself as a learner when it comes to understanding another's experience.

Today, signatories include the Ministry of Health, Ministry of Mental Health and Addiction, regional and provincial health authorities, BC's health regulators, Providence Health Care, Indigenous Services Canada, Health Canada, Public Health Agency of Canada, Pacific Blue Cross, and others.

This new commitment from Doctors of BC adds strength to this common vision, language and framework that guides the health system to transform to addresses systemic racism, and promote culturally safe services through the incorporation of cultural humility.

From Left: Te'ta-in Shane Pointe, Allan Seckel, Dr. Evan Tlesla II Adams, Dr. Eric Cadesky

Ceremonial Roles and Responsibilities

Speaker & xʷməθkʷəy̓əm Family Member

• Te'ta-in Shane Pointe (xʷməθkʷəy̓əm Nation), FNHA Knowledge Keeper

Witnesses

• Dr. Shannon McDonald (Métis & Anishinaabe), FNHA Deputy Chief Medical Officer

• Dr. Jason Wong, Voting Representative from Doctors of BC

• Dr. Warda Toma, Voting Representative from Doctors of BC

• Dr. George Watson, Voting Representative from Doctors of BC

Leaders from the Two Families (Signatories)

• Dr. Eric Cadesky, President of Doctors of BC

• Allan Seckel, CEO of Doctors of BC

• Dr. Evan Tlesla II Adams (Tla'amin Nation), FNHA Chief Medical Officer

• Joe Gallagher, k̓ʷunəmɛn (Tla'amin Nation), FNHA CEO (absent)

FNHA Family

• Janene Erickson (Nak'azdli Whuten), Partnership Development & Projects, FNHA CEO Office

• Katie Skelton (Henvey Inlet First Nation), Partnership Development & Projects, FNHA CEO Office

• Janelle Tom (Squamish Nation), Partnership Development & Projects, FNHA CEO Office

• Kate Jongbloed, Partnership Development & Projects, FNHA CEO Office