East Meets West: A Collision of Medicines
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Within the Indigenous population the Inuit are the most disadvantaged due to low numbers of teachers, crowded living spaces that make studying difficult and high rates of unemployment. Coryse C, Scott K. The determinants of employment among Aboriginal peoples; The number of Indigenous individuals attaining post secondary education is increasing, especially among Indigenous women, but still falls far below the non-Indigenous population.
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Within the Indigenous population there are higher levels of unemployment and lower levels of income as compared to the non-Indigenous population resulting in more Indigenous families that must rely on social assistance from the government as compared to non- Indigenous families. Poverty compounded by more single-parent families and lower incomes has an immense impact on the types of food an individual or family can afford.
The combination of food insecurity, encroachments on land and pollution have begun to limit the ability of Indigenous people to obtain traditional food by means of hunting, trapping and fishing. Processed food is often cheaper and more available than healthy food such as fruits and vegetables in Indigenous communities. This is especially true in remote and rural communities as the high cost of transport makes fresh food very expensive.
Food insecurity and unhealthy eating habits are stressors that can lead to depression, distress and obesity. Within the Indigenous population there are higher rates of alcohol, substance abuse, and smoking, inadequate levels of exercise and unhealthy diet choices.
All these choices represent a significant determinant of health within the Indigenous population. Mortality of urban Aboriginal adults in Canada, Chronic Diseases in Canada. The impact of colonization still has an immense impact on the physical, emotional and mental health of the Indigenous population. Being aware of the Indigenous social determinants of health is paramount in providing adequate and culturally safe care to the Indigenous people. Efforts are being made in public health and clinical services to improve the social determinants of health at the patient, family and community levels through patient education, healthy lifestyle campaigns and community engagement.
Local, regional and government partners are beginning to engage and collaborate with Indigenous peoples and communities, building upon their resiliency and cultural resources to achieve improved health together. For more information on Indigenous social determinants of health see links provided below. The Indigenous peoples of Canada share a rich history, yet diverse languages and traditions that represent important historical, social, political and cultural aspects of Canadian society.
It is clear that the social determinants of health such as housing, education, gender and income , the historical and current context of colonization and the residential schools experiences have negatively impacted health. Recently, systemic racism also plays a role in how well Indigenous peoples receive care. As a result, the epidemiology of health issues demonstrates the significant disparities that exist. To improve health outcomes, health care professionals must aim for and provide culturally safe care by learning about Indigenous health and social issues and the factors that affect their health, lifestyle and communities.
This includes the residential school experiences and multigenerational sequelae that must be appreciated so that health providers and Indigenous patients, families and communities can move forward together in reconciliation. Every treatment has a cultural component. Western medicine is founded on science, but we must recognize that this holds no inherent guarantee of quality or efficacy.
We teach the importance of evidence-based medicine, but there are many therapies for which we have not yet accumulated evidence of effectiveness, so should you dismiss all therapies that are not yet proven? One suggestion is to proceed with an open but enquiring mind — be skeptical i. Western medicine places diagnosis as a central goal, whereas other approaches, including Indigenous medicine, see it as less central and pay more attention to finding a safe environment in which the patient may recover.
For conditions such as mental disorders, this latter approach may prove more effective than struggling to fit a label to the disorder.
Here are some background notes to make you aware of some common Indigenous healing practices that your Indigenous patients may mention. You should at least have a general understanding of what these involve. The medicine wheel symbolizes the interconnection of all life, the various cycles of nature, and how life represents a circular journey. The number four is sacred to the many Indigenous peoples of North America and can represent many things: Hence, you may see the medicine wheel presented in several different ways:.
For a traditional healer, an imbalance e. When Sweetgrass is walked on, it bends but does not break. Hence, it has been associated with virtue: Tobacco connects us to the spirit world; it absorbs prayers and carries them to the spirit world. If a request is accompanied by an offer of tobacco that is accepted, the promise must be honored.
Tobacco can also be used to thank the Creator for his gifts: Tobacco is generally not smoked, except on special ceremonial occasions. Its vitamin C content helped prevent scurvy when fruits and vegetables were unavailable during the winter months. Sage the West is a women's medicine, conferring strength, wisdom, and clarity of purpose. It is a powerful purifying medicine that drives away negative energies. The threefold braid represents body, mind and spirit. A 'smudge' is smoke used for ritual cleansing.
Sacred medicines such as cedar, sage, sweetgrass or tobacco are burned in an abalone shell. The shell represents water, the first of four elements of life; the medicines represent gifts from mother earth and the burning represents fire, the next two elements. The person puts their hands in the smoke and carries it to their body, especially to areas that need spiritual healing mind, heart, body. The smoke represents air, the final element. Perhaps the smell of the burning medicines stimulates the brain to produce beta-endorphins and promote healing processes.
