Andrea Sandmaier recognizes that cancer care isn’t equitable for Métis Albertans and helped direct the Métis Nation of Alberta’s Health Department to create a strategy that will change that
By: Stephanie Joe
Photograph by Buffy Goodman.
Andrea Sandmaier, president of the Otipemisiwak Métis Government of the Métis Nation within Alberta and previously the Métis Nation of Alberta (MNA), listened to her community and knew that cultural safety in cancer care was required for a holistic approach to cancer treatment for Métis Albertans. That is why she, along with former president Audrey Poitras, directed their dedicated MNA Health Department to create The Alberta Métis Cancer Strategy: A Plan for Action.
The strategy was published in April 2023, but work on the strategy began in 2018 when the Métis government secured funding through the Canadian Partnership Against Cancer (CPAC). It also partnered with the CANHelp Working Group, Cancer Care Alberta (CCA) and Alberta Health Analytics and Performance Reporting Branch to complete the 44-page strategy.
“There’s a few different reasons why the strategy is needed,” says Sandmaier. “It outlines the need for culturally meaningful and relevant support and services for Métis citizens, recognizes existing barriers in the health-care system, and emphasizes the right to access safe, quality and timely cancer care.”
The strategy identifies four priority areas, including engagement with Métis in this province to strengthen partnerships with Alberta Health Services; culturally safe care by developing cultural safety training programs to health-care workers; culturally meaningful support by providing Métis-specific peer groups and delivering Métis-specific resources to people facing cancer; and supporting cancer care by developing community-based programming to provide targeted navigation and advocacy support. The strategy also outlines recommendations for CCA in each priority area.
Grounded in Métis perspectives, the strategy is a result of Métis People who shared their experiences during the 2018 and 2019 Métis Nation of Alberta-led Annual Health Forum as well as regional engagement sessions. Some said their spiritual and cultural practices weren’t respected while in the hospital. “One citizen used traditional medicine alongside cancer treatment, which the doctor said was fine to do, but continually staff were throwing the medicine in the garbage,” says Sandmaier. “We want to make sure that health-care providers know who we are and respect our cultural practices.”
She adds that Métis world views are not always recognized in the health-care system and that providers need to understand that family connection is vital to the overall health and well-being of Métis people.
When Sandmaier’s uncle had cancer and was in palliative care in the mid-1990s, she was thankful they were in a hospital in Cold Lake where most of the nurses and doctors knew her family. “We were able to fill a palliative care room with him, and there was never a time where he was alone,” she says. “We would be sitting there playing cards and joking around and just being who we are as a family, which helped him move on.”
What makes this strategy unique is that it collects and reports on Métis-specific experiences while addressing inequities in cancer care for Métis Albertans. The data included in the strategy outlines what citizens want, including a self-determined decolonial approach to cancer care. “Collecting and reporting on that data helps us show funders what the citizens are going through,” says Sandmaier. “The health-care system and health-care providers need to understand that family connection and cultural safety are essential to overall Métis health.”
The strategy’s priorities and recommendations were shared and validated by engagement participants and the Métis community at the Nation’s 94th Annual General Assembly in August 2022. To achieve some of the strategy objectives, Sandmaier and her team are creating a cancer screening tool kit and accessible and user-friendly navigation platforms. As well, they’re developing Métis cancer-care courses for health-care providers and allied professionals to learn about Métis people and their unique experiences.
“We have low attachment rates to general practitioners, which is linked to a late diagnosis of cancer,” says Reagan Bartel, director of health for the Otipemisiwak Métis Government.
Bartel worked as a critical care nurse at the Royal Alexandra Hospital in Edmonton for 17 years before taking on her current position, which she has held for the last four years. “I’m lucky that I have a lot of health educational background,” she says. “But I’m also doubly lucky because I am Métis.”
Bartel also notes the strategy itself is a concrete example of what Indigenous self-determination looks like. Rather than taking a pan-Indigenous approach to cultural programming, this strategy reflects the diversity of Métis Albertans with relevant programming and resources. “They wanted to be seen within the system, and they wanted to be able to access cancer care without barriers,” she says. “The strategy prioritizes community experiences and combines that with the epidemiological report [informed by data on cancer incidence and mortality among Métis Albertans from 2013 to 2019]. We’re lucky that our community is pointing us in the right direction.”
While the strategy centres community voices, Bartel knows strategies like this don’t move forward alone. “If there are folks out there in the cancer care area — psychologists, nutritionists, government and health-care officials — the Métis Nation is always open to collaborating to improve health outcomes,” says Bartel. “I think a healthy Métis population contributes to a healthier province overall.”
In December 2023, the Otipemisiwak Métis Government signed another four-year funding agreement with CPAC to support the actions listed in the strategy. Sandmaier and Bartel are working on bringing the priorities identified within the strategy to life that will improve the cancer experiences of Métis in Alberta.
“With this knowledge and this strategy moving forward, I think we can really make a difference,” says Sandmaier.
“Our people are very resilient, and I want to acknowledge the Métis Albertans that worked with our team and shared their stories. They’re hopeful for the future, and they recognize the hard work that the health team has put into making sure their voices are heard.”
The Alberta Métis Cancer Strategy Timeline
2017
The Alberta Métis Cancer Strategy: A Plan for Action is funded through Canadian Partnership Against Cancer, which is mandated by the government to support cancer care nationally.
2018 and 2019
The Otipemisiwak Métis Government holds engagement and data-gathering sessions at the Annual Health Forum. It hears from Métis cancer patients and their families who share their personal experiences and stories.
2020 to 2022
The Otipemisiwak Métis Government builds, refines and drafts the strategy and identifies four key priorities.
April 2023
The Alberta Métis Cancer Strategy: A Plan for Action is published.
December 2023
The Otipemisiwak Métis Government successfully acquires an additional four-year grant through Canadian Partnership Against Cancer to implement action items identified in the strategy.
