PDF Navigating Challenges Indigenous Peoples in Canada PDF

Navigating Challenges What are the reasons things are the way they are? Indigenous Peoples in Canada face numerous challenges when it comes to income and employment. 1. Systemic Racism and Discrimination Indigenous Peoples frequently encounter racism and discrimination in hiring processes, workplaces, and access to job opportunities. Stereotypes, biases, and discriminatory practices by employers can result in fewer job offers, limited promotions, and hostile work environments. Discrimination also manifests in unequal pay and job insecurity compared to non-Indigenous workers in similar roles. 2. Lower Educational Attainment Due to historical and ongoing educational disparities, Indigenous Peoples, on average, have lower levels of formal education compared to non-Indigenous populations. The legacy of residential schools, underfunded on-reserve schools, and a lack of culturally relevant education have created barriers to academic achievement. Since many jobs require higher education or specific qualifications, this educational gap limits access to well-paying, stable jobs. Many Indigenous workers face a "skills mismatch," where the education and training they receive do not align with the skills demanded by employers or available in their regions. This can result in underemployment, where Indigenous workers are employed in jobs that do not match their skill levels or offer lower wages than they deserve. Underemployment can also arise when workers are overqualified for the limited job opportunities in their communities, pushing them to take part-time, low-wage, or temporary jobs to survive. 3. Limited Access to Jobs in Remote and Rural Areas Many Indigenous communities are located in remote or rural regions with fewer job opportunities, making employment access a significant challenge. Economic development and industries that create jobs are often concentrated in urban centers, leaving many Indigenous Peoples in remote areas with limited employment options, especially those that offer sustainable income. Even when jobs are available in nearby industries, such as resource extraction, these positions may be temporary or seasonal and often do not lead to long-term financial security. 4. Economic Marginalization and Poverty Indigenous Peoples in Canada experience higher rates of poverty than the non-Indigenous population. Poverty creates multiple barriers to employment, including limited access to transportation, childcare, training, and the resources necessary to search for jobs. For those already in low-income jobs, the opportunity to transition to better-paying positions is often constrained by economic pressures to immediately meet family needs. 6. Lack of Culturally Relevant Job Training and Opportunities Indigenous workers may have limited access to job training programs that reflect their cultural values and ways of knowing. Employment training programs may not be adapted to meet the specific needs of Indigenous communities, especially in remote areas, or may fail to incorporate traditional knowledge and land-based skills that are important for Indigenous economic development. The lack of culturally relevant programs can alienate Indigenous job seekers and diminish opportunities for skills development in areas that would support their communities. 9. Housing and Infrastructure Issues Many Indigenous communities face poor housing conditions and lack essential infrastructure such as transportation, internet access, and clean water, all of which are critical for employment. Without reliable transportation, Indigenous workers in remote communities may find it difficult to commute to jobs, while poor internet access limits the ability to pursue online education, training, or remote work opportunities. 12. Impact of Resource Extraction and Environmental Degradation Many Indigenous communities rely on land-based economies, such as fishing, hunting, and agriculture, which have been negatively impacted by resource extraction industries like mining, forestry, and oil production. These industries, often located near Indigenous lands, may offer short-term employment but result in long-term environmental degradation that affects traditional livelihoods. The destruction of land and water systems due to these industries further exacerbates employment challenges by undermining local economies and cultural practices tied to the land. Environment & Health Indigenous Peoples’ relationship with the land and their traditional territories strengthens cultural identity. Traditional ways of knowing view environmental stewardship as a way to honour and protect the land for future generations. This responsibility defines a person’s moral character, and is reinforced through spiritual ceremony and traditional story-telling as a tenet of Indigenous identity. Environmental health and the peoples’ health are interrelated. The key objective of our discussion is to build our understanding for how the land functions for health. The land simultaneously contributes to physical, emotional, mental and spiritual health in a variety of ways: The land provides all the resources necessary for survival. Certain plants,berries,and animals,which are provided by the land,are consumed for nutritional reasons and used in the production of medicines. Cedar, sweetgrass, sage and tobacco are considered to be sacred medicines and they are used in a variety of ways to connect with Mother Earth and the Creator (Wilson, 2003). There is a belief that the land is alive with spirits (inanimate objects have spirits) which lends itself to positive mental and emotional health (Wilson, 2003). Activities with the land,such as hunting wildlife and harvesting medicines, contributes to positive mental health (Wilson, 2003). The physical environment can have both direct and indirect effects on health. For example, bioaccumulation (toxic elements concentrated in the tissues) in animal populations, as a result of land development, has implications for the entire ecosystem (Douglas, 2013). An unhealthy large animal population is a loss of Indigenous traditional hunting practices (culture) , and a loss to a major component of the traditional Indigenous diet (health). As well, we must consider the impact of colonization, which resulted in the loss of access to traditional Indigenous territories. King, Smith, and Gracey (2009) state, “As traditional custodians of the land, dispossessed Indigenous peoples have lost their primary reason for Being”. Land loss is the loss of spiritual and cultural practices for physical and mental well-being; interrupted access to land is closely linked to the post-colonial changes in health among Indigenous peoples in Canada. Reading The words of the Elders (p.50-57), Therapeutic landscapes and First Nations peoples: an exploration of culture, health and place. Access to Health Services Having reliable and timely access to health services is an important factor for improved health outcomes. One health inequity facing Indigenous populations is the poor access to health care as compared to the Canadian population (Auger et.al. 2016). The literature has shown that access to health services is impacted by geography, financial constraints and attitudes toward traditional Indigenous healing methods. “Statistics Canada reported that roughly one third of Indigenous people living in urban areas have access to traditional medicines and healing Practices. The study also found that there was limited access to traditional health care practices in both health care centres and health programs in communities”. Navigating Challenges Geography Many First Nation reservations are remote and isolated from major cities. At these locations, healthcare services are supported in part by community healthcare workers or nurses, whose scope of practice may not meet the needs of every patient. To obtain treatment from medical specialists or access specialized equipment needed for assessment, people must travel to cities- this creates a geographic barrier to healthcare services. For example, many Inuit communities lack year-round road access and must travel by plane to reach the nearest hospital. Weather may contribute