Bamenim - To Care For

Cultural Safety Training for Health Care Practitioners

Empower Your Practice with Culturally Safe Care!

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Approaches To Learning and Curriculum Content

Glossary of Key Terms

Resources

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What Is This Training?

This training bundle consists of knowledge, tools, and resources aimed to improve and equitize healthcare delivery for Indigenous women and their families.

It works to address racism and discrimination in the healthcare system so that Indigenous women and their families can safely access care.
It applies a gender-based lens and two-eyed seeing approach to content grounded in Indigenous ways of knowing and being and guided by Indigenous approaches to knowledge.
It shares Indigenous women's voices, healthcare needs, stories, and experiences from ONWA’s Chapters and Councils across the 4 directions of Ontario.

Why This Training, Why Now?

What we have heard:

Indigenous women face systemic racism in healthcare settings, creating serious barriers to accessing safe, respectful, and equitable medical care.
The national crisis of Missing and Murdered Indigenous Women and Girls (MMIWG) remains unresolved, and Indigenous women continue to go missing and are murdered at alarming rates across Canada.
The scope of cultural competency training is often broad and lacking an Indigenous gender-based analysis that centers the lived experiences of Indigenous women.
Institutional racism is a public health crisis.
To help change this reality, this training is a call to action- a movement towards equitable, culturally safe healthcare experiences for Indigenous women and their families.

We hope that learners come away from this training with:

Information
Knowledge
Understanding
Sense of empowerment
Tools and Know-how
Commitment for change in practice

What Is Cultural Safety?

In the context of healthcare, true cultural safety is achieved when Indigenous women feel safe, respected, valued, and empowered in every space they enter. It is about ensuring that patients feel heard and supported without fear of racism, judgment, or discrimination when seeking care.
It requires a conscious effort to recognize and address power imbalances within systems, relationships, and institutions.
It requires critical self-reflection, accountability, and a commitment to equity and respect in every interaction. It ensures that Indigenous women and their families are treated equitably free from racism and discrimination regardless of their cultural background, identity, or lived experiences.

How Will This Transform Your Practice?

Unlock the Benefits of Culturally Safe Care:

Deliver healthcare that honors the unique needs of Indigenous women and families through cultural competence and humility.

Skills and Insights You'll Gain:

Historical Awareness: Recognize the connection of colonialism and intergenerational trauma, to provide a culturally safe and supportive space for Indigenous women and families.
Reconciliation: Develop skills to actively participate in reconciliation efforts and dismantle racism within healthcare.
Patient-Provider Relationships: Foster mutual patience and respect in every interaction.
Cross-Cultural Understanding: Appreciate, respect, and integrate Indigenous perspectives, knowledge systems, and ways of being into your healthcare practice when needed to support more inclusive and culturally responsive care.
Enhanced Communication: Enhance active listening, empathy, and cultural sensitivity communication techniques.
Trust Building: Build trust in healthcare settings through consistency, trustworthiness, transparency, and active listening.
Foster Diversity: Promote racial and cultural diversity across all levels of the organization. Create inclusive spaces that encourage respectful, positive interactions and value the unique perspectives and contributions of Indigenous women, families, and communities.
Empower Clinicians to Combat Bias: Empower clinicians to combat bias by equipping healthcare providers with the skills necessary to prevent racial bias and deliver equitable, unbiased care.

Approaches To Learning and Curriculum Content

Learning is a journey, not a destination—and in this curriculum, that journey is guided by the medicine wheel and traditional Indigenous teachings. The four directions of the wheel—East, South, West, and North—offer gifts of vision, knowledge, reason, and action, reflecting the spiritual, emotional, physical, and mental aspects of our growth.

Rooted in the wisdom of the Four Sacred Medicines, key life stages, the Creation Story, Feather Teachings, and the Belly Button Teaching, this approach honours the interconnectedness of all living things. Together, these teachings shape a holistic path of learning, healing, and cultural reclamation.

Module 1: Building Brave Spaces

Themes:

Courage & Bravery | Relevance | Cedar | Infancy & Motherhood

Learning is a journey guided by relationships, values, and respect. In this first module, we draw upon the eastern direction of the medicine wheel — the place of vision, new beginnings, and spiritual insight — to set the foundation for learning. This is where we prepare the heart and mind to bravely examine colonial legacies and move forward with compassion and purpose.
This module centers on courage — the courage to witness truth, to challenge systems, and to create safer, more inclusive spaces for Indigenous women and families during some of their most vulnerable moments: childbirth, motherhood, and healing.

