On Red Dress Day, PHC honours missing and murdered Indigenous women, girls, 2SLGBTQQIA+ people

Submitted by the PHC Indigenous Wellness and Reconciliation Team

May 5 marks Red Dress Day, the National Day of Awareness for Missing and Murdered Indigenous Women and Girls (MMIWG).

It honours the lives of missing and murdered Indigenous women, girls, and 2SLGBTQQIA+ people.

Providence Health Care (PHC) acknowledges there is much work to be done to decrease the disproportionate number of Indigenous women who experience violence, go missing or are murdered. We also acknowledge in particular how intimidating it can be for Indigenous women to seek care, especially when they face ongoing colonialism, compounding oppression and challenging or vulnerable circumstances in their lives.

Over the past year, PHC and our Indigenous Wellness and Reconciliation (IWR) team has continued to work with partner organizations to address the system failures inequitably impacting Indigenous women—including enhancing cultural safety and building relationships and trust. We are continuing our direct work with women to better understand their experiences – including those related to maternity care – and develop a shared strategy to support their cultural safety and desired health outcomes.

We continue our work through our first-ever Indigenous Wellness and Reconciliation Action Plan (IWRAP), specifically under the goal to “Undertake targeted initiatives to support Indigenous seniors, women and those with mental health and substance use needs”.

Our IWR team supported the work through continuous engagement with women to learn how and where we can improve current services and sites, and get guidance on how to create better services and sites in the future.

This year, we continued our work towards improving health outcomes and culturally safe care for women, girls and 2SLGBTQQIA+ people trough the following activities:

  • Weekly meetings providing engagement feedback and building relationship - Working with the Pacific Association of First Nations Women, the Aboriginal Mothers Centre and Atira Women's Society
  • Engaging with nine Elders and Knowledge Keepers to create a safe space for women and Two-Spirit people through Medicine Walks, feasts, health fairs, and on-going engagement sessions
  • Continuing to offer Patient Journey Mapping to Indigenous patients and residents so they can share their experiences of care with us in a safe way—some PJMs have focused on experiences related to maternity care and women who use substances
  • St. Paul's Hospital Emergency Department is partnering with the IWR team on an Indigenous Cultural Safety Intervention Project. Part of the project involves creating more culturally safe, welcoming and identity-affirming physical spaces for Indigenous women and in the ED. For example, the team is exploring integrating nature-inspired wall wraps, Indigenous art, soothing lighting and more welcoming, healing interior design overall.

Understanding that St. Paul's Hospital Emergency Department is the locus of care for many Indigenous women, seniors, and those with mental health and substance use needs, we are also taking steps to improve the experience, quality, and model of care in the ED, including through enhanced Indigenous Wellness supports. This is in addition to the daily support for Indigenous women and girls we offer through our Indigenous Wellness Liaisons at our various PHC sites. We are currently looking to expand the IWL program to meet the need to support women and all Indigenous patients who visit our sites. 

PHC has also revamped our processes and training around Indigenous Self-Identification (ISI). We have changed the ISI questions we ask and how we ask them in the hopes that it feels easier and safer for Indigenous people to self-identify and be connected to the Indigenous Wellness services we offer. The Indigenous Wellness and Reconciliation team is working with Registration Clerks at St. Paul's Emergency Department to improve our ISI practices, and hopes to expand this learning out to other clinical areas in the coming year.

Looking at the year ahead, we hope to expand Indigenous Cultural Safety practices into key areas of our work, including maternity, Road to Recovery, and outpatient services, because we have learned through all of the reports that we have a critical role in reducing barriers and making health care safer for Indigenous women, girls, and 2SLGBTQQIA+ people.

The significance of the colour red for this day

​Every May 5, Indigenous families, communities and organizations across the country to display and hang out red dresses to symbolize the loss of their mothers, daughters, sisters, friends and other family members who never came home. As the dresses are empty, they evoke the missing women and girls who should be wearing them. The colour red has spiritual significance to Indigenous Peoples: for some it is a part of a First Nations Medicine Wheel; for others, it symbolizes lifeblood and powerful emotions. Still more see red as embodying power and reminding us of those women who came before us. 

Research and data coming out of various studies including the 2019 final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls, Reclaiming Power and Place, confirms that Indigenous women have long been subject to disproportionate and compounding oppression, especially within the health care system in Canada. Evidence coming out of the National Inquiry led to 231 Calls for Justice to address ongoing systemic abuses and violations committed against Indigenous women, girls and 2SLGBTQQIA+ people.

Missing and Murdered Women and Girls from the Downtown Eastside

​Providence also acknowledges that one of the large populations it serves is residents of the Downtown Eastside (DTES). On April 3, 2019 the Downtown Eastside Women's Centre release a report named Red Women Rising: Indigenous Women Survivors in Vancouver's Downtown Eastside—this report is based on the leadership, lived experience and expertise shared by Indigenous women in the DTES. This report was the culmination of a participatory process with over 100 women regarding the National MMIWG Inquiry, but was specific to the experience of women in the DTES. It culminated in 200 key recommendations specific to their needs and well-being. PHC's Indigenous Wellness and Reconciliation Action Plan indicates where our goals are in alignment with several of the key recommendations.

As stated in our Action Plan, within five years we will have “enhanced our Indigenous-specific services, implemented visible improvements to our facilities, and undertaken initiatives to address the unique and pressing needs of Indigenous women. Still, we know that despite this commitment, patients and residents may experience harm. We are committed to ensuring that we are transparent, accountable and learn from those events and will improve the safety and cultural relevance of our processes for complaints and incidents”.

You can read the complete final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls, Reclaiming Power and Place, and the 231 Calls to Justice at: https://www.mmiwg-ffada.ca/final-report/

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