Indigenous-sensitivity training for Quebec health workers falls short says Richard Budgell

Fundamental flaws of the obligatory training modules relate to the who is delivering the training; the context framing the modules; and the omissions
Image by Graham Hughes /The Canadian Press.

The Quebec government in its health and social services ministry continue to squander opportunities to improve health care for the Indigenous residents of this province.

The most recent example is the training program for all public health-care employees — patient attendants, nurses, physicians — called Sensibilisation aux réalités autochtones. The training was an initiative of the province’s Indigenous affairs secretariat and justice ministry.

I recently had the opportunity to review the obligatory portion of the training modules. That section, three modules totalling one hour and 45 minutes, is deeply flawed. An additional four modules, totalling just over five hours, are also available.

The obligatory modules frequently reflect non-Indigenous perspectives of the history of the land mass now called Quebec.

The co-creators of the modules defended their work in a recent open letter, and say that as of September 2022, about 200,000 government employees have taken the course. They state that 94.8 per cent of those who did a course evaluation say that it has increased their sensitivity in relation to Indigenous realities. However, several First Nations and non-Indigenous health professionals have expressed their disappointment with the training.

Fundamental flaws of the obligatory training modules relate to the who is delivering the training; the context framing the modules; and the omissions.

The who: After the introductory first module featuring the two co-creators, one of whom is First Nations, the bulk of the second module is video of non-Indigenous, francophone male academics — one presenter has more than 20 minutes — explaining the archeological evidence, historical encounters with Europeans and the legal/constitutional position of Indigenous peoples. The third module is similarly problematic.

For many Indigenous teachers, like me, it’s important to ensure that Indigenous voices are used at least as much as non-Indigenous ones, and Indigenous expertise is visibly valued. That was obviously not a preoccupation for the module producers.

The context: The training should address the existence of systemic discrimination and racism in the health-care system, recognized by the Viens Commission and the coroner’s report on the tragic death of Joyce Echaquan. Neither report is mentioned. We know that Premier François Legault has refused to admit the existence of systemic racism in Quebec. But does that mean that government-mandated training cannot even suggest that some people believe it exists?

Finally, the omissions: Inuit realities are practically invisible in the obligatory modules. Presenters typically use the generic term “autochtone” (Indigenous) when describing First Nations realities such as the Indian Act, which have no relevance to Inuit. Inuit are roughly 12 per cent of the Quebec Indigenous population and deserve to have our distinct realities fully described.

When I was in Grade 5, in my hometown of Labrador City, my teacher told us in our geography lesson that the “Indians” — the Innu First Nations people — in North West River, my mother’s home community, were living in tents. I objected, and said, no, Miss, they’re not living in tents, they have houses!

My teacher said, you must be confused, it’s written right here in the textbook. I complained afterward to my mother, who said, you’ll have to get used to that; your teacher is a Newfoundlander, they don’t know anything about Labrador.

That dissonance has been part of my life since then: that someone else’s perspective, even an inaccurate one, may be perceived as more valid.

We should do better than that, in 2022. In British Columbia, the First Nations Health Authority, which has a lead role in health care for Indigenous people in that province, has produced and made available 11 Cultural Safety and Humility Action Webinars. They are carefully designed and primarily hosted by First Nations experts.

We need, more than ever, to work to improve the Quebec health-care system, in ways that are intelligent, appropriate and inclusive. Providing misguided obligatory Indigenous awareness training to health-care workers does not do that.


Richard Budgell (Labrador Inuit) is an assistant professor in the Department of Family Medicine at McGill University who teaches about Inuit health. 


The original article can be found in the Montreal Gazette:

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