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Welcome to my Big Idea Project!

Here I explore how colonialism has created a lasting legacy on Indigenous peoples in terms of intergenerational effects from residential schools and how it has not only manifested into type 2 diabetes, but also how Indigenous people are unable to access equal healthcare to manage it. In response, I also write about how Indigenous peoples and researchers are reversing colonialist views in term of research and treatment to instead promote traditional healing and practices in treating and preventing type 2 diabetes.

Big Idea Essay

Additional Resources:

Diabetes among First Nations, Inuit and Metis populations:

State of Care Documentary: Canada’s segregated health care

As part of FNIS 100, we were assigned a project titled, “Taking it to the People”, to bring our learning outside of the university environment. I would love if you could read the attachment and leave a comment or send me an email (jennaeholloway@gmail.com) answering the questions or bringing forward any of your thoughts you have had in regards to the Indigenous peoples of Canada. I would love to hear your thoughts, questions, concerns, anything!

Click this link to view the questions! –> Questionnaire

In First Nations and Indigenous Studies 100, we have reflected on the historical and contemporary issues within Indigenous communities that have arise because of colonialism and some of the ways that Indigenous peoples are reclaiming their identities, becoming self-sovereign entities, and overall undergoing processes of decolonization.

In the face of stereotyping seen in contemporary culture towards First Nations peoples, it is refreshing to learn about the ways that Indigenous peoples are rebuilding themselves. In FNIS 100, we learned about how Indigenous peoples are switching the narrative, with films and novels being told about Indigenous topics from an Indigenous perspective. My mother, and Indigenous woman, took notice of this, with the recent viewing of a film titled, “An Elder in the Making”, that she was all too excited to tell me about and discuss. Indigenous film has created a platform that my mother can tell me about her frustrations about contemporary culture and the way it treats First Nations. I found that through our learning about Indigenous cinema, how stereotype and ‘spectacularized’ Indigenous culture is through a white gaze. This links back to a reading from SOCI220 – Sociology of Indigenous peoples, titled “Spectacle and spectres: settler colonial spaces in Vancouver” written by Natalie J.K. Baloy. This reading points out how through settlers ‘acknowledging’ Indigenous culture, they are really reducing it to entertainment, such as through the artwork and displays at YVR or through the totem poles in Stanley Park. What these displays do not acknowledge are the negative relationships that Indigenous peoples and settlers have had, and that nothing has been resolved. That’s where the spectres come in, that Indigenous peoples are still haunting areas, such as the DTES, and further emphasize the lack of resolution.

Prior to colonization of what is now called Canada by Europeans, Indigenous peoples lived an active lifestyle that was required for survival. They were not sedentary people, rather they foraged and hunted for food that sustained their high-impact lifestyles. However, after colonization, high caloric and high fat foods were introduced to Indigenous peoples. With the advent of permanent reserves, the inability to hunt and forage for resources, and the eventual forced enrolment in residential schools, Indigenous peoples now live a sedentary lifestyle, much like the rest of the developed world, and are faced with the negative impacts of colonization. These negative impacts have manifested into depression, drug and alcohol abuse, unhealthy diets, and a continuation of an inactive lifestyle. These symptoms of colonization have culminated into the onset of Type 2 Diabetes within Indigenous communities at an alarmingly higher prevalence than what is seen in non-Indigenous peoples of Canada.

Organizations centered around diabetes and the Canadian government have tried to implement protocols and programs to address the disturbing epidemiology of Type 2 Diabetes in Indigenous communities. However, these interventions revolve around westernized, colonized approaches to treating and preventing diabetes. These ways of thinking are what created the problem of Type 2 diabetes in Indigenous communities to begin with, and do nothing to address the underlying problem that many of these people face, that of the first-hand and intergenerational effects of colonization.

