Skennen’kowa

1. Skennen’kowa Aboriginal Health Transition Fund A CULTURAL WORKSHOP

2. Who we are • The Aboriginal Health Transition fund • Identify gaps in health services • Propose means to close gaps • Improve communications with provincial health services • Deliver cultural awareness program • The Kanesatake Cultural Awareness and Sensitivity Training Project • Skennen’kowa – A Cultural Workshop

3. Reasons Well-known that health of Aboriginal peoples much worse than non-Aboriginal Canadians (Health Canada) Efforts to close gaps in health services requires cooperation and participation of Aboriginal peoples Aboriginal peoples must play key roles in programs to improve their own health

4. International priority • According to the World Health Organization: • Dramatic differences in health are avoidable and closely linked with social disadvantage • Inequities in health are due to circumstances in which people grow, live, work, age, and the systems put in place to deal with illness • The conditions in which people live and die are, in turn, shaped by political, social, and economic forces

5. Indigenous population • 2-million estimates at pre-Contact • 100,000 by 1850 • Causes: • Waves of infectious disease • Wars • Destruction of food sources • Poor living conditions post-Contact

6. Indigenous population • Aboriginal peoples today: 900,000(2001 Census) • 610,000 First Nations (N. American Indian); • 45,000 Inuit; • 290,000 Métis. • Experiencing baby-boom while Canada’s population is ageing and nearing retirement • 2/3 of Aboriginal peoples under age of 45.

7. Diverse Indigenous cultures Hundreds of distinct cultures and languages – more than Europe. Many still retain Indigenous identities. • Languages • Socio-Political Systems • Clothing Styles • Shelters • Foods • Art Forms • Musical Styles • Educational Methods • Spiritual Beliefs • Healing Practices

8. Pre-Contact Health First Europeans commented on fitness and fine health of First Peoples Indigenous societies lived close to land and developed medicines and health care systems suited to them Maintained sound system of hygiene, clean living conditions, sports

9. Pre-Contact Health Indigenous agriculture relied heavily on maize, tomatoes, beans, squashes, pumpkins, melons, and fruit orchards The wild grass, seeds, nuts, fruits, roots, supplemented diets of hunter-gatherer societies

10. Pre-Contact Health Infectious disease, minor respiratory diseases and intestinal parasites not significant threat to health Cancers almost unknown. Most infectious diseases absent prior to Contact:

11. Social & Cultural damage Colonization (policies of assimilation) severely erode Indigenous cultures, languages, self-sufficiency, and social well-being; Globalization, education, mass media, pop culture, child welfare system, and institutionalization of generations of young further damage Indigenous cultures and languages.

12. Effects of colonization • Health of Indigenous peoples declined at a disastrous rate: • New diseases • Loss of traditional lifestyles • Loss of food sources • Dislocation • Confinement to reserves • Poor rations diet • Residential schools

13. Effects of colonization • Federal policies resulted in suffering, starvation, disease, and death • “The starvation at Fort Walsh was a cynical and deliberate plan to press the government’s advantage and force the Cree from the area to allow the government a free hand in developing the prairies. The department was well aware of the horrific effects of its policy.” Boyer, Y. First Nations, Métis and Inuit Health Care: The Crown’s Fiduciary Obligation. NAHO, Ottawa. 2004. p. 11 (quoting M. Lux)

14. Effects of colonization • “Gaunt men and women with hungry eyes were seen everywhere seeking or begging for a mouthful of food – little children ... fight over the tid-bits. Morning and evening many of them would come to me and beg for the very bones left by the dogs in my yard. When I tell you that the mortality exceeds the birth rate it may help you to realize the amount of suffering and privation existing among them.” M. Lux, Medicine That Walks: Disease, Medicine, and Canadian Plains Native Peoples: 1880-1940. University of Toronto Press, 2001. p. 38

15. Colonization at Kanehsatake • St. Sulpician Seminary primary authority • Forced Mohawks off land for settlement • Loss of hunting, fishing and farming land • Severe restrictions on ability to work • Land seizures if Mohawks worked elsewhere • Marriages outside forbidden – even to other Mohawks • Punished for other religious or spiritual beliefs • Repeated arrests for challenging authority of Seminary

16. Residential schools • Tuberculosis, whooping cough, measles, rampant in residential schools • High death rates known since 1880s • “24 per cent, of all the pupils which had been in the schools were known to be dead, while at one school … to date 75 per cent were dead at the end of the 16 years since the school opened.” • P.H. Bryce, The Story of a National Crime - Being a Record of the Health Conditions of the Indians of Canada from 1904-1921 Ottawa, James Hope and Sons, 1922. p. 3.

