Montreal's first culturally safe medical clinic

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Montreal's first culturally safe health clinic for Indigenous people officially opened Friday in the Sud-Ouest district.

With its holistic approach, the Montreal Family Clinic will meet a variety of health needs in addition to existing local Montreal services, as well as preventive and global community health.

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“So it's not just a clinic,” said Philippe Tsaroncere Meiller, executive director of Native Montreal. “When members come to our center, they can access it through the language program, the intervention program, the case workers, or they hear about the clinic and come to see a doctor.”

Funded by the Quebec government, the center works with various health partners in the region under a shared responsibility model. Doctors and nurses are provided by local Montreal frontline partner GMF-U de Verdun, Mailleur said.

“This team works in synergy with our clinical staff, including the director, coordinator, health navigator and medical secretary, as well as several psychosocial workers we call navigators,” Meylor said. “Together, they can offer health screenings, chronic disease monitoring or blood samples under one roof, breaking down certain logistical barriers.”

The team also liaises with other facilities and provides culturally appropriate continuity of care for patients if out-of-hospital services are needed, Meiller explained.

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“For too long, our community has faced ignorance of its needs, issues of access, and experiences of discrimination and racism,” she said. “These collective and intergenerational traumas have widened the distrust gap and pushed our people away from traditional health care structures. Therefore, it is very important not only to ensure access to health services, but also to ensure preventive health to eliminate the impact between generations.”

Local Montreal estimates that the Greater Montreal area is home to about 35,000 Indigenous people, including 13,000 on the island. Meiller said he hopes the clinic will be able to meet the needs of the community in terms of capacity.

Decorated with local folk art, the center has an exam room for doctors; a room for nurses for observation, assessment and laboratory work; a cedar room where elders and guardians of knowledge can conduct various cultural practices; and several additional, mixed rooms for mixed workers.

Meilleur was joined Friday by Jan Lafreniere, Quebec's minister responsible for relations with First Nations and Inuit, who said the clinic makes “a lot of sense” given the urban reality of some indigenous communities.

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“There are a few thousand people living in Montreal who are moving in and out,” he said. “This requires culturally tailored services, services. What does this mean? … It means giving them a warm welcome. This means ensuring that the system meets their needs, not their needs. This is the simplest way I can talk about cultural safety.'

Lafreniere referred to Bill 32, proposed in 2023, which would require health and social services agencies across the province to “adopt a culturally safe approach to Indigenous peoples, taking into account their cultural and historical realities in all interactions with them.”

“This is a commitment that (Health Minister) Christian (Dube) and I have made together to bring cultural safety to the health world,” Lafreniere said.

The bill was introduced in the context of the upcoming overhaul of the health care system and in connection with the 2020 death of Atikamekw woman Joyce Echaquan, who was beaten by hospital staff before her death in a Quebec hospital.

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“We were electrocuted by what happened in the Joyce Echaquan incident,” Lafreniere said. “Several local people told me 'you're waking up because you can see it; We have been telling you for years.”

Dube, who was also present Friday, said the clinic's holistic, approachable approach — the concept of a “navigator” who can direct patients to appropriate services — is something he wants to keep in mind as he redefines its meaning. Front-line services in the overhaul of Quebec's health care system.

“The way our health care system works right now is those who can get to the front lines,” he said. “But that doesn't mean we've served them all.”

In response to Dube's enthusiasm for the logistics of the project, Tanya Sirois, executive director of the Regroupement des cents d'amitié autochtones du Quebec, said indigenous peoples and Quebec could learn a lot from each other.

“I have an Innu mother, a Québécois father, and I believe that two cultures can coexist,” she said. “In values, know-how and diverse knowledge. So, how can we marry him and ensure that this marriage is a happy one and also beneficial to society as a whole? Because a healthy local population makes a healthy society. Quebec society and everyone will benefit from it.”

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