I want to explore the ways that colonization has silenced members of the Indigenous communities, and in more detail, the lasting impact that the effects of colonization have had on Indigenous peoples in terms of their access to healthcare. In response to the inadequate treatment that Indigenous peoples receive when accessing westernized healthcare, I want to bring forth the different ways in which traditional medicine and culture have been used within communities to treat not only medical conditions like diabetes, but also the underlying symptoms of colonization. By doing so, I want to highlight that colonialist interventions are not necessary, and sometimes prove to be more harmful, in an Indigenous-oriented setting.

The body of work that I have been looking into started off with the systematic racialized bodies of healthcare that Indigenous people have had to interact with since the advent of residential schools. Tuberculosis ran rampant in residential schools, and often the infected children were sent back to their reserves, which in turn spread tuberculosis within these communities. Justified as separating tuberculosis patients from general care patients in hospitals, Indigenous people were segregated from white patients, often having to be in completely different wings of the hospital, in the basement, or in “Indian Hospitals”. These hospitals offered subpar treatment to Indigenous peoples, and were not equipped to deal with more serious problems once Indian hospitals turned from a tuberculosis-treatment facility to a general care facility. In contemporary society, Indigenous peoples are still faced with discrimination and judgement when seeking advice from health care professionals, with symptoms and concerns often being ignored. In order to address the racism in healthcare settings, there has been an introduction of Indigenous health modules in medical and nursing practicums, sacred healing spaces in hospitals, and encouragement of Indigenous peoples to enrol in nursing or medical school.

Not only have the ignorance of healthcare professionals been a catalyst for the increase of diseases and disorders in Indigenous communities, the ignorance of epidemiologists and researchers have also contributed to propagating the rates of diabetes, amongst other disorders, in Indigenous communities. Previously, westernized interventions have been implemented in Indigenous communities, such as increase physical activity and a more balanced diet to try and address and therefore decrease the rates of diabetes. These implementations proved to be more or less useless, as it failed to address the underlying issues of why there were increased rates of diabetes. As explained by members of Indigenous communities and healthcare professionals who work closely with these members, diabetes is so prevalent because of the intergenerational effects of residential schools. Forced enrolment in residential schools resulted in loss of cultural identity. When identity is lost, Indigenous peoples often felt isolated, alone, and depressed, leading to disinterest in feeding their spirit and body properly. Rather than participating in cultural activities that could promote an active, healthy lifestyle and a happier deposition, Indigenous peoples are leading higher risk lifestyles with increased consumption of unhealthy foods and alcohol, as well as sedentary activity, because they have lost their cultural identity and practices. This is why diabetes should be considered a symptom of colonization, and if you address the adverse effects of colonization, the symptom of diabetes should dissipate.

There has been a paradigm shift in the ways in which researchers have been looking into the prevalence of diabetes in Indigenous communities. Moving away from western, empirical research strategies, researchers have been implementing ideologies from Indigenous culture into how research is conducted. Free and open communication is how data was collected, which aligned with traditional ways of sharing beliefs. It was in this method of data collection that researchers found that it was intergenerational impacts that has been contributing to the prevalence of diabetes and other diseases in Indigenous communities. These papers have been published in peer-reviewed journals, and have given evidence that rather than implementing western interventions, interventions that revolve around re-finding cultural identity should be favoured.

Along with the paradigm shift of research methodologies came a shift in the normalization per say of traditional medicine. There are research papers that show the efficacy of different naturally-derived, traditional medicines in the treatment of diseases, as well as how traditional diets help with diabetes, emphasizing the shift from colonized medical intervention in favour of embracing traditional medicine and lifestyle. Another example of decolonization in terms of health care is Indigenous youths have been promoting a healthy lifestyle by engaging with traditional cultural practices.

Through my research, I hope to emphasize that in response to systematic racism towards Indigenous peoples in colonialist health care settings, a shift from westernized interventions to traditional cultural practices will help to address the intergenerational impacts of residential schools that have manifested into serious diseases, namely Type 2 Diabetes, in Indigenous communities.

