Undeterred by the threat of drug cartels and extremist guerillas, Dr. Judith Bartlett knew she needed to get to where she was going—and fast.
As a physician and researcher, Bartlett’s mission has always been to understand and promote the health and wellness of Indigenous peoples. That goal has meant pushing forward into unfamiliar territory far from her hometown of The Pas, Manitoba.
This trip found Bartlett [MD/87, MSc/04] and her colleagues in southwest Colombia studying best practices in intercultural care and meeting with the Páez people, who ran their own successful health insurance system.
“As we prepared to leave Popayán, a government official advised us, ‘We can’t provide protection if you leave the city’—which was exactly what we had to do. At one point, we were raced down a mountain in an ambulance with bullet holes in it,” Bartlett says, with a laugh.
This pioneer in health care, whose career would impact the lives of communities on several continents, is accustomed to being bold in actions and ideas. This confidence was fostered throughout her UM studies in medicine as she carved out a career as a caring and skilled healer and administrator, embarking on important applied research in Indigenous health.
Not only was she among the first three Indigenous women to graduate with a doctorate of medicine from the University of Manitoba—and did so as a single mom, with two young children in tow—but she developed a game-changing health model that would go on to support the first-ever broad survey of Métis health and wellness.
She based this unique holistic framework on the traditional medicine wheel—at a time when some naysayers even deemed it “witchcraft.” It has since been taught and applied across Canada and around the globe, benefitting thousands of people, from Métis communities in Winnipeg’s North End to Indigenous social workers in Taiwan.
What is wellness really about?
As a co-founder of the Aboriginal Health and Wellness Centre of Winnipeg, Bartlett wanted to develop a holistic tool that could be used for simple, life self-assessments by individuals or groups, as well as for widespread wellness scans and research with Indigenous populations to identify assets and gaps in health and social services.
“It would be a tool to serve as the holistic, Indigenous philosophy our community wanted,” she says.
It had to provide a comprehensive picture, rooted in traditional and contemporary knowledge. Creative and pragmatic, Bartlett calls it the Aboriginal Life Promotion Framework and it’s underpinned with principles such as humility, trust, honesty and sharing.
“Life promotion is about having balance of the spiritual, emotional, physical and intellectual parts of self at all life stages—as a child, youth, adult or elder,” she says. “It’s focused far beyond the disease-based health system to include life as a whole, and looks at how we live as individuals, families, communities and nations at various cultural, social, economic and political levels.”
Using these 16 “determinants of life,” she created wellness areas as a path you move along.
“You can travel from nature—who I really am—to my identity or created self, to my development level, all the way around to my governance—what is my voice? And you can do that at an organizational, national and even political level if you wanted,” says Bartlett, who has presented hundreds of workshops to thousands of people, from Inuit seniors to Tribal Councils to audiences in New Zealand.
When Bartlett was chair of the United Way of Winnipeg in 2002, the framework facilitated an environmental scan—an eagle’s eye view—that resulted in major increases in support to Indigenous agencies.
“By laying out an integrated body of information for the board, that resulted in funding to those organizations going from maybe $20,000 to one organization, to in the millions now to Aboriginal-led organizations,” she says.
“I’m not here to simply do a research project, I’m here to build a long-term relationship.”
Several years later, they did another scan to see if Indigenous health was getting any better, and she says it was. The employment rate was up and there were more people in adult education, but Bartlett says there were still too many people living in poverty.
Requests came in to conduct similar studies in Calgary and Saskatoon, which she did. But her largest study was with the Manitoba Metis Federation (MMF) in partnership with the Manitoba Centre for Health Policy at UM. The study resulted in a large Métis health report that included mortality, life expectancy, chronic diseases, lifestyle, education and more. Later, Bartlett’s MMF research team did age and sex-specific studies for cancer, diabetes, cardiovascular disease, mental health, and infant mortality in the Manitoba Métis population. It gave the provincial government its first set of valid statistics in order to better meet the community’s needs.
“Our full-province, full-population health status study compared Métis to all other Manitobans,” Bartlett says. “It really showed that Métis have higher chronic diseases and lower education than all other Manitobans; Métis men have a lifespan of 72 years compared with other men, which is 78.”
