A Day in the Life with the Kim and Stu Lang Community Healthcare Partnership Program at Kettle and Stony Point First Nations

Student veterinarians working to challenge their own lived experiences

Down a foggy stretch of road in southwestern Ontario, you can hear the roar of Lake Huron from the Kettle and Stony Point Health Centre parking lot.

Home to just over 2,000 Anishinabek people, the community of Kettle and Stony Point is named for the perfectly round rock formations dotting the shores of the lake, eroded over millions of years. Called kettles, they’re unique to only three locations in the world.

According to knowledge keepers, oral historians of First Nations communities, the kettles are eggs of Thunderbirds who bring healing rains to communities in exchange for safekeeping of their sacred nests. They are culturally and spiritually significant to the Anishinaabe.

On a Thursday in late November, healing and wellness is the exact reason for a busy parking lot at the health centre. Up the ramp toward the back of the building, a large open space is bustling with energy. The Kim and Stu Lang Community Healthcare Partnership Program (CHPP) team has been in Kettle and Stony Point for the week, providing veterinary health services to pets of First Nations community members who live within or near the community.

The CHPP helps made-vulnerable communities by improving access to veterinary care services for companion animals. Developed in 2019 with funding from Kim and Stu Lang, the CHPP brings together veterinarians, registered veterinary technicians, students and community partners to provide primary care in a collaborative care model to Indigenous communities, people experiencing housing insecurities and sheltered animals.

During their elective rotation, students have the opportunity to broaden their perspectives, understand cultural differences and increase awareness of barriers to care that made-vulnerable communities face. Students learn about building relationships with people across cultures and are asked to reflect on their own lived experiences. This is reinforced during pre-departure training, delivered by seasoned members of the CHPP team.

“Current final year Doctor of Veterinary Medicine (DVM) students participating in CHPP clinical rotations don’t have a ton of background in community medicine, cultural safety or reflexivity training that would prepare them for working out in these communities,” explains Lynn Henderson, Director of the CHPP. “Before we leave, we explore the basics of these principles and our own privilege and bias, which invites students to consider themselves and their approach to clinical practice in a different setting.”

These teachings are discussed through debriefing sessions held every evening and a reflection assignment required at the end of rotation.

Starting September 2024, the DVM curriculum will be updated across the first three phases to explore these topics and integrate them into veterinary training. The team is also working to create an online Indigenous Cultural Safety course that will enrich and deepen pre-departure training for rotations to come.

During week-long rotations, the CHPP team spends the first two days performing spay and neuter surgeries. Today, the team has spent a portion of their morning converting their temporary surgical space into a clinic for pet wellness visits, offered over the final two days of their stay. The team comes prepared to work in any setting – churches, community centres, portables and parking lots.

This week there are eight veterinary students from Phase 4 of the Ontario Veterinary College’s (OVC) DVM program completing a clinical rotation with the team, in addition to seven staff and a volunteer veterinarian and veterinary technician. They drove from Guelph to Kettle and Stony Point together on Monday. Four days into the experience, they work together with ease to get clients in the door and begin the process of initial paperwork.

Three appointments arrive to kick off the day’s wellness visits.

Mister is an orange cat with big green eyes. Student veterinarians Ellen and Jessica greet his owner and lead them to one of the open examination tables. The team starts by asking each owner the same standard set of questions about the patient’s history including his regular activities (indoor/outdoor), other animals he may encounter and any veterinary or medical history. Today Mister will get his vaccinations updated and have a nail trim.

Toward the back of the room, student veterinarians Jonathan and Aaron are starting an examination for Jägermeister, a small mixed-breed dog who is here today to get his vaccinations up to date. From start to finish, students are exercising many of the core skills they learn as a part of the DVM program, which go beyond diagnosing complex medical conditions and performing surgery.

Today they’re practicing some of the most fundamental skills in their clinical training: communicating with clients, taking a patient history, gauging an animal’s comfort level with physical exams, working cohesively and delivering the basic services effectively.

Nug and Bean are being taken care of by DVM students Melanie and Elizabeth. Bean was in earlier in the week to be neutered, so the team is happy to see him recovering well. Nug is here to get an ear infection looked at, in addition to getting his annual vaccinations.

