1. Transformative Leadership in Indigenous Health
Leslie Bonshor Executive Advisor, Aboriginal Health
Vancouver Coastal Health
PHABC Summer School July 6, 2017

2. Welcome!
We acknowledge and honour that we are on the unceded traditional homelands of the Musqueam, Squamish, and Tsleil-Waututh Nations
Land acknowledgement
Facilitators introduce themselves and their role

3. VCH Aboriginal Health: The Team
Introduce job as Executive Lead – The team and what they do… who they serve

4. Indigenous Transformative Leadership
Top down and bottom up at the same time
System wide transformational change
Empowering leaders to join reconciliation movement – an advocate and a capacity builder
Bridging both worlds
Innovation focused
Personal with a capital “P”
Requires different skill sets
How is Indigenous transformative Leadership different

5. Coming Full Circle Indigenous Women leaders
Focus and commitment to empowering Indigenous women as the key to Indigenous community wellness
My role – transformational and applying an Indigenous lens

6. VCH Aboriginal Health Supporting and Engaging Indigenous Women
Nәćamat Indigenous Women’s Village of Wellness

7. Why Focus on Indigenous Women
Return to Matriarch societies
Nothing about us without us!
Keepers of knowledge and leaders of the family
Strong Indigenous women = strong Indigenous communities
Empowering Indigenous women KEY to Reconciliation

9. Indigenous Women’s Wellness Research
Creation of an Indigenous Women’s Research Group – experts in Indigenous women’s health to guide policy, programming and research
Leading research grants using Indigenous methodologies led by and for Indigenous women

10. Gratitude Pride Community/Support Safety Learning/Sharing
Themes of the day
Gratitude
Pride
Community/Support
Safety
Learning/Sharing
Healing/Growth
Relevance
Gratitude
Community/Support
Safety
Pride
Diversity
Relevance
Touch
Learning/Sharing
Healing/Growth
Diversity
Touch

11. Recommendations when Designing Services & Programs
Diversity in the services available to them.
Treat them with dignity.
Create a sense of community, support, and belonging.
More access to Indigenous healing services, and opportunities to connect with culture.
Create warm welcoming environments where women can make multiple visits and “test the waters”
Opportunities for tactile interaction
Create opportunities for Indigenous women to care for themselves and their community
Indigenous women living in the DTES are a diverse group; they are from different Nations and are at different stages on their wellness journey. Therefore, there needs to diversity in the services available to them.
Women in the DTES have a strong sense of pride: we must treat them with dignity.
Women draw strength from a sense of community, support, and belonging.
More access to Indigenous healing services, and opportunities to connect with culture, are required.
Women seek services and supports that provide them with a sense of warmth, welcoming and safety. Being able to make multiple visits just to “test the waters” and build a connection gives them control over the interaction and an opportunity to increase feelings of safety and comfort accessing services.
Many women responded to tactile objects or interactive activities as part of their services; having something to touch and interact can provide them a sense of comfort, and was a initial way for them to engage.
Wherever they are on their wellness journey, Indigenous women living in the DTES are looking for healing, growth, and ways to overcome obstacles. Our work must create opportunities for women to take care of themselves and their community.

12. Key Indigenous Policies and Calls to Action
United Nations Declaration on the Rights of Indigenous Peoples
Royal Commission on Aboriginal Peoples
Truth and Reconciliation Commission of Canada
BC & Regional Specific Policies
UNDRIP: Control by Indigenous peoples over developments affecting them and their lands….will enable them to maintain…strengthen…promote development in accordance with aspirations and needs….

13. The Truth and Reconciliation Commission – Calls to Action
Items 18 through 24 Health Calls to action
Acknowledge the state of Aboriginal health in Canada being a direct result of policies like residential schools – recognize health care rights
Measurable goals to identify and close the health gaps
Recognize the distinct health needs of off-reserve Aboriginal peoples
Create new holistic Aboriginal healing centers and recognize the use of traditional healing and elders
Increase the number of Aboriginal professionals and cultural competency training
Many of the calls to action are directly related to Aboriginal women although not specifically mentioned in the calls. Child welfare actions 1 through 5 have specific relevancy to women as the caregivers and leaders of their families. Education calls directly impact the moms and parental participation in education. Maternal health outcomes such as FASD interventions (calls 33/34)
Key mentions of indicators such as infant mortality, maternal health, birth crates, child health issues, chronic diseases and availability of appropriate health services – all issues for Indigenous women
Violence TRC items – Call upon all levels of government in collaboration with Aboriginal people to create adequately funded and accessible Aboriginal specific victim programs and services with appropriate evaluation mechanisms. (Item 40)
Call upon federal government in consultation with Aboriginal organizations to appoint a public inquiry into the causes of, and remedies for, the disportionate victimization of Aboriginal women and girls: Inquiry’s mandate would include: investigation into missing and murdered Aboriginal women and girls. Links to the intergenerational legacy of residential schools.

14. The Truth and Reconciliation Commission’s Calls to Action
Calls upon all levels of government to:
Increase the number of Aboriginal professionals working in the health-care field.
Ensure the retention of Aboriginal health-care providers in Aboriginal communities.
Provide cultural competency training for all healthcare professionals.

15. Achieving Reconciliation
Reconciliation initiatives cannot be successful without empowering and supporting urban Indigenous women
A healthy, well and strong population of Indigenous women leads to healthy thriving families and communities.
Lets Interupt the cycles of continual trauma.

16. VCH – Aboriginal Cultural Competency Policy
Policy identifies three areas for implementation to transform care and improve health outcomes:
Aboriginal Leadership in Health Care
Acknowledgment of First Nations Traditional Territory
Cultural and Ceremonial use of Tobacco and Smudging Medicines
CA_5200 (July 2015)

17. VCH, Cultural Competency & Responsiveness Policy
Increase quality and safety of services
Reduce access to barriers
Positively impact patterns of service utilization
Improve clinical outcomes and reduce disparities
Policy CA_4900

18. Declaration of Commitment
FNHA commitment to hardwire our health system
Signed by each CEO in each Health Authority in July 2015
This commitment gives all health professionals a mandate to advance cultural humility and safety in their practices with Indigenous peoples.

19. BC Health Regulatory Bodies
We are seeing momentum as evidenced by:
Signed by 23 Regulatory Bodies March 1, 2017 at Quality and Safety Forum in Vancouver
There are many actions that can be taken in an effort to commit to cultural safety (show FNHA key drivers doc)

20. System Wide Change
Indigenous cultural safety training for health care professionals is the first step in achieving system wide transformational change. Ideally, Aboriginal people should be ale to access culturally safe care at any point within the health care system, and not just from services that are specifically “Aboriginal” focused.

21. Ripple Effect for System Transformation

22. Discussion Questions
You are all agents of change…what can you do within your work and teams to support reconciliation and improve the health and wellness of Indigenous people?
With all the calls to action: UNDRIP, TRC, Cultural Safety Commitments – have you seen any system change? If so, what has changed?
How can you individually and collectively support these calls to action in your work?
How will you use transformative leadership principles to empower your teams to take part in reconciliation actions?
What have you learned and how will this change your practice?