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Promoting reconciliation in HIV and hepatitis C healthcare through paradigm shifts reflected in new language 

Healthcare is traumatizing to two groups of people.1 One is Indigenous cisgender and transgender women with lived and living experiences (IWLE) of HIV and/or hepatitis C.1 The other is peer navigators (i.e., care providers whose roles are based on living and lived experiences that are similar to those of care recipients).1 Part 2.1 of this series showed that this trauma is rooted in a colonial ideology, which is embedded in healthcare’s definition of and relationship with peer (a group that includes IWLE and peer navigators). Expecting reconciliation, IWLE and peer navigators called for uprooting this ideology so that healthcare would become non-traumatizing.

The Peers4Wellness community (see below) asked: Can healthcare shift its language toward reconciling relationships with Indigenous women and peer navigators? 

This article presents a community story about promoting the language of reconciliation in healthcare. The story does the following: 1) it parses how colonial ideology can thrive in the words peer and equal/equality as encountered by IWLE and peer navigators in healthcare, 2) it explains how these words can literally contribute to the traumatization of IWLE and peer navigators in healthcare, and 3) it guides on decolonizing and Indigenizing the words peer and equal/equality toward a healthcare language that is safe for IWLE and peer navigators. To do the work of reconciliation is to also speak the language of reconciliation. This is the motto of our story (the terms reconciliation, decolonization and Indigenization are defined in the body of the article).

Braiding Voices of reconciliation

This article is part of a series that aims to respond to the Truth and Reconciliation Commission’s Calls to Action and the Calls for Justice of the National Inquiry into Missing and Murdered Indigenous Women and Girls. The series shares learnings from the Peers4Wellnesss project.1 Peers4Wellness is an Indigenous- and peer-led community-based research study in British Columbia (B.C.) on the unceded territory of the Coast Salish peoples. The knowledge shared in the article was gathered during a needs assessment (2017–2021) with the Peers4Wellness community (referred to as the community in this article). The assessment explored the need for Indigenous-centred peer navigation programs in B.C.

This article applies the methodology Braiding Voices, which is influenced by Indigenous storytelling.1–3 The primary storytellers are members of the community. The first and senior authors are the story stewards. Using quotations, the story is written primarily in the first-person voices of the community and Indigenous scholars. The audience is invited to connect with and gain their own interpretation of the quotes. The unquoted text reflects the first and senior authors’ learnings from the community and literature. Braiding Voices honours and privileges the ideas and expressions of the community and Indigenous people.

Synopsis: Reawakening the spirit of peer

IWLE, peer navigators and the Peers4Wellness community at large reclaim the word peer and its essence of equality. The spirit of peer reawakens.

Peer sheds its colonial meaning. Peer is not synonymous with “them.” Peer means everybody or nobody. Peer is not synonymous with unequality [1] in societal status and human rights. Peer means equal. Peer drops sameness as the colonial precondition for equality. Peer adopts authentic connection (a common ground that embraces diversity) as an Indigenous criterion for equality. Peer teaches that equal reflects how we bond together regardless of how similar or different we are. Peer evokes a language that is non-traumatizing for IWLE and peer navigators. Peer nudges healthcare to speak the language of reconciliation. Peer heals from coloniality. Peer invokes Indigeneity of being. Peer helps healthcare decolonize and Indigenize its traumatizing language. 

Story teachings

  1. Reconciliation is a journey to heal relationships between peer (representing a group that includes IWLE and peer navigators) and healthcare. A goal of reconciliation is to end healthcare’s (re)traumatization of IWLE and peer navigators (i.e., healthcare historic trauma). To achieve reconciliation, healthcare needs to uproot the coloniality of being (i.e., decolonization) and seed the Indigeneity of being (i.e., Indigenization). 
  2. Coloniality (shorthand for coloniality of being) is an invisible generator of healthcare historic trauma. In HIV and hepatitis C care, coloniality is embedded in how healthcare defines peer (as a group identity) and relates to peers (i.e., members of the peer group). 
  3. Indigeneity of being refers to beliefs, attitudes and relationships that reflect Indigenous kinship, wholeness and relationality. Indigeneity of being is protective against healthcare historic trauma. 
  4. In HIV and hepatitis C care, IWLE and peer navigators can experience the word peer to be marginalizing and traumatizing. 
  5. To decolonize healthcare’s language, the community discounted the colonial logic and symbolism of the word peer. 
  6. At its essence, peer expresses a collective identity that is uniting, strength-based and healing.
  7. To Indigenize healthcare’s language, the community reclaimed the spirit of the word peer. Some community members proposed adapting peer as a title for everybody in healthcare who engages in safe (non-traumatizing) and healing relationships.
  8. In healthcare, peer can mean that IWLE and peer navigators are equal. Simultaneously, peer can also mean that IWLE and peer navigators are unequal to everyone else in healthcare. The community rejected this divisive conceptualization of equal/equality.
  9. To experience equal/equality is to share a common ground. In healthcare, this common ground is based on sameness (e.g., similarity in health condition, healthcare role, assigned societal class). For the community, the common ground for equality is authentic connection (i.e., relating on (an) innate level(s) irrespective of sameness or difference by embracing our kinship as part of the web of life). 
  10. Walking the walk of reconciliation (as guided by part 2.3) is also talking the talk of reconciliation. The community called on healthcare to speak the language of reconciliation. 

