One year in: Inside Unity Health’s first Indigenous Wellness Centre

For generations, Canada’s healthcare system has been shaped by the legacy of colonization, leaving First Nations, Inuit and Métis peoples to navigate a system that was not built with them in mind.

In 2021, Unity Health Toronto made a commitment to drive meaningful change and help to create a health system that is inclusive of indigenous needs and perspectives. A key part of that promise was to create Indigenous sacred spaces across all three Unity Health Toronto sites and to bring Indigenous leadership into the organization to spearhead the work.

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Roberta Pike, Anishinaabekwe from Henvey Inlet First Nation, joined the organization as its inaugural Director of Indigenous Wellness, Reconciliation and Partnerships in 2023.  She brings more than three decades of experience working to improve the health and wellbeing of Indigenous communities.

When a transformative $11 million donation from the Krawczyk Family Foundation last year made the opening of the Indigenous Wellness Centre possible at St. Michael’s Hospital, it marked something Roberta had also long been working toward: a dedicated space within a hospital where Indigenous patients can access culturally informed care and begin to build trust with a system that has historically failed them.

A space to heal

The Indigenous Wellness Centre at St. Michael’s Hospital is a 650-square-foot space, featuring a large ceremonial circle, special exhaust ventilation to permit indoor smudging ceremonies, and Indigenous art and a welcoming environment. It is the first of three planned Indigenous wellness spaces across Unity Health’s hospital sites, with spaces to follow at Providence Healthcare and St. Joseph’s Health Centre.

“It’s a welcoming space where our community members know they can come by and pop in,” said Roberta. “That didn’t exist before.”

Today, a dedicated Indigenous Wellness Team operates from a space strategically located near the Emergency Department (ED), serving First Nations, Inuit and Métis patients across all departments, including renal health, mental health and end-of-life care. The team provides wellness navigation, connection to ceremony, discharge planning and home readiness support – working to ensure that when patients leave, they return to safe, healthy environments.

“We have the time to sit down and talk to people and really get a good sense of what their needs and concerns are and go deeper into their unmet needs,” she said. “Indigenous people have a history of going to the hospital and expect to either not survive or be abused. Having an Indigenous Wellness team member show up as early as possible, whether it’s in the ED or on the floor, helps because we’re able to calm some of their anxiety and address their concerns to build more trust. It helps having an advocate.”

The Indigenous Wellness Centre has become an essential space for staff learning. Roberta hosts Smudge N’ Talks, informal small-group gatherings for staff to openly ask questions and engage with Indigenous culture without the fear of asking questions or getting it wrong.

“You can’t be afraid to make a mistake,” said Roberta. “A lot of people are. Having a safer space where you can make mistakes is good.”

The work ahead

The work, Roberta notes, is far from finished. In fact, it is only just getting started. Planning is underway for the Indigenous Wellness Centre at Providence Healthcare, which will include a teaching arbour and a ceremonial outdoor space. Behind the scenes, Roberta is working with the Human Resources teams to support Indigenous employees and to reduce barriers for Indigenous community members and students pursuing careers at Unity Health.

At St. Joseph’s Health Centre, Roberta is already in early conversations with the St. Joseph’s Health Centre Foundation about dedicating a section of a planned new build to Indigenous wellness, with the potential for both indoor and outdoor ceremonial space connected to the land. “It might be eight to ten years,” she said. “But it is a beautiful opportunity.”

Roberta’s vision extends beyond Unity Health’s three sites. She is part of a growing provincial network of Indigenous healthcare leaders from hospitals across Ontario, convened by the Ontario Hospital Association (OHA) and led by Paul Francis Jr, Executive Director of Indigenous Health at the OHA. The group is meeting to share what’s working, identify common challenges and collectively define what the future at Ontario hospitals should look like, including the question of how community-based traditional leaders, ceremonialists and knowledge-keepers can work alongside Western medicine.

“What we are working toward now is a future where Western medicine and traditional medicine work alongside one another, where ceremonialists, healers and knowledge keepers are part of the fabric of care. But it is going to take a big change in mindset for the system to truly embrace that.”

Roberta speaks of patience as integral to seeing change happen. Looking ahead, she’s under no illusion that the path ahead will be easy. There have always been challenges, and there certainly will be more.

“You have to have patience to see change happen. Period,” she said. It is a lesson, she notes, that was passed down to her by her mother who often said change is slow like molasses in January.

The wheels of change may be slow, but after decades of working towards it, Roberta knows that the work of reconciliation is not measured in months or years. It is reflected in the spaces built, the trust earned, the doors opened for the patients and community members counting on it, and a desire to build better relations with Indigenous Peoples.

By Zehra Goawala

Photos by Katie Cooper and Kevin Van Paassen