Awasisak Indigenous Health Program builds bridges between patients and pediatric care

Pediatric residents encouraged to become involved with program

Tamara Vineberg - 03 June 2019

A child returns to a northern Alberta community from the Stollery Children's Hospital and requires specific medication immediately. However, the community pharmacy informs the family that the medication will only arrive in seven days. Another child is released from the hospital but can't return home because their community can only be accessed by plane or boat certain times of the year. The family has limited funds and cannot afford to stay in Edmonton any longer. These stories are heard frequently by the Stollery Awasisak Indigenous Health Program.

Hayley Turnbull became interested inequities and barriers to health care services during her master's in public health and previous work in global health. This interest continued to grow through residency training. She understands some populations face more barriers than others. When Turnbull was approached to join the Stollery Children's Hospital Awasisak Indigenous Health Program's steering committee, it was an opportunity to develop further understanding around Indigenous health and continue advocating for health equity.

For the past four years, the Awasisak Indigenous Health Program has been making headway in bridging a gap in services for First Nations and Metis children who access the Stollery.

"It's about being creative and innovative in how we deliver services to meet the needs of First Nations and Metis children because accessibility of services varies on First Nation and Metis settlements. While health care is provided by the province, First Nations peoples are a federal responsibility. Breaking down the jurisdictional barriers is one of the tasks we are working on to provide equitable access to services by working with Alberta Health Services and First Nations communities," explains Sherri Di Lallo, team lead for the Awasisak program.

Turnbull, who is now a clinical lecturer in the Department of Pediatrics, approaches the care of Indigenous patients differently now that she has an understanding of how Awasisak can help. "You can't make a blanket assumption about a child's needs or barriers. Individuals and communities face different barriers and have different resources. Having a team that can liaise and work with the individual community has been really helpful because I don't feel I have the local knowledge," she says. "The Awasisak program helps in part by working with patients, families and communities to ensure that patients have what they need in their home community."

Di Lallo and her team spend time building relationships in Indigenous communities by holding day-long talking circles as well as raising awareness among pediatric health care providers. Residents and health care professionals can both take the opportunity like Turnbull did and become involved in the program by joining the steering committee or attending a talking circle. Talking circles provide a chance for community members and health care providers to discuss how health inequities can be addressed.

Di Lallo hopes that by listening to these perspectives, healthcare providers will change the way that they practice medicine. "We are in an academic environment. To actually be in a community and hear stories from the families that struggle with access to services could change the way they deliver the service. As they get further on in their education or practice, they will be aware of the disparities and the struggles that our families face when accessing pediatric services," says Di Lallo.

Hasu Rajani, professor in the Division of General and Community Pediatrics, is one of the physicians who helped create the Indigenous Health Program after witnessing firsthand the limited health resources in central and northern communities. He invited Turnbull to join the steering committee and hopes more residents will become involved.

"Residents are invited to participate in the Awasisak steering committee to provide their perspective in improving care for these patients. This would raise awareness of the challenges that patients and families from Indigenous communities face. As individuals who often make first contact with these patients, pediatric residents can become strong advocates in bridging gaps in health care in a culturally competent manner," says Rajani.