CCBI News – National Day for Truth and Reconciliation: TRC—Health Care; Pope Francis—Penitential Visit; Palliative Care—Paramedics

National Day for Truth and Reconciliation

September 30, 2022

Dear Friends of CCBI,

The Truth And Reconciliation Commission Calls To Action
Bridget Campion, PhD

The Truth and Reconciliation Commission was formed in 2007 as part of the Indian Residential Schools Settlement Agreement. According to the National Centre for Truth and Reconciliation, the Commission sought to uncover the truth about the residential school system in Canada and its effects on survivors, families and communities, and to communicate this to “all Canadians.” To this end, the Commission spent six years listening to “First Nations, Inuit and Métis former residential school students, their families, communities, the churches, former school employees, government officials and other Canadians.” The Commission also sought to contribute to reconciliation; as part of this, its final Report submitted in 2015 contains ninety-four calls to action. Numbers 18-24 deal specifically with health care and, as part of honouring Truth and Reconciliation Week, I list them here:

18. We call upon the federal, provincial, territorial, and Aboriginal governments to acknowledge that the current state of Aboriginal health in Canada is a direct result of previous Canadian government policies, including residential schools, and to recognize and implement the health-care rights of Aboriginal people as identified in international law, constitutional law, and under the Treaties.
19. We call upon the federal government, in consultation with Aboriginal peoples, to establish measurable goals to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities, and to publish annual progress reports and assess long-term trends. Such efforts would focus on indicators such as: infant mortality, maternal health, suicide, mental health, addictions, life expectancy, birth rates, infant and child health issues, chronic diseases, illness and injury incidence, and the availability of appropriate health services.
20. In order to address the jurisdictional disputes concerning Aboriginal people who do not reside on reserves, we call upon the federal government to recognize, respect, and address the distinct health needs of the Métis, Inuit, and off-reserve Aboriginal peoples.
21. We call upon the federal government to provide sustainable funding for existing and new Aboriginal healing centres to address the physical, mental, emotional, and spiritual harms caused by residential schools, and to ensure that the funding of healing centres in Nunavut and the Northwest Territories is a priority.
22. We call upon those who can effect change within the Canadian health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients.
23. We call upon all levels of government to:
    i. Increase the number of Aboriginal professionals working in the health-care field.
    ii. Ensure the retention of Aboriginal health-care providers in Aboriginal communities.
    iii. Provide cultural competency training for all healthcare professionals.
24. We call upon medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties and Aboriginal rights, and Indigenous teachings and practices. This will require skills-based training in intercultural competency, conflict resolution, human rights, and anti-racism.

These calls remind us that when it comes to indicators, outcomes and experiences there is a scandalous gap between health care provided to non-Indigenous individuals and communities and health care provided to Indigenous individuals and communities. This gap also affects Indigenous persons living off-reserve and is a legacy of the injustices of colonialism, including the residential school system. There is a need to begin to redress this through education –particularly in the health care professions – and by making room for and respecting Indigenous wisdom and practices in health care. I think it is true to say that there cannot be real social justice without the fair provision of health care, and that there cannot be good health care without social justice.

Sources
National Centre for Truth and Reconciliationhttps://nctr.ca/about/history-of-the-trc/truth-and-reconciliation-commission-of-canada/
Crown-Indigenous Relations and Northern Affairs Canada, “About the Truth and Reconciliation Commission” https://www.rcaanc-cirnac.gc.ca/eng/1450124405592/1529106060525#chp1 ; “Calls to Action” https://www.rcaanc-cirnac.gc.ca/eng/1524499024614/1557512659251
The Truth and Reconciliation Commission of Canada website has been archived. You can find it here: https://web.archive.org/web/20200507215137/http://www.trc.ca/about-us/our-mandate.html
You can access the Calls to Action here: https://www2.gov.bc.ca/assets/gov/british-columbians-our-governments/indigenous-people/aboriginal-peoples-documents/calls_to_action_english2.pdf
(For those who may need it: The National Residential Schools Crisis Line 1-866-925-4419)

Palliative Care Paramedics
Bridget Campion, PhD

When we think about the response to a 911 call, we often picture a speeding ambulance and wailing sirens, with paramedics applying life-saving technologies to patients before loading them onto stretchers and transporting them to hospital. With the creation of community paramedics, this model is rapidly changing.