Meetings held to heal physical, emotional and spiritual wounds. A symbolic object, often an eagle feather, may be given to a person who wishes to speak, and then it is passed around the circle in sequence to others who wish to speak. Shamans may conduct the ceremony. A ceremonial sauna used for healing and cleansing. It made of a wooden framework covered by blankets or skins, usually igloo-shaped, about 1. Hot stones are placed in a shallow hole in the centre of the lodge.
A medicine man pours water on the stones to produce steam and participants may spend an hour sweating in the lodge. The lodge combines the four elements of fire, water, air and earth. Ceremonies include offerings, prayers, and reverence. At times, excessive exposure to the heat of the lodge may have health effects; also toxins can be released if grasses that have been exposed to pesticides are placed on the rocks. A ritual that celebrates the harmony between man and nature, and spiritual dedication.
Originally practiced at the summer solstice, the sun dance represents continuity between life, death, and regeneration. The symbolism often involved the buffalo, on which plains Indian groups depended, so deserving reverence, but which they also had to kill. Four days before the ceremony, the dancers prepare by purifying themselves, at times in a sweat lodge, by meditating and collecting ceremonial items of dress to use in the sun dance.
The sun dance itself takes another four days, and generally involves drumming, singing, and dancing, but also fasting and, in some cases, self-inflicted pain. This symbolized rebirth and often involved piercing the skin and attaching cords that the person had to tear out. This element led governments to suppress the sun dance around , but it has been re-introduced.
The pipe is used individually and in groups for prayer and ceremonial purposes. Participants gather in a circle. A braid of sweetgrass is burned to purify the area and those present, to make a sacred place for the spirits to visit. Tobacco or kinnickkinnick, a traditional mixture of bearberry and wild herbs or red willow shavings, is smoked so that prayers can be made to the Great Spirit or requests made of the spirits.
The pipe may also be smoked to open other meetings or ceremonies. When not in use, the bowl and stem are separated and carried by one individual, the pipe holder. A ceremonial feast among northwest Pacific coast Native peoples held to celebrate major family events such as a marriage or birth. The host distributes gifts according to the status of each guest; reinforcing the perceived hierarchical relations between groups. At times the gift-giving became competitive, the host giving away personal possessions in anticipation that others would reciprocate in their turn.
Missionaries encouraged government to outlaw the potlach around ; it is now common. Caring for Aboriginal patients: There is huge variation between different Indigenous groups, but you should be aware of several common values held by many groups. Taken together, they form a beautiful approach to living:.
Acupuncture and Oriental Medicine, PLUS | Jerry Rankin, D.O. M.
Traditional perspectives on child and family health. Paediatr Child Health ; It really does take a community to raise a child, but whose community? Since colonization, Indigenous ideas of health were put aside by mainstream ideas, which were presumed to be a better way of caring for Indigenous children …. Their decisions, actions and beliefs have had a direct impact on our lived experience, just as our decisions will affect generations to come …. Respect for culture and language Culture shapes concepts of health and health care, defining what is considered legitimate health care practice and what is not.
Shared responsibility for health: For that to happen, the mainstream needs to make space for Indigenous concepts of health. It needs to improve its capacity to work with Indigenous children and families. One way is to improve the links between professionals working in child and youth health and communities, increasing their understanding of Indigenous perspectives of health. An elder prescribes the contents of the pouch, which may include the four sacred plants, or items such as diamond willow fungus, dried or powdered beaver testicles, and buffalo droppings.
They will usually be burned when the owner wishes to invoke the power of the spirits. A sacred pouch must not be touched by anyone but the person wearing it or the elder, for doing so would be a violation of the religious sensibilities of the wearer and a desecration of the contents. The sacred herbs are sometimes worn pinned to clothing. An elder may provide guidelines for the fast and ensure that the health of the individual is adequate for fasting conditions. These foods vary between tribal traditions. At times of sickness, rattles may be used to call the spirit of life to assist in healing the affected individual.
A sick person may wish to burn tobacco, sweetgrass or other sacred herbs as an aid to healing. Funeral and mourning practices vary among different Nations and individual families. Most First Nations people who are Christian usually prefer the funeral and burial practices particular to their church. Hair may be braided; three braided strands signify the body, mind and spirit.
Braids or uncut hair generally signify that the style worn is of spiritual and cultural importance to the individual and reinforces his or her sense of identity as a member of a particular First Nation. In Nunavut and the Northwest Territories, Indigenous people form the majority of the population with The median age of the Indigenous population in was 28 years — 13 years younger than the median of 41 for the remainder of the Canadian population. The younger median age is primary due to higher fertility rates and shorter life expectancy. Before contact with the Europeans, the Indigenous peoples were healthy and vibrant nations living on the lands, many groups leading a nomadic lifestyle.
