Remembering that this web journey was intended to investigate Aboriginal involvement with medical education, and remembering that my roots lie in the veterinary field, a last effort will be made to find reference to Aboriginal participation in veterinary medicine, so far, pretty rare.  Solitary veterinary references make a thin gruel compared to the chunky stew of public health and medical career support. 

1) http://vet.ucalgary.ca/node/884

The University of Calgary Veterinary College participated in a recent workshop outlining principles for conducting research in First Nations communities.  In terms reminiscent of Linda Smith (1999), the workshop reviewed principles based on ownership, control, access, and possession (OCAP) for research involving First Nations. Interestingly, these OCAP principles had already been discussed with and adopted by Aboriginal leaders in Canada in 1997.  Every funding application for research in First Nations communities needed approval according to the following stipulations: that Aboriginal communities “control what research data is collected in their communities, how the data is collected, how the information is used, and who has access to it.” Unfortunately, the graduate veterinary students already conducting caribou disease research confessed that they had not applied OCAP principles in their projects and were, in fact, unsure how to proceed given their circumstances with hunters in far flung Inuit communities. However, the workshop introduced the veterinary graduate students to the pre-existing protocols at least and hopefully their results will reflect the changes.

2) http://caid.ca/DogCon010708.pdf2)

R.G. Herbert, D.V.M. (2005) respectfully submitted a First Nation veterinary infrastructure program for the Anishinaabe Nation November 23, 2005 as part of an ongoing effort to control dog populations on reserves. He suggested permanent solutions will only come from within reserve community settings with guidance from First Nations Elders.  He stated that non-native dog management infrastructure can only go so far without addressing traditional law, issues, and choices.  Herbert provided historical context for the cultural difference in dealing with this issue. Elder teachings that “successfully guide communities with wildlife issues”, he wrote, are generally ineffective with “European-descended dogs literally man-made for very specific European roles” which is why, for many First Nations, dog overpopulation remains a “man-made (settler) problem.”

Veterinary services are considered a fundamental community infrastructure in the developed world but not to Northern Ontario’s First Nations communities, according to Herbert. He created his program for the Christian Aboriginal Infrastructure Developments (CAID), a not-for-profit Non-Governmental Organization (NGO) based in Whitehorse, Yukon (http://caid.ca/). The CAID wants to reconcile Aboriginal and non-Aboriginal rights and rebuild what was destroyed through a process of meaningful consultation. Healthier communities are one of their goals.

3) http://calgary.ctvnews.ca/pet-posse-huge-success-1.832648

     One First Nation community accessing help with pet overpopulation is highlighted in this CTV news report.  When invited, the Alberta Task Force will work in remote First Nation communities.  The village of Sitsitka had more than 400 animals attended by both veterinarians and veterinary technicians over one weekend.  Admittedly, this CTV report is a light story but it does highlight the logistics necessary to organize such an event. The work is fast paced under less than ideal conditions, both mentally and physically challenging but also important to tackle because larger, free roaming dogs living in First Nations communities can pose a risk to community members or livestock.

     Veterinary technicians are also known as Animal Health Technologists (AHTs), the equivalent of nurses. Details for AHTs wishing to volunteer for such weekends can be found at the Alberta Task force web page – http://alt.abtaskforce.org/ForAHTs.aspx. AHTs are encouraged to engage with community members by answering their questions, inviting their participation, and explaining what an AHTs role is. AHTs are also advised to respect the community by driving safely through the reserve because the community had invited them “to assist them with their animals.” By being present, AHTs can learn more about Aboriginal philosophies, too.

