On November 1, 2019, the BC College of Family Physicians (BCCFP) signed the BC First Nations Health Authority (FNHA) Declaration of Commitment to Cultural Safety and Humility

The BCCFP respects and upholds BC First Nations and Indigenous people’s right to self-determination and to achieve equity in health care. We acknowledge their right to address settler-colonialism and to enable the full expression and enjoyment of Indigenous human rights, consistent with the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP).

Transforming mainstream health services to ensure they are culturally safe and that they provide the highest quality health care for BC’s First Nations people requires a resetting of the relationship between First Nations people and the health care system in ways that are inclusive and respectful of First Nations rights and perspectives of health and wellness.

As the first point of contact to the health care system for most British Columbians, family physicians have an important role to play in this work.

Through initiatives aimed at embedding cultural safety and humility in the practice of family medicine, the BCCFP is working to identify and address systemic and institutional harms and barriers that First Nations and Indigenous people experience.

The timeline below is a living record of our Cultural Safety and Humility Journey in the practice of family medicine in BC, set against the landscape of historic events and milestones related to First Nations and Indigenous health and wellness and the evolving relationships with BC and Canada.

We invite you to follow along with our events and milestones as we continue to move forward with humility:

TIMELINE

2015     2019     2020     2021      2022      2023

2015

JULY 2015

BC Ministry of Health Signs Declaration of Commitment to Cultural Safety

In 2015, the BC Ministry of Health, along with all BC Health Authority CEOs, signed the first Declaration of Commitment on Cultural Safety and Humility with the First Nations Health Authority. Since then, many other provincial and federal health system partners have signed on as well. The Declaration has created a foundational framework to enable a climate of change and accountability to First Nations and Indigenous people in BC.

2019

NOVEMBER 2019

UNDRIP Becomes Law in BC

In 2019, the BC government became the first jurisdiction in Canada to pass legislation adopting the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP).

UNDRIP affirms the inherent or pre‐existing rights of Indigenous peoples, both as individuals and as nations. While Indigenous peoples are entitled to the same human rights as all peoples through existing international human rights instruments, UNDRIP’s 46 articles make an important case for recognizing that Indigenous peoples may need special protections to maintain their cultural identities.

UNDRIP was adopted by the UN General Assembly in 2007, but, at the time, Canada was one of four countries that opposed it. Canada reversed its decision in 2010, signaling that it would support the UNDRIP, but it was not until 2021 that the Parliament of Canada passed The United Nations Declaration on the Rights of Indigenous Peoples Act (formerly Bill C-15).

This followed the completion of the Truth and Reconciliation Commission (2015), which acknowledged that the Indian Residential School system had a profound and lasting intergenerational impact on the cultural heritage of Indigenous Peoples in Canada. Also, the National Inquiry into Missing and Murdered Indigenous Women and Girls (2019), which addressed the damage caused to Indigenous culture as a result of colonialism.

The Declaration on the Rights of Indigenous Peoples (Declaration Act) became law in BC on November 28, 2019. Through this act, BC formally adopted the internationally recognized standards of UNDRIP as the Province’s framework for reconciliation, making it the first province in Canada to commit to aligning with these laws.

November 2019

BCCFP Signs FNHA Declaration of Commitment to Cultural Safety and Humility

First Nations Health Authority chief medical officer, Dr. Evan Adams, and BCCFP president Dr. Jeanette Boyd participate in a ceremony to sign the Declaration of Commitment to Cultural Safety and Humility

In November 2019, the BCCFP signed the BC First Nations Health Authority (FNHA) Declaration of Commitment to Cultural Safety and Humility. The signing signals a shared intention to advance Cultural Safety and Humility among family physicians involved in the delivery of health services to First Nations and Indigenous populations in BC.

Representatives of both organizations came together for a Blanket Ceremony to honour the commitment being made by the BCCFP.