Reconciliation

Generally, reconciliation can be defined as a process of healing relationships between Indigenous communities and systems of settler colonialism (colonialism for shorthand).4 A primary goal of reconciliation is to mend and end the harms inflicted by colonialism.4 Reconciliation requires systemic change.1 The roadmap is outlined by the Calls to Action and the Calls for Justice. The work of reconciliation involves decolonization (i.e., de-constructing colonialism) and Indigenization (i.e., de-oppressing Indigenous systems toward Nation–Nation(s) relationships).4,5

In this story, we define reconciliation as a journey to heal relationships between peer and healthcare. The goal of reconciliation is to end healthcare historic trauma (defined as the perpetuation of historic trauma in healthcare. Historic trauma is the intergenerational trauma harming the Indigenous people in Canada and globally by colonialism) (1). Reconciliation requires addressing the root causes of historic trauma in healthcare. To achieve reconciliation, “we need rich soil,” lent [2] a member of the Peers4Wellness community. This means that healthcare needs to uproot the coloniality of being (i.e., decolonization) and seed the Indigeneity of being (i.e. Indigenization).6

Coloniality of being 

Part 2.1 in this series exposed coloniality as an invisible generator of healthcare historic trauma.6 Here is a recap. Coloniality refers to separatist beliefs, attitudes and relationships that create social divisions and hierarchies. In HIV and hepatitis C care, coloniality manifests in the framing of peer as a devalued and deprivileged identity. Further, coloniality is expressed in the unequal standing of peer (second class) and everyone else in healthcare in terms of innate worth and claim to human rights. This creates a (re)traumatizing social environment, which enables healthcare to deny peer (as group) universal healthcare rights (i.e., basic standards of care and work that all Canadians are entitled to enjoy). 

Language can cement coloniality by giving it symbolic form.6 This article shows how the conceptualization of peer and equal in healthcare can embed colonial meaning and in turn propagate healthcare historic trauma. Further, the community nudged healthcare to decolonize the words peer and equal/equality (i.e., decolonize the words’ conceptual characteristics, boundaries and preconditions).7 

Indigeneity of being 

We define Indigeneity of being as beliefs, attitudes and relationships that reflect the kinship, wholeness and relationality of Indigenous worldviews.8–11 Indigeneity of being fosters a safe social environment, where everyone’s universal healthcare rights are protected and in turn healthcare historic trauma is prevented.

Kinship means “connection with everything,” lent a member.8,11 Everyone is part of “a web of relations that have been woven since time immortal,” described Erika Campbell and co-authors (p. 9).11 We are woven into “the spiritual, the mental, the physical, the emotional” and wholistic dimensions of life, paraphrased a member. “And this is how we all connect” on a rudimentary level, lent another member. 

Wholeness means that all parts of the kinship web are equal.8,12,13 We “are like the worker bees,” lent a member. Everyone has the same in value and deserving of human rights. 

Relationality means being accountable to “All My Relations,” as put by a member.8,11,14,15 Relationality is expressed as social connectedness, where people experience belonging and act in solidarity to protect everyone’s human rights.16–18 

This article describes how Indigeneity of being can thrive in words, which embed the unity of kinship, the equality of wholeness and the solidarity of relationality. Therefore, the community invited healthcare to amend its language by manifesting Indigeneity of being. 

