Ricky Bell speaking at the session

Question your assumptions about health services for Indigenous people

The first ever WCPT Congress session on meeting the needs of Indigenous populations challenged participants to think how their health service perspectives were affected by colonisation and the ingrained attitudes it brought.

Chairing the discussion session, Stephanie Nixon from Canada, said that all too often in discussions about healthcare for Indigenous people, they are framed as a “problem”

“The question people always ask is: ‘What can we do to save or help these people?’ That’s such a dominant way of thinking that we can’t even see it.”

Physical therapists, she said, had to see that deciding where the “problem” lies is a conscious choice. “It’s about putting the upstream causes, not the people, under the microscope,” she said. “Being a better physical therapist for Indigenous people means understanding your relationship to colonialism, indigeneity and the land you’re on.”

Ricky Bell from the University of Otago, Dunedin, New Zealand, whose mother comes from a First Nations family, said that colonial ideas and assumptions permeate health services, which could leave Indigenous people marginalised.

“We talk about evidence based practice – but what’s my evidence may not be your evidence,” he said. He described how concepts of time could also be very different in Indigenous people – meaning rigorous appointment schedules were often ill-suited to them.

Sarah Oosman, Assistant Professor at the University of Saskatchewan, Canada, described a university project looking at what kind of healthy ageing programmes would best support Métis communities in remote rural areas.

“We’re looking not at Western models, but at what matters to that particular community. The health promoting interventions for older adults are driven from the community perspective.”

She said that students going into these communities start to understand the socio-economic problems they encounter. “We build awareness around the Métis world view, and what that means for health services. That’s a very different perspective than students normally get at a Western university.”

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