Then BCCFP president, Dr. Jeanette Boyd, signed the declaration with Dr. Evan Adams, chief medical officer for the FNHA. Others who participated in the ceremony included: Te’ta-in Shane Pointe (FNHA knowledge keeper and xʷməθkʷəy̓əm (Musqueam) elder); Dr. Terri Aldred (BCCFP director); Toby Achtman (BCCFP executive director); Dr. Francine Lemire (CFPC executive director & CEO); and Dr. Rebekah Eatmon, co-chief resident of UBC’s Indigenous Family Medicine Program.

“Today’s ceremony is a reflection of our shared intention to advance Cultural Safety and Humility among family physicians involved in the delivery of health services to First Nations and Indigenous Populations in BC.”

~ Dr. Jeanette Boyd, BCCFP President

2020

March 2020

BCCFP Launches Online Cultural Safety Resources

In March 2020, the BCCFP launched a cultural safety and humility resource portal on our website. These resources highlight the issues of health inequities experienced by Indigenous populations in BC, and encourage and enable our members to incorporate cultural safety and humility in their practice of family medicine. Since then, the BCCFP has continued to add relevant resources and information to the site to support our members in the practice of culturally safe care.

May 2020

BCCFP Shares Resources to Support Culturally Safe Care in Response to COVID-19

In response to the onset of the COVID-19 pandemic, the BCCFP developed and published a two-page resource on Practising Cultural Safety and Humility in the Response to COVID-19. Our COVID-19 resource webpage also included a dedicated section on caring for Indigenous populations as a priority population.

These resources helped to highlight the issues of health inequities experienced by Indigenous populations during the pandemic, and helped members incorporate cultural safety and humility into their practice to address these issues.

June 2020

Claims About Racist Behavior in Some BC Hospitals Prompts Independent Review

In June 2020, claims surfaced regarding a “Price is Right”-type game allegedly being played in BC hospital Emergency Departments, in which health care workers guess blood alcohol levels of Indigenous patients.

BC Health Minister Adrian Dix appointed former judge, and legislative advocate, Dr. Mary Ellen Turpel-Lafond, to lead an independent review into these allegations.

The Review team was asked to investigate the “Price is Right” allegation, situated and examined within a broader context of Indigenous-specific systemic racism in the health care system in BC, and to make findings of fact, and describe recommendations. The result was the In Plain Sight report, published in December of that year.

October 2020

BCCFP Family Medicine Conference Features Indigenous Presenters

When preparing for the BCCFP’s 2020 Family Medicine Conference, it was important to us that we ask Indigenous speakers to participate. Among the sessions was a presentation on racism in medicine, by Dr. Danièle Behn Smith, the Aboriginal health physician advisor for the province of British Columbia. Other Indigenous presenters included BCCFP Director and family physician, Dr. Terri Aldred and dermatologist, Dr. Nathan Tegee.

Through these sessions, more than 150 family physician attendees had the opportunity to learn about the existence and impact of systemic racism and were provided with strategies to enhance anti-racism and cultural safety in their practices.

Members can watch Dr. Behn Smith’s presentation Racism in Medicine (Login to the BCCFP’s online Learning Vault is required. Once you arrive at the Conference and Materials page within the Learning Vault, then search for the video under ‘Presentations and Recordings’. For login assistance, contact office@bccfp.bc.ca)

“I believe that we must take anti-racist  action by recognizing diverse worldviews,  embodying cultural humility, and arresting  white supremacy in policies and practices.”

~ Dr. Danièle Behn Smith

December 2020

BC Government Releases Report Investigating Indigenous-specific Racism in BC healthcare

In Plain Sight ReportIn December 2020, in response to a request from the BC Minister of Health to investigate Indigenous-specific racism in BC healthcare, former judge and legislative advocate, Dr. Mary Ellen Turpel-Lafond published In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care.

