Showing papers in "International Journal of Indigenous Health in 2009"

Colonialism and State Dependency

Abstract: This paper conceptualizes colonialism from an indigenous perspective and analyses the effects of colonization on First Nations, with particular focus on explaining the fundamental roots of the psychophysical crises and dependency of First Nations upon the state. Central to its analysis is the effect of colonially-generated cultural disruptions that compound the effects of dispossession to create near total psychological, physical and financial dependency on the state. The paper argues that it is the cumulative and ongoing effects of this crisis of dependency that form the context of First Nations existences today. Social suffering, unresolved psychophysical harms of historical trauma and cultural dislocation are identified as the main sources of a crisis in which First Nations’ opportunities for self-sufficient, healthy and autonomous lives on individual and collective levels are extremely limited because Indigenous people have developed complexes of behaviour and mental attitudes that reflect their colonial situation. Through a review and consideration of the scholarly literature, it identifies a direct relationship between government laws and policies applied to Indigenous peoples and the myriad mental and physical health problems and economic deprivations. The paper concludes with a set of recommendations for developing policy responses to the situation which are oriented towards supporting and facilitating Indigenous people’s reconnection to their homelands, restoration of land-based cultural practices and the rebuilding of indigenous communities.

Community Resilience: Models, Metaphors and Measures

Abstract: In this paper, we discuss the importance of community resilience for Aboriginal health and well-being. The concept of resilience has been used in developmental psychology and psychiatry to describe individuals’ capacities to achieve well-being and thrive despite significant adversity. Resilience is also a useful concept in ecology where it draws attention to the ability of ecosystems to adapt to environmental stress through transformation. The study of community resilience builds on these concepts, to understand positive responses to adversity at the level of families, communities and larger social systems. Despite historical and ongoing conditions of adversity and hardship many Aboriginal cultures and communities have survived and done well. In this review, we critically assess the various definitions of resilience as applied to individuals. We then examine resilience as applied to families, communities and larger social systems. We examine links between the concept of resilience and social capital. We then consider interventions that can promote resilience and well-being in Aboriginal communities. These include strengthening social capital, networks and support; revitalization of language, enhancing cultural identity and spirituality; supporting families and parents to insure healthy child development; enhancing local control and collective efficacy; building infrastructure (material, human and informational); increasing economic opportunity and diversification; and respecting human diversity. We also discuss methods of measuring community resilience, examining advantages and disadvantages to each method. Community resilience is a concept that resonates with Aboriginal perspectives because it focuses on collective strengths from an ecological or systemic perspective.

Cultural Safety Exploring the Applicability of the Concept of Cultural Safety to Aboriginal Health and Community Wellness

Abstract: The goal of the research paper is to explore both the concept of cultural safety and its practical implications for policies and programs designed to improve the health of Aboriginal people and the wellness of Aboriginal communities. The paper demonstrates the concept of cultural safety can shift from a being a tool to deliver health care services to individuals to a new and wider role. The concept of cultural safety can have a significant impact the way policy and services are developed at an institutional level in fields such as health, education, the courts, universities, and governance (both First Nations and other types of government). Four case studies at the end of the research paper show how cultural safety has helped communities at risk and in crisis engage in healing that led to lasting change. The research paper, defines cultural safety and how it differs from cultural competence or trans-cultural training and practices; shows why it’s important to move from the concept of cultural safety to the outcome of cultural safety, namely the success of an interaction; explores the idea of a shift from cultural safety for individuals to cultural safety at institutional and policy levels; and provides recommendations in five areas.

Intergenerational Trauma: Convergence of Multiple Processes among First Nations peoples in Canada

Abstract: Stressful events may have immediate effects on well-being, and by influencing appraisal processes, coping methods, life styles, parental behaviours, as well as behavioural and neuronal reactivity, may also have long lasting repercussions on physical and psychological health. In addition, through these and similar processes, traumatic experiences may have adverse intergenerational consequences. Given the lengthy and traumatic history of stressors experienced by Aboriginal peoples, it might be expected that such intergenerational effects may be particularly notable. In the present review we outline some of the behavioural disturbances associated with stressful/traumatic experiences (e.g., depression, anxiety, posttraumatic stress disorder, and substance abuse disorder), and describe the influence of several variables (age, sex, early life or other experiences, appraisals, coping strategies, as well as stressor chronicity, controllability, predictability and ambiguity) on vulnerability to pathology. Moreover, we suggest that trauma may dispose individuals to further stressors, and increase the response to these stressors. It is further argued that the shared collective experiences of trauma experienced by First Nations peoples, coupled with related collective memories, and persistent sociocultural disadvantages, have acted to increase vulnerability to the transmission and expression of intergenerational trauma effects.