Learning Objectives:

Understand the impact of birth alerts and evacuations on the health and well-being of Indigenous women and their families.
Explore patient-centered approaches to maternity care, including the significance of the Maternity Calls to Action, in enhancing Indigenous maternal health outcomes.
Understand traditional medicines and birth practices and explore how they can be integrated into a two-eyed seeing approach to ensure culturally safe care for Indigenous women.
Explore ways to incorporate cultural practices and values to create brave spaces where women feel empowered to express their thoughts, experiences, and identities without fear or judgment.
Develop skills in cultivating empathy through active listening and dialogue to improve the patient-care experience for Indigenous women and their families.

Module 2: Honouring Stories & Strength

Themes:

Humility | Respect | Tobacco | Elderhood

As we move into the southern direction of the medicine wheel, we are guided by the gift of knowledge—a space for learning, listening, and relationship-building. This module invites us to honour the lived experiences and deep resilience of Indigenous women, many of whom carry the weight of intergenerational trauma and systemic discrimination.
Grounded in the teachings of humility and respect, and with tobacco as a symbol of connection and truth-telling, this module centres Elder wisdom and story-sharing as powerful tools for healing and transformation. Here, we reflect on the past not to dwell in it, but to better understand the present and our shared responsibility in creating culturally safe care.

Learning Objectives:

Understand how past trauma, like colonization and residential schools, affects how Indigenous women and families experience healthcare today.
Gain knowledge of the significant roles Indigenous women held in their communities before European contact and the impact of colonization on these roles.
Explore how cultural humility in healthcare builds trust, respects cultural values, and helps address past trauma and healthcare inequalities.
Learn the key principles of trauma-informed care and how to apply them in healthcare settings when caring for Indigenous women and families.
Understand and use strength-based approaches to support empowerment and healing, helping Indigenous women and families feel valued, capable, and in control of their own health and well-being.
Explore how respect is demonstrated in healthcare with Indigenous patients by listening, understanding, and valuing their worldviews and practices.

Themes:

Truth & Wisdom | Responsibility | Sweetgrass | Adulthood

In the western direction of the medicine wheel, we are guided by the gift of reason and the life stage of adulthood, where responsibility and accountability come to the forefront. Sweetgrass—used for healing and purification—reminds us that truth-telling must be met with clear intention and grounded action.
This module calls participants to confront hard truths about how colonialism, racism, and gender-based discrimination continue to shape healthcare systems. It challenges us to hold space for wisdom, to take responsibility, and to shift our focus from individual bias to institutional transformation.

Module 3: Holding Systems Accountable

Learning Objectives:

Understand how colonialism and gendered stereotypes and biases manifest in healthcare settings and the impact they have on Indigenous patient care, trust, and access to services.
Explore dehumanization in healthcare and how it negatively impacts Indigenous patients' dignity, autonomy, and health outcomes.
Identify the unique social determinants of health (SDH) affecting Indigenous gender and sexual minority populations, including systemic barriers, discrimination, and healthcare inequality.
Explore strategies for integrating anti-racism into healthcare practice to promote equity, dignity, and cultural safety for Indigenous patients.

Module 4: Practicing Accountability in Action

Themes:

Love & Honesty | Reciprocity | Sage | Childhood & Adolescence

In the northern direction of the medicine wheel, we are guided by the gift of action—the movement toward balance, healing, and right relationship. This is also the place of childhood and adolescence, a life stage marked by growth, learning, and truth-seeking. Sage represents clarity, protection, and the renewal of spirit—reminding us that care rooted in love and honesty has the power to transform.
This module focuses on how we move from learning into doing. It explores the role of healthcare providers in recognizing harm, disrupting patterns of neglect, and advocating for systems that prioritize the dignity and safety of Indigenous patients. Love, honesty, and reciprocity guide this work, helping us build relationships based on trust, care, and mutual respect.

Learning Objectives:

Identify strategies for healthcare professionals to recognize and address power dynamics, fostering more equitable, culturally safe, and patient-centered care for Indigenous individuals.
Explore patterns of neglect and harmful delays in healthcare that disproportionately affect Indigenous patients, and the root causes of these issues within healthcare systems.
Understand the Pyramids of Love and Hate as frameworks for exploring the continuum of behaviors that can either uplift or harm individuals, particularly within healthcare contexts.
Understand allyship and advocacy in the context of Indigenous healthcare and the role of healthcare professionals in addressing systemic inequities, confronting racism, and advocating for the rights and needs of Indigenous women and families within healthcare systems.