 In Plain Sight, is based on consultations with nearly 9,000 people, including 2,780 Indigenous people and 5,440 health care workers. The report describes findings of widespread systemic racism against Indigenous peoples in the B.C. health care system. In particular, 84% of Indigenous peoples described personal experiences of racism and discrimination that discouraged them from seeking necessary care and that reduced access to care, negatively affecting their health. These outcomes reinforce stereotypes and perpetuate the cycle of inequity.

Dr. Turpel-Lafond’s report makes recommendations to improve equity in health care and calls on the B.C. government and the health care system, in collaboration with Indigenous peoples, to remedy the lasting consequences of colonialism and improve accountability for Indigenous-specific racism. The report also calls attention to the need for improved cultural safety in health care and increased Indigenous leadership within health services, regulators and education.

In response to the report, the BCCFP issued an apology to all those who have experienced racism at the hands of health care provider – a response in line with Dr. Mary Ellen Turpel-Lafond’s recommendation that all health care-related organizations in BC apologize and take responsibility for systemic racism. We encouraged our members to read the report and commit to action, suggesting further resources to support them in doing so.

“As family physicians, we must practise cultural safety and humility in our work every day. We need to understand and address the needs of Indigenous patients. I encourage all family physicians to make themselves aware of the report’s findings and recommendations and come together as a specialty to make a positive ongoing impact for equity in health care.”

~ BCCFP President, Dr. Marjorie Docherty.

Watch Mary Ellen Turpel-Lafond, lead investigator, and Adrian Dix, Health Minister, review allegations of racism in the health-care system. (Comments begin at 8:53 /1:08:35)

2021

May 2021

BCCFP Adopts Cultural Safety and Humility as One of its Three Core Principles

The BCCFP is the heart of family medicine in BC, providing leadership, support, advocacy, and education. We are guided by the vision of inspiring family physicians to providing and supporting equitable, culturally safe, longitudinal care, for all British Columbians.

In May 2021, the BCCFP revised our strategic plan, setting out key priorities to guide the organization’s work over the next three years.

In keeping with our long commitment to health equity, and the findings of the In Plain Sight report, we established as one of the BCCFP’s three priorities, our commitment to cultural safety and the demonstration of anti-racist approaches to health care.

May 2021

Confirmation of a Mass Grave of Children on the Site of Former Kamloops Residential School

On May 27, 2021,  the Tk’emlúps te Secwépemc Nation confirmed the finding of 215 children who were students of the Kamloops Indian Residential School. The finding was a confirmation of a tragic history that was spoken about but never documented by the residential school system.

Since then, remains have been uncovered at other former residential school locations across the country. 

The findings are a stark reminder that systemic anti-Indigenous racism is not only a recent issue for our province, but an ongoing lived reality for many people. The mental and physical health impacts of residential schools continue to be felt every day across British Columbia.

In a statement following the discovery in Kamloops, the BCCFP reaffirmed our commitment to culturally safe care, encouraging our members to engage in self-directed learning on the history of residential schools and colonialism in Canada.

The Kamloops Industrial School was opened, under Roman Catholic administration, in 1890. It became the largest school in the Indian Affairs residential school system. Enrolment peaked in the early 1950s at 500. In 1910, the principal said that the government did not provide enough money to properly feed the students. In 1924 a portion of the school was destroyed by fire. In 1969, the federal government took over the administration of the school, which no longer provided any classes and operated it as residence for students attending local day schools until 1978, when the residence was closed. (Photo courtesy of the Indian Residential School History and Dialogue Centre).

August 2021

BCCFP Appoints Indigenous Physician Lead

Dr. Rebekah EatmonBuilding on the priorities set out in the 2021-24 Strategic Plan, the BCCFP has appointed Dr. Rebekah Eatmon as our Indigenous Physician Lead. In this ongoing role, Dr. Eatmon is working to help embed cultural safety and humility learning and practices in the BCCFP’s work.