to delays if it makes travel difficult (Chan et.al. 2020). Financial Constraints Federal and provincial funding for Indigenous-specific health services is often inadequate, resulting in under- resourced healthcare facilities, insufficient staffing, and limited availability of services in Indigenous communities. When local healthcare services are lacking, individuals must seek care outside their communities, incurring additional financial burdens. This underfunding also affects the quality and comprehensiveness of care available within Indigenous communities. While Indigenous Peoples in Canada are eligible for public healthcare through the Non-Insured Health Benefits (NIHB) program, this coverage is often inadequate. Gaps in coverage can leave individuals paying out-of-pocket for essential services such as: Vision and dental care, which are critical but may not be fully covered under NIHB or provincial health plans. Mental health services, where wait times for publicly funded programs are long, and private therapy can be prohibitively expensive. Specialized care and treatments that are not available within the community, requiring travel to urban centers, which is not always fully funded by the government. Mainstream Attitude Perceptions on Indigenous traditional medicine and healing practices have been shaped by Canada’s colonial history. Health care practitioners may view traditional health care as antiquated or primitive, and this mainstream rhetoric (Auger, 2016) trivializes the value of traditional health care. This attitudinal barrier limits the potential for integration of traditional health care in Western clinics, which contributes to the lack of available knowledge and services. It is not only a matter of available health care services, but whether services are culturally appropriate. Horrill et. al. (2018) states that assumptions and stereotyping on the part of healthcare providers contribute to the “othering” mentality which reduces the quality of patient care. In the post-colonial lens, we must acknowledge the historical effects (direct and intergenerational) of colonization and the Indian Residential School System, which have led to a distrust in the healthcare system and its providers. Indigenous people must overcome negative experiences, and a fear of being judged on the basis of race or social class- this has historically contributed to delays in seeking care (Horrill, 2018). “Our relatives tell us how the structures of colonization are visible in hospitals in that they look no less daunting and dominant: Western medicine and knowledge are a hierarchy, in which Indigenous medicine is not valued or considered inferior. The “evidence-based” biomedical model implicitly renders Indigenous medicine and knowledge as less scientific and therefore dubious” (de Leeuw, 2015, p.245). Race/Racism Colonialism Colonialism is not just a historical event but an ongoing process that continues to shape the social, economic, and political conditions in which Indigenous Peoples live. These conditions, in turn, have profound effects on health and well-being, making colonialism a foundational social determinant of health for Indigenous Peoples. Historical introduction of diseases: When European settlers arrived in Indigenous territories, they brought with them diseases like smallpox, influenza, tuberculosis, and measles, to which Indigenous Peoples had no immunity. Colonial Policies/Legislation: Underfunded healthcare systems: Indigenous health services have historically been underfunded, leading to inadequate healthcare infrastructure and access to essential services. Indigenous communities often face poor health outcomes as a result. Displacement and marginalization: Policies that relocated Indigenous Peoples to reserves limited access to resources, traditional medicines, and healthy food systems, increasing vulnerability to malnutrition, chronic diseases, and poor living conditions. Restricted rights to land and water: Colonial laws restricted Indigenous Peoples’ access to their lands and water sources, making it difficult for communities to maintain healthy living environments, traditional diets, and self- sustaining economies. Health impacts of forced assimilation Intergenerational trauma: Survivors of residential schools experienced physical, sexual, and emotional abuse, leading to deep psychological scars. This trauma has been passed down through generations, resulting in increased rates of depression, anxiety, substance abuse, and suicide in Indigenous communities. Disruption of family and community bonds: The forced separation of children from their families disrupted traditional family structures and support systems, weakening the social fabric necessary for mental and emotional well-being. Loss of cultural identity: The erasure of language, cultural practices, and spiritual beliefs caused by forced assimilation contributed to a sense of alienation, identity loss, and cultural disconnection, all of which are linked to mental health issues. Land Dispossession and lack of access to traditional economies Loss of traditional food sources: The inability to hunt, fish, farm, or gather traditional foods has contributed to food insecurity and reliance on unhealthy, processed foods. This has led to higher rates of obesity, diabetes, and heart disease in Indigenous communities. Environmental degradation: Colonial resource extraction industries (mining, logging, oil) have polluted lands and water sources, leading to environmental health hazards, including exposure to toxins, respiratory issues, and contaminated drinking water. Disconnection from cultural and spiritual practices: Land is integral to Indigenous spiritual and cultural practices. The forced removal from land has led to a loss of traditional healing practices and spiritual ceremonies, which are essential for physical, mental, and emotional health. Economic marginalization: Without access to their traditional economies, many Indigenous Peoples have been pushed into poverty, which is a major determinant of poor health. Poverty restricts access to healthcare, nutritious food, and healthy living conditions. Distrust in colonial systems/institutions Reluctance to seek healthcare: Many Indigenous Peoples are hesitant to engage with mainstream healthcare providers due to past experiences of racism, discrimination, and cultural insensitivity. As a result, they may delay or avoid seeking medical care, leading to untreated or advanced health conditions. There are and have been direct effects of colonialism or colonial policies on Indigenous health, for example, the introduction of contagious diseases like smallpox; the extinction of the Beothuk4 The World Health Organization ; or the gamut of negative experiences within the residential schooling system, to name a few. However, the above disparities also reflect the protracted effects of land dispossession and sedentarization on cultural continuity, access to traditional economies, as well as physical separation from mainstream monetary economies, to name a few. In other words, these health gaps hint at the distal effects of colonial legislation. Yes, colonialism is considered a social determinant of health for Indigenous peoples. It shapes the political, economic, and social contexts that directly impact their health outcomes. Colonialism's effects are not limited to the historical introduction of diseases or forced assimilation through residential schools, but extend to systemic inequalities in education, healthcare, employment, and environmental access. Colonialism functions as a distal determinant, influencing all other determinants of health by creating unfavourable conditions such as land dispossession, cultural disruption, and economic marginalization. These structural realities result in health disparities between Indigenous and non-Indigenous populations. Indigenous communities face higher rates of illness, poverty, food insecurity, and limited access to healthcare, all of which stem from colonial policies that continue to affect their well-being. In summary, colonialism is a fundamental social determinant that has shaped and continues to shape the health of Indigenous peoples by creating the conditions for ongoing inequalities. What is TB and how does it spread TB is an infectious disease caused by mycobacterium bacteria, spread through the air when someone with contagious TB coughs, sneezes, sings or talks. It mainly affects the lungs and airways but can also affect other parts of the body. What happens if I breathe the TB germs into my lungs? One of 3 things can happen: 1. Your immune system kills the bacteria and you do not become infected. 