Peer is not them 

Part 2.1 of this series described how coloniality constructs the peer identity in a way that is traumatizing to IWLE and peer navigators. “And really, it’s time that peers, people with lived experience, do this work. That we assert what our role is, define what our [title] is, and assert it, wherever that is,” said a member. As a first step, the community sought to decolonize the word peer by deconstructing its underlying colonial logic. 

According to the community, peer refers to a subgroup of people in HIV and hepatitis C care. Instead of denoting “people like us,” lent a member, the name peer can single out people who are “HIV or hepatitis C positive, or current or former drug user[s]” and/or who are not “professionals,” said members.1,19 Peer can also mean deficit and echo “that judgmental tone, like they [i.e., everyone else in healthcare] are so much better than me [i.e., peer],” said a member.1,19 According to the community, the name peer can be marked with stigma related to HIV and hepatitis C and can be associated with a lack of expertise. 

The colonial logic behind this conceptualization of peer is random and biased for two reasons. First, it imposes rigid boundaries between disease and person, between lived and professional experiences, and between inexpert and expert roles.1,20–30 Second, it attaches negative connotation to peer boundaries, while sparing everyone else’s boundaries. The community explained.

Colonial logic (as we see it): Having a disease is synonymous with being the disease. Therefore, a care recipient is typically named a “patient” not a “person.”31,32 

Community’s response: “I don't want to be called a patient” because “the person isn’t defined by the disease.” “It is people first and foremost; the sicknesses and the disease would be in the background.” You and “I want to be seen as a person, as a whole.” 

Colonial logic (as we see it): Lived and professional experiences are nonoverlapping. Therefore, the peer label is reserved for non-professionals (i.e., people with lived experience).

Community’s response: We all have lived experience even if we have professional experience. “As human beings, we share far more than we are apart.” And “in some ways, we all have lived experience when it comes to dealing with the healthcare system, right?” Our shared lived experience unfolds on a spectrum from specific to universal. For example, people with HIV and/or hepatitis C share “personal knowledge that you’re not gonna find out from the medical [people].” People with HIV and/or hepatitis C also share human experiences with “professionals.” For example, when a community member was a medical intern, “people were asking me if I could be the intermediary; they seemed to be more comfortable talking to me about things that they needed and then I’d be the one to go and deal with other healthcare professionals.” Irrespective of your credentials, “if you come across as a human being…you can work with them and start [from] that foundation” of shared lived experience.

Colonial logic (as we see it): Inexpert and expert roles are mutually exclusive. 

Community’s response: Inexpert–expert roles are non-binary. Peer and inexpert are not synonyms. Similarly, professional and expert are not synonyms. Peers are the “experts in the community.” Professionals can be inexpert in that regard. For example, “most doctors don’t have a clue what hepatitis C is about” nor do they “understand where the women are coming from.”

Peer is not synonymous with “them.” Accurate and neutral logic (i.e., decolonized logic) would say that “whether they have HIV or hepatitis C or anything else, [healthcare is] not looking [at] ‘them’ as so separate from the rest of the [healthcare] community.” A decolonized logic would account for the unity of the whole person, the spectrum of lived experience and the fluidity of expert–inexpert roles. Seeking to decolonize the word peer in healthcare, the community debunked its founding colonial logic. In addition to being unsound from a community standpoint, a colonial logic can turn the word peer itself into a source of healthcare historic trauma. 

Peer is nobody or everybody

Words have a priming effect.33–36 This means that words can influence individuals (e.g., their emotions, thoughts, actions) and precondition social relationships and behaviours.33–36 This applies to the word peer.

In healthcare, the word peer can propagate coloniality. The community alluded to the internalization by individuals of the colonial symbolism in the use of the word peer. “We've become what they say we are, a sickness, a disease,” explained a member. Consequently, in healthcare settings, some IWLE and peer navigators “don’t have that confidence” to demand their rights, lent a member. “They’ve been disarmed to the point where it does them harm,” added the member. On a social level, healthcare’s definition of peer (as experienced by IWLE and peer navigators) can cement the colonial beliefs and attitudes that root healthcare historic trauma. 

The spirit of the word peer embraces the solidarity of “All My Relations.”19,29,37–40 According to community logic, peer signifies that you are “walking with somebody else, who is also healing.” This logic aligns with the theoretical foundations of peer navigation practice, wherein peer denotes a positive collective identity that is associated with promoting wellness.19,29,37–40 In principle, according to the community, the word peer can invoke “a sense of, ‘it will be ok, you can do this’” because “if you need our support, we’re there, no matter what.” 