Dr. Eatmon is a family physician serving both urban and rural Indigenous peoples at the Lu’ma Medical Centre in Vancouver, as well as Carrier Sekani Family Services in Northern BC. She is Tsimshian from Lax Kw’alaams, from the Raven Clan on her father’s side and Métis on her mother’s side. She completed her medical training at UBC, where she participated in cultural safety learning as a resident in the Indigenous Family Medicine Program.

“There are many family physicians who are working towards an equitable healthcare system, but there is still much work to be done. As an Indigenous family physician, I hope to use my medical training and lived experience to help other physicians deepen their understanding on how to practise culturally safe care.”

– Dr. Rebekah Eatmon

September 2021

BCCFP Recognize First-ever National Day of Truth and Reconciliation

On September 30, 2021 the BCCFP joined others across the country in recognizing the first National Day for Truth and Reconciliation. The federal statutory holiday was passed into legislation this past June in response to Call to Action 80 from the Truth and Reconciliation Commission of Canada.

In recent years, September 30 has been known as Orange Shirt Day  – a date chosen because it is the time of year in which children were taken from their homes to residential schools. National Day for Truth and Reconciliation builds on the efforts of Orange Shirt Day to  commemorate the history and ongoing trauma caused by residential schools. The day was announced  shortly after the remains of 215 children were confirmed found in late May by the Tk’emlúps te Secwépemc First Nation

In a communication shared with members and on our website, the BCCFP honoured all those who were lost and the survivors, families and communities who continue to grieve. The communication also acknowledged the important fact that recognition of the day is just one small step in our ongoing journey of reconciliation with Canada’s Indigenous people, and provided resources to support members in learning more about the history of residential schools and reconciliation in Canada.

November 2021

BCCFP Announces Cultural Safety and Humility Web Series (CS&H Web Series)

The BCCFP is launching a web series aimed at deepening family physicians’ understanding of cultural safety and humility. Through discussion, supported learning, and self-reflection, the Cultural Safety and Humility in Family Medicine Series is an opportunity for family physicians to learn more about integrating cultural safety and humility in their practice and in their interactions with First Nations and Indigenous patients.

November 2021

CS&H Web Series - Session #1 : “Ask Me Anything” with Dr. Eatmon

In Session 1 of the Cultural Safety and Humility in Family Medicine Series, BCCFP’s Indigenous Physician Lead, Dr. Rebekah Eatmon and Dr. Elder Roberta Price spoke openly with attendees about the experience of Indigenous people in BC’s healthcare system, and ways for family physicians to practice culturally safe care. Members had the opportunity to discuss, listen, and ask questions about cultural safety and humility in an open and safe learning environment.

“Being kind isn’t necessarily culturally safe,” said Dr. Eatmon, as she discussed the importance of self-reflection and learning to understand our own biases and blind spots.

“There are many well-meaning physicians who are tolerant and non-discriminatory. But they are not necessarily culturally competent if they aren’t trained to recognize when their actions (or inactions) reinforce the status quo, privileging some and marginalizing others.”

Among the ways to enhance culturally safe care, Dr. Elder Roberta spoke of the importance of getting to know and engaging with our own local Indigenous communities, and ensuring that all aspects of the patients experience are considered.

“Simple things, like a warm and authentic welcome at the front desk can go a long ways in building trust and safety with Indigenous patients,” she said.

Click here to watch the webinar on demand (Login to the Member’s Learning Vault required. For login assistance, contact office@bccfp.bc.ca )

Dr. Rebekah Eatmon (left) and Dr. Elder Roberta Price (right)

2022

February 2022

BCCFP Introduces Cultural Safety and Humility Grants program

As part of our commitment to advocating for culturally safe health care and demonstrating anti-racist approaches to address health equity, the BCCFP has launched an annual Cultural Safety and Humility Grants program, aimed at supporting family physicians to continue or initiate new culturally safe practices.