2. You become infected, but your immune system keeps the germs in an inactive or sleeping state within your body. This is called latent TB infection, or sleeping TB. Latent TB does not cause any symptoms and is not contagious. 3. You become infected and then develop active TB or TB disease. This may happen soon after infection (weeks or months) or years later. Active TB will make you feel sick and it is contagious. If I have TB, can it spread to my friends and family? Latent or sleeping TB infection cannot be spread to others. Active TB or TB disease can spread to others by coughing, sneezing, talking or even singing, when it is in the lungs or airways. You cannot spread TB to others by shaking hands or sharing dishes with them. Anyone can get TB, and people often don't know they have it until they are tested or they get very sick. People affected by TB are not at fault. Symptoms If you have active TB disease, you may feel sick with some of the following symptoms: cough lasting more than 2 weeks coughing up sputum (phlegm) coughing up blood chest pain no appetite unexpected or unexplained weight loss weakness or lack of energy chills or fever sweating at night other symptoms that are undiagnosed (that is, abdominal pain, back pain, bone pain) If you are sick with any of the above symptoms and wonder if it could be TB, you should see your health care provider and ask them whether your symptoms could be related to TB. Factors that increase the chance of developing active TB If you have latent TB infection, there is a 5 to 10% chance over your lifetime that it will become active TB. The chance increases if you experience conditions that weaken the immune system (such as HIV, substance use, diabetes, severe kidney disease, organ transplant recipient, taking medications that weaken immune system), food insecurity and are of a young or advanced age. First Nations, Inuit and Metis in Canada are disproportionately impacted by factors that increase the chance of being exposed to TB or progressing to active TB in the context of inequities and the historical and ongoing impacts of colonization. There are 3 levels of determinants for Indigenous health; distal determinants create the structure for systems and environments that influence Indigenous health; the intermediate determinants are systems of care and can include relationships and treatment within those systems; proximal determinants are the visible impacts of physical, emotional, mental and spiritual health. Proximal Determinants of Health Health Behaviours Physical Environments Employment and Income Education Food Insecurity While proximal determinants represent the root of much ill health among Aboriginal peoples, intermediate determinants can be thought of as the origin of those proximal determinants. Intermediate Determinants of Health Health Care Systems Educational Systems Community Infrastructure, Resources and Capacities Environmental Stewardship Cultural Continuity Distal determinants have the most profound influence on the health of populations because they represent political, economic, and social contexts that construct both intermediate and proximal determinants. Distal Determinants of Health Colonialism Racism and Social Exclusion Self-Determination Indigenous Social Determinants of Health Connection to the land as a youth-identified social determinant of Indigenous Peoples’ health. The article titled "Connection to the land as a youth-identified social determinant of Indigenous Peoples’ health" emphasizes the importance of land in shaping health outcomes for Indigenous youth, particularly those from the Yellowknives Dene First Nation (YKDFN) in the Canadian Northwest Territories. The article identifies several reasons why land is considered a social determinant of health for Indigenous Peoples, particularly from the perspective of the Yellowknives Dene First Nation (YKDFN) youth: 1. Cultural Connection: The youth emphasized that a connection to the land is integral to practicing cultural skills, learning traditional knowledge, and maintaining a sense of identity. Being on the land allows them to engage in activities like harvesting, hunting, and preparing food, which are tied to cultural heritage and well- being. 2. Traditional Knowledge Transfer: Elders pass on knowledge about how to live off the land, respect animals and plants, and practice sustainable cultural activities. This intergenerational transfer strengthens both individual and community health by preserving traditions and fostering resilience. 3. Physical and Mental Health: Engaging in land-based activities reduces stress, provides a sense of belonging, and reinforces traditional ways of living that contribute to overall health. 4. Environmental Health: The youth linked land health to community health. They raised concerns about environmental damage, such as pollution and contamination, which they identified as threats to their well- being. Protecting the land from such harms is seen as essential to protecting their own health. 5. Spiritual and Social Harmony: The youth viewed health as a balance between people, land, and the environment. A healthy relationship with the land contributes to spiritual well-being and fosters harmonious community relations, which are considered essential for a healthy life. 6. Future Health Solutions: The youth suggested that future health initiatives must involve on-the-land activities, reinforcing their connection to the land. This connection is seen as a proactive approach to maintaining health, as it fosters cultural continuity and community strength. In summary, land is a determinant of health because it provides the foundation for cultural identity, intergenerational knowledge, physical and mental well-being, environmental stewardship, and social harmony. Cultural Continuity Yes, cultural continuity is a critical social determinant of health for Indigenous peoples. It refers to the preservation and transmission of cultural practices, knowledge, and values across generations. For Indigenous communities, maintaining cultural continuity is vital for spiritual, mental, emotional, and physical well-being. Cultural continuity helps Indigenous peoples maintain their identity, sense of belonging, and connection to the land, which are all essential for holistic health. Practices such as traditional language use, ceremonies, storytelling, and land-based activities (like hunting, fishing, and harvesting) foster resilience, strengthen communities, and provide a sense of purpose and empowerment. When cultural continuity is disrupted—due to colonialism, forced assimilation, residential schools, and land dispossession—it leads to social, emotional, and physical health disparities. Supporting cultural continuity has been shown to improve health outcomes for Indigenous peoples by reinforcing community ties, enhancing mental health, and addressing the historical trauma caused by colonial policies. Therefore, it is considered a vital factor in promoting health and well-being within Indigenous communities. Supporting cultural continuity improves health outcomes for Indigenous peoples because it fosters a sense of identity, belonging, and resilience that is deeply tied to their holistic concept of well-being. Here are key reasons why it positively impacts health: 1. Mental and Emotional Well-Being: Cultural continuity helps individuals maintain a strong sense of identity, which protects against the negative effects of colonial trauma, racism, and marginalization. Cultural continuity reinforces Indigenous concepts of health, along with integrated approaches, aligning health practices with cultural values and providing a more complete sense of well-being.Preserving cultural practices, such as language, ceremonies, and traditional knowledge, promotes psychological resilience and a sense of self-worth, which are essential for mental health. 