The word peer can be traumatizing. The word peer can also be safe and healing. Some community members said that they “no longer want peer in their title.” Other community members reclaimed the word peer instead of abandoning it. Those who wished to reclaim the word proposed peer as a title for everyone in healthcare, as long as they are engaged in safe (non-traumatizing) and healing relationships. 

“My peer would be my doctor and his team.”

“The only peer support I have is the nurses from the clinic.”

“They helped me out, through some hardships and stuff…The nurse over at the hospital, and pharmacist. Like, I call them all the dream team...They are the peer; they are my peers.”

Together, the community invited healthcare to either decolonize the word peer or Indigenize it. After proposing a revision of who is named peer in healthcare, the community asked for a change in how equal/equality is defined in healthcare.

Equal and peer are bound together 

When it comes to equal/equality, healthcare speaks a language that deviates from the language of English dictionaries, public policy and the community. This language gap is exemplified by the relationships between the words equal and peer. The community explained.

Healthcare on equal and peer: Equal and peer have a twisted relationship. Peers are equal in being unequal to everyone else in healthcare. “Peer, that’s their friend, that’s their equal.” However, “staff is not peers…there’s a fine line between staff, and volunteer and peers.” This equal–unequal fine line is defined by coloniality, which “separates and isolates one another from each other” because of the diversity of the individuals involved in healthcare.20–23,27–30,41,42

English dictionary on equal and peer: Equal (n.) and peer (n.) are synonyms. Peer comes from the Latin word “par” which means equal. Peer is one who is of equal standing with another. 

Public policy on equal and peer: Public policy speaks in the terms of relational equality, which means that all people are equal in their innate worth and human rights.22,43–48 In the language of relational equality, equal means everyone. Speaking this language, policy would say that peers “need to be treated as equals [to] doctors,” lent a member. 

The community on equal and peer: Healthcare’s definition of equality is a conservative interpretation of the dictionary’s definition and an interpretation of the principle or concept of relational equality. In the community’s language, peer means equal all the way. 

In all four languages (healthcare, English, public policy, community), equal and peer are bound together. 

Accordingly, said a member, “peers should be equal, have a voice [i.e., a seat] at all tables” and not just at their own segregated tables. However, healthcare speaks a different language that is mirrored in healthcare’s unequal relationship with IWLE and peer navigators. This unequality is at the soul of healthcare historic trauma. Seeking reconciliation of languages and relationships, the community offered guidance on Indigenizing the conceptualization of equal/equality in healthcare.

Equality is grounded in authentic connection

Equal/equality can be a unifying or a divisive word. From a policy and community standpoint, the word equal/equality is uniting. But in healthcare, according to the community’s experiences, the language around equal/equality can be dividing. To help bridge this gap, the community guided an Indigenization of the criterion for defining equal/equality. 

As the community understands it, the precondition for conceptualizing equal/equality is sharing a common ground.42 In healthcare, according to the community, this common ground is based on sameness (i.e., similarity in attributes, abilities, circumstances, experiences) and follows colonial divisions. For example, IWLE and peer navigators are deemed equal because they are similar in having lived experiences of HIV and/or hepatitis C. In contrast, IWLE and peer navigators are seen as unequal (in status and healthcare rights) to medical care providers because of their different societal classes. However, the community sought an inclusive common ground that can hold everyone in healthcare. “There has to be a common denominator” that crosscuts people’s differences, said a member. “How do you get these people together?” irrespective of their similarities and differences, asked the member.

Indigeneity of being elicits a logic that sets authentic connection as the ground for equality. Adapting from Linda Linklater (p. 137),49 we define authentic connection as an embodiment of Indigenous kinship (our innate relatedness as part the web of life). The community explained that authentic connection is a bond (or bonds) that people can attend to and experience irrespective of their sameness or difference (e.g., health condition, healthcare role, assigned societal class). 

