By Odette Auger, Local Journalism Initiative Reporter, Windspeaker.com

The First Nation Health Authority in British Columbia has partnered with the national Health Standards Organization to develop a guide of behaviours and expectation of quality as the professional benchmark for cultural safety and humility in health care.

The result is a first-of-its-kind Cultural Safety and Humility Standard (CSHS) to be used as a tool to end Indigenous-specific racism in the B.C. health-care system.

This partnership began in 2018, said Dr. Nel Wieman, (Anishinaabe), the deputy chief medical officer at FNHA. She co-chaired the technical committee that created the new CSHS standard.

The work began two years before the In Plain Sight report, which documented widespread racism in B.C.鈥檚 health-care system toward Indigenous people.

鈥淚ndigenous-specific racism in B.C.鈥檚 health-care system is long-standing and pervasive and its ongoing presence continues to have harmful impacts on the overall health and well-being of B.C. First Nations people today,鈥� reads a FNHA press release announcing the standard.

For this reason, First Nations health professionals, with input from community chiefs, led the development of the new standard.

鈥淢ost importantly, we included the voices of patients,鈥� said Wieman.

Representatives from the Patient Voices Network were included on technical committee. The committee reviewed 1,100 statements from Indigenous people in B.C., health organizations and health professionals.

Elder Gerry Oleman (St鈥檃t鈥檌mc) co-chaired the technical committee which was made up mostly of Indigenous people. He explained the essence of the new cultural safety and humility standard.

鈥淲hen we say justice, we mean justice and absolute fairness for all. Today I can say there is a standard. We set a high bar about dealing with cruelty and fairness. We鈥檙e talking about accountability.鈥�

Part of the work was moving from a reference standard to an assessment standard. As Wieman explains, 鈥渢here aren鈥檛 any teeth, so to speak, in a reference standard. (The new standard) is asking organizations to take a hard look at their organization and see where they sit in terms of cultural safety.鈥�

There are eight sections in the new standard. Section eight outlines the need for more Indigenous health-care professionals. This answers Truth and Reconciliation Commission call to action #23.

While there are 鈥渟elf-identifying鈥� check boxes on the membership form of the College of Physicians and Surgeons in B.C., the problem with those, Wieman explains, is 鈥渘ot everybody does [identify] partly because they might not trust 鈥榳hat鈥檚 going happen with my data? What does that mean for me? What does it mean if I identify as an Indigenous physician? Am I going to be treated differently by my institution or organization I work with鈥�?鈥�

Wieman just finished serving a six-year term as the president of the Indigenous Physicians Association of Canada, and notes that just because these organizations exist, not all physicians may register. She observes 鈥渢here is no really good or accurate tracking of the number of Indigenous physicians, from where I sit.鈥�

Wieman says, B.C. has more than 100 licensed Indigenous physicians, but if you look at that number, out of all the physicians in B.C., we are still less than 1 per cent. 鈥淲e are still vastly underrepresented.鈥�

Wieman sees the next level of a standard as an accreditation standard, and 鈥渢hat鈥檚 really where the actual accountability and 鈥榯eeth鈥� come into it. We are hoping that we will be able to move or transform this standard from its current reference or organizational status to an accreditation status,鈥� she said.

This means health services and social services are accredited. Wieman gives an example of a hospital getting a certificate to put at the front door 鈥渟o that patients coming in and their families can say, 鈥榦h, this hospital has achieved the highest level of accreditation, so the care there is going to be terrific鈥�.鈥�

鈥淚f, however, they鈥檙e not meeting their accreditation standard, they get a lower score,鈥� said Wieman. 鈥淪o people will know there鈥檚 been some issues identified with this organization. 鈥業 need to be aware of this in using this particular hospital鈥�,鈥� she said.

鈥淲e are saying that this is no longer acceptable. The way that First Nations people are treated in our healthcare system is no longer acceptable. And we are going to move towards accountability, forcing change if we need to by using a lever of accountability and accreditation.鈥�

To read the new standard, visit

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