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Cultural Safety & Humility
Changing how we care
Introduction
In 2020, the BC Ministry of Health commissioned a review of Indigenous-specific racism in the provincial health care system, which resulted in the release, on November 30, 2020, of a summary and full report entitled In Plain Sight: Addressing Indigenous-Specific Racism and Discrimination in B.C. Health Care. The In Plain Sight report is a deep examination of the problem of Indigenous-specific racism in BC’s health care system. The full report concludes with 24 recommendations, which are introduced with the following words:
Addressing Indigenous-specific racism in B.C.’s health care system as identified in this report requires attacking the roots of the problem.
Despite progress and efforts made, the current health care system continues to reflect the legacy of colonialism. This legacy enables and permits systems, behaviours, and beliefs in which racism and discrimination against Indigenous peoples remain.
The work of addressing the impacts of colonialism and Indigenous-specific racism is known as decolonization. A commitment to decolonization requires the recognition that colonialism has harmed and compromised the lives of Indigenous peoples through the taking of their lands, the suppression of their culture, and the forced requirement that they conform to the structures of the colonial state. Decolonization requires understanding Indigenous history and acknowledging the truth and consequences of that history.
Ultimately, the goal of decolonization is to create cultural safety and a society in which Indigenous people can thrive. A culturally safe environment is one that is physically, socially, emotionally, and spiritually safe. It is an environment in which cultural identities are recognized and respected, without challenge or denial. Cultural safety goes hand in hand with cultural humility, which for health professionals
[…] begins with an in-depth examination of the provider’s assumptions, beliefs and privilege embedded in their own understanding and practice, as well as the goals of the patient-provider relationship. Undertaking cultural humility allows for Indigenous voices to be front and centre and promotes patient/provider relationships based on respect, open and effective dialogue and mutual decision-making.
In Plain Sight, full report, page 8
Commitment
CMTBC commits itself to this work as the regulator of a health profession that provides touch-based therapy to the public.
It is essential for all health professionals, including RMTs, to acquire deep understanding that intergenerational trauma and abuse has a lasting effect on Indigenous peoples. The work begins by learning about the history of colonialism and Indigenous-specific racism.
Building trust is the cornerstone of the therapeutic relationship. Massage therapists are trusted by their patients to address pain, ease physical limitations, and improve physical function, and they do so through touch. Therapeutic touch can be helpful, but touch can also trigger trauma responses and other harms. It is also the responsibility of each health professional to approach their work with cultural humility and curiosity, and to create the environment for cultural safety. Providing equitable opportunities for respectful and positive health outcomes for Indigenous peoples must be the goal of decolonizing health care.
Action
- As we approach the second National Day for Truth and Reconciliation on September 30, CMTBC’s Board makes the following commitment to action. Our commitment acknowledges that intergenerational trauma and abuse cannot be corrected until each of us – individuals and organizations – understands why we have a role to play in changing how we care.
CMTBC acknowledges that:
- It is time for us to address the consequences of intergenerational abuse and trauma of Indigenous peoples.
- Silence is harmful and affects Indigenous people seeking care, affects RMTs who self-identify as Indigenous, prevents us from learning from each other, and affects our staff and volunteers on whose input we rely.
- Massage therapy, through touch, has the potential to further traumatize when it is provided without care and attention to complex trauma and the backdrop of cultural safety.
- Cultural humility begins with us and will be demonstrated in our actions: we will act with humility and a commitment to creating cultural safety for Indigenous peoples.
CMTBC commits to continuing to educate Board members, committee members, and staff in cultural safety and humility, unconscious bias, and trauma-informed care. Further, CMTBC’s Board begins its strategic planning for 2023 and beyond with a committed focus on evaluating its structure, standards, and processes with respect to Indigenous peoples. CMTBC has already taken steps to sustain a climate for change by recognizing unceded territory in formal regulatory proceedings such as inquiry and discipline hearings and providing training to Board members and staff.
CMTBC has developed this Cultural Safety & Humility section of the CMTBC website as a new resource for registrants to support meaningful engagement and learning with respect to Indigenous anti-racism and cultural safety and humility. This resource includes a timeline providing a brief history of institutional and systemic racism directed at Indigenous peoples. Next, it sets out the principles of cultural safety and humility, and provides RMTs with guidance on how these principles can be applied to massage therapy practice. To learn more about cultural safety and humility, selected resources are also provided.
Cultural humility requires that CMTBC commits to change, to reflect on its assumptions, biases, and processes, and to learn from Indigenous guides, Knowledge Keepers, and Elders.
We begin here. There is much work to do.
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