Most of the appointments today will be for similar care such as annual check-ups, vaccinations, microchips and acute care for conditions such as ear infections or minor wounds. Occasionally there are appointments related to quality-of-life, and euthanasia is available in community with the team when needed. In remote Indigenous communities, the nearest veterinary clinic is sometimes hours away, leaving a significant barrier to some of the most basic aspects of primary veterinary care.

“Often the medical services we provide are what we might refer to as ‘routine’ – vaccinations, examinations, deworming – but to the people we serve, these services are priceless,” Henderson describes, “The privilege of being part of that will never get old.”

In conversation with Melanie, she notes the educational value of providing hands-on care through her CHPP rotation. Her schooling began at the height of the COVID-19 pandemic, requiring much of her phase’s clinical teaching over the first two years to be delivered online. Rotations like these offer students in her year a chance to apply hands-on learning with repetition.

A tiny mew from the back of the room comes from Lucky, a new kitten who is here today to receive his first vaccinations and microchip.

Usually, microchips are implanted while pets are spayed or neutered because the needle is thicker and can be uncomfortable. Lucky isn’t old enough yet to be neutered, so DVM students Ellen and Jessica work together to hold him comfortably and place the microchip between his shoulder blades. After it’s placed, they check to make sure the chip can be read and give aftercare instructions to his owner.

In the afternoon, Bear, Baby, Ivy and Jack arrive with their owners for wellness checks, which will take place outside.

“Appointments can take place anytime and anyplace, especially with larger dogs who might be reactive or nervous,” Henderson explains. “We have to be ready to pivot and prioritize the patient.”

Outside, Jonathan and Aaron work with Bear, an older lab who is here today to get assessed for itchy and irritated skin and a possible ear infection. In asking basic questions about what and how much Bear eats in a day, the team can have a valuable conversation about his diet that could benefit his skin health.

Nearby, Bear’s housemate Jack, is getting a squishy lump on his belly assessed by Ellen and Charlotte. After a quick assessment, his owners are advised to keep an eye on the lump for changes in size or shape. The team will see him again when they return to Kettle and Stony Point in the spring.

By evening, the team has spent an hour relaxing and decompressing after a long day. A cheerful voice fills the room as food arrives from Chunk and a lovely group of local women who cater meals to feed the CHPP team while they’re here on rotation. The students agree they’ve never been so well fed.

As supper ends, Henderson and CHPP faculty member, Lauren Van Patter, move to sit at the head of the table. The chatter dies down and the team begins its evening debrief. The students reflect on feelings from the day, noting that they often had to reach out to experienced veterinarians in the room to work through more complex medical cases involving heart murmurs, coughing and skin issues. They acknowledge the creativity required to think quickly on their feet and pivot when an animal needs to be seen outdoors or isn’t comfortable with some clinical practices.

The students acknowledge the discomfort that comes with recognizing their privilege, while seeing a client struggle to pay for services their pet needs. In the moment, Henderson reminds them: “You may not be able to do everything here for them today, but there may be something they can do,” she says. “Send them out the door with some sort of action they can take and implement at home.”

The feedback session ends on a powerful note. Before arriving, students were asked to look up the terms of the treaties from the cities where they’re from. They’ve come prepared to give an overview of their hometown’s treaty name and historical timeline, which Indigenous peoples are affected, and what geographic area it covers. After everyone has shared, Van Patter asks the students their thoughts on territorial acknowledgements, which are verbal or written statements that acknowledge the Indigenous history of a location, often used at the opening of meetings or events.

Students acknowledge the benefits and drawbacks of land acknowledgments, recognizing that the intention is good, but how the statements are used should be thoughtfully examined. The sentiment around the table is universal: territorial acknowledgements should be more than words, but should signify an intention towards learning, reconciliation or action. The team agrees that, without action, allyship is performative.

For Henderson, these moments signify the critical thinking students are doing to come full circle during rotation.

“Students are leaving with recognition that we all hold biases and pre-conceived ideas about other people and the world around us,” she says. “This is totally normal and a part of the first step on a lifelong journey towards knowing yourself and serving others authentically.”

She adds, “Hearing the thoughts and ideas from the students who participate in these experiences alongside our team is so rewarding. We often see a transformation in how students perceive themselves as future clinicians, and the clients in front of them. Sometimes these transformative moments are subtle, and only evident to the keenest of observers; other times we see them in the profound comments or emotions they express during their time with us. I love being part of this phase of their learning journey.”