Feature: A shared commitment to Indigenous health advocacy

By Alexandra Burza, MMJC’19

The Poole sisters say it started with their mother. Growing up in Wallaceburg, they watched their mom attending nursing school, eventually earning her degree and beginning a career as a registered nurse. They were inspired.

Cassie, MD’20, a family medicine resident and Kristin, Medicine Class of 2024, stepped into their mother’s footsteps with a goal to become family physicians.

“There were a lot of things I really respected about her career as a nurse, such as the opportunities she had to interact with patients,” Cassie said. “But I was drawn to medicine. I believe it will give me the opportunity to not only work closely with patients in the community, but also to address any health or social issues beyond their initial health concerns.”

Cassie says that as a Métis member of a smaller rural community with a large Indigenous population, she was conscious of the challenges and barriers to access and support that some patients experience. Now completing her postgraduate training in Family Medicine, she plans to continue practising locally.

“As someone who is Métis, I bring not only the Western conceptualization of health, which tends to focus on medicine, but I also understand a patient’s health holistically and work with them and their traditions of health,” she said. “I know what type of connections I can provide specific patients to make health care access easier in this area.”

Kristin shares her sister’s passion for longitudinal and holistic care of patients’ health and wellness, and also hopes to specialize in family and rural medicine. At McMaster University, where both sisters earned undergraduate degrees, Kristin was involved in the student-led Indigenous Health Movement, raising awareness and facilitating learning opportunities on Indigenous health care and equity.

“I think it’s important to ensure accessibility to health care, but also accessibility to culturally safe care. Those who are responsible for providing care should be aware and educated on inequities within the communities they are treating, as well as understanding the cultural differences and beliefs of that community,” Kristin said.

When the time came for Kristin to apply to medical school, Cassie, then at the tail-end of her clinical placements at the Schulich School of Medicine & Dentistry, provided valuable insights.

“Watching her go through some of the challenges she faced, and overcoming them, helped me make an informed choice about going into the field,” Kristin explained. “And I really liked the importance of community engagement that I saw at Schulich Medicine, such as the Indigenous MedLINCS program.”

During her time in medical school, Cassie spent two summers volunteering with the MedLINCS program. For six weeks, she lived and worked at Neyaashiinigmiing, or Cape Croker, with the Chippewas of Nawash and Saugeen First Nation communities, helping with nutrition initiatives, running youth programs and getting to know community members.

“Having an understanding of the community where they lived, what kind of access to health care they had, transportation challenges they faced, and hearing their positive and negative stories of experiences they had in health care was a really fantastic learning experience that I’ve carried forward in my clinical practice,” she said.

Cassie says the openness of others in sharing their experiences and perspectives gave her the chance to learn, become a better advocate and speak alongside, rather than on behalf of, other Indigenous voices. Kristin shares her sister’s desire to be an advocate, recognizing it as an important step in decolonizing health care.

“It’s important to recognize that Indigenous voices are marginalized and underrepresented in health care. Significant structural and systemic barriers to Indigenous health continue to create inequities in care,” Kristin explained.

There is a unique opportunity, Kristin says, for Indigenous physicians like her sister to amplify patients’ voices, raising awareness of Indigenous health disparities, cultural practices and social services among colleagues and within health systems.

“My hope for the future of medicine is that Indigenous patients will come away from clinical interactions feeling they were heard and understood,” Cassie said. “That can make such a fundamental difference in how someone experiences health and how they perceive the health care system.”