Grants will be awarded that support or enhance cultural safety and humility among family physicians for initiatives that: 

  • Assist family physicians to engage and develop relationships with First Nations and Indigenous people within their communities.
  • Embed CS&H into an integral aspect of the community-based family practice, Patient’s Medical Home, or primary care network.
  • Create or modify tools and/or resources, and quality improvement mechanisms to better care for Indigenous Patients.
  • Support the creation of a network or community of practice to pool and acquire knowledge and practical ways to incorporate CS&H into practice.
  • Develop a mechanism whereby family physician voices can be heard and lent to advocacy efforts around CS&H to create a climate for change.

To learn more about our Cultural Safety and Humility Grants program, click here.

March 2022

CS&H Web Series - Session #2: Panel Discussion on In Plain Sight Report

In the second webinar of the Cultural Safety and Humility in Family Medicine web series, Dr. Rebekah Eatmon was joined by Dr. Elder Roberta Price, and other Indigenous physicians and physicians working closely with Indigenous populations in BC, including Drs. Jane Bishop, Michael Dumont and Unjali Malhotra, to reflect on the In Plain Sight Report – Addressing Indigenous Specific Racism in B.C. Health Care. The panel discussed the implications of the report and how family physicians can help to break the cycle of racism by providing culturally safe care in their clinical practice.

Click here to watch the webinar on demand (Login to the member’s Learning Vault required)

Screen shot

During the webinar, Dr. Eatmon shared an image by Indigenous artist and bioethicist, Lisa Boivin. The image is a reminder that, just as physicians come with a circle of knowledge, the patient brings their own circle of knowledge, and and it is a profoundly important part of the clinical relationship.

More of Lisa Boivin’s artwork can be viewed at: redbioethics.ca

July 2022

BCCFP Responds to Canadian Senate Report on Forced and Coerced Sterilization

BCCFP’s Journey Towards Reconciliation – BCCFP

On June 14, 2022, the Canadian Senate Committee on Human Rights released a report calling on the federal government to compensate and apologize to all people who were subjected to forced and coerced sterilization.

The scars that we carry, Forced and Coerced Sterilization of Persons in Canada – Part II outlines the committee’s findings from the second part of its study into this deeply disturbing practice, which persists today and disproportionately affects vulnerable and marginalized groups in Canada including indigenous women, Black and racialized women, and people with disabilities.

Members interested in learning more about the report and the issue of forced and coerced sterilization of Perssons in Canada can read more here or email our upcoming webinar on the topic, scheduled for September 29, 2022 as part of the Cultural Safety and Humility in Family Medicine web series.

September 2022

CS&H Web Series - Session #3: Contraceptive Coersion

On September 29, Dr. Elder Roberta Price, and Dr. Rebekah Eatmon, BCCFP ’s Indigenous Physician Lead hosted the third in a series of webinars on Cultural Safety & Humility. Guest speaker Dr. Unjali Malhotra, who serves as the Chief Medical Officer for Women’s Health at the First Nations Health Authority, presented on the topic of contraception coercion, and discussed how family physicians can help their Indigenous and other patients, make informed, coercion-free decisions. 

“We are all here together to make the system a better one – we didn’t build it, but we can certainly change it,” Dr. Malhotra exclaimed while speaking about the role of family physicians in making the health care system culturally safe. Her message to the participants was to reach to a place of shared decision making with their patients by getting to know them, understanding, and respecting their beliefs and values, and speaking to them as allies in their health care journey.

Click here to watch the webinar on demand (Login to the member’s Learning Vault required) 

September 2022

BCCFP Announces the Recipients of its First Intake of Cultural Safety & Humility Grants

On the occasion of National Day for Truth & Reconciliation on September 30, BCCFP announced the recipients of our first intake of Cultural Safety and Humility grants. Seven projects from across the province were selected based on their potential to support family physicians in delivering culturally safety care to First Nations and Indigenous patients.

The grants program was introduced as part of the BCCFP’s commitment to advocating for culturally safe health care and demonstrating anti-racist approaches to address health equity.

To find out more about the selected projects, their completion timeline, and our next intake opportunity, check out our CS&H Grants webpage.

