As the Cree Board of Health and Social Services of James Bay (CBHSSJB) transforms service delivery and employee support models, it is guided by the principle of Nitutâmh (“my relations”) to prioritize kinship, connection and belonging.
Nitutâmh was the theme of the CBHSSJB’s recent annual report. It also informs a healing approach to staff training, aiming to foster safe and respectful workspaces and promote collaboration among colleagues.
“It really comes down to relationships,” said chairperson Jeannie Pelletier. “Health care is about people and our strongest services are built when we trust one another and work together.”
The board holds four three-day Nitutaamh sessions for employees annually, which Pelletier described as an “experience” rather than training. Rooted in the Cree tradition of storytelling, staff learn communication tools that can help at work and with their families.
Since becoming chairperson nearly two years ago, Pelletier has advanced what she calls the Nisk model of holistic care to improve service access and health outcomes by promoting lasting relationships with care providers. Suggesting the CBHSSJB grew so quickly that services had become fragmented in silos, the Nisk model replaces the typical revolving door of doctors and nurses with dedicated multi-disciplinary teams.
“We’re moving away from asking people to navigate a complicated system on their own,” said Pelletier. “When you go to our cabins in the bush, they’re open concept. There’s better communication that happens when the person is right in front of you.”
Inspired by the teamwork of geese (Nisk), assistant executive director Holly Danyluk said this family-centred approach is improving attendance at appointments, chronic disease control and client satisfaction.
Results were apparent when Pelletier introduced the Nisk model in her former role as director of Chisasibi’s Community Miyupimaatisiiun Centre (CMC). But she says this transition is far from complete on a regional level. A more comprehensive re-design will soon reorganize employee roles.
“First you have to do an inventory,” Pelletier explained. “You know when you clean out your closet and make a big mess at the beginning before getting to the actual work? That’s the process we’ll be going through but I’m confident in the managers and staff.”
With interim executive director Christina Biron, who replaced Daniel St-Amour when he retired last year, a first priority was a new agreement with the provincial government, which was achieved in August.
“It brings stability and opportunity because we’ve been operating without an agreement the last three years,” Pelletier told the Nation. “It helps us plan for the long-term and respond to changing realities. It gives us a stronger foundation to improve access, renew infrastructure and support better care for future generations.”
Several infrastructure projects across Eeyou Itschee are nearing completion or have recently opened. Waskaganish is positioned as the third regional healthcare pole, alongside Chisasibi and Mistissini. An expanded Waskaganish CMC opened last January while the Wâpimâusûkimikw birthing home welcomed its first births this summer.
Construction is completed for Chisasibi’s new Elders’ home, with only its Mitchuap teepee to be finished before an expected spring opening. The $300 million regional hospital is still years away, so restorations are ongoing at the present aging facility.
Primary care is expanding in all communities, supported by a network of mobile clinicians. Advancements include at-home sleep tests for respiratory therapy, orthotics and prosthetics service growth, and broadened speech and language therapy.
Calls to the Wîchihîtuwin helpline launched during the pandemic increased by 60% this year. This growth likely reflects both escalating health and social concerns in the region and greater awareness about the free, confidential and culturally grounded resource. Callers can be referred to psychosocial services, traditional healers and other programs.
“Many people are carrying a lot now, whether it’s stress, addictions, mental health concerns, housing pressures or caring for loved ones,” said Pelletier. “Our responsibility is to make sure help is available when people need it the most. It tells us people are trusting it.”
A rise in serious crimes is stretching the capacity of Youth Protection services, resulting in staff burnout and forcing the CBHSSJB to reach out to other provincial directors to house Cree youth. Pelletier said complex issues such as homelessness require extensive partnerships.
“We have to invest more in prevention, encouraging people to seek help before they become evicted,” Pelletier asserted. “In medicine, you have your target you can hit most of the time. With psychosocial [issues] it’s more complex – your target is there but your dart is a bird.”
As many Cree patients still have to travel south for care, Montreal’s Hotel Espresso is renovating its kitchen and arrival areas, with a new third-floor space for long-term clients and their families. Pelletier hopes to develop a new area for patients staying in the city, responding to requests for more access to nature and the water.
Having dialysis machines in each community is unrealistic for diabetes patients, Pelletier said. She emphasized the importance of healthy grocery options, safe walking paths and school presentations on Miyupimaatisiiun, the Cree vision of lifelong wellness.
“Sometimes you can’t change the trajectory of somebody’s health, but you can enhance their quality of life,” said Pelletier. “It makes me proud to see that shift in how we think about care, building a system that reflects who we are as Eeyouch and organizes itself around the people and families.”