17. Residential schools

18. TB & colonization • 1924 - Indigenous peoples < 5% of British Columbia • 25% of all TB deaths in the province • Early diagnosis vital to effective treatment • Indian agent approval required • Requests then had to be approved by Ottawa • Most requests denied • Medical authority in the first half of the 1900s deemed Native people biologically inferior and disease-prone.

19. TB & colonization • “[T]he facilities for early diagnosis, treatment and prevention that have been used to such good advantage in the White population have never been made available for the attack on the Indian problem.” • Canadian Tuberculosis Association Bulletin, 1937. In Boyer, Y. First Nations, Métis and Inuit Health Care: The Crown’s Fiduciary Obligation. NAHO, Ottawa. 2004. p. 12

20. TB & colonization “… anti-tuberculosis campaigns in Canada framed Native people as a disease menace to themselves and others.” High rates of TB submitted as proof that “Native people were incapable of making the transition from nomadism to ‘civilization’.” Indian Affairs: Native people would only gain the good health enjoyed by non-Native Canadians when they ceased being Native.

21. Legal Rights • Section 91(24) of the Constitution Act, 1867: • Exclusive Federal authority and responsibility for “Indians, and Lands reserved for the Indians.” • Canada’s Constitution Act, 1982, three distinct categories of Aboriginal Peoples are recognized: • Indian, Inuit, and Métis. • Section 35 of the Constitution Act, 1982 states: • (2) In this Act, “aboriginal peoples of Canada” includes the Indian, Inuit and Métis peoples of Canada.

22. Legal responsibility Provinces have primary responsibility for health care delivery for non-status Indians (which is no different than their responsibility to non-Aboriginal Canadians). Territories are federal jurisdiction and responsible for delivering health care services to all residents, including non-Aboriginal people.

23. Legal responsibility Federal and provincial governments quarrel over responsibility that results in “hit or miss” delivery of health care to First Nations. Health care chronically under-funded. “fragmented jurisdictional incoherence” results in a confused patchwork of health care delivery.

24. Health issues Trading with settlers led to a rapid erosion of traditional “whole food” nutrition patterns ‘Home foods’ displaced in diets by: • White sugar • White flour • White rice • Sweetened jams • Tinned milk • Tinned meat • Processed food • Alcohol

25. Health issues Changes in diet lead to: • Physical degeneration • Stress • Impaired immune systems • infectious disease epidemics • Increased rates of chronic diseases, such as: • Hypertension • Diabetes • Cardio-vascular diseases • Obesity

26. Health issues Changes in lifestyle lead to: Resulting in: • Increased stress • Increased instances of violent behaviours • Decreased self-esteem • Decreased coping • Dependency • Anger • Depression • Substance abuse • Anxiety disorders

27. Finally… “Although it is difficult to prove a direct causal link, it is likely that the collective trauma, disorientiation, loss, and grief caused by these short-sighted and often self-serving policies are major determinants of the mental health problems faced by many Aboriginal communities and populations across Canada.” (Kirmayer &Valaskakis, 2009, p. xv)

28. Social Determinants of Health According to the Public Health Agency of Canada: • Income and social status • Personal health practices and coping skills • Social support networks • Healthy child development • Education and literacy • Biology and genetic endowment • Employment/working condition • Health services • Social environments • Gender • Physical environments • Culture

29. Indigenous Determinants According to the National Aboriginal Health Organization, there are additional determinants of health for Indigenous peoples: • Colonization • Access • Globalization • Territory • Migration • Poverty • Cultural continuity • Self-determination

30. Keep in mind “Indian reserves have become dangerous environments, not only in a physical sense but in a psychological sense as well; colonization has created double-barreled psychophysical effects. The research shows how it is due to the unrelenting stresses of colonization that reserve cultures do no reflect a meaningful notion of ‘community’ and why life on reserves is characterized by a much higher degree of violence, hate, and aggression-drive substance abuse than other communities.” Gerald Taiaiake Alfred, Journal of Aboriginal Health, Nov. 2009. p, 49

31. What to do? How to be? • Be interested. • Be honest. • Be truthful. • Use humour. • Use humility. • Be open. • Be patient. (Slow down.) • Learn the patient’s rhythm. • Respect silences. • Listen to and observe the patient. • Ask questions.