When grounded in authentic connection, equal/equality can mean wholeness (united diversity) instead of sameness (i.e., siloed homogeneity). A connection is authentic, lent a member, when “I can relate to someone, who can actually relate to me” on an intrinsic level (i.e., emotionally, spiritually, practically, mentally and/or wholistically). This can be “someone who’s been there, someone who’s done it” or someone who is different from me, added another member. Relational equality emerges organically from the mutuality of this connection.8,11 For example, “my doctor, she knows me inside and out, she is the best in the world. I love her to pieces.” Despite our different backgrounds, the doctor and myself are equal because we share an emotional common ground. Similarly, “I’ve never used drugs in my life, and everybody thinks that I have, because I fit so well with the people.” This “fit” can reflect our spiritual connections, which “are somethings that are shared throughout humanity.” The “fit” can also reflect a mental connection, where people “understand where we’re coming from,” lent another member. Therefore, we are equals because we share spiritual and mental grounds. 

Because being in silos is at the essence of coloniality, the community’s criterion for equal/equality is defined in terms of ‘how we are together’ irrespective of “who we are.” This conceptual shift is intended to prime or form the theoretical foundation of safe healthcare practice. Introducing a practical healthcare model that is based on authentic connection, part 2.3 in this series will show how Indigenizing the word equal/equality can potentially create a healthcare environment that is non-traumatizing from the viewpoints of IWLE and peer navigators.

Promoting the language of reconciliation 

Language can be segregating and traumatizing; language can also be harmonizing and healing.1,37,39,50 Reconciliation entails the latter. 

In response to this knowledge about the importance of language, the community guided a decolonization and Indigenization of healthcare’s language. The community challenged the colonial logic that creates the peer–nonpeer and equal–unequal conceptual binaries. Further, the community invoked Indigenous logics of kinship, wholeness and relationality to reawaken the spirits of the word peer and equal/equality. In doing so, the community partook in uprooting the separatists’ ways of coloniality and sowing the “oneness,” lent a member. The intention is to take steps toward preventing healthcare historic trauma and fostering a healthcare environment that is safe for IWLE and peer navigators. 

Walking the walk of reconciliation (which part 2.3 aim to help guide), healthcare can start with talking the talk of reconciliation. Otherwise, how will healthcare achieve reconciliation and simultaneously say otherwise? 

Definitions 

Healthcare1: The services aimed at improving or maintaining health. The scope of healthcare is policy driven and dependent on the definition of health. The functions of healthcare fall anywhere under a continuum from public health to medical care. 

Peer navigation and peer navigators1: Peer navigation is health navigation that is provided by peer navigators. Health navigation involves supporting care recipients to overcome barriers to healthcare. Peer navigators are care providers whose leading qualification is having lived and living experiences that are similar to those of care recipients. 

Coloniality of being (part 2.1):A mentality and a relationship that transforms diversity into divisiveness. The coloniality of being involves beliefs and attitudes that separate people on the basis of “race,” class or gender. This mentality manifests in an unequal relation, where select people are singled out as being unworthy and undeserving of human rights.6

Historic trauma1: The ongoing and intergenerational harming of Indigenous people as a group. The word historic acknowledges the colonial origins of this lingering trauma. In Canada, historic trauma is the result of colonization and subsequent policies and practices including the dispositions of Indigenous lands, Indian Residential Schools, the Sixties Scoop, child welfare, the correctional system, racism, social exclusion and violence against Indigenous women. On an individual level, historic trauma causes cumulative stress. This stress leads to physical, mental, emotional and spiritual harm. To cope with these harms, some individuals resort to undesirable practices such as substance use or the avoidance of traumatizing places including healthcare centres.

Healthcare historic trauma: The perpetuation by healthcare of the intergenerational colonial harming of Indigenous people in Canada and globally (e.g., historic trauma).2,3 Healthcare historic trauma is the product of Indigenous-specific racism.2,3

Universal healthcare rights (part 2.1):  Basic standards of care and work that all Canadians are entitled to enjoy. To honour these rights, healthcare must deliver on two fronts. First, it must uphold relational equality. Second, it must act accordingly by guaranteeing equality of treatment, equality of dignity, equality of opportunity, equality of interaction and equality of outcomes.43,45–48 Universal healthcare rights fall under human rights. Some of the instituting policies include the United Nations Universal Declaration of Human Rights (UNDHR) (Article 1, Article 23, Article 25), the Canada Health Act and B.C.’s Human Rights Code (Section 8).

Wellness1A concept that includes the physical, social, emotional, cultural and spiritual, for both the individual and the community.

Relational equality45,48: The principle that people have the same value and hence the same human rights. Relational equality is distinct from but linked to distributive equality, defined as the enactment of the latter principle; it is achieved when everyone can enjoy their rights. 