Disrupted Attachments: A Social Context Complex Trauma Framework and the Lives of Aboriginal Peoples in Canada

Abstract: “Disrupted attachments” describes multiple levels on which the historic and contemporary assaults on Aboriginal Peoples in Canada have resonated. Not only have the policies of colonialism expressly aimed to sever the attachment of Canada’s First Nations to their lands, customs, cultures, modes of self-governance, languages and ways of life, but the traumatic impact of these disrupted attachments have reverberated through both the communities and through the individual lives of Aboriginal Peoples in this country historically and today. The new and more expansive conceptualization of “complex trauma” has, as one of its core and defining features, alterations in relationships with one’s sense of self, as well as alterations to relationships with others. We reframe the idea of “alterations” in relationships to that of “harms” to relationships to self and others, and situate these harms within the insights of attachment theory. In this paper, we explicate a social context complex trauma framework, building on insights from the fields of psychology and neuroscience, to provide a fuller development of the pervasive and developmental impacts of trauma. In developing our conceptualization of a social context complex trauma framework, we draw on the foundational constructs from trauma theory, from attachment theory, and from the insights of the literature on historical trauma, as well as the interdisciplinary research literature on the health and well-being of Aboriginal Peoples in order to advance a developmental perspective situated within a political analysis of social contexts of injustice and inequality. We also point to some directions for healing and transformation efforts. Most importantly, we speak to the need for a strengths-based trauma model and approach, which identifies and expands the resiliencies of the Aboriginal Peoples.

Resilience and Aboriginal Communities in Crisis: Theory and Interventions

Abstract: Resilience in Aboriginal communities is a long process of healing that allows to supersede the multiple trauma and the loss of culture experienced during the colonization and after. The presence of social capital is central to this process in building bridges between persons, families and social groups with the aim of developing a spirit of civic culture. The process usually relies in the first stage on the vision of a few leaders whose example brings forward a larger segment of their community. Characteristics specific to the notion of resilience in Aboriginal cultures are: spirituality, holism, resistance and forgiveness. The main obstacle to overcome in the process of resilience is the phenomenon of codependency which leads to superficial attachment, lack of trust, and refusal of authority. The concept of cultural identity is central to resilience in this context and there is a need to create a new cultural ethos in continuity with the traditions. Each community has to undergo its own course and cannot copy success stories, mainly be inspired through a process of lateral knowledge transfer. Finally, community resilience has to rely on the capacity of families to be resilient themselves which involves breaking the law of silence, naming problems and coping with them with the support of networks and institutions.

Traditional Medicine and Restoration of Wellness Strategies

Abstract: The overview of literature provides emergent themes on the topic of Aboriginal health, culturally oriented interventions and prevention strategies. Recommendations are also provided on how to apply indigenous knowledge and traditional medicine approaches in the intervention for at risk Aboriginal populations or communities in crisis. Through a literature review of indigenous knowledge, it is proposed by several Indigenous scholars that the wellness of an Aboriginal community can only be adequately measured from within an indigenous knowledge framework which is a holistic and inclusive approach that seeks balance between the spiritual, emotional, physical, and social spheres of life. Their findings indicate that high rates of social problems, demoralization, depression, substance abuse, and suicide are prevalent in many Aboriginal communities and must be contextualized within a decolonization or self-determination model. The evidence of linkages between the poor mental health of Aboriginal peoples and the history of colonialism is key to improving the wellness in communities. Conversely, there is sufficient evidence that strengthening cultural identity, community integration, and political empowerment contributes to improvement of mental health in Aboriginal populations including at risk youth and women. The interconnection of land, language and culture are the foundations of wellness strategies. The overview clearly suggests adopting new strategies for intervention and prevention, and learning from historical wrongs to ensure future policies support of the restoration of traditional practices, language and knowledge as a means of developing strategies for this generation’s healing and wellness.