According to the Ontario Community Paramedicine Secretariat, the Community Paramedicine Program in Ontario arose out of the Living Longer, Living Well Report published in 2012. The pilot projects undertaken as part of that program were determined to have been so successful that the Ontario Ministry of Health made the program province-wide. The Ontario Community Paramedicine Secretariat was then created in 2018 “to support the ongoing development of community paramedicine across Ontario.”

As part of this initiative, the Niagara Region has adopted a “Mobile Integrated Model of Care” which, according to the Niagara Region’s website: “provides patient-centred care visits that are [d]elivered in the patient’s home or where they’re at”; [b]ased on the patient’s needs and preventive services”; and are “[a]vailable 24 hours per day, seven days a week”. The point of this model is not to take patients to hospital but to provide needed health care in situ – for instance, when a fall occurs or to assist with mental health or addiction issues. Community paramedics also deliver palliative care.

Many people want to be able to die at home, in familiar surroundings with family and pets and other loved ones nearby. And families are often eager to support their dying loved ones in this but usually have little experience with the demands of this kind of care. While they may receive help from visiting members of a palliative care team, events may nevertheless occur when family is on its own. With palliative care paramedics, a 911 call when a patient is in a great deal of pain or struggling to breathe does not mean that the patient will be transported to hospital; instead the paramedics will arrive (without sirens) to attend to the patient – and the family. In a recent article published in the Welland Tribune, Lisa Bath, a team leader, explained that not only do palliative care paramedics have the training and medications meant to provide comfort and pain relief for dying patients, they also have the time to be with them. As she says, “’We’re there as long as we have to be, or until the nursing staff can get there to take over.’”

A recent CBC report noted that: “Palliative care … is in short supply both in sparsely populated areas … and larger urban centres. A Canadian Institute for Health Institute Information report found that most Canadians with a terminal illness would choose to die at home if they could access palliative care, but only 15 per cent are able to do so.” Palliative care paramedics may help make it possible for more patients to die at home naturally with skilled support and care. Families, too, benefit from this program. The Welland Tribune article quotes Marty Mako, Niagara’s Mobile Integrated Health Commander: “’You’re serving people during the most vulnerable time of life, and we’ve had really positive feedback from families, we’ve been mentioned in obituaries. It’s some pretty powerful feedback we’ve received.’”

Sources
Ontario Community Paramedicine Secretariat https://www.ontariocpsecretariat.ca/
Niagara Region Mobile Integrated Model of Care https://www.niagararegion.ca/living/health_wellness/ems/mobile-integrated-health.aspx
Allan Benner, “Dying with dignity at home with the help of Niagara EMS ‘angels’” Welland Tribune https://www.wellandtribune.ca/news/niagara-region/2022/09/21/dying-with-dignity-at-home-with-the-help-of-niagara-ems-angels.html
Brandie Weikle, “Community paramedics could be part of the solution to a nation-wide shortage of palliative care” CBC News https://www.cbc.ca/radio/whitecoat/these-paramedics-are-helping-give-canadians-the-choice-to-die-at-home-1.6155242#:~:text=This%20spring%2C%20Ontario’s%20Ministry%20of,morphine%2C%20as%20well%20as%20sedatives.

Walking Together, The Penitention Visit Of Pope Francis To Canada

An additional resource on this National Day of Truth and Reconciliation is www.papalvisit.ca:

Healing and Reconciliation: An Historic Journey

Pope Francis made a pastoral visit to Canada from July 24 to 29, 2022. The Pope’s visit provided a unique opportunity for him, once again, to listen and dialogue with Indigenous Peoples, to express his heartfelt closeness and to address the impact of colonization and the participation of the Catholic Church in the operation of residential schools throughout Canada. The papal visit also provided an opportunity for the shepherd of the world’s 1.2 billion Catholics to connect with the Catholic community in Canada.

The Catholic Church has a responsibility to take genuine and meaningful steps to journey with Indigenous Peoples of this land on the lengthy path to healing and reconciliation. This site provides information on the historic journey of Pope Francis to Canada, a significant step on the road to truth, understanding and healing. We invite you to join us as we reflect, pray and welcomed the Holy Father for these special days among us.

Pope Francis’ Intention for September

Abolition of the Death Penalty
We pray that the death penalty, which attacks the dignity of the human person, may be legally abolished in every country.

Moira, Bridget and Bambi