Braiding Accountability: A Ten-Year Review of the TRC’s Healthcare Calls to Action

WE SEE THIS TURN to performance in the health-related Calls to Action 18–24, which challenge governments and health authorities to acknowledge colonial harms, close health gaps, recognize Indigenous approaches to healing, and transform healthcare systems. And Call 57, which expands this responsibility to all levels of government, requiring public servants to be educated on Indigenous history, law, and Treaties to prevent the ongoing reproduction of colonial systems.

Over the past decade, instead of meaningfully engaging with the Calls, governments and health authorities have increasingly turned to what we call reconciliation theatre: symbolic gestures and highly visible activities that create the appearance of progress while leaving the structures of colonial power intact.

These are not accidental oversights or stalled reforms —

they are deliberate choices to preserve control while projecting the image of reconciliation. Land acknowledgments, cultural safety workshops, and glossy reconciliation reports are showcased as progress, even as Indigenous Peoples continue to experience chronic underfunding, systemic racism, and preventable deaths.

As Yellowhead Institute has documented (2021; 2023), settler institutions consistently prefer symbolic inclusion over structural transformation. This report extends that analysis into the health sector. Using the Braiding Framework for Health Accountability (Sasakamoose, forthcoming 2026), we evaluate how health authorities and governments respond to TRC Calls 18–24 and 57.

By braiding together three pathways — restoring Indigenous wellness, creating ethical middle ground, and transforming service delivery — the framework reveals where institutions remain stalled and what true transformation requires. Our findings demonstrate that most systems remain trapped in the earliest stages of symbolic engagement, while almost none advance toward Indigenous governance, law, or authority in health.

The result is stark: nearly a decade after the TRC, there has been little measurable improvement in Indigenous health outcomes. Institutions continue to substitute activity for accountability, performance for transformation.

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