Richard Budgell is a Labrador Inuk and lectures, writes and researches on Inuit health. Prior to joining McGill University’s Department of Family Medicine, he was a federal government public servant in First Nations and Inuit health, and other Indigenous fields, for more than thirty years. He was awarded the Queen Elizabeth II Golden Jubilee Medal in 2002 for exemplary public service in his role in the creation of the Aboriginal Head Start program, an early childhood development program for First Nations, Inuit and Métis children and families. He has a Master of Arts degree in Canadian Studies (Aboriginal concentration) from Carleton University and began doctoral studies in History at McGill in 2021. He is involved in a variety of research projects, including Inuit cultural safety in health care and the Inuit community in southern Quebec. Prof. Budgell was appointed Assistant Professor in the Department of Family Medicine in 2020.
Alex M. McComber is Kanien’keha: ka (People of the Flint, Mohawk), Bear Clan from Kahnawake Territory on the St. Lawrence River across from Montreal, Quebec. After twenty-years in Kahnawake secondary education at teacher and principal with the Kahnawake Survival School he became part of the Kahnawake Schools Diabetes Prevention Program (KSDPP), a 28-year community-based participatory research project in partnership with the Dep. of Family Medicine PRAM (Participatory Research and McGill). These experience grounded McComber in health promotion, wholistic wellness, Indigenous research, community mobilization and personal empowerment. His work with the Department of Family Medicine has focused on teaching, curriculum development, mentorship (of both Indigenous children, youth and post-secondary students. He has been co-director of the SPOR Indigenous Expertise Project with an emphasis on empowering Indigenous patients to help transform the Quebec health learning system; he is also former director of the Quebec Indigenous Mentorship Network. A McGill graduate with a Masters in Education Administration, McComber received an Honorary doctorate in science from Queens University in 2016. He has been a part-time assistant prof with the Dept. since 2017.

Who do you belong to? That’s how Professor Budgell started the conversation. I found it fascinating that the question included a “who” and not “where” as it implied that it is the people who influence our identity and not necessarily the place. We all started sharing our stories of our families and the places that we call home. It was a great way to learn more about who we are, and our ancestors. We realized that we all, to a certain extent, come from a complex heritage.

Addressing Canada’s colonial past

Professors Budgell and McComber both stated that their work involves educating the public about Canada’s colonial history. The fact that many Canadians today are ill-informed about how Canada came to be, is indeed extremely problematic. Being honest about what happened during Canada’s colonial past is the very first step if we are to be serious about reconciliation. Professor Budgell however points out that many Indigenous people struggle with the meaning of the term “reconciliation” which has become a buzzword. Many argue that it is a process of conciliation — which the Oxford dictionary describes as “the action of mediating between two disputing people or groups” — before reconciliation can occur. In the 2015 Truth and Reconciliation Commission report, education was highlighted as one of the avenues the federal and provincial governments could take to reduce bigotry directed towards Indigenous peoples. Learning the truth about colonialism is a fundamental part of reconciliation.

“When you create a State and put people under your thumb, you indoctrinate them into the support of the State. You also create the history of heroes and mythology. Canada and the U.S. are two of the most genocidal states in the world, yet they proclaim to be the center pieces of democracy and freedom. There’s so much hypocrisy around that. When things go belly up in the State, you distract the people with bread and circuses,” says Professor McComber.

Systemic racism against Indigenous People

The death of Joyce Echaquan, an Atikamekw woman from Manawan First Nation, who was filming nurses making derogatory comments to her as she lay dying in a hospital bed in Joliette, northeast of Montreal, took place almost a year to the day after a public inquiry, known as the Viens Commission, released 142 recommendations aimed at improving Indigenous Peoples’ access to government services. In 2019, this Quebec-mandated Viens Commission concluded that it is “impossible to deny” that there is systemic racism against Indigenous people in Quebec. More specifically, that “prejudice toward Indigenous Peoples remains widespread in the interaction between caregivers and patients,” and recommended “cultural safeguard principles” be incorporated into health services and programs for Indigenous people. Professor Budgell adds that the contentious provincial language-reform legislation known as Bill 96 will, by default, go against this cultural safety.

