By Lynn Henderson, DVM MEd CHPV, Veterinary Director, Kim & Stu Lang Community Healthcare Partnership Program at Ontario Veterinary Program, CASCMA
It is a privilege to be writing this article about Indigenous cultural safety for veterinary teams; I am a non-Indigenous settler and companion animal veterinarian currently practicing community medicine alongside several First Nations in Ontario. I am positioned to write this article secondary to this work, and from my time studying Indigenous health and education at the University of Toronto; I acknowledge my own limitations and continued journey within this space and share only what others have taught me.
This is merely a brief introduction into Indigenous cultural safety; it is an expansive body of work and one in which I am not qualified to teach in any depth. I have attached several links at the bottom of this article for those of you interested in exploring this work further. I view my role as a curator of resources and leave it with you to chart your own course.
Each of us must do the work, no one can do it for us.
What is Cultural Safety?
“•When an educator/practitioner/professional can communicate competently with a patient in that patient’s social, political, linguistic, economic and spiritual realm. “ – Baba 2013.
When embarking on a learning journey towards cultural safety, it is important to understand that it is a lifelong process. We are never done. To believe that one can achieve an end goal of being ‘culturally-safe’ is narrow-minded and false. Rather, the first step on this path is to begin exploring Indigenous history in Canada, the social determinants of health for Indigenous communities (and animals) in Canada, and to acknowledge all that we do not know. This is the humility that is necessary to learn and grow. In a broader context, this is the lens through which we should endeavour to see all our clients and community connections, as having a story we do not yet know, nor fully understand.
Cultural ‘safety’ is not something that we as the learner or care-provider can determine for another individual or community; it is the person or community that determines when they feel safe.
Begin by getting to know all that you don’t know…
The University of Alberta (& Coursera) offer an excellent free course: ‘Indigenous Canada’ (link).
In working alongside made-vulnerable groups, we must recognize and understand the 3-P’s:
POWER: One’s ability to exert their influence over others.
As veterinarians, we inherently hold power during a clinical consultation; an individual has come to us and asked for our help or opinion. We must have humility in recognizing the power imbalance that can occur between ourselves and all individuals/communities in this space.
Consider ways of equalizing this power imbalance; consider the clothes you wear, where a conversation or appointment takes place, and how you hold yourself during the appointment (sitting, standing, in front of client, or beside).
Are you doing more listening than talking, or more talking than listening?
Are you a curious participant in the dialogue, a teacher, or an expert?
POSITIONALITY: Who we are, where we come from, what we bring to any situation or experience.
As veterinarians, we meet a variety of people coming from a variety of situations and lived experiences. In approaching each person, we must recognize what we bring with us in the way of biases and judgements; our positionality is how we view and carry ourselves in relation to others.
Aim to recognize and name your feelings and biases as they occur; these feelings are not inherently bad or wrong. They can serve your personal growth.
Consider why you feel what you feel…
Where does this feeling originate?
What about you might underly this judgement or anxiety?
What do you need to understand better in order to validate or invalidate your assumptions?
PRIVILEGE: One’s social advantage through belonging to, or feeling part of a certain social group.
As veterinary team members, we must recognize our privilege in having completed our education(s) and in being in the position to give advice or care to another; there is privilege inherent simply in being asked for your advice or opinion. We often forget this in client interactions and view our work as giving wisdom or knowledge from our position as knowledge-holder.
Consider how it feels to change the narrative to one of gratitude and humility for the place of privilege in which you sit.
Working Within Community
When endeavouring to provide veterinary care services to a community, it is important that the project be community-engaged. There as many definitions of this term as there are groups studying and working in the space, but in general terms it implies that you are working with and alongside the people or community you are hoping to serve.
Community health trips to Indigenous communities should occur by invitation only; it is inappropriate to simply decide to begin offering services in a community without having community invitation. Invitation is in fact, only the first step. Once a community has reached out and invited your group to begin offering veterinary services, a community-engaged dialogue must take place whereby you aim to learn all you can about what the community is seeking;
What are their concerns for their animals?
What services are they lacking or hoping that you can provide?
What has their experience been with veterinary teams or healthcare providers in the past?
It is important to ascertain if there have been any specific animal-related incidents in the community’s past (pack of dogs/uncontrolled population growth, dog attacks, dog culls, dog theft from outside the community). The answers to these questions will shape your public health decisions as well as how you can work alongside the community members to achieve their specific goals. Their goals shape your team’s goals, not the other way around.
The community must be involved and must drive every step of the journey. If this sounds odd to you, please re-visit the 3 P’s above!
Community care should be planned with the goal of building a long-term relationship; whenever possible, aim to be a service that can be counted on, even if at longer intervals than you might like. Finances and team availability for travel are very real concerns, and we can only do what we can do. What I mean by a long-term relationship is that you should not be building rapport with a community in order to provide service once and never return; this is only helpful in the very short term and is not in the spirit of reconciliation or trust-building. Be a service that can be counted on; when you say you will come back or will remain in touch, come back…stay in touch.
Learn about the community you are going to; this is best learned from the community members you will be serving. It is ok to ask questions when you do not know. Seek experts who will support your learning, explore formal training (see Resources below), and embrace the journey!
Resources:
Baba, L. (2013). Cultural safety in First Nations, Inuit and Métis public health: Environmental scan of cultural competency and safety in education, training and health services. Prince George, BC: National Collaborating Centre for Aboriginal Health.
Cancer Care Ontario – A variety of course modules on Indigenous health and cultural safety.
Indigenous Canada – University of Alberta; An excellent primer on Indigenous history and current issues in Canada.
https://www.coursera.org/learn/indigenous-canada
San’yas – Formal training programs on Indigenous Cultural Safety
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