The European impact was significant, particularly related to the spread of infectious diseases. For example, in B. Statistics Canada National Household Survey. Who are Indigenous people? Although currently widely used, there is no legal definition of the term. It can refer to the Indian peoples in Canada, Status and non-Status see below. Indians or First Nations can be divided into three main groups: Status Indians receive non-insured health benefits coverage which helps cover cost for expenses such as medications, medical transports, vision care, dental, and counseling as a condition of their status and treaty.
To be designated a Status Indian , a First Nations person must be registered under the Indian Act and qualify if one or both parents are registered or are eligible for registration. If Indigenous ancestry through one or both parents can be proven from birth, baptism, marriage and death certificates. The First Nations people are very diverse as there are over First Nations or Indian bands and over 60 Indigenous languages spoken by the First Nations people of Canada.
According to the National Household Survey, there were , persons who identified as First Nations, nearly half of all Indigenous people in Canada. Within the First Nations population This number varies depending on the province from the highest in Quebec This stretched from around modern Bancroft in the west to Mattawa in the north and Cornwall in the south, to roughly Montreal in the east. However, successive wars with other First Nation groups drove the Algonquins east of the Ottawa River, until they migrated back in the early s.
The singular of Inuit is Inuk. There are several dialects of Inuktitut. The Inuit population forms about 4. The Inuit have inhabited the arctic tundra for more than years.
For many generations, the Inuit people survived in the north, living a nomadic way of life, hunting and fishing to support and raise their families on the land. Upon the arrival of the European whalers in 16th century the Inuit lifestyle began to change. The Europeans would bargain with the Inuit people and in exchange for helping them find the prime whaling locations and teaching them how to properly butcher the whales the Inuit received food and other supplies. This relationship did not last long as the whale population began to dwindle due to intense whaling.
By the 20th century, this economy shifted from whaling to the fur trade. The Europeans then traded different goods such as tobacco, tea, sugar, guns, ammunition etc with the Inuit in exchange of furs. Aboriginal Health Initiative Committee. J Obstet Gynaecol Can. Many Inuit died as a result of exposure to new diseases small pox, influenza, tuberculosis and measles brought to the north by the Europeans.
By the s, the government presence in the north increased as they provided health, education and social services to the Inuit people. The government worked to move the Inuit into larger, permanent settlements in order to be able to offer these services.
This was a dramatic shift from the migratory lifestyle they were used to and was extremely damaging to the Inuit way of life. The federal government promised during the relocation that communities would remain together and that if the Inuit were not happy they would be permitted to return home. Neither of these promises was kept; communities were separated in the relocation and were not permitted as promised to return home.
Their husky dogs were slaughtered to prevent the Inuit from returning to their original community and this severely impacted their hunting and fishing traditions. The government also failed to inform the Inuit people as to where they were going and how different their lifestyle would be. The entire process was poorly planned as the Inuit were not provided with the shelter and supplies needed to survive.
In August , the Canadian government issued an apology for the forced relocation of the Inuit people. When this land was sold to the Dominion of Canada issues surrounding land ownership arose. Negotiations in Ottawa led to the formation of the Manitoba Act of This Act resulted in the formation of the province of Manitoba and established a framework for eligibility and ownership of land.
Louis Riel was put on trial and hung for his role in the Rebellion. Growing numbers of people are acknowledging their Aboriginal ancestry. This has led to tensions with other, established First Nations groups in the region. University of Ottawa Library; Aboriginal Health Research Guide Health and Social Issues of Indigenous People in Canada Virtually every health indicator suggests that the health of Indigenous peoples in Canada is significantly poorer than that of the remainder population, although the gap in life expectancy between Indigenous and non-Indigenous Canadians has been narrowing.
Higher adult obesity rates exist in Indigenous populations: However, educational attainment is improving. Most common barrier was waiting lists for health services. As well, half of First Nations households reported the presence of mould or mildew in their homes. Very few First Nations people reported speaking to a professional regarding their mental or emotional health psychologist, psychiatrist, or social worker , but preferred talking to a family member or friend.
In , Statistics Canada reported that 14, Indigenous children under age 14 were in foster care: First Nations and Inuit Health Life Expectancy In , the projected life expectancy by Stats Canada for the Canadian population is 79 years of age for men and 83 years of age for women. The Inuit have the lowest projected life expectancy; 64 years for men and 73 years for women. Aboriginal Stats at a Glance The Indigenous life expectancy projections for show an average of years of additional life expectancy as compared to the values recorded in Though the life expectancies of the Indigenous population in Canada are projected to increase, there is still a discrepancy as compared to the general population.
