Minnie's Hope, where culture and medicine go hand in hand

Women in Quebec’s far north say they’ve developed a unique recipe for supporting children and keeping them with their parents. They hope to share it across the North to reduce the high rates of youth protection cases.

Social pediatrics centre in Quebec's Nunavik region offers community-based, holistic approach to child health

Nathalie Esperon told the Viens Commission that the staff at Minnie’s Hope made it possible for her and one of her six children to make it through a difficult time. (Catou MacKinnon/CBC)

The women who created Minnie's Hope see Nathalie Esperon as a symbol of their success.

Esperon and her six children live in Kuujjuarapik, an Inuit village at the mouth of the Great Whale river on the Hudson Bay coast.  Last summer, one of her sons was being violent at home and she was struggling with depression.

"I was almost close to giving up with my son because there were so many problems, especially in school," she said.

She and her son started going to Minnie's Hope, a holistic child health centre, regularly — he got speech therapy, and she had someone to talk to. Now, he is calmer and sleeps better.

"He changed a lot, and I am so thankful."

Minnie's Hope is officially called a social pediatrics centre, which is a community-based and holistic approach to child health.

The staff includes doctors, social workers, educators and volunteers who offer help for children and their parents — the family experience is not considered less worthy than advice from professionals trained in the south, executive director Marianne Martin said during the Viens Commission.

Volunteers, staff and clients from Minnie’s Hope, a new social pediatrics centre in the shared Inuit and Cree village of Kuujjuarapik and Whapmagoostui. (Catou MacKinnon/CBC)

Community members had been looking for solutions to chronic problems in the north, especially the high rates of youth protection intervention for years, before Minnie's Hope opened in 2014.

According to testimony that emerged during the commission, the number of children placed in foster homes in Nunavik increases every year. It was 544 for 2017-2018, compared to 347 four years before.

During the almost two years of hearings, the commission heard dozens of times that First Nations and Inuit children are overrepresented in Quebec's youth protection system.

The team of women who work and volunteer at Minnie's Hope testified before the commission, which looked into systemic discrimination of Indigenous people, in November because they believe the centre offers possible solutions to long-term problems, which is part of the inquiry's mandate.

Building trust, developing confidence

The centre is in Whapmagoostui, a Cree village right beside Kuujjuarapik. The shared village is the only place in Nunavik where people from the two communities live together.

It was named to honour the memory of Minnie Natachequan, who was killed in 2008 by her domestic partner along with their two Inuit-Cree sons.

A health clinic, community centre, therapy room and support group all rolled into one, it has been running full steam since May 2017.

From the outside, it doesn't look like much. Inside the one-floor bungalow that used to be a Catholic chapel, there is a community kitchen, a living room, a play area and an exam room.

There is sand-play therapy, where children use figurines instead of words to express themselves so language isn't a barrier, an after-school program for pre-teens at risk and a summer "prep" camp for children entering kindergarten.

Doctors and therapists consult with entire families, sitting around a table at the centre instead of discussing problems in the sterile environments of a medical clinic or government office.

"We build trust and help develop confidence so those young parents have good education and support to pass on to their children," said Marianne Martin, the centre's executive director.

Minnie’s Hope is housed inside a former chapel in Whapmagoostui. (Catou MacKinnon/CBC)

Martin said the board of directors guides the staff and ensures Cree and Inuit culture are part of what is taught, since the two communities coexist side-by-side.

The limits to a doctor's role

Pediatrician Dr. Johanne Morel is one of the driving forces behind Minnie's Hope.

As part of her work with the Montreal Children's Hospital, she spends 15 weeks practising in northern communities, travelling there regularly since 1987.

During a phone interview a few weeks after her presentation, Morel said her perspective changed in 2008 when she heard a Radio-Canada radio documentary about about the Inuit, calling them a "people in distress."

She stopped her car right after she heard then-Puvirnituq mayor Harry Tulugak asked, "Is there anyone out there who cares about our children?"

At the time, she'd been treating Cree and Inuit children in the North for two decades.

She said she realized that there was a limit to what she could accomplish as a doctor, seeing children in the local health clinic, without taking the rest of the child's life into consideration.

Dr. Johanne Morel, pediatrician and director of the Northern and native child health program at Montreal’s Children Hospital, said patients tell her Minnie’s Hope feels as comfortable as their grandmother’s kitchen. (Catou MacKinnon/CBC)

"The medicine that we have studied and that we offer does not always have the expected benefits," she told the commission.

Over the years, life expectancy, infant mortality and suicide rates have not improved in the north as they have in the south, she said.

So she changed where and how she practises — for example, she holds her consultations at Minnie's Hope so it's less intimidating and she learned a few sentences of Inuktitut to help put children at ease.

So far, more than 140 children have been seen at the centre since it opened. People have told her it's like being at their grandmother's, because they feel at home, she said.

Morel said there's a saying in the North: that the region is where good intentions go to die, in part because people from the south always think they have solutions, but don't ask those who live in the north for their opinion.

"We're ignorant of our own ignorance," Morel said about her own experience as a white person who works in the north.

A life beyond 'pain and struggle and despair'

Winnie Mickeyook grew up in Kuujjuarapik with an alcoholic sibling and parents. She also overcame problems with addiction.

"Like anybody else, I went through my struggles," she said, her face full of tears while speaking at the commission.

She became a school counsellor after studying in Montreal at Dawson and John Abbott Colleges.

"I had an opportunity to get out of my community and see there's so much more than pain and struggle and despair," said Mickeyook.

She volunteers on the board of directors at Minnie's Hope because she believes in what they're doing.

"With this centre, we're trying to give our children that hope."

Minnie Mickeyook spends part of her free time volunteering on the board of directors for Minnie’s Hope because she thinks it can make a difference for a new generation of Cree and Inuit. (Catou MacKinnon/CBC)

Mickeyook said the 990 Crees and 713 Inuit who inhabit the neighbouring villages have co-existed for thousands of years.

"We've known each other since the beginning," she said in a phone interview with CBC.

But the 1975 James Bay and Northern Quebec Agreement changed things — Kuujjuarapik fell under provincial jurisdiction and Whapmagoostui, federal.

Now, the community is divided with two schools, two daycares, a band office and a village office, and while the relationship between the two communities is "harmonious," there have been difficulties in the past, she said.

She said the centre's non-judgmental cultural approach can help families struggling get help confidentially, and also help build new bridges between Inuit and Cree — the services are offered to Cree and Inuit, and both cultures are represented in the staff.

Mickeyook hopes the centre continues to receive funding, attracts more volunteers and continues to grow.

"It's one of a kind in the North," she said.

"Imagine if we have this, we can present it to the other communities and tell them what we're doing to help our children."