2. Connection to the Land: For many Indigenous communities, health is intrinsically linked to the land. Maintaining cultural practices like land stewardship, traditional harvesting, and environmental care provides not only physical activity and nutrition but also spiritual and emotional fulfillment. This connection strengthens the community’s overall health. 3. Community Cohesion: Cultural continuity reinforces community bonds, fostering strong support networks. Elders passing down knowledge to youth through traditional practices fosters intergenerational ties, which provide emotional support and enhance social cohesion—both of which are critical for health. In summary, supporting cultural continuity allows Indigenous peoples to reclaim their heritage, strengthen community ties, and address the underlying causes of health disparities. This holistic support improves health by fostering identity, resilience, community cohesion, and self-determination. References Auger, M., Gomes,T., Howell, T. (2016). Moving toward holistic wellness, empowerment and self-determination for Indigenous peoples in Canada: Can traditional Indigenous health care practices increase ownership over health and health care decisions? Canadian Journal of Public Health, 107(4-5), 393–e398 Chan, C., Nguyen, N., Subhan, F. & Williams, K.(2020). Barriers and Mitigating Strategies to Healthcare Access in Indigenous Communities of Canada: A Narrative Review. Healthcare, 8(112), 1-16. De Leeuw, S., Greenwood, M., Lindsay N.M., Reading, Charlotte. (2015). Determinants of Indigenous Peoples’ Health in Canada. Canadian Scholars Press Inc. Douglas, V. (2013). Aboriginal Health and Health Care in Canada. Springer Publishing Company, LLC. Gracey, M., King, M., Smith, A. (2009). Indigenous health part 2: the underlying causes of the health gap. The Lancet, 374(9683): 76-85. Horrill, T., McMillan, D., Schultz, A. and Thompson, G. (2018). Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives. The Authors Nursing Inquiry, 1(1), 1-9. R. Bethune, N. Absher, M. Obiagwu, T. Qarmout, M. Steeves, M. Yaghoubi, R. Tikoo, M. Szafron, C. Dell, M. Farag. (2018). Social determinants of self-reported health for Canada's indigenous peoples: a public health approach. Public Health, 176, 172-180 St. Denis, V. (2007). “Aboriginal Education with Anti-Racist Education: Building Alliances across Cultural and Racial Identity Politics”. Canadian Journal of Education 30/4, 1068-1092. Wilson,K. (2003).Therapeutic landscapes and First Nations peoples: an exploration of culture,health and place. Health & Place, 9(2), 83–93. Introduction “Traditional Healers and Elders say that the Great Spirit works through everyone, so that everyone has the ability to heal, whether it’s the mother who tends to the scrapes of her child, a friend who eases your pain by kind words or the Healer who heals your sickness. Everything that was put here is healing – the trees, the earth, the animals and the water” (Anishnawbe Health Toronto, 2000). Holistic health (body, mind, spirit and heart). All traditional healing is holistic. The holistic notion of body, mind, heart, and spirit refers to the healing tradition of seeking balance in all parts of the individual with the community and the environment- where one part is unwell then the whole person is also unwell. First Nations, Inuit, and Metis place health within the context of the family and community (Douglas, 2013) which emphasizes harmony and respect for all living things. Indigenous worldviews often have the philosophy of interconnectedness and belonging. This is the understanding that all people are related, connected to each other and to all life on Earth. The interdependency with all things promotes a sense of responsibility and accountability. This concept is somewhat of a novelty in Western society, which can be individualistic and hierarchical. Indigenous perspectives are slowly becoming recognized in patient care in clinical practice, but bridging the cultural divide can be a challenge. Holism as Reciprocity First Nations believe that relationships with all living and nonliving things are symbiotic and holism is a reciprocal process (de Leeuw, 2015,p.26). Maintaining harmonious relations emphasizes being respectful of the relationship between humans and natural systems- Indigenous peoples’ survival is dependent on the survival and health of their environment. When people take something from nature, there are ceremonies and rituals performed to recognize the importance of this delicate balance and enforce an attitude of reciprocity with nature. The "Spiritual" dimension of Holistic Health For many Indigenous peoples, spiritual health is expressed and sustained in relationships with family and community. Spiritual health is defined as “A dynamic and intrinsic aspect of our humanity through which persons seek ultimate meaning, purpose, & transcendence, and experience relationship -- to self, family, others, community, society, nature, and the significant or sacred. Spirituality is expressed through beliefs, values, traditions, and practices” (Hull et al. 2014, p.646). Reading Traditional Healing, Anishnawbe Health Toronto: https://www.aht.ca/images/stories/TEACHINGS/Healing.pdf Traditional Indigenous Epistemology One of the pillars of this course is exploring Indigenous worldviews. Every person has a way of knowing, seeing, explaining, and living in the world. They have distinct values and different ideas about what is important in life. In order to appreciate Indigenous history and culture, we must deepen our understanding of their worldviews. Epistemology refers to “ways of knowing”. Cultural competency in healthcare requires the cooperation of both the Indigenous person and the healthcare provider- both must recognize and respect that each party’s approach to health is rooted in different epistemology (Douglas, 2013). Before colonization, Indigenous peoples had a strong system of health and wellness. As healthcare providers, we are working to integrate this traditional knowledge into clinical practice through developing an understanding of First Nations models for health and healing. The resurgence of this knowledge contributes to the decolonization of the Canadian health care system. For Indigenous peoples: 1. There is no distinction between physical and spiritual health. 2. The health of individuals is placed in the context of the family and community. 3. The traditional Indigenous approach to health is not exclusive. Indigenous communities are interested in the benefits of modern biomedical techniques and technologies presented by Western authorities (Douglas, 2013). Two-eyed Seeing Two-eyed seeing is a traditional Indigenous guiding principle which refers to the collaboration between Indigenous and non- Indigenous ways of knowing. It means, in a very literal sense, to see with one eye in the Indigenous worldview and the other eye in the Western worldview (Martin, 2012). Learning to use both these eyes together in a balanced way will maximize the benefits from both perspectives. “As Elders, we also know that today First Nations peoples all have to be able to walk in two worlds: that of their Native community and that of the newcomers, of the white people, whose ways are the ways of mainstream society. We cannot overemphasize how important this ability is for the recovery and health of our communities and our community members, and especially for the nurturance of our children and youth in grade schools” (de Leeuw, 2015, p.17) Here are some examples of Two-Eyed Seeing in practice: 1. Integrating Traditional Ecological Knowledge (TEK) and Western Science Example: Environmental Monitoring and Conservation Indigenous communities have a deep connection with the land and possess intricate knowledge of ecosystems, which has been passed down for generations. In some environmental monitoring projects, Indigenous Peoples' Traditional Ecological Knowledge (TEK) is integrated with Western scientific methods. For instance, in monitoring caribou populations in the Arctic, Western satellite tracking is combined with Indigenous hunters' observations of migration patterns, animal behavior, and environmental changes. ○ Impact: By using both TEK and Western science, conservation efforts become more effective, sustainable, and culturally relevant. 