Vancouver Foundation

Uprooting Pharmacy Reports

“Uprooting Pharmacy: A Two-Eyed Seeing Path for Change” sought to uproot colonial and systemic issues in pharmacy that have led to discriminatory practices experienced by Indigenous individuals, families, and communities, by exploring the question: 

What are the culturally safe principles for integrating Indigenous and Western worldviews in the decolonization and Indigenization of community pharmacy practice? 

The project’s primary goal was to catalyze the re-imagination of community pharmacy using a modified Mi’kmaw Two-Eyed Seeing approach that honours both Indigenous and Western worldviews and knowledge systems. We acknowledged the direction of our progress is more important than the destination and expected to learn a great deal collectively, as we unpack this complex question. UPROOT’s role was to provide research support, pharmacy-specific expertise, and actionable change by developing educational resources for practitioners in their effort to decolonize and Indigenize their practice. 

There are a total of 5 reports as part of this project:

1. Community Engagement Report
2. Indigicare Medicines Practicum
3. Pharmacy Colonization Report
4. Traditional Medicines Guide
5. Clinical Pharmacist Service Model

Community Partner(s)

Lu’ma Native Housing Society

Lu’ma Medical Centre

Metro Vancouver Aboriginal Executive Council (MVAEC)

Slaxin Lelum Medicine House

Student(s)

Katie Arisz, E2P PharmD Student

Kadence Cave, NITEP Student

Katherine Huerne, UBC PhD Candidate

Ilaha Ibrahimova, UBC Masters Student

Sunu (Isabel) Kim, UBC PhD Candidate

Madison Runa, E2P PharmD Student

Hailie White, E2P PharmD Student

Olivia Yeung, UBC Masters Student

Granting Agency/Partner(s)

Vancouver Foundation

Faculty

Larry Leung, Associate Professor of Teaching

Jason Min, Associate Professor of Teaching

Indigicare Medicines Pharmacy Workshops

In response to community engagement feedback from patients, we developed a series of 10 monthly workshops that can be hosted by Indigicare Medicines pharmacy open to all patients. The workshops have been designed to be delivered with the support of UBC pharmacy students with supervision by a pharmacist. The setting of the workshops are envisioned to be primarily at Indigicare Medicines, but may also be offered in an outreach environment, such as at Lu’ma’s various housing sites.

These workshops cover a variety of topics, thoughtfully chosen informed by the engagement process in our research, with attempts to have topics correspond with notable events during the year (e.g. May is mental health awareness month, so a mental health workshop is suggested). Each workshop is scheduled for 1 hour and contains an icebreaker, presentation, an interactive activity, and some suggested take-home items for participants.

In feedback during the design of Indigicare Medicines pharmacy, it was clear that patients wanted more opportunities to meet with pharmacy staff, ask questions, and learn in different ways than typical pharmacies provide. Hence, these workshops will emphasize engagement with healthcare professionals and provide attendees the opportunity to ask questions and gain knowledge about managing health, medications, and overall wellness. By offering targeted education and resources, the pharmacy strives to empower its community, promote healthier lifestyles, and ensure that patients and housing clientele are equipped with the tools they need to make informed decisions about their care.

Note that these are student-generated and in draft form. There is always a chance that the content can be out of date as the evidence for these topics advances. Prior to use with patients, they should be reviewed for accuracy and modified to suit the audience and context.

Community Partner(s)

Indigicare Medicines

Lu’ma Medical Centre

Student(s)

Alyssa Burrows, E2P PharmD Student

Kadence Cave, NITEP Student

Nailah King, NITEP Student

Tyler Floen, NITEP Student

Emma Mills, E2P PharmD Student

Granting Agency/Partner(s)

Vancouver Foundation

Faculty

Larry Leung, Associate Professor of Teaching

Jason Min, Associate Professor of Teaching

Uprooting Pharmacy: A Two-Eyed Seeing Path for Change

The Uprooting Pharmacy project seeks to uproot colonial and systemic issues in pharmacy that have led to discriminatory practices experienced by Indigenous patients. We seek to answer the question: what are the culturally safe principles for integrating Indigenous and western worldviews in the decolonization and Indigenization of community pharmacy practice? We will explore this question from the perspectives of the communities impacted: Indigenous patients, care providers, Elders and Knowledge Keepers. Identifying the benefit of this work to our community and how it can synergize with existing health programming will be a related topic to investigate. We also acknowledge that traditional knowledge is privileged and in desperate need of revitalization and preservation, and may apply differently to a diverse urban population of Indigenous people in Metro Vancouver.

Through our collective and ongoing engagement with the Indigenous patients and partners we serve, there is a clear community expressed need to better understand how we can provide culturally safe pharmacy services that integrate both Indigenous and western worldviews to support the physical, mental, emotional and spiritual wellbeing of Indigenous peoples.

Pharmacists are a key component of the healthcare system, frequently identified as one of the most accessible and trusted care providers. As a profession, pharmacy is deeply rooted in a colonial and Eurocentric view of western values, evidence-based medicine, and a transactional approach to care provision. Ironically, this model of “community” pharmacy often lacks the humility, flexibility, and understanding of the Indigenous communities they are destined to serve, contravening Canada’s Truth and Reconciliation Commission’s Calls to Action, the United Nations Declaration on the Rights of Indigenous Peoples, and In Plain Sight. The result has been a homogenous and discriminative culture of community pharmacy that is often steeped in harmful stigma and pervasive implicit bias. For Indigenous people, this results in significant barriers to receiving traditional medicines and healing practices, and pressure to forgo those methods as inferior. Further exacerbating these issues in community pharmacy is the unsafe environment for Indigenous-identifying pharmacists, an absence of learning pathways for Indigenous pharmacy students, and a lack of Indigenous-owned pharmacies. Connections between these systemic issues to the determinants of health can be traced back to the structural conflict between Indigenous and western worldviews.

Community Partner(s)

Metro Vancouver Aboriginal Executive Council (MVAEC)

Metro Vancouver Indigenous Services Society (MVISS)

Lu’ma Medical

Student(s)

Brandon Whitmore, E2P PharmD Student

Tia DeGroot, NITEP Student

Ryan Knowles, E2P PharmD Student

Madi Runa, E2P PharmD Student

Emma Mills, E2P PharmD Student

Katie Arisz, E2P PharmD Student

Kadence Cave, NITEP Student

Granting Agency/Partner(s)

Vancouver Foundation

Co-Developing a Culturally Safe Engagement Framework with Urban Indigenous Partners

There is a long-standing history of improper engagement with Indigenous individuals that often lacks respect, humility, and understanding of Indigenous protocols. To rebuild trust with people, researchers must commit to reconciliation and develop strategies for ethical engagement. The UPROOT team has more than 10 years of history working with individual Nations to decolonize and Indigenize pharmacy education and practice. The team has primarily worked with individual Nations, but their next project will focus on Urban Indigenous people which represent various First Nations, Métis, and Inuit people. Due to the diversity, UPROOT lacks clarity on the proper principles of engagement in lieu of Nation-specific approaches. 

This project aims to create an engagement framework for engaging with Indigenous individuals, communities and/or organizations by answering the following research question: What are the culturally safe principles and protocols for engagement with Urban Indigenous partners?

Community Partner(s)

None

Student(s)

Brandon Whitmore, E2P PharmD Student

Tia DeGroot, NITEP Student

Granting Agency/Partner(s)

Vancouver Foundation