Roberta Pike, Director, St. Michael’s Indigenous Wellness Centre
As we mark National Indigenous History Month, we’re taking a moment to look back on the first year of St. Michael’s Indigenous Wellness Centre (IWC). We spoke with the Centre’s Director, Roberta Pike, about what it has made possible, the lessons learned along the way, and what comes next.
As we mark one year since opening, what’s been on your mind lately? What feels most important to reflect on right now?
We’ve had a lot of success this year. We’re building a space where patients, staff, and community members feel welcome to come and learn with open hearts and minds. We’ve hosted workshops, seasonal ceremonies, panels, and "Smudge N’ Talk" sessions, but people will also pop in for a tea and a quick chat.
At the same time, real change is slow. It’s taken a long time for Indigenous people to begin to have voice and to be heard in the Canadian healthcare system, and as a leader in a non-Indigenous organization, I have to come to terms with that. As passionate as I am about my work, I have to temper my expectations because it’s going to take a while to see the kind of change we’re looking for.
I’m grateful to the Krawczyk Family Foundation for recognizing this and for giving us the time and space to lay a solid foundation. It goes back to that principle of seventh-generation thinking: that what we do now will have an impact on seven generations into the future. I'm hoping by the time I retire that the health outcomes for Indigenous people at our hospital sites will have significantly improved because of the foundation we're laying now.
Can you tell us about a particularly meaningful program or event from the past year?
We recently hosted a renal cooking class here. From the limited data we have, we know that renal disease and diabetes are two of the leading reasons Indigenous people get admitted to our hospital, so we’re building programming that’s responsive to those needs. We brought in our dietitians, who prepared some healthy dishes and discussed the nutritional benefits of the ingredients. The IWC has a fully functioning kitchen, which is wonderful for programming like this. Participants had the opportunity to ask questions specific to their renal status—whether they were on dialysis or post-transplant—and to get answers tailored to their health needs.
We’re looking forward to doing more of this—harnessing data to better understand why Indigenous patients are coming to the hospital and what kinds of prevention or early intervention programs we can offer in collaboration with what’s happening in the community.
How has the community shaped the Centre?
Everything we do has community involvement. We've made sure of that since the beginning, when we planned the community engagements that led to our Indigenous Voices report. As an Indigenous person, I have an opinion. But I'm only one person. So, I need to hear the voices of people who are using the system and those who are supporting our community members here within the hospital. We need to make sure that the community advises us on all the work we're doing and that we're always moving forward, thinking about the benefits to them, their families, and future generations.
What has this first year shown you—about what people need, and what meaningful care really looks like?
We’re seeing our Indigenous patients stay in the hospital anywhere from three to five times longer than the average patient. That speaks to the level of complexity they are dealing with in terms of health and well-being. They often wait longer to come to the hospital, so they are showing up sicker than the average person. And they may have a primary reason for admission but also have multiple comorbidities that need to be managed.
A first step is just truly understanding that there are a lot of things that Indigenous people are trying to cope with. And it's not their fault. It’s the legacy of intergenerational trauma. We want to support people in seeing a healthy and vibrant future for themselves, finding their purpose in life, and not giving up.
Part of what's been lost to Indigenous people is the connection and understanding of what our life, purpose, and role are on this earth. We are spirit beings in a physical body. Sometimes that physical body breaks down and being able to heal not just the physical stuff, but also the emotional, mental, and spiritual aspects of our beings is a critical part of why this program is successful.
Where do you see gaps that still exist? Where do we need to keep doing better?
I think one of the challenges is offering what have been largely community-based services within the hospital. Our traditional healers, elders, and ceremonialists don’t exist in hospitals. Yet it’s essential for this westernized system to see the benefits of working within a different framework, a different spirituality, and to understand what wellness really means to Indigenous people. Our medicines and ceremonies have real benefits, but it's hard to convince a system that doesn’t understand the internal shifts that happen through offering ceremony.
This year, we started offering Smudge N’ Talk sessions at the Centre, where we host hospital staff in a sharing circle and offer teachings on the benefits of our medicines and ceremony. What it means to be able to smudge at the bedside, when you're in a place that historically has not been kind to Indigenous people, in terms of calming anxiety alone is phenomenal. To know that there are people there to support you, that understand your experience without you having to explain anything, and to have those ceremonies reduces a lot of anxiety and fear about symptoms, diagnoses, surgery risks, and what the next steps might look like.
The Krawczyk Family Foundation made a transformational gift last year to help light the way for Indigenous-led care at every level. What would you want them to understand about the impact their support is having?
You know, even a little bit of change can make a big difference. Our team can provide transportation because of donor funds and just getting folks here to be seen—most people don’t understand how big a deal that is. When we have a patient who comes in super sick, and they’re not doing well, seeing them go back home into the community much better than how they landed here, with so many more supports than they had when they came into the hospital, that's pretty rewarding.
This is a busy city, and there are services and supports out there, but many people are isolated, and they don't have a lot of trust. Being able to build relationships where people can come back and know they'll get the help they need is amazing. It feels really good to be able to see people in the community live the type of life that they are hoping for.
What are you focused on building or deepening next?
Over the next year, I'm looking forward to working with the community and our partners to map out the areas we want to focus on and put together Unity Health's Indigenous Health Plan. Hospital leadership has been extremely supportive of ensuring that Indigenous health is called out in the new strategic plan. That will give us even more traction going forward to doing the work we need to do to make a real change. And I see the change as beneficial not only to Indigenous people but to all people who experience barriers within our system.
We know these things won't happen overnight. It will take time, but I am looking forward to having three beautiful sites with lots of programming, where the communities surrounding us feel engaged and know that this is a place where they are welcome and are safe to seek care.
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