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Community ᐄᐦᑖᐧᐃᓐ

Indigenous family health clinic opens in Montreal

BY Patrick Quinn May 8, 2024

Native Montreal opened Montreal’s first culturally safe healthcare clinic for Indigenous people April 12. It provides holistic and tailored care that complements existing public services for patients’ medical and social needs. 

“You can meet your doctor, get your appointment for a blood test and get your follow-ups by a nurse all in house,” explained Philippe Tsaronséré Meilleur, executive director of Native Montreal. “You’re not going to different places because we know that’s a logistical nightmare. To make this model work, we had to force the system to change their ways.”

The initiative has been in development since Native Montreal’s foundation in 2014, inspired by the innovative model of the Minowé clinic at the Native Friendship Centre in Val-d’Or. The latter’s integrated services have been replicated in urban settings such as La Tuque, where Meilleur visited during his second week on the job. 

It wasn’t until the pandemic and the 2020 death of Joyce Echaquan that the province recognized the need for culturally appropriate services. But there was still resistance to establishing a wrap-around service model. Eventually the health system was convinced that Native Montreal’s inviting space and cultural sensitivity training would help treat Indigenous people. 

“Indigenous people have avoided healthcare for a long time,” Meilleur told the Nation. “We’ve created a culture of avoidance in being preventative – we’re not rushing to see doctors. There’s a culture of wellness we have to bring back slowly and progressively.”

Meilleur said the Indigenous community has long faced ignorance of its needs, and issues of access, discrimination and racism that all increased distrust. Preventative care is important to reverse these intergenerational impacts. In 2023, Quebec passed Bill 32, which requires institutions to take Indigenous “cultural and historical realities into account in all interactions with them.”

Overcoming convoluted bureaucracy where responsibilities are divided by borough was another major challenge. Located on Saint-Jacques Street in Montreal’s Sud-Ouest, the clinic shares responsibility with CIUSSS du Centre-Sud-de-l’Île-de-Montréal, GMFU Verdun and other partners but is open to all Greater Montreal’s estimated 35,000 Indigenous people.

This streamlined approach to primary care was applauded by Health Minister Christian Dubé, who said it could guide widespread change in the provincial system. Dubé attended the launch along with Indigenous Minister Ian Lafrenière, who said similar projects are already being developed.  

“More than half of First Nations and Inuit people don’t live in communities, they live in urban areas,” said Lafrenière. “We need culturally adapted services. That means having navigators, making them feel welcome, and ensuring that the system meets their needs rather than their needs meeting the system’s needs.” 

The clinic employs psychosocial workers they call navigators who help patients access support services. They liaise with hospitals, accompany people to their appointment and check in with them afterwards. If patients experienced discrimination, navigators assist with submitting complaints.

“In health, we don’t have this customer service follow-up, usually,” said Dubé. “This navigator principle is a good example of my vision of patient service.”

This approach has already seen success with the roughly 100 patients the clinic has served since November. There have also been cases where they have been called by hospitals to assist with Indigenous people experiencing an emergency. Native Montreal helped liaison with their community’s health services. 

“There are patients who have come here super anxious, very worried and who have left smiling and were like, ‘I’ve never had a doctor listen to me properly,’” said Métis health navigator Rachel Albert.

While there is limited capacity in the clinic’s first phase, with a doctor present two days a week and a nurse five days a week, they’re considering requests from the Inuit health services to support children in the Department of Youth Protection. As more people register with Native Montreal and the clinic, they intend to further advocate, recruit and build the service.

The space provides a welcoming environment adorned with colourful Indigenous art. There is an exam room for doctors, a room for nurses to complete follow-ups and additional mixed-use rooms for intervention workers. There’s also a unique cedar room where members can meet with Elders and knowledge keepers for advice or traditional cultural practices.

“There’s appropriate seating for Elders, cultural artifacts and specific ventilation,” said Meilleur. “You can see on the corner there’s a smudging site. They’ll understand they have access to Elders and all types of other supports. That’s our challenge because we offer a lot, and it can confuse people.”

Meilleur hopes to work with youth councils, language programs and other Indigenous organizations to generate awareness about the clinic’s services. For example, he said parents registering their child for a day camp could learn how the clinic’s holistic services can take them further in life.

Meilleur believes the initiative will improve healthcare outcomes throughout the system by developing practitioner training. The doctors and nurses they train will share their cultural sensitivity among their peers through the Friendship Centre movement.

“Local Indigenous organizations will be raising the bar on quality of care for all Indigenous peoples,” Meilleur asserted. “Imagine if we have more Cree nurses and doctors who can do their internship at our clinic, that’s going to impact progressively our self-determination.”

Native Montreal is applying for more funding to establish greater healthcare capacity in Quebec’s urban areas. The family clinic’s grand opening is a milestone in creating foundational services for Indigenous peoples.

“The strength of Indigenous people is when we need to create things for ourselves, we can,” said Meilleur. “I invite any person to come by and meet our team, see what’s in it for them. If they establish themselves in Montreal, they have kids or come and study, this place is for them too.”

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Patrick Quinn lives in Montreal with his wife and two small children. With a passion for words and social justice, he enjoys sharing Eeyou Istchee's stories and playing music.