ABSTRACT:
Food is central to Nuxalk governance, ecological knowledge, and cultural continuity. Yet colonial food safety regulations and institutional policies have long restricted the presence of traditional foods in healthcare settings. The Nuxalk–Bella Coola General Hospital (BCGH) Traditional Foods Project seeks to transform the hospital food system in Nuxalk territory by restoring access to locally harvested and culturally meaningful foods within clinical care. This multiphase, mixed-methods study is co-led by Nuxalk partners and supported by hospital staff and researchers at the Vancouver Coastal Health Research Institute. The project moves beyond menu modification to address systemic barriers embedded in food safety plans, procurement practices, and institutional protocols. Key components include the redevelopment of the hospital’s food safety plan to accommodate traditional harvesting and preparation methods; the introduction of a seasonal menu featuring locally sourced Nuxalk foods; and the hosting of community feasts that function as ceremonial, relational, and evaluative spaces. These feasts provide opportunities for shared learning, accountability, and reciprocal knowledge exchange between community members and healthcare staff. An embedded evaluation framework measures outcomes across multiple domains, including patient and staff satisfaction, cultural safety, greenhouse gas emissions, food waste reduction, and local economic impact. Data collection methods include surveys, in-depth interviews, food waste audits, and environmental and economic metrics. By centering Nuxalk knowledge and governance within hospital food services, this project advances Indigenous food sovereignty while also promoting environmental sustainability and institutional reconciliation. This initiative offers a scalable model for rural and Indigenous-serving health institutions seeking to respectfully integrate traditional food systems into Western clinical contexts. It demonstrates how Indigenous leadership and place-based knowledge can reshape healthcare environments to better reflect the lands, communities, and relationships they serve.