A shared vision for better health

Gitxan Elder Marr Dorvault has long been an active and vibrant Indigenous voice in Vancouver, sharing her cultural knowledge and participating in ceremonies and events across the city, including at UBC. Over the past year, she’s experienced a number of health challenges that have impacted her mobility and day-to-day life — including vision loss.

“I used to do traditional beadwork, but because of my vision I can’t do it much anymore,” she says.

One of the places Elder Marr receives care is the Vancouver Coastal Health Downtown Eastside (DTES) Eye Clinic, where she has access to specialist eye care from ophthalmologists and optometrists who donate their time and expertise as part of the clinic’s mission to address health disparities faced by marginalized communities.

The clinic plays an important part in Elder Marr’s care, but for many Indigenous people living with the effects of inter-generational trauma and discrimination, healthcare facilities can feel unsafe and emotionally triggering.

“There’s a lot of racism out there. A lot of our people aren’t comfortable speaking out when they experience discrimination, because of their experiences in residential school,” says Elder Marr.

Dr. Zaid Mammo, co-director of the clinic and a UBC clinical assistant professor in the Department of Ophthalmology and Visual Sciences, says this distrust and discomfort can lead patients to avoid getting the care they need. “We receive many referrals from local Indigenous health centres, and it’s not uncommon for patients to choose not to follow up,” he shares.

To help address this issue, Dr. Mammo is taking part in a unique community-led UBC partnership research project with the clinic.

Seeing Change: Addressing Eye Health Disparities in Vancouver’s Downtown Eastside Through Indigenous Patient Leadership brings together researchers in the UBC Research Excellence Cluster in Vision with Indigenous cultural liaisons and patient partners including Elder Marr. In knowledge-sharing circles, they set research priorities that will guide community-based outreach activities aimed at improving eye health and well-being among Indigenous people and the underserved DTES community.

“I joined the project because I want to help my people. I want to share my knowledge to help more of our people understand what’s going on with their eyes,” says Elder Marr.

Bridging these community relationships is project lead and fourth-year MD student Jean Oh. “I started volunteering at the clinic in my first year of studies, and I began to understand how the intersecting effects of colonialism, racism and poverty affect Indigenous patients,” she says.

These compounding effects make it harder for patients to access care and stay connected with treatment. That’s cause for concern, because eye symptoms can sometimes indicate a serious underlying illness.

“It’s really important that everyone has access to vision care, because through your vision you might find out about other health conditions,” says Dr. Laura Bulk, a UBC assistant professor of teaching in the Department of Occupational Science and Occupational Therapy and a member of the Seeing Change research group.

“One of the first signs of multiple sclerosis, for example, is often vision-related. Diabetes and high blood pressure can also lead to vision loss.”

Dr. Mammo says it’s not uncommon to discover serious underlying health concerns when treating patients at the clinic.

“Recently, a patient came in with reduced vision, and we found significant bleeding in the eye. When we checked his blood pressure, it was very high, and we sent him to the emergency room right away.”

Dr. Mammo and Oh are hopeful that Seeing Change will yield transformative insights to provide Indigenous people, who experience higher rates of eye diseases, with more equitable care.

“It’s time we asked: Are we really exploring our patients’ perspectives? What are the barriers they face? What are the struggles they have in getting to the clinic? And even, what is vision and what is blindness through an Indigenous lens?” says Dr. Mammo.

“By centering and empowering patient voices,” Oh adds, “we can move towards initiatives that truly reflect the needs and priorities of the communities we hope to serve.”

Elder Sandy Lambert, the project’s cultural liaison and knowledge-sharing focus group facilitator, stresses that the key to delivering culturally safe care is to build trusting relationships. “[As a care provider], you can’t just walk into a patient appointment and say, ‘I’m so-and-so, I’m going to look after you, and this is the way it is.’ You need to approach it in a better way.”

For Dr. Neeru Gupta, professor and head of UBC’s Department of Ophthalmology and Visual Sciences, the project is a reflection of the department’s commitment to community-engaged research.

“Projects like Seeing Change really embody our mission to transform vision health for everyone, and that means working alongside patients and communities as partners,” says Dr. Gupta. “Together, we can shape a future for eye care in B.C. that is grounded in cultural humility and built on trust, equity and belonging.”

Ultimately, Seeing Change is about building community — between patients and caregivers, sighted and non-sighted, Indigenous and non-Indigenous. That’s important not only for the project, but also for the well-being of patients like Elder Marr, says Dr. Bulk, who brings her own experience of vision loss to the project.

“Being connected with community and other people who have sight loss can help you discover that there is life with vision loss. You’re not just a sighted person missing your sight, but you’re living in the world in a unique way,” she says.

Elder Marr’s experience certainly reflects this. Throughout her health journey, her community has remained a source of strength and resilience. She’s resumed her work as an Indigenous Elder at her local community centre, and is even crafting again.

“There’s always somebody ready to help me. I’m not doing much beading, but I’ve been making button blankets,” she shares.

It’s taken time for Elder Marr to regain her strength, just as it will take time for Seeing Change’s impact to be fully realized.

“You have to be really slow and steady in building trust,” says Elder Sandy. “You can’t just say it’s a culturally safe space. You have to actually cultivate cultural safety. And you do that by building relationships first.”

Seeing Change is a 2025 recipient of a UBC Community-University Engagement Support Fund award, which supports community-led initiatives while advancing collaborative research, teaching, and learning.

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