Glossary of Key Terms

Cultural

Medicine Wheel

The Medicine Wheel is a holistic guide to well-being and balance across all aspects of health. While symbolism varies by community, it commonly includes teachings tied to the four seasons, directions, life stages, sacred medicines, elements, and animal guides.

The East represents love, new beginnings, and the arrival of spring—symbolizing birth, rebirth, and connection to new life, especially children. It grounds us in spirituality, offerings, and our responsibility to care for the Earth. Tobacco, a sacred medicine, sits in the East.

The South symbolizes learning, emotional expression, and the breath of life. As spring turns to summer, it reflects growth, youth, and self-discovery. It fosters love, loyalty, justice, and compassion while guiding us to protect and nurture the young. Sage sits in the South.

The West represents the physical self, strength, water, and feminine life-giving energy. As summer fades into fall, it teaches patience, healing, and perseverance through adulthood. It offers personal and communal protection. Cedar sits in the West.

The North brings wisdom, rest, and ancestral guidance. As fall turns to winter, it is a time of stillness, reflection, and the elder phase of life. It emphasizes truth, humility, and the full circle of life. Sweetgrass sits in the North.

The circle reflects natural cycles, relationships, and equality, embodying the Indigenous teaching “All my relations.” While not all First Nations, Métis, or Inuit use the medicine wheel, the core belief is shared: health includes spiritual, emotional, mental, and physical aspects. True well-being comes from balance in all four directions—body, mind, spirit, and heart.

Mino-Bimaadziwin

Mino-Bimaadziwin, or “the Seven Stages of Living the Good Life,” is an Anishinaabe framework for personal growth and community harmony. It emphasizes fulfilling original instructions, following the Seven Grandfather Teachings, and learning life’s lessons at each stage. These teachings—rooted in kindness, truth, generosity, and strength—guide both Indigenous and non-Indigenous people toward a respectful, balanced life

The Seven Grandfather Teachings

These Anishinaabe principles support minobimaadiziwin—a good life in balance with Creation. Though adapted by different communities, they remain foundational in promoting integrity, connection, and well-being.

Truth (Debwewin) – Represented by the turtle, truth means living with honesty and integrity, grounded in personal experience.
Humility (Dabaadendiziwin) – Taught by the wolf, humility is recognizing our equal place within Creation and living selflessly.
Respect (Mnaadendimowin) – Modeled by the buffalo, respect is acknowledging the value of all life and acting with care and balance.
Love (Zaagidwin) – Shown by the eagle, love is unconditional and rooted in peace, self-worth, and community care.
Bravery (Aakwa’odeewin) – Symbolized by the bear, bravery means facing challenges with a strong heart and standing for what is right.
Wisdom (Nbwaakaawin) – The beaver teaches us to use our gifts for the greater good through thoughtful, purposeful action.
Honesty (Gwayakwaadiziwin) – Represented by the giant, honesty is being true to oneself and living with authenticity and integrity.

Traditional Medicines

Indigenous women have the right to services that support a healthy, fulfilling life. Reconciliation blends evidence-based and Indigenous approaches, alongside Western practices, to promote holistic healing for women, families, and communities.

Traditional medicine, recognized by the WHO, plays a key role in this healing, addressing physical, emotional, mental, and spiritual well-being.

This curriculum highlights four sacred medicines:

Tobacco: Used to communicate with the Spirit World.
Sage: Cleanses and brings calm, clarity, and protection.
Cedar: Purifies and protects against negativity.
Sweetgrass: Symbolizes love, kindness, and unity.

The Four R’s: Guiding Principles of Our Training

Rooted in Indigenous ways of knowing and being, this training is built upon the Four R’s — Reciprocity, Responsibility, Respect, and Relevance. These guiding values ensure that the curriculum is not only culturally grounded but also meaningful and empowering for Indigenous women and the communities they serve.

Reciprocity

Building strong relationships
Community engagement
Respecting nature’s gifts

Responsibility

Fostering ownership and agency within healthcare providers

Respect

Cultural sensitivity
Elder and Knowledge Keeper involvement

Relevance

Addressing community needs
Integration of indigenous knowledge systems

Wholistic Healing

Wholistic healing is an Indigenous framework for wellness that sees all parts of a person - mind, body, heart, and spirit - as connected. When one part is harmed, the whole being is affected. Healing must therefore support all aspects, not just physical symptoms or emotional pain.