2. Health Care Collaboration Example: Mental Health and Healing Practices In some Indigenous communities, mental health programs integrate Western psychiatric treatment with traditional healing ceremonies, such as talking circles, sweat lodges, and the use of sacred medicines like sage or sweetgrass. For example, in Canada, programs for Indigenous youth experiencing mental health crises might offer both counseling sessions and access to traditional healers. ○ Impact: This combination respects cultural practices and offers a more comprehensive treatment plan that honors both the physical and spiritual dimensions of healing, leading to higher success rates in mental health recovery. 3. Land and Resource Management Example: Fisheries Management The Unama'ki Institute of Natural Resources in Nova Scotia brings together Mi'kmaq knowledge with Western scientific research to manage fish populations, such as salmon. Indigenous knowledge, which emphasizes balance and sustainability, is combined with modern biology to create management strategies that protect fish populations while supporting Indigenous rights and livelihoods. ○ Impact: This approach ensures that resource management aligns with both scientific data and cultural practices, supporting sustainability and ecosystem health. 4. Education and Curriculum Development Example: Blending Indigenous Knowledge and STEM Some schools are incorporating Two-Eyed Seeing in their STEM (Science, Technology, Engineering, and Math) curriculum by including Indigenous knowledge. For instance, students may learn about engineering from a Western perspective while also understanding how Indigenous Peoples engineered sustainable housing, transportation (like canoes), or food storage methods (e.g., underground caches). ○ Impact: This approach not only broadens students' understanding of science but also values Indigenous innovations and promotes cross-cultural learning. 6. Food Sovereignty and Agriculture Example: Revitalizing Traditional Farming Practices with Modern Techniques In some Indigenous communities, traditional agricultural methods, such as polycultures or companion planting (e.g., the "Three Sisters" of corn, beans, and squash), are being revitalized and enhanced by modern agricultural science. For example, Indigenous farming techniques that promote soil health are combined with modern irrigation technologies or soil analysis methods. ○ Impact: The combination of traditional farming wisdom and modern science can improve crop yields, enhance sustainability, and preserve Indigenous food systems while adapting to contemporary challenges. 7. Marine Conservation Example: Pacific Salmon Restoration In British Columbia, Two-Eyed Seeing has been applied to the restoration of Pacific salmon populations. Indigenous fishers and scientists collaborate by combining Indigenous practices of observing water temperature, animal behavior, and ecological signs with Western scientific research on salmon breeding cycles, genetics, and habitat requirements. ○ Impact: This collaboration results in more culturally respectful and ecologically sound approaches to managing fish populations and protecting biodiversity Reading Martin, D. (2012). Two-Eyed Seeing: A Framework for Understanding Indigenous and Non-Indigenous Approaches to Indigenous Health Research. Canadian Journal of Nursing Research. 44(2): 20-42. Medicine Wheel Originating among the Prairies First Nations, the Medicine Wheel has become a symbol of Indigenous health and wellness. The traditional Medicine Wheel is a hoop defined by four colours: black, white, yellow and red. The colours carry many symbolic meanings: The four directions (North, South, East, West) The four stages of life (birth, youth, adulthood, death) The four elements (sun, air, water, earth) The four seasons (spring, summer, fall, winter) The four aspects of human life (spiritual, emotional, intellectual, physical) (Douglas, 2013). Whatever the symbolism, the message is the same: there is a holistic relationship and interconnectedness between all things. To be healthy an individual must look beyond physical health and pursue balance between all aspects of life. If one element within the medicine wheel is neglected or receives too much attention, then health suffers in all four areas. "According to beliefs, all four elements of life, the physical, emotional, mental and spiritual, are represented in the four directions of the medicine wheel. These four elements are intricately woven together and interact to support a strong and healthy person. One of the main teachings of the medicine wheel is that balance between all four elements is essential for maintaining and supporting good health. Balance extends beyond the individual realm such that good health and healing also requires that an individual live in harmony with others, their community and the spirit worlds” (Gracey, 2009, p.76). Here are some examples of the Medicine Wheel in practice: 1. Holistic Health Care Example: Healing Programs for Addiction and Mental Health In addiction treatment centers for Indigenous populations, the Medicine Wheel is often used as a framework to address recovery holistically. Each quadrant of the wheel represents a different aspect of healing: ○ Physical: Nutrition, exercise, detoxification, and medical treatment. ○ Emotional: Counseling, talking circles, and trauma recovery. ○ Mental: Cognitive therapies, education about addiction, and mindfulness practices. ○ Spiritual: Participation in traditional ceremonies, such as smudging, sweat lodges, and prayer. ○ Impact: This holistic approach helps individuals recover in a culturally sensitive and balanced manner, addressing the root causes of addiction and mental health issues from multiple perspectives. 2. Education and Learning Example: Culturally Responsive Pedagogy In Indigenous education, the Medicine Wheel is used as a teaching tool to support students' holistic development. Educators use the four directions of the Medicine Wheel to create a balanced learning experience: ○ Mental (North): Intellectual development and academic skills. ○ Emotional (South): Social-emotional learning and relationship-building. ○ Physical (West): Physical activities, sports, and outdoor education. ○ Spiritual (East): Incorporating Indigenous culture, ceremonies, and teachings about respect for all living things. ○ Impact: The use of the Medicine Wheel in education helps foster a more inclusive, holistic learning environment that nurtures students’ diverse needs and supports their overall well-being. ○ 4. Community Healing and Reconciliation Example: Healing Circles and Restorative Justice In many Indigenous communities, the Medicine Wheel is used in healing circles or restorative justice processes, emphasizing the interconnectedness of all individuals and the need to restore balance within the community. The four directions of the Medicine Wheel guide discussions about the harms done and the healing required: ○ Physical: Addressing tangible outcomes, like repairing physical harm or restitution. ○ Emotional: Creating space for expressing emotions, such as grief, anger, or forgiveness. ○ Mental: Understanding the root causes of conflict and making plans to avoid future harm. ○ Spiritual: Conducting ceremonies or rituals to seek guidance, support, and peace. ○ Impact: Using the Medicine Wheel in these processes promotes holistic healing and fosters stronger, more resilient communities by addressing not just the conflict but also the underlying emotional and spiritual issues. 