4)https://www.vetswithoutborders.ca

     Personally knowing several of the veterinarians involved with Vets Without Borders, the international association of veterinarians founded in 2005, gives me the assurance that the organization is genuinely working towards improving communities.  Since most of work is done in areas of deep poverty, it unfortunately means most of their work is done in Aboriginal neighbourhoods too, in similar conditions worldwide. An article from the Provincial newspaper explains the connection between healthier animals and healthier communities in this way: ” One of the tenets of Veterinarians Without Borders is that humanitarian work doesn’t always have to focus exclusively on humans. In fact,  in  many developing countries the welfare of animals and people are so interdependent that improving the health of their livestock or companion aninmals can have a dramatic effect on entire communities. http://blogs.theprovince.com/2012/05/15/vets-without-borders-provides-animal-care-to-improve-human-welfare/

     In Canada, there are two projects that seem less about community health and more about dog sled teams – the Sahtu settlement in the NWT on the south shores of the Great Slave Lake and Kuujjuak, Nunavit, on shores of Koksoak River which feeds into Ungava Bay, west of northern Labrador.  Veterinarians fly in to provide veterinary services for two weeks out of every year. 

5) https://www.youtube.com/watch?v=rNFZmpb_ERs

     The veterinarian featured in this Chilean YouTube story is a good friend, as dynamic as she appears. I find the cultural differences between Canada and Chile very interesting. Blogs associated with her program show a reciprocal exchange of science. Veterinarians from South America come to the Atlantic Veterinary College in PEI, Canada, to conduct their research while third year Canadian veterinary students volunteer in her research project to satisfy the aboriginal component of their program; their stories are a nice touch.

The third instalment of weblogs starts with a reality check.

Site number one:

winnipegfreepress.com/local/students-sue-over-midwifery-program-144072116.html

In chasing down information on the exciting-to-me aboriginal orientated midwifery course in northern Manitoba which I highlighted in my last weblog, Google revealed a newspaper article in the Winnipeg Free Press March 24, 2012: “Students sue over midwifery program: allege UCN failed to provide an education”. Oh dear.

Four students from the University-College of the North (UCN) claimed the college had insufficient instructors, failed to provide adequate supervision, and neglected to ensure students attended the required number of births to complete their courses. Not only that, but the program was shutting down and although students had been invited to transfer to the midwifery program in Winnipeg, the two aboriginal spots had already been filled leaving no room in the class for them to finish their studies.

The article stated there hadn’t yet been one graduate in the six years of the midwifery program instead of the 22 graduates I had described. Working from University statistics. I must have interpreted the numbers incorrectly. Half the KOBP students had left the program for ‘family reasons’.

The article further explained that in the province of Manitoba there are only 44 registered midwives, not all of them practising. Given those low numbers, it is understandable the students could not get enough mentoring.  Politicians blamed each other for the midwife shortage, citing failure to initiate more classes. But isn’t that what they were trying to address by opening the UCN class?

The UCN says it is restructuring and will reopen the program; no date was provided.

I have learned a valuable lesson – doesn’t matter how recent the webpage, check it someplace else or you may end up with stale data like I did.

Site number two:

http://www.cbc.ca/trailbreakers/main-blog/2012/08/08/high-school-program-aims-aboriginal-kids-at-healthcare-field/

After that shock, I needed something reliable so I turned to CBC radio. Trailbreakers is a program focused on First nations issues.

Rina Bright is an educator/teacher at the Children of the Earth School in Winnipeg in a special program aimed at Aboriginal students who want to become health care workers. The students get a chance to work in clinics and assist in surgeries. Bright stays with the students for four years which I think addresses the need for mentorship and community support, elder wisdom and guidance. This was a very uplifting site and good for a discouraged soul (mine!), friendly and optimistic but really no more than light reading.

Site Number three: 

wsd1.org/cote/welcome.html

Just to make sure it really existed and to test my trust in the CBC radio site, I searched for the Children of the Earth high school in Winnipeg. The school was there but their web page was last updated in 2008, unfortunately.

They claim a pedagogy that is culturally based, flexible and centred on the needs of the students. Aboriginal values and perspectives are incorporated into everyday life. “We believe in a holistic approach to education that integrates the physical, academic, social and spiritual well being of our students”, a sentiment that mirrors the medicine wheel model discovered at the University of Saskatchewan web site (reminder: aerc.usask.ca/projects/healthtraining.html).