The premature mortality rate for Métis men in the Downtown and North Point Douglas areas of Winnipeg is seven times that of all other men in the city. Bartlett says it was critical the results were taken to Métis region offices for interpretation with their affiliated health authority.
Defining these inequities was what pushed her into research in the first place, having been a fly-in doctor to northern communities St. Theresa Point and Wasagamack First Nation. While working with Métis, she saw the urgency for an effective system to better bring together academics, health authorities and the community.
“So we had a stool with three legs,” she says.
And when you explore gaps, it was key that no blame be assigned, but instead [make] a plan for positive changes, some that could happen right away, some that needed to come to life over time. But throughout, it was important for her to build trust.
“I’m not here to simply do a research project, I’m here to build a long-term relationship,” says Bartlett, who led many quantitative Métis health research projects as associate professor in the Rady Faculty of Health Sciences until her retirement five years ago.
“This is about my family as much as it is about all other Métis in Manitoba.”
A girl left on her own
Bartlett was one of 11 children. Nobody used the term “Métis,” she says, and it wasn’t until years later, after having moved from The Pas to Winnipeg and touring Louis Riel’s historic home, that she better understood some traditional aspects of her upbringing.
“I saw this huge poster of a man and a woman and a little girl. And it kind of took me aback because it made me realize, yes, we were definitely Métis. The little girl’s hair was done exactly the way our mom did our hair,” which Bartlett says was a centre, front part with braids wrapped on top of the head and a ponytail in the back.
“Life was hard as a kid,” she says. “You experienced racism but you didn’t know what to call it.”
When she was 10 years old, her cousin came to live with them.
“She was very fair, and you could see the veins through her skin and my skin was really dark and you couldn’t. And I knew she was being treated better. It took me many years to get rid of that sense that I’m nothing, that I have absolutely no value,” says Bartlett, who, in 2017, would be named to the Order of Canada.
Hers is a story of raw grit. Bartlett’s father was a diamond driller up north and was rarely home. When he stopped coming back entirely, her mother had to wash dishes to support them. Bartlett believes ending up on welfare is what broke her mom, who started drinking a lot.
“When I was 16, I went to my grandpa’s in Snow Lake for the summer. When I got home, mom and the five youngest had moved further north to Wabowden,” she recalls.
Bartlett was forced to quit school and find a job after being refused welfare support on her own. At 18, she was pregnant and on her way to Winnipeg.
“I knew the options were limited without education,” Bartlett says.
She credits a UM counsellor from the Access Program with talking her into applying for the Special Premedical Studies Program, then a ground-breaking UM initiative to increase the number of Indigenous medical students. In 1979, it was the first of its kind in Canada.
Through the premedical program, Bartlett was able to catch up on science courses she missed from Grade 9 to 12 in only a year and a half, better positioning herself for the grueling workload to come.
“In my first months of internship, I cried often on my way home from 36-hour shifts, knowing I had two kids at home that needed my time. There were days on end I never saw the sun,” she says.
Bartlett said she initially went back to school to provide a good life for her children but was also motivated by an interest in science and working with others. She felt a strong sense of purpose and credits the UM for helping her realize her true potential.
“I became a doctor because I knew I had something to offer health services for Aboriginal people. I felt I had to prove that Aboriginal people could do medicine, and thus put a lot of pressure on myself needlessly,” Bartlett says.
“I was in third year before I started to realize that I could do it just for me. Medicine was not, for me, so much a career as it was a wonderful open door that allowed me to go in many directions: providing direct clinical services, doing health research, health administration, and being involved in community development activities. It was about doing what I loved.”
Advocacy in Action
Dr. Judith Bartlett co-produced a watershed report on Indigenous women at risk of being coerced into sterilization and, for some, of also having their babies apprehended at birth.
This 2017 review was in response to several women in the Saskatoon health region reporting to media they were pressured and harassed before or during labour to sign consent forms to undergo tubal ligation.
The 57-page report outlined calls to action and resulted in the opening of a reproductive centre for pregnant Indigenous women in Saskatoon in 2018. The document is now used across Canada and internationally.
“Some women have been supported with excellent outcomes for moms and babies, but there is still work to do across the country,” says Bartlett.