Integration of Traditional Indigenous Medicine in Contemporary Indigenous Communities
Diseases and conditions, such as diabetes, HIV/AIDS and mental illness, are at a higher prevalence within Indigenous communities compared to non-Indigenous communities. The implementation of western health care prevention and treatment strategies are seemingly not effective enough to combat these alarming statistics. I am exploring the reasons why these interventions are not effective by looking at the transgenerational impacts that are still lingering from enforced attendance in Residential Schools as well as the systemic racism that prevents Indigenous peoples from seeking healthcare.

PEER-REVIEWED ARTICLES

1)  Bagelman, J., Devereaux, F., Hartley, R (2016). Feasting for Change: Reconnecting with Food, Place & Culture. International Journal of Indigenous Health, 11(1). Doi: 10.18357/ijih11201616016

• Speaks about the decolonization of western health practices and discourses in Indigenous communities through a project called, “Feasting for Change”.
• The goal of the project is to empower Indigenous communities, to revitalize traditional knowledge, and to discuss the healing powers of food

2) Eid, H.M, Haddad, P.S. (2014). Mechanisms of Action of Indigenous Antidiabetic Plants from the Boreal Forest of Northeastern Canada. Advances in Endocrinology 2014. Doi:10.1155/2014/272968

• Exploring the efficacy of traditional medicinal plants from Indigenous Traditional Medicine in the Boreal forest in the treatment of Type 2 Diabetes.
• Provides an interesting avenue for traditional Indigenous medicine to be introduced into mainstream health care as a treatment for Type 2 Diabetes, rather than western medicine being imposed into Indigenous communities

3) Ghosh, H., Gomes, J. (2011). Type 2 Diabetes among Aboriginal Peoples in Canada: A Focus on Direct and Associated Risk Factors. Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 9(2).

• Acknowledges that thus far, diabetes intervention strategies have not been successful because it has not offered Aboriginal-specific prevention strategies
• This paper looks at the multifaceted risk factors for diabetes (modifiable, intermediate, and nonmodifiable) in order to develop specific interventions

4) Goodman, A., Flemin, K., Markwick, N., Morrison, T., Lagimodiere, L., Kerr, T. (2017). “They treated me like crap and I know it was because I was Native”: The healthcare experiences of Aboriginal peoples living in Vancouver’s inner city. Social Science & Medicine 178, 87-94. Doi:10.1016/j.socscimed.2017.01.053

• A study of the experiences of Aboriginal peoples who use illicit drugs or alcohol and live in Vancouver’s inner city
• This study was done using Indigenous methodologies, straying away from colonialist approaches
• Demonstrates that systemic racism is still very much present and affects the healthcare that Aboriginals people receive

5) Hackett, C., Feeny, D., Tompa, E. (2016). Canada’s residential school system: measuring the intergenerational impact of familial attendance on health and mental health outcomes. Journal of Epidemiology and Public Health, 70, 1096-1105. Doi: 10.1136/jech-2016-207380

• This statistical study looks at the long term effects of residential schools on Indigenous families by looking at the intergenerational prevalence of different mental health disorders
• Shows that familial residential schools definitely had an impact on mental health issues in these families

6) Howell, T., Auger, M., Gomes, T., Brown, F.L., Leon, A.Y. (2016). Sharing Our Wisdom: A Holistic Aboriginal Health Initiative. International Journal of Indigenous Health, 11(1). Doi: 10.18357/ijih111201616015

• This paper focuses on understanding and describing Aboriginal traditional healing methods in place or as an adjuvant to mainstream health practices
• The paper also stays away from traditional research practices and instead incorporates traditional Aboriginal knowledge sharing which helped to foster participation

7) Jacklin, K.M., Henderson, R.I., Green, M.E., Walker, L.M., Calam, B., Crowshoe, L.J. (2017). Health care experiences of Indigenous people living with type 2 diabetes in Canada. CMAJ 189(3). Doi:10.1503/cmaj.161098

• To study how colonization has impacted Indigenous health
• The experiences of Indigenous peoples in regards to health care

8) Laurie Meijer Drees (??). Reserve Hospitals and Medical Officers: Health Care and Indian Peoples in Southern Alberta, 1890s-1930.

