Better access to healthcare for Indigenous Peoples in Canada

Recognition of the needs of Indigenous communities

British Columbia, on the west coast of Canada, is home to many Indigenous Peoples, some of whom live in rural and more remote areas of the province. Living in or near cities, access to healthcare facilities is only a short drive or walk away. But in rural and remote areas of British Columbia, access to healthcare is limited. And this narrows the medical opportunities for the Indigenous Nuu-chah-nulth nations living there. Indigenous Peoples in Canada are significantly disadvantaged by a high incidence of chronic illnesses, like diabetes, chronic obstructive pulmonary disease (COPD) and mental health. For example, 80 percent of Indigenous Peoples in Canada will develop type 2 diabetes (T2D) in their lifetime. Accessing primary care in an urban center often requires traveling hundreds of kilometers.

A system not meeting the needs of an entire community was something Mehmood Alibhai, Director of National Policy and Patient Access at Boehringer Ingelheim Canada, and his team were no longer willing to accept. “We wanted to work with the national Indigenous steering committee and focus on a healing journey,” he shares. Together, Boehringer Ingelheim Canada and the Indigenous Advisory Council created programs with the local community of Nuu-chah-nulth on the northwest coast of British Columbia that reflect their views and culture.

“Partnership is where you listen to the Indigenous community as to what their needs are. You respect the community to know what is best for their community in optimizing care,” says Mehmood. Today, this partnership is known as PATHWAYS – Indigenous Health Collaborations. It is Indigenous-led and Indigenous-informed and has the vision to close the health gap with Indigenous communities, while focusing on relationship-building and a positive, sustainable future for all partners.

Virtual care for Indigenous T2D patients of the Nuu-chah-nulth

One of the pilot projects with the Nuu-chah-nulth aims to empower health care staff to leverage technology better. In return, this improves virtual diabetes care and supports health care staff in providing culturally sensitive care that considers the historical impacts and the unique needs of Indigenous Peoples: “Our vision is to reach out to all Nuu-chah-nulth Peoples living with diabetes and seeing what their needs are and what kind of support they would like to move forward in their health journey,” explains Rachel Dickens, who works as a Registered Dietitian and Certified Diabetes Educator with the Nuu-chah-nulth community.

Walking miles with small steps

Small things can already make a big health difference, Rachel tells us: “I find that empowering community members with the knowledge in how to adjust their own insulin has made such a big difference in their overall blood sugar management.” One of the PATHWAYS pilot participants is Paul San, a member of the Ahousaht First Nation which are the largest member group of the Nuu-chah-nulth Tribal Council. He shares his success with T2D treatment: “I really had a hard time walking. Now I can walk for miles.”

More to come

To date (2023), the program has impacted over 50,000 people in a total of 30 Indigenous communities across Canada through eight pilot projects (British Columbia, Alberta, Manitoba, Ontario, Nova Scotia and Nunavut). Each is tailored to the Individual needs of the respective community. What’s next has already been identified: “We are expanding into progressive fibrosing interstitial lung diseases (PF-ILD), as our Advisory Circle has identified a need in this therapeutic area,” says Mehmood.