6. Traditional Child Rearing Practices Example: Parenting Programs Rooted in the Medicine Wheel Some Indigenous parenting programs use the Medicine Wheel to teach traditional child-rearing practices. Parents are encouraged to focus on nurturing the whole child using the wheel as a guide: ○ Physical (West): Ensuring the child has proper nutrition, rest, and physical activity. ○ Emotional (South): Supporting the child’s emotional development through love, encouragement, and connection to family. ○ Mental (North): Encouraging intellectual growth, problem-solving, and curiosity. ○ Spiritual (East): Instilling traditional values, respect for nature, and connection to culture and ceremonies. ○ Impact: These programs support holistic child development, reinforcing the importance of cultural teachings and ensuring children are raised with balance in all aspects of life. 8. Leadership and Governance Example: Indigenous Leadership Models In leadership and governance, the Medicine Wheel is often used as a framework to guide decision-making processes that are balanced, inclusive, and culturally aligned: ○ Physical (West): Addressing the tangible needs of the community, such as infrastructure, resources, and economic stability. ○ Emotional (South): Listening to the emotional needs of the people and fostering unity and trust within the community. ○ Mental (North): Making informed, thoughtful decisions based on knowledge, wisdom, and foresight. ○ Spiritual (East): Ensuring that decisions align with spiritual values, respect for the land, and the ancestors' teachings. ○ Impact: Leaders who follow the Medicine Wheel model strive to create balance within their communities, addressing both material and cultural needs while maintaining harmony Exercise 3. Personal Development and Wellness Example: Life Balance and Goal Setting The Medicine Wheel is used as a personal development tool to help individuals assess and create balance in their lives. Each direction of the wheel corresponds to a different area of life, and individuals reflect on how balanced these areas are: ○ Physical (West): Assessing physical health, exercise, diet, and rest. ○ Emotional (South): Evaluating emotional well-being, relationships, and self-esteem. ○ Mental (North): Reflecting on intellectual growth, learning, and mental clarity. ○ Spiritual (East): Connecting to one's spirituality, values, and sense of purpose. ○ Impact: By regularly reflecting on these four aspects, individuals can make intentional decisions to create balance and achieve their personal goals, ensuring that all aspects of their life are in harmony. Construct your own Medicine Wheel for health: Spiritual, Emotional, Intellectual, and Physical. Fill in your Medicine Wheel with factors that positively influence your spiritual, emotional, intellectual and physical health. For example: Mental can be friendship, Physical can be jogging, Emotional can be painting, and Spiritual can be meditation. Isn’t Modern Medicine Enough? The text raises concerns about the impact of modern medicine on Indigenous peoples, particularly in Canada. Despite extensive funding and services provided to Aboriginal communities, they still suffer from high levels of illness and social breakdown. The Royal Commission on Aboriginal Peoples described the situation as a "crisis," pointing out that modern medicine has failed to solve these issues. Four key problems with modern medicine are highlighted: 1. It displaces traditional medical knowledge developed over centuries. 2. It undermines local control and community involvement in health practices. 3. It cannot reverse certain types of diseases. 4. It often causes harm through its methods of treatment, without sufficient monitoring or compensation for those affected. The text suggests that Indigenous peoples might have been healthier if they had been allowed to rely on their traditional healing systems, rather than being forced into adopting modern, Western medicine. Reference: https://lfs-indigenous.sites.olt.ubc.ca/files/2014/07/RayObomsawin.traditional.medicine-1.pdf Spiritual Ceremony sweat lodge: The sweat lodge is a traditional way of healing and cleansing the body and spirit for many Indigenous peoples across Canada. It has been described as one of the most “immediate and powerful [Indigenous ceremonies] in restoring a balance of spiritual, emotional, mental and physical well-being.” fasting ceremony: Fasting is one of many ceremonies that has been practiced in First Nations communities for thousands of years, but not one which is practiced very often today due to medical knowledge about the dangers of fasting. In the past, the Elders of a community would take the young people out to fast in order to help them find their direction in life. On a fast, You may go out to seek direction in your life or you may go out to learn more about Indigenous ways of knowing and about Creation. This ceremony should always be practiced under the direct guidance of an Elder. A Fasting Ceremony can take place from one to four days with a preparation period ranging from weeks to months. The Elder will select the Sacred area for the Fast and oversee the person Fasting. pipe ceremony: The Sacred Pipe is a sign of respect and friendship and is a connector to the Great Spirit. It is designed in two parts representing the female and male and balance of life. A person receives the honor to become a Pipe Carrier by learning the cultural teachings from the Elders.Sacred Pipe ceremonies are performed in different ways depending on the teachings of the Pipe Carrier. The pipe is very sacred to First Nations people. In the past, it was used to open negotiations between different nations as a way to promote peaceful conversation.This ceremony was also regarded as the way by which participants would be truthful, respectful and abide by the decisions and agreements that were made during the meeting time. Tobacco that has been blessed through prayer is normally used for the ceremony. The pipe is usually kept in a sacred bundle that is owned by the pipe carrier, and only he (or a helper) is allowed to open the bundle to prepare for the ceremony. After all preparations are accomplished, the ceremony can start. When asked, the pipe carrier can do the ceremony in almost any location. The participants sit in a circle with the pipe carrier. Amongst some First Nations, the men sit in an inner circle and the women sit in an outer circle; in others, all sit in one circle. Women who are in their menstrual period are required to excuse themselves from participating in this ceremony because it is believed that they have great power and could do harm to the ceremony. The helper places the sacred tobacco into the pipe and lights it in front of the pipe carrier. The pipe carrier, who is the host of the ceremony, says prayers and The pipe is then passed to the participants for them to either touch or smoke it. The passing of the pipe can be repeated several times. The tobacco is then allowed to “die” and the pipe is disassembled to be returned to the bundle until the next ceremony. After this, the pipe carrier may speak a few words of gratitude about life and expectations; each participant is also invited to speak such words; and the ceremony is considered closed. full moon ceremony: A moon ceremony is a ceremony for women and girls. This ceremony is held to honor our Grandmother the Moon and all she does for female life. Special songs are sung, food is prepared, and there is talking and sharing with other women and the Grandmother, and even requests are made. A Moon Ceremony is always held during a Full Moon. This is when the Grandmother Moon is at her strongest and most able to help. Pow wow The powwow is the most popular and far-reaching form of celebration among First Nations communities today. For those who participate, the event is often a way to reaffirm their cultural heritage. Today powwows celebrate First Nations traditions through singing, dancing, and drumming. The powwow takes place in a circle, as do many other ceremonies.There are four main types of powwow dances: Traditional, Fancy, Grass, and Jingledress. Jingle-dress dancing is derived from the Anishinabé people of northern Ontario, while Traditional, Fancy, and Grass dancing have their roots in Plains culture. Some powwows are competitive, and offer prize money for some dances. For example, the Skydome Powwow in Toronto used to offers $75 000 in prize money. Some of these powwows are huge gatherings lasting two to three days or longer, with contests in different categories. Powwow protocol includes proper procedures for everything from when photographs are allowed to not touching a dancer’s regalia