Understanding the Impact of Self- Determination on Communities in Crisis

Abstract: Canada is struggling to recast its relationship with Aboriginal peoples in response to massive disparities, mounting resentment, and emerging political realities. The interplay of racism, paternalism and disempowerment has inflicted a serious toll in terms of social, health, economic, and cultural costs. Many Aboriginal people have lost their language and identity, and this spiritual loss is compounded by skyrocketing rates of alcoholism, substance abuse, domestic violence, suicide, diabetes, and heart disease. The need for structural change is broadly acknowledged by Aboriginal and non-Aboriginal leaders alike, but they disagree on how to hasten this transformation from colonial subjects to self-determining peoples. Central to most proposals for restructuring is establishing Aboriginal self-government as a basis for healing (Fleras, 1996, p.122).

Culturally Competent Care for Aboriginal Women: A Case for Culturally Competent Care for Aboriginal Women Giving Birth in Hospital Settings

Abstract: Increasing numbers of Aboriginal women are using urban hospital settings to give birth. Culturally competent care, including an understanding of cultural, emotional, historical, and spiritual aspects of Aboriginal Peoples’ experience and beliefs about health and healthcare, is important to the provision of quality care. While there is a body of literature on culturally competent care, no models specific to Aboriginal women giving birth in hospital settings exist. This article explores Aboriginal peoples’ historical experience with western health care systems, worldviews and perspectives on health and healing, and beliefs regarding childbirth. Some of the existing models of culturally competent care that emphasize provision of care in a manner that shows awareness of both patients’ cultural backgrounds as well as health care providers’ personal and professional culture are summarized. Recommendations for the development of cultural competency are presented. Acquisition of knowledge, self-awareness and development of skills are all necessary to ensure quality care. It is essential that - at both systemic and individual levels - processes are in place to promote culturally competent healthcare practices. Recommendations include: partnering with Aboriginal physicians, nurses, midwives and their representative organizations; conducting community-based research to determine labour and delivery needs; identifying and describing Aboriginal values and beliefs related to childbirth and its place in the family and community; and following Aboriginal women’s birth experiences in hospital settings with the overarching goal of informing institutional practices.

First Nations Communities at Risk And in Crisis: Justice and Security

Abstract: This paper argues that colonialism is far too often overlooked or dismissed in designing security and justice remedies in First Nation communities. Yet, as a process of domination, colonialism has proven destructive to the peoples of the world who have suffered colonization. For First Nations peoples in Canada, the colonial regime has applied pressure against their cultures, practices and traditions. In naming colonialism as a major and central source of harms, models for the future must address systemic structures of colonialism. A decolonizing approach is highly challenging both for the individuals who take these steps and for the communities who undertake collective transformations. Healing means setting out on un-walked paths to decolonization. The paper’s framework starts with examining the current stressors for First Nation communities at risk or in crisis. Reviewing the currently published findings on justice and security related stressors, this research paper looks closely at: on-research health, education, poverty reduction and social assistance, child welfare, youth gang issues, policing services, crime rates, and safety of health workers. The research finds that Aboriginal traditions and approaches to health, healing, knowing, and doing can exist within other institutions and frameworks, to help alleviate community stressors. The authors of this study outline five decolonizing recommendations for ways to move forward in building models for the future; then, provides practical advice on how to build preventive and proactive community plans, support community capacity and infrastructure, build relationships, and model positive development.

The Responsibilities of Women: Confronting Environmental Contamination in the Traditional Territories of Asubpeechoseewagong Netum Anishinabek (Grassy Narrows) and Wabauskang First Nation

Abstract: From the early 1960s to the late 1970s, Reed Paper dumped more than 50 000 pounds of mercury into the English-Wabigoon River system. At the time, Anishinabek people, whose territory encompasses the river system, were dependent upon the river for food and water. Fish from the river system were a staple in the diet of community members, and fishing was an important cultural and economic activity. People got their drinking water from the river and hunted and trapped animals that were also dependent on the same resources. Many community members suffered from severe mercury poisoning, and all communities dependent upon the English-Wabigoon river system continue to deal with the social, cultural and health impacts of living in a contaminated ecosystem. In 2003, a group of women from the communities of Asubpeechoseewagong Netum Anishinabek (Grassy Narrows) and Wabauskang First Nation, located in North-Western Ontario began to study the impacts of environmental contaminants on their traditional territories using both Anishinabek knowledge and western science. They were concerned about the impact of environmental contaminants on the health and well-being of women and their children. From 2001 to 2005, the two communities completed a large traditional foods testing program and held two Anishinabek Knowledge workshops to discuss the impact of contamination on their communities. The purpose of this paper is to share the women’s, Elders’ and Anishinabek Knowledge Holders perspectives on how contamination continues to impact their communities.

