Mike Anderson, the strategic lead for University Health Network’s Indigenous Health Program, worked with the Indigenous Design Studio at Brook McIlroy to design a culturally safe place for Indigenous patients at Toronto Western Hospital.Supplied
When the Indigenous Health Program (IHP) team at the University Health Network (UHN) went to Indigenous patients for feedback about what could make hospital spaces more welcoming, there was one overarching request: natural materials like wood, so the patients could see a connection to the living world.
Unfortunately, strict healthcare regulations didn’t allow the use of natural materials, which posed a problem for team, which was working on creating a first-of-its-kind Indigenous Wellness Centre at UHN’s Toronto Western Hospital. Invested in bridging this gap, the IHP hired the Indigenous Design Studio (IDS) of Brook McIlroy, an award-winning Canadian architecture firm, to work with healthcare architectural firm C& Partners and PCL Construction to design and create the wellness centre.
The guiding principle for IDS was, “how do we incorporate Indigenous cultures into the built environment and how do we draw upon those stories from communities — making sure when people come to these spaces, they’re feeling heard and seen?” says Danny Roy, an associate intern architect and planner with the IDS, and part of the English River Dene Nation in Treaty 10 territory and Cree Métis from the northern community of Sakitawak (Île-à-la-Crosse, Saskatchewan).
Mr. Roy’s team works regularly with Indigenous communities, both directly and through other avenues such as post-secondary institutions, to indigenize institutional spaces. The idea for the IDS first began through a collaboration between Brook McIlroy and architect Ryan Gorrie, who worked with the firm on the Spirit Garden, a waterfront park in Thunder Bay that was designed in collaboration with First Nations and Métis community members. Gorrie is now the principal and director of the IDS.
“We formed the Indigenous Design Studio in 2016 when I joined full time as a desire to carve out a specific practice area devoted to supporting projects with Indigeneity as their focus,” Gorrie says. “It has evolved over time with contributions from current and past Indigenous staff and has become a core part of our firm.”
UHN’s new Indigenous Wellness Centre is located in Toronto Western’s atrium, which meant it was an opportunity to “introduce that public presence of Indigenous design, up front and centre within a hospital setting,” Mr. Roy notes. “Understanding some of the complexities and historical traumas that Indigenous peoples have faced entering hospitals or healthcare settings, we wanted to flip that by creating a welcoming space for those accessing healthcare.”
This brought the team back to the question of natural materials.
“I always joked that this was a project of turning noes into yeses,” says Mike Anderson, the strategic lead for IHP and medical director of Inner City Health Associates, which provides support to vulnerable and unhoused people. “The infection team’s first reaction was no wood, and then you challenge it, and you say, ‘so why is that? Is there any real reason?’ And you delve into it more and more and actually — there isn’t any good reason. You can stain wood; you can do things that make it infection safe. It’s just the reflex answer is no.”
One key element of the new Indigenous Wellness Centre is natural wood, which Indigenous community members requested as a way to give the space a connection to nature.Supplied
Once the project got the go-ahead to use wood, IDS designed a feature wall showcasing different clan animals, while the floor mimics water and land to reflect the natural environment. The design for the Indigenous Wellness Centre also offers Indigenous people a gathering place with access to a ceremonial space and traditional medicines by integrating Indigenous design elements and innovative problem-solving. For example, the team worked to ensure the space could accommodate smudging without negatively impacting air ventilation and smoke detection systems, resulting in an approach that could be implemented at other institutions, too.
Having this dialogue with communities throughout the design process is key, as Anderson and the Indigenous health team at UHN regularly engage with Indigenous community members about what they would like to see. “One of the things that routinely comes out is that we don’t see ourselves in these places, in institutional healthcare spaces. There’s nothing visible that sort of says, you’re welcome or represented here,” says Mr. Anderson, who is part of the urban Indigenous community in Toronto, with Mohawk (Bear Clan) and mixed European ancestry with family roots in Tyendinaga Mohawk Territory.
Ideally, the Wellness Centre will serve as something of a pilot project, in that those who worked on it hope to see similar projects follow.
“Many of the Indigenous design firms are small,” said Mr. Anderson. “Part of this is not just designing the space, but also trying to make other parts of healthcare, like building and designing, porous. The procurement process gates out a lot of Indigenous companies. But what we look to is a model where an Indigenous partner would partner with a firm that met healthcare requirements.”
In fact, that’s why the Centre also includes entryways to learning for non-Indigenous staff, such as a library and retail space.
“We do so much work right now in healthcare around cultural safety training, and so much of it is, frankly, largely ineffective online modules,” says Mr. Anderson. “On the other hand, we have good evidence that what works is experiential learning. The problem in healthcare is to do experiential learning, you almost always have to backfill staff, and it’s expensive and so forth. We’re hoping this [centre] provides a low-barrier opportunity for staff to drop into, to ask questions, to learn.”
Mostly importantly, though, it needs to be a place where Indigenous patients feel welcome, safe and cared for. After the Indigenous Wellness Centre opened its doors earlier this year, an elder in the city told Mr. Anderson, “I did not think I would see these things in hospitals in my lifetime.”
If IHP and the Indigenous Design Studio have anything to say about it, there will be many more to come.
One in a regular series of stories. To read more, visit our Indigenous Enterprises section. If you have suggestions for future stories, reach out to IE@globeandmail.com.