without permission. Legal framework The Ontario Human Rights Code, Canadian Human Rights Act, Canadian Constitution, Charter of Rights and Freedoms and United Nations Declaration of the Rights of Indigenous Peoples All of these include legal protections for the fundamental right of Indigenous peoples to freely practice their religious and spiritual traditions, and to be treated equally and with dignity. Employers, unions, housing and service providers that fall under provincial jurisdiction have a legal duty under the Ontario Code to uphold Indigenous peoples’ right to be free from discrimination based on creed. As part of this obligation, where there is a negative impact on Indigenous peoples’ spiritual beliefs and practices, there is a duty to accommodate up to the point of undue hardship. The law has clearly recognized Indigenous Spirituality to be within the meaning of creed under the Code.] Organizations should generally accept in good faith that a person practices a creed, unless there is significant reason to believe otherwise. Individuals and organizations must not impose their own subjective view of what is a creed or creed-related practice (for example, assuming that a creed is one which must have a written text, likea bible). if an accommodation need or request is creed-based,it is essential that organizations meaningfully engage the Indigenous persons seeking accommodation to understand their needs. Medicinal Plants Indigenous Peoples in Canada have long relied on medicinal plants for healing, wellness, and maintaining balance between the body, mind, and spirit. These plants, often used in conjunction with spiritual practices, are deeply intertwined with the land and cultural traditions. Indigenous knowledge of medicinal plants has been passed down through generations, and the relationship with these plants reflects a holistic worldview, where healing involves treating both the physical and spiritual aspects of a person. Since time immemorial Indigenous peoples in Canada have been using plants and other natural materials as medicine. Plant medicines are used more frequently than those derived from animals. In all, Indigenous peoples have identified over 400 different species of plants (as well as lichens, fungi and algae) with medicinal applications. Medicine traditions — the plants used, the ailments treated, protocols for harvesting and application, and modes of preparation — are similar for Indigenous peoples across the country. In many Indigenous communities, there are recognized specialists trained in traditional medicine, and their practice often reflects spiritual aspects of healing as well as physical outcomes. In many cases, the therapeutic properties of Indigenous medicines are attributable to particular compounds and their effects on the body, but in other instances, their application is little understood by western medical practitioners. Within Indigenous communities, specific methods of harvesting and preparation of medicines are considered intellectual property of particular individuals or families. History of Indigenous Medicine The use of medicinal plants has been a part of people’s healing traditions worldwide, probably from humans’ earliest beginnings. Among Indigenous peoples in Canada, the origin of some medicinal applications is chronicled in stories, such as in the Siksika (Blackfoot) narrative of how a woman named Last Calf, who had tuberculosis, gave food to a beaver, who in turn gifted her with a vision of a cure for her ailment. She was told to boil the pitch of the lodgepole pine (Pinus contorta) in water and drink the infusion, while singing a special song. After following these instructions, Last Calf was cured. When Europeans and other newcomers arrived in Canada, they quickly learned about and adopted many of the plant medicines used by Indigenous peoples. One famous example is how French explorer Jacques Cartier and his crew, suffering from scurvy when they were overwintering at Stadacona (now Quebec City) in 1536, were saved by local Haudenosaunee. The Haudenosaunee brought them a coniferous tree (which Cartier named “tree of life”) and told them how to prepare it as a medicine. In turn, Indigenous peoples in Canada learned to use medicines from Europe and other parts of the world, such as the latex of the common dandelion (Taraxacum officinale) to remove warts, or the fragrant pineappleweed (Matricaria discoidea) to make a medicinal tea. How Are Indigenous Medicines Used? For Indigenous peoples in Canada and elsewhere in the world the line between food and medicine is blurred. There is a notable overlap between plant species that are edible and those with recognized medicinal qualities. All different parts of plants — roots and underground parts, bark, leaves, buds, flowers, fruits, and sap or pitch — have had recognized medicinal uses, and there are many different modes of preparing and applying them. Medicinal plants contain a range of diverse organic compounds, including alkaloids, glycosides, tannins, flavonoids, resins and volatile, or essential oils. The quantities of these compounds vary with the lifecycle stage, plant part, location, and genetic makeup of the plant, as well as what the weather was like recently and which plants are growing nearby. The specific compounds may interact in different ways to produce therapeutic effects. Medicinal plants are treated with great reverence and respect, in acknowledgement of their gifts and service to people. Healers carefully prepare themselves for their work, and follow strict cultural protocols relating to harvesting, preparing and administering their medicines. Although some types of healing require particular spiritual preparation, traditionally healers and shamans in Canada have not relied on mind-altering plants or mushrooms to the same extent as in parts of central and South America. Healers do undergo particular purification rituals to give them special energy that often involve fasting and taking certain preparations of plants as emetics or purgatives said to give them the powers required to do their work. There is often no strict division between physical and spiritual aspects of healing. Commercial Uses of Indigenous Medicines Of the approximately 400 species of medicinal plants, lichens, fungi and algae documented as used by Indigenous peoples in Canada, few have been exhaustively analysed chemically or tested in clinical trials. However, a number of the plants used medicinally by Indigenous peoples in Canada have been adopted more widely and incorporated into western medicine. In the past century, for example, cascara bark (Rhamnus purshiana) from British Columbia was harvested commercially for the pharmaceutical industry for use as a laxative medicine. Other plants like kinnikinnick, or uva ursi (Arctostaphylos uva-ursi), wild ginger (Asarum caudatum), blue cohosh (Caulophyllum thalictroides), goldthread (Coptis trifolia), echinacea (Echinacea purpurea) and witchhazel (Hamamelis virginiana) have also harvested commercially, and, more recently, with the discovery of the anticancer drug Taxol in the bark of Pacific yew ( Taxus brevifolia), yew bark was heavily exploited, leading to a decline in the populations of this slow-growing and relatively uncommon tree of western Canada. Another valued medicinal plant, roseroot (Rhodiola rosea), of northern Canada has been recently highlighted as an “adaptogen,” a medicine to help the body resist stress and increase energy, endurance and strength. Plants growing under particular environmental conditions, such as mineral rich soils, are also being highlighted for their healing qualities. In fact, many herbal medicines are being “rediscovered” for their healing and health-maintaining properties, and research on their phytochemical properties, efficacy and applications is ongoing. The Indian Act of 1867 Over time, the relationship between the early Europeans and the First Nations shifted and an attitude took form which saw Indigenous peoples as savages who needed to be saved. The government of Canada set out on a Christianizing and civilizing mission to assimilate Indigenous peoples into Western culture. Law enforcement is a tool used for colonization, where law