Beginning with Our Voices: How the Experiential Stories of First Nations Women Contribute to a National Research Project.

Abstract: The purpose of this paper is to review how the experiential stories of First Nations women contribute to a national research project. The project focuses on how women’s healing is impacted by their views about themselves as - and the stigma associated with being - a drug user, involved in crime and an Aboriginal woman. Our project began with three First Nations women on our research team documenting the role of stigma and self-identity in their personal healing journeys from problematically using drugs and being in conflict with the law. In this paper we discuss how key components of feminist research practices, Aboriginal methodology and community-based research helped us position the women’s experiential stories in authoritative, recognized and celebrated ways in our study. We illustrate how the women’s stories uniquely contributed to the creation of our interview questions and the research project in general. We also discuss how the women personally benefited from writing about and sharing their experiences. Key benefits include the women discovering the impact of the written word, promotion of their healing, personal recognition of their ability to offer hope to women in need, increased self-esteem, and increased appreciation of the importance of sharing their lived experiences with others. Our method of research differs from a conventional western scientific approach to understanding, and as such made important contributions to both the project itself and the women who shared their experiential stories.

Health Research, Entitlements and Health Services for First Nations and Métis Women in Manitoba and Saskatchewan

Abstract: Since 1982, the term “Aboriginal” has been defined in the Canadian constitution as including Indian, Inuit and Metis peoples and has become part of the Canadian vocabulary. However, among the groups included in this term, there are significant differences in access to health care services based on treaty and historical entitlements and related government jurisdictions and policies. In spite of good intentions, research on Aboriginal women’s health can fall short when it fails to recognize differences in entitlements and health services available under the term “Aboriginal.” We explored the historical developments leading to current legal entitlements to health care services for First Nations and Metis women. We then interviewed service providers in Manitoba and Saskatchewan to investigate women’s access to health, including barriers created by differing entitlements to services and lack of understanding about services. We discuss why the differences in health service entitlements must be taken into account for health research.

Social Capital and Aboriginal Communities: A critical assessment Synthesis and assessment of the body of knowledge on social capital with emphasis on Aboriginal communities

Abstract: The social capital paper consists of four sections. Synthesis and Assessment of the Body of Knowledge on Social Capital with Emphasis on Aboriginal Communities provides a general background and overview of the concept of social capital, discussing its intellectual history and examining the areas of study where the notion of social capital has been applied to. It reviews in-depth the use of the concept of social capital for the study of Aboriginal communities. The Measurement of Social Capital and its Impacts with Emphasis on Aboriginal Communities examines the literature related to the measurement of the concept of social capital and synthesizes research that has sought to assess the impact of social capital on various societal outcomes. Influencing Social Capital: A Review of the Literature with Emphasis on Aboriginal Communities reviews both research and policy initiatives that sought to impact social capital of communities and understand the potential mechanisms at play. It presents some case descriptions and addresses the evidence related to influencing social capital and potential interventions to that effect. Aboriginal Social Capital: A Review of the Literature pulls together the main conclusions from the previous documents and provides guidance in relation to the potential of social capital as a notion for research and practice among Aboriginal communities.

Body-related experiences of two young rural Aboriginal women

Abstract: There has been a gradual increase in health research that explores the body-related experiences of young Aboriginal women living in urban and reserve settings. However, the voices of rural Canadian Aboriginal women not living on reserves, appear to be absent from this literature. The purpose of this study, therefore, is to better understand the body-related experiences of young Aboriginal women living in rural Canadian communities. Case study was utilized as the strategy of inquiry in which each of two young women (both 15 years of age) represented a case. One-on-one interviews were used to explore the young women’s experiences. Four themes emerged: (1) fitting in, (2) rural uniqueness, (3) role models, and (4) body talk. The primary contribution of this study is that it sheds light on the unique body-related experiences of two young women, each living in a rural community where she is the only teenaged Aboriginal woman. Despite some similarities, the young women related very different stories of their experiences in their respective communities. This research also highlights some of the ethical challenges of ensuring that the stories of the young women are adequately represented, while their confidentiality is respected.