• http://iportal.usask.ca/docs/Prairie%20Forum/Reserve%20Hospitals%20(v21no2_1996_pg149-176).pdf
• This paper gives an older perspective on “Indian” health care in Canada and would therefore be an interesting topic to include
• The article speaks about the implementation and the history of hospitals built on Indigenous reserves and how the health care system tried to apply middle-class Canadian values of Indigenous peoples

9) MacDonald, C., Steenbeek, A. (2015). The Impact of Colonization and Western Assimilation on Health and Wellbeing of Canadian Aboriginal People. International Journal of Regional and Local History 10(1). Doi:10.1179/2051453015Z.00000000023.

• This research article adapts a post-colonial, feminist, theoretical approach to begin to understand the inequalities that Aboriginal peoples face in health.
• The researchers focus on how colonization and the subsequent assimilation of Aboriginal people
• Health problems are looked at in multifaceted contexts such as historical, economic, and socio-political

10) Marielle Christine Leilani Young (2016). To Empower and Educate: Bringing Native Students into the Healthcare Professions. Tribal College Journal, 27(4), 46-47.

• http://web.b.ebscohost.com/ehost/detail/detail?sid=6debc74c-b0bc-4c80-bb84-18a1eb4ab7a1%40sessionmgr101&vid=0&hid=123&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=fph&AN=115246639
• This article describes efforts to engage with Indigenous college students to speak about the health issues that are prevalent in Indigenous communities
• The goal of engagement is to peak these students’ interests in health care and its applicability to their tribes in order to bring them into healthcare professions

11) Rice, K., Te Hiwi, B., Zwarenstein, M., Lavallee, B., Edward, D., Harris, S.B. (2016). Best Practices for the Prevention and Management of Diabetes and Obesity-Related Chronic Disease among Indigenous Peoples in Canada: A Review. Canadian Journal of Diabetes, 40(3). 216-225. Doi: http://dx.doi.org/10.1016/j.jcjd.2015.10.007

• A colonialist approach to providing intervention programs, such as dietary changes or exercise changes, to better manage diabetes in Indigenous communities
• They claimed to doing little to address the systemic marginalization and colonialization experiences in these communities, and it is interested to note that the intervention programs did very little in managing diabetes

12) Sheehy, T., Kolahdooz, Schaefer, S.E., Douglas, D.N., Corriveau, A., Sharma, S. (2014). Traditional food patterns are associated with better diet quality and improved dietary adequacy in Aboriginal peoples in the Northwest Territories, Canada. Journal of Human Nutrition and Dietetics, 28(3), 261-271. Doi:10.1111/jhn.12243.

• With colonization came import of processed foods that do not agree with Aboriginal peoples adaptations to their traditional diets
• Researchers looked at the nutrients in traditional and non-traditional diets, as well as traditional and non-traditional peoples, and found that Aboriginal peoples who ate traditional foods had better quality of diet.
• Return to traditional diets could help with intervention of obesity-related diseases, such as diabetes

13) Tang, T., Community Wellness Program, Jardine, C.G. (2016). Our Way of Life: Importance of Indigenous Culture and Tradition to Physical Activity Practices. International Journal of Indigenous Health 11(1). Doi: 10.18357/ijih111201616018

• Inactivity is a leading cause of type 2 diabetes. This article looks at how Indigenous youth are developing videos to encourage physical activity, while integrated culture, tradition, participation, and theme of culture identity
• This article demonstrates the ways that Indigenous youth are taking part of acts of decolonization to promote their own culture while creating preemptive measures against disease

BOOKS

14) Allan, B, Smylie, J. (2015). First Peoples, Second Class Treatment: the Role of Racism in the Health and Well-Being of Indigenous Peoples in Canada. Canada, Toronto, ON: the Wellesley Institute.

• How the health of Canada’s Indigenous peoples have been impacted by racism and colonization
• Speaks about the experiences of Indigenous peoples in regards to health care and well-being from an Indigenous perspective
• Discusses the barriers that Indigenous peoples face when trying to access healthcare

15) Vasiliki Douglas (2013). Aboriginal Health and Health Care in Canada: Bridging Health and Healing. New York NY: Springer Publishing Company.

