Can we make #MMIWG the next #MeToo?

By Jennifer Stranges

Health care service providers must recognize the legal, ethical and moral obligations they have to Indigenous patients as detailed in the recently released final report into the National Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG), says Dr. Suzanne Shoush, an Indigenous family physician at Sumac Creek Health Centre, one of St. Michael’s Hospital’s Academic Family Health Team clinics.

The report, released June 3, includes striking findings about the disparity in health care and outcomes for Indigenous girls, women and 2SLGBTQQIA (two-spirit, lesbian, gay, bisexual, transgender, queer, questioning, intersex and asexual) people.

We sat down with Dr. Shoush to discuss her reaction to the findings of the report and what health care providers and all Canadians can do better.

The report has several calls to action for health care service providers, which include receiving ongoing training, education and awareness in areas such as the history of colonialism, anti-bias and local culture. What are your major takeaways?

The biggest takeaway is that the framework the calls to action are presented in are as legal, ethical and moral obligations. They’re not recommendations, they’re not suggestions; they are calls to action that are framed on national and international treaties, on our Charters of Rights and Freedoms, on our Constitution, and on the UN Declaration on the Rights of Indigenous Peoples.

These are obligations that Canadians themselves can act on, that health care service providers can act on. It’s not just about holding government accountable and hoping they put money towards programs. The report shifts the accountability to the collective public.

According to the report, Indigenous women, girls and LGBTQ2IA people are more likely to experience suicide ideation and to suffer poverty and poor health. Do you see these findings reflected in your patient base?

Absolutely. I see it reflected not only in my patient base, but also in the patients I don’t see. I see a relatively small number of women and girls and LGBTQ2 people from Indigenous communities coming to my practice. I spend a lot of time going to different community agencies with the goal of finding out what I can do as primary care provider to liaise and help, and a lot of the health care needs of Indigenous people are not being met. There are a lot of gaps. The report and its findings are quite accurate.

What is your family practice currently doing to address the disparity in treatment towards Indigenous Peoples?

Within a week of me joining the Sumac Creek Health Centre, a large group of colleagues and I founded Healing our Roots, an advocacy campaign that is looking to improve the ability of St. Michael’s Academic Family Health Team to be safe and inclusive for Indigenous patients. We’re looking at what barriers exist to improve the number of patients who feel safe, are willing to self-identify as Indigenous, have their health care needs met and have better health care outcomes.

We’re aiming to gain credibility as a health care provider. Word of mouth is powerful. If Indigenous people feel safe, it will become known. If they had a bad experience, it will also become known. It’s our “build it and they will come” mentality – we are looking to improve ourselves and our practices, and to earn the trust of Indigenous patients who will be willing to self-identify.

What is your goal and how will you get there?

My goal is improved health outcomes for Indigenous people. Measuring change is challenging, because a huge barrier is data collection. There is so much fear for an Indigenous person that if they walk into an emergency department and their chart shows they are Indigenous, it will change the way they’re seen or treated. Health care has traditionally disenfranchised Indigenous people, and now we’re asking them to self-identify. It can be a very scary ask.

Rather than base progress on the patients, we’re looking at the providers more reflectively. What do we as health care providers know about Indigenous people, about traditional healing and medicine, about the Indian Act? What do we not know? Do our clinics represent Indigenous people through art or through health posters that are reflective of their needs? Introspection will lead to greater health care provider understanding and competency.

What do you think the final report will do to change medical treatment and prejudice towards Indigenous Peoples?

I’m looking for a similar spark to the #MeToo movement and #TimesUp. Those movements looked at the way culture operated for years and years, in a manner which was unacceptable but collectively accepted. A string of events transformed the way our culture treated women and accepted sexual or workplace harassment. I hope we raise awareness and have a transformative cultural moment. I hope we shift away from the current culture, which continues to contribute to the genocide described in the report, to a place where we honour the sacred life of Indigenous human beings.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.