Macleans magazine included this Aboriginal high school amongst their 2005 Top Ten High Schools in Canada – a silly reference that reassured me greatly.

A reassuring site but not really meaty enough for anything more than a nice visit.

Site number four:

http://ctlt.ubc.ca/2012/09/25/aboriginal-initiatives-classroom-climate-series/

Staying with the school theme, site number four comes from UBC: “What I learned in Class Today: Aboriginal Issues in the Classroom”, a gold mine of information and advice.  Thanks to classmate Janet B. for the introduction to the UBC web page.

One Aboriginal student said she “trained myself to be really diplomatic” so as to carry the responsibility of representing all things Aboriginal to every class but some days she felt it too heavy a burden, “like a brick on my back”.  Another section encouraged non-Aboriginal instructors to “speak through the discomfort and not be silent because of it” when faced with Aboriginal course content that was foreign to them.

There are good, solid, practical tips for teachers to incorporate Aboriginal topics to classrooms and how to deal with the discomfort. A very good site.

Site number five:

http://.unsettlingamerica.wordpress.com/

Angry webpages are not usually my cup of tea but they suddenly felt good after saccharine course promos for no-longer-existing courses. Sometimes it’s good to have a little bit of acerbity for balance.

Unsettling American: Decolonization in Theory and Practice is an energetic website filled to the brim with links to other energetic websites devoted to unsettling the settlers. Snappy titles attract the eye: Unsettling Ourselves: Reflections and Resources for Deconstructing Colonial Mentality began with an explosive “Columbus was insane” and the muscles flexed from there.  Although it’s good to know what’s out there, this site is not helpful for recruiting or retaining healthcare workers. Heaven help me when one of these angry students enrols in my class.

1. https://www.mja.com/au/journal/2007/186/10/development-first-nations-inuit-and-m-tis-m

In my search for information on education for Canadian Aboriginal health care providers, the Medical Journal of Australia surprised me with an article on just that very subject.  Anderson and Lavallee (2007) described new educational goals for Canadian First Nations medical students, agreed upon at the 2005 Kelowna Accord.  The deal was characterized as “historic”. In it, federal, provincial, and First Nations were adapting health education to better support First nations “cultural competencies.” These lofty statements were short on specifics but the proposal came with a $100 million pledge of support over 5 years.

On an interesting note, UBC and the Universities of Manitoba and Alberta were given credit for already adapting their curriculum to better embrace the aboriginal student. As a reminder, my posting last week of the Province newspaper article mentioned UBC’s largest First Nations graduating class in 2012.

Also, Anderson and Lavallee (2007) noted how First Nations were being invited to control their own community health programs.  In their report on the Kelowna Accord, reference to “the right of the indigenous people’s to set priorities and strategies for health programs affecting their communities” was made. I set about searching for confirmation.

2) http://fnbc.info/

This glossy, well linked site provided many helpful links to Indigenous health care.  Because the site is managed by the First Nations Technology Council of Vancouver, I assumed, perhaps incorrectly, that the concise history provided was a better reflection of a First Nation’s perspective.  It expanded my concept of Aboriginal health care providers to include midwives, at least.

Here was confirmation of First Nations administering their own health care.  The collective goal of the Tripartite First Nations Health Plan (tripartite refers to federal, provincial and First Nations governments) was to ensure First Nations were “equal partners in the planning and management of health services for our people.” The Formal Consensus-based Decision Making Model first proposed by the Alaska Tribal Health Compact was recommended by First Nations in British Columbia as the model to use to facilitate equal partner status. This model will be investigated further.

3) http:www.canadianmidwives.org/main.cfm?1=en&p=04_2003)

Aboriginal students are invited to apply to every four year university midwife program in Canada but recently, the Kanaci Otinawawasowin Baccalaureat Program (KOBP) at the University College of the North in Manitoba opened specifically for the Aboriginal student. Introduced in 2006/07, the KOBP program has graduated 21 Aboriginal midwives as of 2010. Their program focuses on “traditional/indigenous midwifery knowlege and culturally appropriate learning pathways along with contemporary health, social and biological sciences.” One of their distinct teaching tools includes mentorship, something I need to understand more fully. What are the practicalities of a program involving mentorship? What makes that new? What makes that particularly Indigenous?

