By Nicole O’Reilly
Jodi Rock likes to think of herself as “piggybacking” clients as they navigate the health system.
Sometimes that means holding their hand during a doctor’s visit, or helping set up transportation, or getting them into post-discharge programs. As Hamilton’s inaugural aboriginal patient navigator she “bridges the gap” between local members of the aboriginal community and health-care providers.
“We service cradle to grave, all ages, all diseases, we look at all aspects of health: physical, mental, emotional, spiritual,” she said, adding that unlike other programs they focus on the whole family.
Rock is one of three navigators being funded through the Hamilton Niagara Haldimand Brant Local Health Integration Network as part of the Aboriginal Health Network.
The other two navigators are in Brant and Niagara. The program received $ 94,950 for this fiscal year to get it off the ground. It then gets $ 242,400 in annual base funding to keep the program running.
When Rock began her job in March, there was already a wait list of people who had heard about the service through word of mouth.
Since then, she’s met with upwards of 70 people a month.
The program is run through the De dwa da dehs nye>s Aboriginal Health Centre on Main Street East, which offers health care — both traditional and western — to the local aboriginal population. But Rock is based out of the Hamilton Regional Indian Centre on Ottawa Street North, with the idea of being highly visible in the community.
“This is a program that is getting people to the right care, at the right time and place and prepares them for a healthier life both short and long term,” said Donna Cripps, CEO of the HNHB LHIN.
The program works with an existing aboriginal patient navigator who deals exclusively with cancer patients at Juravinski Cancer Centre.
Rock says her job is to help patients and their care providers overcome barriers. But it’s also about educating them on how diseases affect the community differently.
A first-of-its kind study released in July looked at Hamilton’s urban aboriginal population and access to health care. Speaking with 554 community members referred through De dwa da dehs nye>s, it found staggering poverty and higher rates of chronic diseases.
“The reality is any of those diseases affect our people differently: cancer, diabetes, our people are struggling more with mental health and addiction,” Rock said. “That’s our reality.”
She said cancer hits the aboriginal community “earlier, harder and faster.”
This idea has been central in two high-profile cases involving aboriginal girls with leukemia who stopped chemotherapy at McMaster Children’s Hospital in favour of traditional medicine.
In one of the cases, the hospital has taken Brant Children’s Aid Society to court, arguing the child welfare agency should have intervened and forced the child to have chemotherapy.
De dwa da dehs nye>s cannot comment on those cases, but Tara Williams, manager of advocacy and outreach services at the health centre, said there is not a growing trend of people rejecting Western medicine for treatment of terminal illnesses.
Rather, they often take a collaborate approach to health-care, weaving Western and traditional methods and relying on culturally specific programs for general health and well-being.
The whole idea of the patient navigator program is to help community members help themselves, Williams said.
“We try to let our people plan their own care … ultimately it’s their choice.
“The philosophy is to ensure our community members have access to the best culturally appropriate health care and supportive services as possible and to identify some of those barriers in service,” she said.
Rock said there is concern about the McMaster Children’s Hospital cases causing some mistrust in the local aboriginal community, a rift she is trying to mend by convincing the community it is still safe to go to hospital.
Ontario Court Justice Gethin Edward, who is presiding over the case, touched on this paradox in court.
“At the end of the day, there needs to be a better effort to work collaboratively. Aren’t we looking at two great cultures? Why do we have to have the antagonism?”
Rock said establishing trust is one of the biggest barriers she helps break. This can be as simple as advising a doctor about eye contact or tone of voice when dealing with a patient.
“For generations we have been second-class citizens, less than … it’s difficult to talk about ourselves,” she said. But this doesn’t mean the patient wants to be difficult, she added.
Williams said it’s a “beautiful thing” when she helps someone gain the confidence and ability to advocate for themselves.
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