What could pharmacy look like through an Indigenous lens?

When Kahwahteeket Muska Iskwew, also known by her English name Katherine Cooper, first moved to Vancouver, she needed to find a new pharmacy. Living with Parkinson’s disease—a neurological condition that can cause tremors and affect movement—she relied on multiple medications and searched online for a pharmacy that seemed welcoming enough.Instead, she says, the pharmacist took one look at her and asked how long she had been a “drug addict.”“Now I’m very respectful,” said Cooper, choosing not to react to the pharmacist who had stereotyped her before learning more about her medical history. “So I just walked out, never to return, of course.”Cooper, today the elders program coordinator at Lu’ma Medical Centre, shared the experience at BCPhA’s annual conference, earlier this month, to illustrate the kinds of assumptions and stereotyping many Indigenous patients still encounter when trying to access care from pharmacists.The panel, titled “Re-imagining Community Pharmacy: Honouring Indigenous and Western Medicines,” brought together Cooper alongside Dr. Michael Dumont, medical director and family physician at Lu’ma Medical Centre, as well as Jason Min and Larry Leung, both associate professors of teaching in the Faculty of Pharmaceutical Sciences at the University of British Columbia. Central to the conversation was Lu’ma Medical Centre itself, an Indigenous-led clinic in East Vancouver that has spent nearly a decade building a healthcare model designed specifically around Indigenous patients, many of whom have long histories of difficult experiences within the healthcare system.Dr. Dumont, an Anishinaabe physician from Shawanaga First Nation, said the clinic emerged because Indigenous-focused healthcare options in Vancouver were limited, while mistrust of mainstream healthcare remained widespread.“A lot of our relatives don’t show up,” Dr. Dumont said. “They don’t set foot inside the door.”That mistrust, he explained, is often shaped by generations of negative interactions with healthcare institutions, including racism experienced directly by patients or their families. So the clinic was intentionally designed to feel different from a typical medical office.Dr. Dumont described spaces filled with Indigenous art, warm colours, ceremony rooms and traditional medicines visible at the entrance, rather than the “cold and clinical” feel many patients associate with healthcare settings.Lu’ma now operates with physicians, nurse practitioners, counsellors, social navigators, elders, knowledge keepers and traditional healers working alongside more conventional healthcare services. At the clinic, patients can access everything from bloodwork and chronic disease care to counselling, ceremony and traditional medicines under the same roof.Leung said their work is grounded in “Two-Eyed Seeing,” an approach that attempts to bring Indigenous and Western knowledge systems together without treating one as secondary to the other.“Pharmacy is a Western system of medicine,” Leung said. “And that’s okay. But there are other knowledge systems that have existed for millennia.”Speakers stressed that traditional medicines should not simply be understood as herbs or alternative remedies, but as practices deeply tied to ceremony, relationships, language and connection to land.“When we speak about our traditional medicines, people think about herbs, plants. For us, it’s so much more than that,” Cooper said.The goal, she emphasized, is not to replace Western medicine, but to allow both systems to work together. Both approaches have been critical in her own care.“Without the Western medicine, I’d probably be in the nursing home somewhere,” she said. Leung emphasized the need for connecting the two approaches, during the Q&A.“We have very clear evidence—including Western evidence—that when patients reconnect with culture and reconnect with the land, it leads to better health outcomes,” Leung said.And for Dr. Dumont, pharmacists are already part of this conversation whether they realize it or not. The challenge for pharmacy, he suggested, is whether the profession is willing to build systems—and relationships—that acknowledge that reality.“Most of my patients are using traditional medicines. It’s happening already,” Dumont said. “So we need to be comfortable understanding what people are taking, be they pharmaceutical medications or traditional medicines from our Elders and knowledge keepers. We need to be able to have those conversations.”

What could pharmacy look like through an Indigenous lens?

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