Doris Warner
Engagement Liaison, SE Health First Nations, Inuit and Métis Program
In 2011, the SE Health First Nations, Inuit and Métis Program received funding through the Canadian Partnership Against Cancer to collaborate with rural, remote, and isolated First Nation communities. The goal was to better understand the cancer pathways experienced for First Nation people. This important project was grounded in the knowledge that cancer is the leading cause of death in Canada, and that First Nation people are at increased risk for cancer and experience poorer outcomes.
Why I Joined the Journey
The Cancer Pathways Project was the reason I joined the SE Health First Nations, Inuit and Métis Program. I was hired on an eight-month contract to lead engagement with communities and organizations. I was so impressed with the work SE Health was doing with First Nations, Inuit and Métis communities that I resigned from my position at Cancer Care Ontario, without regret, and took a leap of faith. I knew this project would be an incredible experience.
More importantly, I saw this as an opportunity to work for a not-for-profit health care organization that was investing its human, time, and financial resources to support collaboration with First Nations, Inuit and Métis communities in their efforts to improve health and well-being. To the best of my knowledge, no other not-for-profit health care organization in Canada had stepped up in this way simply because it was, and still is, the right thing to do.
Our Approach
We worked collaboratively with First Nation communities across Canada to build a comprehensive understanding of cancer care pathways. This included:
- Identifying gaps and barriers for First Nation community members (Status and Non-Status) in cancer control
- Highlighting leading models of cancer care programs and services
- Gathering culturally responsive resources
- Identifying opportunities for action to improve cancer control for First Nations
We used a variety of data collection methods, including:
- e-surveys
- In-person surveys
- Phone interviews
- Key informant interviews
- Sharing sessions (in-person focus groups)
Our strength-based approach created opportunities for knowledge sharing in a safe and supportive environment, where participants felt comfortable sharing their experiences openly. The result was a much richer understanding of the cancer pathway for First Nation individuals living in rural, remote, and isolated communities.
Our Collaborators
We were fortunate to work with:
- Over 250 individuals working with or in First Nation communities across Canada
- Cancer Care Manitoba
- Alberta First Nations and the Alberta First Nations Information Governance Centr
- Assembly of Manitoba Chiefs
- Council of Yukon First Nations
What Did We Learn?
For many First Nation individuals, the cancer pathway is shaped by feelings of fear and mistrust, deeply rooted in the impacts of intergenerational trauma. These feelings are compounded by the adverse effects of social determinants of health, such as overcrowding and substandard housing.
Along this pathway, gaps and barriers related to access, partnerships, and jurisdiction hinder access to cancer care. This leads to under-screened populations and diagnoses at more advanced stages. When cancer is diagnosed, care options are often linked to isolation, requiring individuals to leave their home communities.
We also identified a significant gap in support for caregivers, who play a critical role in helping loved ones remain at home. In response, the First Nations, Inuit and Métis Program led the development of a First Nation Supporting Natural Caregivers Course.
Ongoing Impact
The findings from this project have inspired further collaboration in areas such as research, community-based action, cancer education, and knowledge sharing. New relationships emerged with:
- BC Cancer Agency Centre for the North
- Gitxsan Territory and Nisga’a Nations
- Council of Yukon First Nations
- Government of the Northwest Territories
- Fort Good Hope, NT and Fort Resolution, NT
Our report, “Walk a Mile in My Moccasins: Foundations for Action in First Nations Cancer Control”, reflects the voices of over 250 people across nine provinces and one territory. It provides rich insights into the current realities for First Nation people affected by cancer.
Looking Ahead
Fear around cancer in First Nation communities still exists, and there is still work to be done. The SE Health First Nations, Inuit and Métis Program deeply believes that education that is rooted in community strengths and ancestral knowledge around living a good life is key to building wellness-focused initiatives that reduce the risk of cancer and other chronic diseases.
As we continue this journey, we invite opportunities to explore new collaborations with communities and organizations that share our values and aspirations of equity and inclusion in advancing culturally safe care. Together, we can make this happen.