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About the Authors 

Sadeem Fayed 

My name is Sadeem Fayed. I am a woman and a newcomer to the traditional lands of the Indigenous people in Canada. I live on the unceded Coast Salish territory in Vancouver, British Columbia. I work with Pewaseskwan (the Indigenous Wellness Research Group). I am also a PhD student in the Faculty of Health Sciences, Simon Fraser University. I have been learning and working in the field of Indigenous health and wellness research since 2017. My focus is the Peers4Wellness project, where I position myself as an invited outsider to the community. My work with Peers4Wellness has been guided by the mentorship of Dr. Alexandra King and Prof. Malcolm King. I also have been practising in relation with Dr. Sharon Jinkerson-Brass, Candice Norris and Nicole Smith who are my Indigenous research partners — we call ourselves the Clan. As a first author, I bear the trust of the Kings, the Clan and the rest of the Peers4Wellness community. I take this responsibility seriously and courageously. Being in this role, I am not only accountable to the community but also to all my relations as a Muslim whose Creator “offered the Trust to the heavens and the earth and the mountains, and they declined to bear it and feared it” (Quran, Verse 33:73). 

I acknowledge that this series of articles is biased. It features the perspectives and needs of peer navigators and Indigenous women, but it is missing medical care providers’ side of the story. Also, the undertone of the series points at healthcare (as an institution) to do the heavy lifting of system change. I believe that this bias is justified for three reasons. First, the bias is inevitable because the article is driven by the voices of the Peers4Wellness community, where Indigenous women and peer navigators are overrepresented. Second, the bias is not against medical care providers. “It’s not entirely their fault,” as put by community, that healthcare perpetuates historic trauma. Echoing the community, we/I recognize that “the system is designed almost to burn everybody out: nurses, doctors, everybody” and that “we need wellness for everybody.” Finally, the bias is necessary because the responsibility for enacting reconciliation falls on colonial institutions such as healthcare. 

I heard Dr. Alexandra King tell me that she is concerned about losing medical providers as an audience because of this bias. I listened and sought guidance from Dr. Sharon Jinkerson-Brass, who is the Indigenous Knowledge Holder on the Peers4Welness project. Sharon wrote that “we all understand the penetrating and comforting heat from a fire on a cold winter’s night and the beauty of a cool bath on a hot day. If we could remember the sacred fire and holy water when we are dreaming a new relationality in the healthcare system.” Being accountable to community, responding to Alexandra’s point and learning from Sharon’s wisdom, I offered the above acknowledgement (water) with the hope of cooling off the bias (fire).

Peers4Wellness Community 

This article is guided by the voices of the Peers4Wellness community in British Columbia on the unceded territory of the Coast Salish People. The community includes 53 people: Indigenous women (cis- and trans-gender) who have lived and living experiences of HIV and hepatitis C; Indigenous and non-Indigenous peer navigators including frontline workers and community organizations and Indigenous matriarchs including Dr. Sharon Jinkerson-Brass, Knowledge Holder and community research associate; Candice Norris, culture support worker and peer research associate; Nicole Smith, community research associate and Dr. Alexandra King, internist physician and principal investigator. Dr. Alexandra King is also the senior author of this article. 

Dr. Alexandra King

My name is Alexandra King. At least that is the name recognized by the government and in day-to-day life. However, I have been gifted with two spirit names that truly connect me to my ancestors and all my relations. I am a member of Nipissing First Nation, which is located in what is now known as Ontario. My First Nation ancestry flows from my Mother’s bloodline, while my Father was of mixed European ancestry. I have been welcomed by the Mississaugas of the Credit First Nation, my husband’s community, where I have the privilege of living. I work, mostly virtually, on Treaty 6 territory and the Homeland of the Métis on what has become known as Saskatoon at the University of Saskatchewan. I am honoured to be the Cameco Chair in Indigenous Health and Wellness, which is primarily a research chair; I also do clinical work as an internal medicine specialist. I have always deeply admired lived and living experience and the wisdom that this potentially brings to a culturally safe and responsive healthcare system. I see the Peers4Wellness research (funded by CIHR) as a critical piece supporting this work.


[1] Unequal signifies that the negation of equality is not intrinsic but imposed and reversable. Peer and others are equal even if healthcare sees and treats them otherwise

[2] We use “lent” to signal that a quote is featured in a way that reflect what was said and what the story re-tellers heard. Here, the re-tellers join the community to become story co-tellers.