The First Nations crude mortality rate was 4. However, the age-standardized mortality rate for First Nations was approximately twice the rate of the general population. Life time suicidal thoughts among First Nations. All First Nations age groups up to age 65 are at increased risk, compared with the Canadian population; males higher than females. The greatest disparity with the Canadian rates is for females aged 15 to 24 and aged 25 to 39 approximately eight and five times the Canadian rates, respectively. This includes conditions such as high blood pressure, arthritis, asthma, depression and diabetes which are relatively novel phenomena as lifestyle and food choices have changed significantly in recent years.
In , the incidence rate of tuberculosis in Canada according to the WHO was just under 5 per , Within the Inuit population in Canada, the incidence rate is much higher at Access to health care in the Inuit population is an important determinant of health. Many of the individuals who require advanced diagnosis or treatment must leave their communities for long periods of time. Recruitment and retention of health professionals in Inuit communities is difficult which limits further access to health care.
Food insecurity is a problem in Inuit communities due to the higher prices of healthy food. Aboriginal Peoples Survey, Residential Schools History Residential schools were created and initially run by the federal government through legislated acts to assimilate Indigenous children and youth and remove their cultural identity.
Hazmat investigation results in several charges
TRC Final Report Lasting Effects Residential school students attempted to adapt to their circumstances using the following coping strategies: Detachment shutting down, not participating in the group Reinterpretation living out fantasies about the future or present, idolizing those who ran away from school, etc Accommodation currying favor with those in power; this may have led to exposure to sexual abuse out of a desire to obtain protection Resistance defending younger children, stealing food, running away Since the residential schools continued for several generations, the effects have been devastating and pervasive for survivors and their families, including; Loss of cultural identity and self-esteem Loss of indigenous languages, traditions and lifestyle Loss of parenting skills and sense of responsibility for caring and teaching children The hierarchical institutions discouraged the development of decision-making skills, autonomy and initiative.
A high incidence of abuse and violence affecting Indigenous people, families and communities, reflecting the sexual, physical and emotional abuse in the residential schools. Extensive consequent alcohol and substance abuse and high rates of mental health problems, including suicide. Truth and Reconciliation Commission of Canada TRC By , a large number of abuse claims had been filed by former students against the federal government.
Within the calls to action are two very important statements related to the health care education; First, the importance of increasing the number of Indigenous professionals in the health care field. Second, the requirement of all medical and nursing students to learn about Aboriginal health issues, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples , Treaties and Aboriginal rights, and Indigenous teachings and practices. The recognition of the Indigenous right of self-determination More appropriate funding allocation for services from the government Systematic tracking of the progress made since the TRC Aiding in the long process of reconciliation.
Wiley-Blackwell, pp Stereotyping is dangerous and damaging as it unfairly characterizes an entire group of people. What has been done? What you can do Racism is not routinely addressed, especially by people of a dominant group who may not be directly impacted by it. Links Understanding Racism Aboriginal experiences with racism and its impacts Policies, program and strategies to address Aboriginal Racism Bernard Guerin; Combating everyday racial discrimination Robert Sinclair additional information and article Housing There are substantial housing shortages in many of the Indigenous communities, leading to homelessness and overcrowding.
Education, Income and Employment Inadequate levels of secondary and post-secondary education and high drop-out rates result in less specialized skills to offer in the labor market, typically resulting in lower paying jobs. Food Insecurity Poverty compounded by more single-parent families and lower incomes has an immense impact on the types of food an individual or family can afford. More detail on food insecurity Healthy Choices Within the Indigenous population there are higher rates of alcohol, substance abuse, and smoking, inadequate levels of exercise and unhealthy diet choices.
Conclusion The Indigenous peoples of Canada share a rich history, yet diverse languages and traditions that represent important historical, social, political and cultural aspects of Canadian society. Indigenous medicine contains innumerable folk remedies based on plants , many of which have formed the basis for pharmaceutical treatments that we use routinely in Western medicine Traditional approaches to healing are holistic and consider mind, body and spirit.
As Donald Warne points out, it is somewhat ironic that modern physicians say they provide health care when they really treat diseases. Traditional Indigenous care recognizes many routes to healing.
Jerry Rankin, D.O. M.
Seven routes are commonly mentioned: Talking, Crying, Laughing, Dancing, Sweating, Yawning, and Yelling giving vent to your feelings, not yelling at someone! Much traditional healing centers around group ceremonies, including prayers, the sharing of a meal, the use of traditional medicines and practices such as sweat lodges. Healing also involves feeling part of a shared culture, of being outdoors and in connection with the land and with nature.
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