A Saskatchewan adventure
The Lynn Kratcha Memorial Bursary is awarded to a small group of second-year JCU medicine students annually. The bursary supports those who wish to take on an international rural medicine placement in America or Canada.
Emily Johnston and Supreet Sandhu were lucky recipients of the bursary in 2019, prior to COVID-19 limiting international travel. They went on a four-week placement in Saskatchewan, Canada. Emily has reflected on the unforgettable experience in the ‘land of the living skies’.
The adventure begins
At this present moment, it is a typical 30°C morning in northern Queensland. I am looking out across a sparkling ocean towards the tranquil Magnetic Island and it is hard to believe that halfway across the world, the beautiful country I visited is tucked up in bed, hiding from the somewhat ‘mild’ negative 40°C winter outside.
The Lynn Kratcha Memorial Bursary provided both Supreet Sandhu and I with a most memorable cultural experience, unlike any other placement in Australia. Saskatchewan was established in 1905 and is the middle of Canada’s three Prairie Provinces. The spirit of Saskatchewan is reflected in the culture, history and traditions of the First Nations and Métis people, which we spent a significant amount of time learning about and immersing ourselves in.
Largely focussed on community engagement, the placement exposed us to entirely different cultures and areas of medicine from what we had seen before, broadening our perspectives and knowledge of medicine and healthcare. Additionally, we were intrigued to discover that the major health concerns and prevalent chronic diseases in Canada are very similar to what we are experiencing in Australia.
Reminiscing on our placement, I cannot believe how much we packed into four weeks. We literally ensured each day was full of more activities then what the day before provided. I think we both slept for at least a week once we were home, but in no way do we regret turning every waking moment of our adventure into different experiences and stories.
The heart of rural Canada
Saskatoon was our base city, home to The University of Saskatchewan with a population of approximately 273 000, just over that of Townsville. Here, we made contact with very like-minded medical students with similar aspirations and focuses on rural, remote and Indigenous medicine to the students at James Cook University.
We most definitely became accustomed to long country drives travelling far and wide in all directions across the Provence of Saskatchewan to experience some incredible rural communities, Indigenous Reserves and country-sides. In each small rural community, there was something special about the close connectedness, sense of belonging and welcoming nature of the people. This was reflected through the highly dynamic and collaborative hospital and health centres we undertook clinical placement and cultural activities in. The delivery of rural family medicine was something truly exceptional.
Travelling 470kms north of Saskatoon, we visited the uniquely special community, Ile a la Crosse. At the entry way to the English River District, Ile a la Crosse is surrounded by a network of freshwater lakes and is the ‘hub’ of medical healthcare for Northern Saskatchewan.
I was privileged with the opportunity to travel on a small Cessna 185 plane to the Indigenous Reserve, Patuanak. Observing the land from above, I was mesmerised by its pristine quality and beauty. Watching the wildlife below emerge in and out of snow laden habitats whilst the pilot gave explanations as to what I was overseeing, I felt as though I was in the midst of the filming of one of David Attenborough’s wildlife documentaries. The image I observed is nothing I will forget; a landscape fully frozen, yet still abundant with life. The realisation that I was flying some hundred meters above frozen lakes, towards an Indigenous rural community that would otherwise not have the opportunity to see a doctor, provided me with a new found level of passion and love for rural medicine. It was something I would never have had the chance to experience anywhere else.
Understanding history and culture
Travelling to many medical clinics on Indigenous Reserves, a large focus of our placement was to develop an understanding of the history of the Indigenous Canadian people. We were privy to work alongside some very knowledgeable practitioners and Indigenous people whom educated us on the cultural teachings of Saskatchewan’s First Nations and Métis population. From our experiences, it was evident that the emotional, spiritual and physical trauma of the events which occurred during the colonisation of Canada, is still very real today. It continues to provide significant barriers and inequalities towards the delivery of healthcare.
We were humbled to be so warmly welcomed into communities by many First Nations and Métis people. They openly shared with us their cultures, traditions and ways of life. We learnt to make traditional ‘seed bead’ jewellery, sew ribbon skirts, partake in smudging ceremonies, cook (and eat) bannock, jam jams, moose stew, wild rice and pike, perform traditional dancing ‘jigs’ and play the sacred First Nations drum at song and dance gift ceremonies. A most memorable experience was participating in a ‘sweat ceremony’. The sweat lodge is a sacred place which promotes healing and healthy living. Describing the ceremony in writing would simply not pay it the justice or respect it deserves. However, I can say that on completion I had experienced the hottest and coldest temperatures of my life, cured any form of illness I thought I was developing and had witnessed the quintessence of humanity.
True patient-centred care
330kms south east of Saskatoon was a small village, Fort Qu’Appelle. Translating to ‘who calls?’ the area is located within a stunning valley that holds a rich and vibrant history. Here, the All Nations Healing Hospital provided us with an insight into the true integration of western and Indigenous medicine. The incorporation of traditional Indigenous natural medicines for patients undergoing renal dialysis, explained to us by a First Nations elder, demonstrated successful fusion of the two forms of medicine. From my experience I learnt that to many people, health is so much more than having a perfect hospital chart. Spirituality, family and community is most often of highest concern. This teaching I will remember when working in Australia where numerous parallels run between the two Nation’s Indigenous populations.
The First Nations people say “miyo maskihkiy”, meaning ‘to practice good medicine’. I truly believe I witnessed the essence of patient-centred care and ‘good medicine’ whilst in Saskatchewan.
To me, the passion, empathy and genuine love for the medicine being practiced and community being served, demonstrated by the doctors we worked with, was just as inspirational and motivational as the medicine itself.
Emily Johnston
It showed me how important it is to find an area of medicine which inspires and excites you in order to practice ‘good medicine’, “miyo maskihkiy”. A final lesson that has stuck with me is the fourteen First Nations’ laws and teachings. Each is represented by one of the fourteen poles of the ‘tipi’; obedience, respect, humility, happiness, love, faith, kinship, cleanliness, thankfulness, sharing, strength, good child rearing, hope, ultimate protection and control flaps. Together, the teachings resonate the true foundations of strength, meaning and value which I will endeavour to apply to today’s living.
I feel most privileged to have had an opportunity so incredible and diverse as our Saskatchewan adventure. As one who originally obsessed over summer, I can genuinely say that melting here on a café stool, I am truly missing the snow, ice, toques and moccasins of Canada. I am so grateful to all who made our trip possible; Carlyn, Joanna, Dr Tom and Deanne, Sharon, Val and Cal and every mentor Supreet and I had along the way. I know that we will definitely be back one day.
Ready for a rural adventure? Find out more about the Lynn Kratcha Memorial Bursary.