In the words of Renée Linklater, this approach acknowledges the collective impacts of colonialism, intergenerational trauma, and systemic violence, while also centering culture, ceremony, and community as essential parts of the healing journey.

Two-Eyed Seeing

Two-Eyed Seeing, introduced by Mi’kmaq Elders Dr. Albert and Dr. Murdena Marshall and Professor Cheryl Bartlett, is the practice of viewing the world through both Indigenous and Western perspectives. It values the strengths of both knowledge systems, encouraging respectful integration to solve problems holistically. This approach promotes cultural diversity, collaboration, and sustainable solutions.

Cultural Humility

Cultural humility is a lifelong journey beyond cultural competency, which involves building awareness and skills to engage respectfully across cultures. It means:

Continuously reflecting on and challenging personal biases
Acknowledging harm caused by cultural ignorance or assumptions
Committing to ongoing learning and accountability

Rather than a final goal, cultural humility is about approaching every interaction with openness, respect, and a willingness to grow.

Systems of Oppression

Colonialism

Colonization occurs when groups invade Indigenous lands, seize resources, impose laws that violate Indigenous rights, suppress their governance and culture, and force assimilation into the colonial state (e.g., Champlain’s 1608 settlement at Quebec City).

Decolonization

Decolonization is the active resistance to the exploitation and control of Indigenous bodies, lands, and minds. It involves dismantling oppression and rebuilding respectful, accountable relationships.

It requires both Indigenous and non-Indigenous engagement, with non-Indigenous people learning about colonial history, reflecting on their roles, and challenging complicity.

At its core, decolonization is about changing relationships and supporting Indigenous communities to reclaim languages, cultures, governance, and land. It embraces complexity while committing to transformation.

Reconciliation

Reconciliation is an ongoing, shared process of building respectful relationships between Indigenous and non-Indigenous peoples in Canada. It requires acknowledging past harms, taking responsibility, and committing to truth, justice, and meaningful change.

It involves learning Indigenous histories, respecting cultures and rights, and challenging racism and stereotypes. Reconciliation is about solidarity, healing, and mutual respect—not guilt, blame, or one-time actions.

Together, we must act with honesty and courage to create a just and equitable future for all.

Genocide

Genocide, as defined by the UN, is any act intended to destroy, in whole or part, a national, ethnic, racial, or religious group. This includes killing, causing harm, forcing conditions to destroy the group, preventing births, or forcibly transferring children.

Genocide involves not just mass killing but also cultural and systemic destruction aimed at erasing a group’s identity and future. Understanding genocide is key to recognizing the lasting effects of colonization and systemic violence worldwide, including in Canada.

Forced Sterilization

Policies aimed to prevent those deemed “mentally defective” from reproducing were forcibly applied to Indigenous mothers through residential schools. Forced sterilizations occurred from 1929 to 1972, preventing Indigenous women from conceiving or raising children.

These sterilizations were part of systemic discrimination that continues today—such as a 2019 case where a woman was sterilized without full consent. Forced sterilization is recognized as cultural genocide under the UN Convention on Genocide (1948).

Patterns of Neglect

Neglect in health care can take many forms, often falling into two main categories: procedural and caring neglect.

Procedural neglect occurs when care fails to meet established professional or institutional standards—such as ignoring protocols or regulations. This may result from individual disinterest or systemic breakdowns.

Examples include:

Failing to feed, hydrate, or turn a bed-bound patient
Neglecting hygiene or basic medical care

Caring Neglect involves behaviors that, while not breaking formal rules, signal a lack of empathy or attentiveness. These acts may not cause immediate physical harm but can deeply affect a patient's sense of dignity and safety.

Examples include:

Not being helped to eat
Having concerns dismissed
Being treated without compassion or respect

Both forms of neglect undermine trust and can cause lasting emotional and physical harm.

Bias

Explicit bias refers to conscious attitudes or beliefs we hold about certain groups. These biases are known to us, often expressed openly, and can include overt acts like racist comments or behaviors.

Implicit bias works unconsciously, shaping how we see and treat others based on race, gender, age, and more, often without awareness. It leads to unequal care, harming patient trust and quality, even among those who reject prejudice.

Addressing both implicit and explicit bias requires honest reflection and intentional action to ensure fair, respectful care.