4) http://fnbc.info/sites/default/files/documents/FNHC_Health_Governance_Book-web2.pdf.

On this website, the connection between First Nations’ and their health is clearly spelled out. The connection is nothing less than “health, food, work, culture, family and community” combined.  Social determinants such as these, only recently valuted in western medicine, are integral to Aboriginal concepts of holistic health: “ancestors taught that understanding the land, leadership, sustainable use of resources and the ability to provide for family and community were essential to survival”.  As long as physicians, nurses, and midwives can be recruited, community health care will be based on these all-encompassing concepts.

5) http://aerc.usask.ca/projects/healthtraing.html

The University of Saskatchewan website is a very rich resource for investigating First Nations health training.  Among the many links are Indigenous specific definitions and teaching goals. For example,  the link to “Indigenous pedagogy” offers a sensitive and thorough reflection on the topic.

I also found a paper by Dr. Alex Wilson (2008) discussing the creation of virtual Aboriginal Health Training Centres of Excellence – I’m still not certain if this concept ever made it off the ground but in the 23 pages of sound recommendations was a very helpful medicine wheel model for holistic healthcare.  Emotional, Spiritual, Physical and Mental components are shown to be equal partners to Holistic Indigenous Education.

This cyber-traveller is starting in  her own backyard.

Site #1. The Cowichan Tribes are a strong presence in the Cowichan Valley but through sheer laziness, I do not know much about their culture.  The opportunity is there but until now, I never investigated. It pays to snoop around. Their website is well laid out with general information about their history, tribe, government, and education, last updated 2010. There seems to be a couple of  scholarships for medical education. http://www.cowichantribes.com.

Site#2. The Province newspaper featured an article by Suzanne Fournier on May 24, 2012. She featured Dayna Briemon, one of the twelve First Nations physicians graduating from the UBC Medical Program this year, the “largest number of First Nation graduates in the history of the UBC faculty, and possible in all of Canada”. It is a light article, serving as introduction to the topic.  http://www.theprovince.com/business/First+Nations+doctors+going+rural/6670603/story/html.

Site#3. There is an Indigenous Physicians Association of Canada (http://www.ipac-amic.org/). On their site, a section on becoming a doctor, very general, very vague.

Site 4. The IPAC did, however, host the Pacific Region Indigenous Doctors’ Congress (Pridoc) at Whistler, B.C. in 2010.  Their entire proceedings are available online: http://www.pridoc.org/2010presentation1.aspx. Since one day’s presentation concentrated on the education of indigenous medical students, I felt it was a goldmine of information. I will return!

Site 5. There is an Aboriginal Nurses Association of Canada, founded in 1975. Sadly, their 2012 National forum was cancelled due to budget cuts. In 2007, only 8 schools had aboriginal specific access/bridge way/transition program to encouragement enrollment in nursing. Nevertheless, the number of Aboriginal nursing students in Canada increased from 237 to 737 within the past five years (posted 2006). http://www.anac.on.ca/

Statement Connecting Research Interests and Weblog

A cursory search of the internet reveals low numbers of indigenous people involved in medicine. In an effort to invite more to the study of medicine, colleges have offered scholarships and entry programs with some success but the question remains, what else can be done to increase interest in a vital discipline? How best to retain the students actually enrolled? And how best to reflect native traditions within a curriculum that must teach what it must teach?

The healing arts would seem to offer groundedness and a sense of community for the indigenous but maybe their tradition of healing takes a different path than the Western tradition. Can the paths exist side by side, learning from each other, or must the streams be separate in a yet unthought version.

So far, my search of health care providers reveals indigenous nurses and doctors but veterinarians and veterinary technicians are less represented. My research will focus on the former with an eye out for the latter. I have worked as a veterinary technician for 37 years and can see a place for indigenous workmates. It is worth a look.