Mobilizing Reconciliation: Implications of the Truth and Reconciliation Commission Report for Physiotherapy in Canada

One might assume that the Truth and Reconciliation Commission of Canada (TRC) final report¹ is about Indigenous peoples in Canada. It is, and it is not. The 528-page report, as well as its 94 recommendations, released in June 2015,² is about and for all Canadians. If you live in Canada, this report is written for you. If you are a health care provider, educator, or leader, this report has specific recommendations for you.

The TRC was a component of the Indian Residential Schools Settlement Agreement, reached on November 20, 2005. Schedule “N” of the settlement agreement outlined the mandate for the TRC and described reconciliation as “an ongoing and collective process, [that] will require commitment from all those affected including First Nations, Inuit and Métis former Indian Residential School (IRS) students, their families, communities, religious entities, former school employees, government and the people of Canada.”^3(p.1)

The dual goals of the 2015 TRC report¹ are (1) to help Indigenous peoples and their communities to heal and (2) to help restore the relationship between Indigenous and non-Indigenous peoples in Canada. The report is the result of a 6-year process during which 7,000 witness testimonies were heard by three commissioners (Justice Murray Sinclair, Dr. Marie Wilson, and Chief Wilton Littlechild) and a 10-member advisory committee made up of Indian residential school survivors. With great clarity, the report outlines how the government of Canada and many allied institutions used the Indian residential school system as a form of cultural genocide to erase Indigenous peoples and their culture from the Canadian landscape.

Why This Matters for Physiotherapy

Indigenous peoples in Canada experience a vastly disproportionate burden of chronic illness and disability compared with non-Indigenous Canadians.⁴ Physiotherapists have a crucial role to play in addressing these care gaps, as outlined by two seminal statements from the Canadian Physiotherapy Association, “The Role of Physiotherapy in Aboriginal Health Care”⁵ and “Access to Physiotherapy for Aboriginal Peoples in Canada.”⁶

However, the TRC report not only calls for more care, it also calls for more effective care, referring to services that are provided in ways that are culturally safe and take into account the multiple intersecting barriers that are a legacy of the atrocities committed through the residential school system.

Seven of the 94 recommendations explicitly target health, including Recommendation 24, which states,

We call upon medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties and Aboriginal rights, and Indigenous teachings and practices. This will require skills-based training in intercultural competency, conflict resolution, human rights and anti-racism.^2(p.3)

This recommendation should apply equally to physiotherapy programmes. This call to action may also help to redress the involvement of Canadian universities in supporting the mandate of the Indian residential schools system.⁷ Furthermore, Recommendation 19 calls for, among other health priorities, closing the gaps in outcomes between Indigenous and non-Indigenous communities related to the incidence of chronic diseases, illness, and injury as well as to the availability of appropriate health services.⁸

Our Calls to Action

We call on all physiotherapists in Canada to

1. Read the TRC report. Be forewarned that it will take time and commitment to read the entire report—not only because it is long, but also because the nature of much of the content is tragic. Institutional racism and cultural genocide are painful topics. However, a key recommendation for non-Indigenous Canadians is to learn their history (which was intentionally absent from the curricula of most grade schools in Canada for decades), and so the TRC report is a good place to start. It is important to stress that the report is also inspiring because it speaks to the courage and resilience of Indigenous peoples.

2. Listen to the TRC report being read. To increase accessibility and reach, the “#ReadtheTRCreport” project involves powerful YouTube videos of Indigenous and non-Indigenous people reading portions of the report out loud.⁹

3. Advocate for others in physiotherapy, and health care more broadly, to read and disseminate the report and its recommendations.

4. Respect and acknowledge the diverse personal histories of Indigenous individuals (including those who exhibit both potential trauma and resilience) who are seeking physiotherapy services so as to provide care in a culturally safe and humble manner.

We call on physiotherapy in Canada, as a profession, to

1. Listen to Indigenous physiotherapists and physiotherapy students when they speak about opportunities for advancing truth telling and reconciliation as a profession.

2. Address Recommendation 23 by ensuring that physiotherapy education programmes across the country use effective strategies to attract Indigenous students (including affirmative action admission policies) and retain Indigenous physiotherapists in clinical practice.⁸ An increase in the number of Indigenous physiotherapists will improve the cultural safety of our services.^10,11

3. Address Recommendation 24 by ensuring that effective education about Indigenous history and rights, cultural safety, and anti-racism skills is incorporated into physiotherapy curricula and continuing education for physiotherapists already in practice.

4. Proactively and robustly respond to other relevant recommendations in the TRC report's Calls to Action—for example, those related to sports and physical activity.⁸

5. Nurture respectful research by and with Indigenous peoples¹² to advance the profession's knowledge about

   • reducing health disparities related to chronic illness and injury
   • developing effective educational strategies for physiotherapists and others that teach cultural humility, cultural safety, and anti-racism.

Our actions in response to the TRC report will reflect the maturity of our profession. We will be measured by how well we engage with this historic opportunity to show leadership in the health and wellness of Indigenous peoples in Canada and in the long-term process of restoring the relationship between Indigenous and non-Indigenous peoples in this country.