NOVEMBER 2022

BCCFP Launches Second CS&H Grant Cycle

On November 22, 2022, BCCFP announced the second Cultural Safety & Humility grant cycle. The grants support family physicians to continue or initiate new culturally safe practices and another seven members will be awarded $5000 each.

Recipients will be announced in May.

2023

MAY 2023

Dr. Rebekah Eatmon delivers talk exploring the unique view of leadership from an Indigenous physician's perspective

On May 10, Dr. Eatmon delivered the keynote address at the BCCFP Leaders Dinner in Vancouver.

Dr. Eatmon’s talk started out by sharing an insight into her upbringing, the history of Indigenous matriarchies and how these come together to shape her ways of thinking as an Indigenous woman and physician.

She then explored The Principle of Seven Generations – an ancient Iroquois teaching – and challenged everyone to consider how they are impacting the future seven generations of family physicians. She asked: “What are you thankful for that your ancestors have taught you? What lessons will you pass on to family/mentees/learners?”

To conclude, Dr. Eatmon shared teachings of the totem pole. “Totem poles tell the story of each clan. What story do you tell? What story will your ancestors tell about you? We don’t want to get stuck in past or traditions, otherwise we won’t change, but look to what our ancestors have built for us that we can build on. 

Dr. Elder Roberta Price at the BCCFP Leaders Dinner 2023.

June 2023

BCCFP Announces the Recipients of its Second Intake of
Cultural Safety & Humility Grants

The second call for project proposals closed in January, 2023. The BCCFP’s Cultural Safety & Humility Working Group subsequently selected seven grant recipients to receive $5000 each, listed below:

  1. Journey Home Project: Knowledge translation for the next generation of Palliative Care Providers – Saanich
  2. St. Paul’s Hospital Perinatal Substance Use Program – Vancouver
  3. Continuation of the PG cultural humility and competency working group – Prince George
  4. A place of welcome: expressing care, safety and humility through patient intake forms – Surrey-Langley
  5. Cowichan Maternity Clinic Indigenous Reconnection & Primary Care Network Priority Attachment – Duncan
  6. Integrated locally planned cultural safety KAIROS blanket exercise – Lillooet
  7. Cowichan District Hospital Emergency Department Cultural Humility Learning and Development Plan Community Engagement Project – Duncan

Read more about each of the projects here.

June 2023

BCCFP Shares Details of Completed Grant Projects

On the occasion of National Indigenous Peoples Day, BCCFP shared outcomes and photos from the first round of Cultural Safety Grant projects.

The grants program was introduced as part of the BCCFP’s commitment to advocating for culturally safe health care and demonstrating anti-racist approaches to address health equity.

To find out more about the completed projects, visit the Completed Projects webpage.

September 2023

BCCFP Launches Third CS&H Grant Cycle

On September 14, 2023, the BCCFP announced the third Cultural Safety & Humility grant cycle. The grants support family physicians to continue or initiate new culturally safe practices and this round will provide another seven members with $5000 for their respective projects.

The deadline for this round of grant funding is November 2, 2023. Application guidelines can be found here.

September 2023

CS&H Web Series - Session #3: FNHA Health & Medication Benefits with Dr. Eatmon

In the third webinar of the Cultural Safety and Humility in Family Medicine web series, opened by Dr. Elder Roberta Price, Dr. Rebekah Eatmon is joined by Richard George, Tanya Duncan and Dr. Terri Aldred from the First Nations Health Authority (FNHA) and BC family physicians Dr. Nancy MacPherson. 

Learning objectives:

  • First Nations Health Authority Plan W for Indigenous patients – origins and background
  • Specific applications of Plan W in the family practice/community clinic setting and how to contact FNHA staff with questions
  • Plan W support for Urban and Away patients

Watch the webinar recording here.

During the webinar, Richard George from FNHA talks through the different types of ‘benefits’ that are available to First Nations patients – as seen in the above screen grab. There is also a list of resources and contact details available on the webpage with the recording.