Stereotypes

Stereotypes are oversimplified beliefs about people based on traits like age, gender, or race. They act as mental shortcuts but often lead to unfair generalizations, limiting how individuals are seen and treated. For example, sexual stereotypes impose limiting roles on boys and girls. While everyone holds stereotypes, it’s important to recognize and challenge them to improve our interactions.

Assimilation

Assimilation refers to a deliberate colonial policy designed to extinguish Indigenous ways of life and forcibly incorporate Indigenous Peoples into the dominant Canadian settler society. It involved laws, such as the Indian Act, and systems like residential schools, child welfare policies, and land dispossession. The ultimate goal was to eliminate Indigenous sovereignty, cultures, and identities in favor of conformity to Euro-Canadian norms and values. Although officially renounced in 2008, assimilation remains embedded in many of Canada’s legal, political, and social structures today.

Power and Privilege

Power is the ability to influence decisions and control resources, often held by individuals or groups in dominant positions.

Privilege is the unearned advantage or access granted to people based on their social identity (such as gender, race, or class).

In healthcare, power and privilege can shape who is heard, believed, or valued—often disadvantaging Indigenous women in systems built without their voices.

Gender-Based Violence

Birth Evacuation

Birth evacuation is a federal policy forcing many Indigenous women, especially in remote areas, to leave their communities weeks before birth. Though called a safety measure, it denies access to culturally safe, local care and is rooted in colonial and patriarchal systems.

This practice causes emotional, cultural, and physical harm, exemplifying institutional racism in healthcare. It disrupts family bonds, violates bodily autonomy, and perpetuates intergenerational trauma tied to historical policies like the Indian Act.

Social Justice

Allyship

Allyship is the active use of privilege and power to support justice and dismantle oppression. True allies:

Challenge systems of oppression
Advocate for inclusion in dominant cultural spaces
Stand with those affected by discrimination

Authentic allyship involves self-education, acting alongside marginalized communities, and stepping back when those with lived experience lead. Indigenous peoples are the experts of their own histories and futures.

Brave Spaces

Brave Spaces are environments where individuals feel empowered to share their thoughts and experiences without fear of judgment. These spaces foster open dialogue, especially on complex topics like race, gender, and discrimination, and are rooted in mutual respect. They encourage vulnerability, challenge biases, and promote healing, with clear agreements ensuring safety and participants committing to active listening, empathy, and meaningful engagement.

Health and Ethics

Integrity in Healthcare

To apply a holistic understanding of integrity in your practice, integrating honesty, accountability, and alignment with cultural values and principles. This includes adhering to teachings from Elders, respecting traditions, and honoring the connection to the land and community.

Trauma-Informed

A trauma-informed approach recognizes the ongoing impact of both historical and current trauma, especially the effects of colonialism—on Indigenous women, families, and communities.

Instead of asking “What’s wrong with you?” it asks, “What happened to you?”
This shift helps healthcare providers respond with empathy, understanding that behaviors often stem from deep, intergenerational trauma.

Trauma-informed care means:

Acknowledging the effects of colonial violence, displacement, and systemic oppression
Building trust through cultural humility and respectful relationships
Creating safe, supportive spaces where people feel seen, heard, and valued

Patient-Centred Care

Patient-centred care is an approach that prioritizes respectful, compassionate, culturally appropriate, and competent care. It is rooted in responsiveness to the unique needs, values, beliefs, and preferences of clients, patients, and their families.

Rather than delivering care to or for individuals, patient-centred care emphasizes working with clients and families, partnering in decision-making, goal setting, and healing journeys.

Resources

Explore a collection of teachings, articles, videos, and creative works that support your learning toward culturally safe care.

You Are The Medicine by Asha Frost
Braiding Sweetgrass – Robin Wall Kimmerer
Decolonizing Trauma Work: Indigenous Stories and Strategies by Renee Linklater
Indigenous Healing Psychology: Honoring the Wisdom of the First Peoples - Richard Katz Ph.D
The Inconvenient Indian – Thomas King
The Four Agreements – Don Miguel Ruiz
Stories of Metis Women-Bailey Oster & Marilyn Lizee
Inuit Stories of Being and Rebirth-Bernard Saladin d’Anglure
True Reconciliation- Jody Wilson-Raybould
Kaandossiwin How We come to Know Indigenous re-Search Methodologies-Kathleen Absolon (Minogiizhigokwe)
Indigenous Research Methodologies

Partners

This project was made possible through the financial support of Health Canada and Ontario Health.

Disclaimer: The views expressed herein do not necessarily represent the views of Health Canada or Ontario Health.