This book goes in depth about the issues prevalent in First Nations, Metis, and Inuit communities in Canada, the differences between western and Aboriginal ways of knowing, and the different health problems that are prevalent within these communities

NEWSPAPER ARTICLES

16) Hoath, L., Sturino, I. (2016 Jun 21). Meet Dr. Nadine Caron, Canada’s first female First Nations. CBC Radio. Retrieved from:http://www.cbc.ca/radio/thecurrent/the-current-for-june-21-2016-1.3644974/meet-dr-nadine-caron-canada-s-first-female-first-nations-surgeon-1.3645029

• An article written about Dr. Caron, who is Canada’s first female First Nations surgeon
• Writes about the existing racism towards First Nations patients and even towards herself, and the problems that colonialism still perpetuate in today’s society

17) Lefebvre, D. (2013 Jun 21). Traditional Aboriginal Medicines Find a Home at St. Paul’s Hospital. Providence Health Care. Retrieved from http://www.providencehealthcare.org/news/20130625/traditional-aboriginal-medicines-find-home-st-pauls-hospital

• Paul’s Hospital in Vancouver, BC opened an All Nations Sacred Space
• “Provides an area for smudging and pipe ceremonies, recognizing these traditional medicines as an important component of aboriginal health care”
• “By bringing traditional aboriginal medicines into our hospital, we’re opening our doors to the aboriginal community and expressing our desire to accommodate their culture”

18) McCue, D. (2015 Feb 03). Racism against aboriginal people in health-care system ‘pervasive’: study. CBC News. Retrieved from: http://www.cbc.ca/news/indigenous/racism-against-aboriginal-people-in-health-care-system-pervasive-study-1.2942644

• This short clip shows interviews about Aboriginal people who have faced discriminatory profiling when seeking medical treatment in hospitals.
• Also brings up integration of traditional aboriginal healing techniques in mainstream, colonial hospitals

19) Morris, N. (2016 Feb 28). Residential Schools in Canada, and Why It Matters in Health. Canadian Foundation for Healthcare Improvement. Retrieved from: http://www.cfhi-fcass.ca/SearchResultsNews/2016/02/26/residential-schools-in-canada-and-why-they-matter-in-health

• This information page gives a short and sweet summary on why people need to consider the history of residential schools and why it affects the health of Indigenous peoples

SHORT CLIPS

20) Tremonti, A.M. (2013 Jan 30). State of Care Documentary: Canada’s segregated health care. CBC Player. Retrieved from: http://www.cbc.ca/player/play/2330496879

• This piece explores the emergence and establishment of ‘Indian-only hospitals’ that allowed segregation of Indigenous patients from white patients
• Indian-only hospitals were first established to treat tuberculosis, which was prominent during the residential school era, but soon began to treat not only TB, but also served to be a general hospital

Type 2 diabetes is caused by your pancreas unable to produce the insulin at the levels required to keep blood sugars from getting too high. Lifestyle choices, such as inactivity and poor diet, are a few of the known factors that contribute to type 2 diabetes. Type 2 diabetes is known to be at a higher prevalence in Indigenous communities, and for this reason, I wanted to begin to dissect the reasons why this is the case as well as what is being done to address the issue.

Ever since colonization by Europeans, the culture and ways of life of the Indigenous peoples of Canada have slowly been snuffed out in favour of the ‘white way’ of doing things. Although the advent of modern medicine and technology has undoubtedly brought forth many benefits in terms of health care, it seemingly has failed to benefit the lives of members within Indigenous communities. Richard Hovey, Treena Delormier, and Alex McComber explore why colonial attempts at healthcare have fallen short of success within Kahnawà:ke, a Kanien’kehà:ka community in Quebec, in the paper titled “Social-Relational Understandings of Health and Well-Being from an Indigenous Perspective”.