The goal of cultural safety is for all people to feel respected and safe when they interact with the health care system. It includes addressing the health inequities (many Indigenous People in Canada have poor health outcomes compared to other Canadians) which includes institutionalised racism and ensuring a health care system that delivers appropriate and equitable care. It is argued that cultural safety goes far beyond the importance of cultural competency and awareness.

“For many Inuit and Indigenous people in general, they are feeling demeaned, diminished, and ignored in health care settings. They now even expect to be uncomfortable in these places. There is something profoundly wrong about that. You are going to these places to get healing and help,” says Richard Budgell.

“Joyce Echaquan’s death was a slap in the face to Indigenous women, men, people and patients. It was a sign of the atrocious racism by health professionals and the system. It is an endemic problem,” says Professor McComber.

Teaching cultural safety in healthcare

One way that Professors Budgell and McComber fight against systemic racism against Indigenous people is inside their classrooms as they educate aspiring researchers, physicians and health professionals around cultural safety.

Professor Budgell’s course, entitled Inuit Health in the Canadian Context explores the histories, perspectives, and contemporary realities of Inuit health in the four regions of Inuit Nunangat (the Inuit homeland) with a particular focus on the Nunavik region of northern Quebec. It is apparently the first-ever Inuit-focused health course in a Canadian university. In his lectures, Professor Budgell works to “Inuit-ize” concepts and definitions of health which allows for a more holistic outlook on the overall health status of Inuit, beyond the commonly referenced indicators which focus on health deficits. Using Inuktitut opens the possibility of describing health in ways that contrast with the prevailing ‘Western’ vision of the health care system. An interesting example of an Inuit health and wellbeing concept is Inuuqatigiitsianiq which refers to harmonious relations among people who share a place. The quality of relations with family, friends, neighbours, and people within the community (including non-Inuit) is a key dimension of the lived experience of health and an imperative consideration for Inuit.

Similarly, Professor McComber’s course, entitled Indigenous Perspectives Decolonizing Health Research explores Indigenous-grounded health promotion and health research in primary health care, with the goal to foster more meaningful patient and community engagement in research and practice. This course explores the nature of Indigenous Peoples’ ways of understanding the world and cultural ways of knowing and doing, with focus on health and wellness. It reviews the foundations of values and world view and practices of pre-contact Indigenous culture primarily from a Haudenosaunee (People of the Longhouse) and Kanien’keha:ka (People of the Flint, Mohawk) perspectives, Canadian history of colonization and assimilation, and the outcomes and impacts through the lens of Indigenous Peoples. It also focuses on the efforts and actions of indigenous communities, knowledge keepers and up and coming Indigenous scholars on bringing Indigenous ways into the research field; it also takes a focus that the patient is the expert at the table.

Doing your homework for (re)conciliation

Professors McComber and Budgell state that education is not the end point to resolve issues surrounding decolonization and systemic racism. Most importantly, there is a need for personal reflection and analytical thinking by student and health professional learners beyond the classroom.

“It is not just about understanding what you’ve heard. People need to reflect deeper to their own beliefs and their own foundation of values and worldviews that they have grown up with. Indigenous people want to see transformation,” says Professor McComber.

“People need to ask themselves the questions about how this (new piece of information) is impacting them personally. We’re exposing them to a world that they may be completely unfamiliar with. They need to relate to that and imagine themselves in it,” says Professor Budgell.

Ultimately, what Professors Budgell and McComber are telling us is that the work of (re)conciliation is the work of everyone. Non-indigenous people need to demonstrate engagement, learning and actions to make things better. It is our shared responsibility, not simply that of Indigenous people. We also need to frame people as people, not as the disease they may be suffering with. And for those looking for quick fixes, there are none. It’s about demonstrating genuine kindness, respect, and empathy.

The Department of Family Medicine is excited to announce that we will be opening our new Indigenous space this coming Fall – keep your eyes peeled!

More information and contact details:

Here are the links to the Indigenous courses taught by Richard Budgell and Alex McComber:

https://www.mcgill.ca/channels/channels/news/register-these-two-upcoming-indigenous-health-courses-331890

If you’d like to contact them personally, you can do so here:

richard.budgell@mcgill.ca

alex.mccomber@mcgill.ca