The first main question brought up is if diabetes is a symptom, rather than a disease, as a result of oppressive social conditions, such as colonialization. If that is the case, then addressing the social conditions would hopefully address the physical manifestations of those conditions, such as diabetes. The researchers decided to use philosophical hermeneutics as a research approach because it closely aligned with the interpretive relationship amongst Coyote, Raven, and Hermes, the three tricksters that required interpretation of a collaboration of messages to ultimately understand what is being said. It also allows for a conversation amongst members of the community, holding in nature more traditional ways of sharing beliefs, values, and customs.

Social-relational connections was another approach brought forth by Hovey et al. The concept is a two-pronged approach. The first emphasis is on the social structure within a community that can be influenced by colonial social structure and practices. The second part is the relational aspect, that emphasizes the relationships that connect individuals, families, and communities. Social-relational connections have been adversely affected by the continuing dominance of a colonialist society. This is the society that disrupted traditional food systems through the introduction of alcohol, salt, sugar, lard, and flour. The same society tore apart families through residential schools and made a large impact on the effort of demolishing Indigenous culture and identity.

Taking the social-relational connections within an Indigenous community into consideration, as well as what can adversely affect those connections, the researchers interviewed members of the Kahnawà:ke community “about diabetes prevention strategies that consider medical and behavioural lifestyle modifications as well as interventionist approaches within the context of overarching social circumstances” (Hovey 42). The participants did not give answers regarding government intervention or help with medication, but rather they gave insightful answers that spoke about diabetes in relation to their self, their identity, and their spirit. One quote that I quite liked was:

“[I]f you don’t feel who you are, you’ll be so outside of yourself and reckless and don’t care. So when you feel, and you know who you are, and you can feel that things are wrong, and you pay attention, you’re at peace because people who are stressed will start taking to cigarettes, taking to alcohol, taking to food, or any kind of reckless behaviour. So when they’re calm, they’re content, and they’re feeling at peace, they’re going to want to feed their spirit healthy foods, you know? And when I do my conferences, I make sure that they know that the foods that they eat will affect their emotions; will affect their spirit, who they are”.

Addressing diabetes preventing is a multifaceted approach that requires not only medical intervention, but more importantly, intervention on the current ways of thinking in Indigenous communities. Before addressing rampant illnesses, researchers need to address what may be causing the manifestations of these diseases. Type 2 diabetes is known to be caused mainly by lifestyle, and it only makes sense that the negative emotions that Indigenous peoples experience in regards to colonization manifest themselves as poor eating behaviours and inactivity.

Source:
Hovey, R., Delormier, T., McComber, A.M. (2014). Social-Relational Understandings of Health and Well-Being from an Indigenous Perspective. International Journal of Indigenous Health. 10(1), 35-49. doi: http://dx.doi.org/10.18357/ijih.101201513195

Final Topic Chosen – Integration of traditional and western medicine in Indigenous communities

1) History of traditional medicine in Indigenous communities
a. A look into what was used for medicine and for what ailments, who could administer the medicine, and any other details regarding the history of traditional medicine

2) Current medical practices in Indigenous communities
a. Looking into if traditional medicine is still used in certain Indigenous communities and what other aspects in regards to traditional medicine as used in the history still pertain
b. Looking to see what modern medical treatments are used
i. Hospitals, clinics, etc.
ii. Prenatal care, vaccinations
iii. What sort of public health issues are dealt with in a community forum, i.e., proper handwashing etiquette in schools, diet and exercise regimens, etc.
c. Do Indigenous community members prefer to use traditional medicine over modern medicine

3) Prevalence of health issues in Indigenous communities
a. Epidemiology of health issues
i. Diabetes, obesity, HIV/AIDS, etc.

4) Incorporating western medicine with traditional medicine to help intervene on health issues
a. What sort of steps can be taken to promote healthier lifestyles in Indigenous communities?

5) Importance of working with Indigenous youth
a. Encourage them to be involved in the healthcare system
b. Will hopefully bring modern medicine to Indigenous communities so to promote healthier lifestyles

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