is used to assert control over aspects of Indigenous peoples’ lives. To these efforts, colonial legislation was consolidated in the Canadian federal law, the Indian Act of 1876 (Dickason & Newbigging, 2015). The Indian Act was enacted to encourage assimilation of Indigenous peoples into Western culture, eroding their cultural, social, economic, and political distinctiveness. This federal law issued many control measures over aspects of Indigenous ways of life, including but not limited to: Early Indigenous health policy supported the dichotomy of “white” as racial superior, assimilation goals, and an irrational fear of “interracial” contagion. “The Indian Act gave power to the Minister of Indian Affairs to enforce regulations regarding the suppression of communicable disease, reserve sanitation, and the provision of medical treatment and health services. The government encouraged a belief “that health could only be guaranteed through assimilation meant that Indigenous bodies became sites of colonization by missionary doctors” (de Leeuw et.al., 2015, p.7). Health care became a colonial obligation and the legacy of these historical attitudes continue today in a health care system which is not adequately equipped to serve Indigenous populations in culturally competent ways. The Indian Act has had a signi cant impact on Indigenous Peoples' health in Canada in several ways 1. Health Service Provision: Federal Responsibility: The Indian Act designates the federal government as responsible for providing health services to First Nations. However, this responsibility has often been met with inadequate funding and resources. Health services on reserves frequently lack the same level of access and quality available to non-Indigenous Canadians. Chronic Underfunding: Many communities face chronic underfunding for health services, leading to shortages of health professionals and facilities, which affects the availability of primary and specialized care 2. Cultural Disconnec Imposition of Western Practices: The Act has largely enforced Western medical practices, often sidelining traditional healing methods and cultural practices that are integral to Indigenous health and well-being. This can alienate individuals from the health care system Lack of Culturally Safe Care: Many Indigenous patients report experiences of discrimination and racism within the health care system, which can discourage them from seeking care and result in poorer health outcomes 3. Residential School Historical Trauma: The Indian Act facilitated the establishment of residential schools, which aimed to assimilate Indigenous children. The physical and emotional abuse experienced in these institutions has had lasting effects on individuals and communities, contributing to high rates of mental health issues, substance abuse, and family disintegration Intergenerational Impact: The trauma from residential schools affects not just those who attended but also their descendants, leading to a cycle of trauma that continues to impact health and well-being 4. Living Condition Substandard Housing: Many Indigenous communities, particularly on reserves, face inadequate housing, overcrowding, and poor sanitation. These conditions can lead to increased rates of respiratory infections, communicable diseases, and other health issues Access to Clean Water: Many Indigenous communities have long-standing boil water advisories, which impact overall health and increase risks of gastrointestinal diseases and other health problems :... s s t. fi... 5. Mental Health Challenge Impact of Marginalization: The systemic racism and marginalization faced by Indigenous Peoples have resulted in signi cant mental health challenges, including depression, anxiety, and higher rates of suicide Loss of Identity: Disconnection from cultural practices, languages, and community structures, often enforced by policies linked to the Indian Act, contributes to a loss of identity and belonging, further impacting mental health 6. Limited Autonom Restrictive Governance: The Indian Act limits the self-governance of Indigenous communities, constraining their ability to develop and implement health policies that re ect their unique cultural needs and priorities Decision-Making Power: Without the ability to make autonomous decisions about health care, communities are often forced to adapt to external policies that may not align with their values or needs 7. Access to Bene t Eligibility Criteria: The Indian Act outlines speci c criteria for accessing health bene ts, which can leave some individuals and families without necessary support, particularly if they do not meet certain de nitions of "status" under the Act Barriers to Care: Complexities in navigating the health bene ts system can create additional barriers, discouraging individuals from seeking essential health services Overall, the Indian Act has contributed to systemic inequities that affect the health and well- being of Indigenous Peoples in Canada. Addressing these issues requires a comprehensive approach that involves recognizing and supporting Indigenous rights, autonomy, and self- determination in health car The forced sterilization of Indigenous women in Canada is a deeply troubling chapter in the country’s history, and its effects continue to reverberate today. This practice, rooted in colonialism and eugenics, re ects systemic racism in health care and broader societal structures. Here is a summary of its history 1. Early 20th Century: The Rise of Eugenic Eugenics Movement: In the early 20th century, eugenics, a pseudoscienti c belief in improving the genetic quality of human populations, gained popularity in Canada and other parts of the world. Eugenicists promoted sterilization as a way to prevent people they deemed "undesirable" (those with disabilities, mental illnesses, or those who were poor) from reproducing fl fi. fi. s y e fl : s fi fi.. fi s. fi fi.. Targeting Indigenous Women: Eugenic policies disproportionately targeted marginalized groups, including Indigenous women, whom colonial authorities often viewed as "un t" or "lesser." The sterilization of Indigenous women was seen as a means to "improve" society by reducing their population and exerting control over their reproductive rights 2. Provincial Sterilization Law Alberta Sexual Sterilization Act (1928-1972): Alberta passed one of the most infamous sterilization laws in 1928, legalizing the forced sterilization of individuals deemed "mentally de cient" by the Eugenics Board of Alberta. Indigenous women were disproportionately affected by these policies, as were other marginalized groups British Columbia Sexual Sterilization Act (1933-1973): British Columbia also passed similar legislation in 1933. Like in Alberta, the law permitted the sterilization of people deemed mentally un t, and again, Indigenous women were often targeted During this period, many Indigenous women were sterilized without their consent or under coercion, often following the birth of a child or during routine medical procedures. They were either not informed or misled about the procedure 3. Coercion and Lack of Informed Consen Indigenous women and girls were often coerced into sterilization, particularly after childbirth. Health care providers sometimes pressured women to sign consent forms while they were in labor or immediately after delivery, when they were in vulnerable physical and emotional states In many cases, Indigenous women were not given proper information about the procedure or its permanent effects. Some were told the sterilization was reversible or necessary for their health, while others were threatened with the loss of their children or access to social services if they refused Many women who underwent forced sterilization were not informed of the procedure until after it was performed, leaving them to discover later that they could no longer have children 4. Post-War Era and Ongoing Sterilizations (1940s-1970s While forced sterilization was often associated with the pre-war period, the practice continued into the 1960s and 1970s, even after public opinion started to shift away from eugenics. Indigenous women were often sterilized as part of broader efforts to assimilate Indigenous Peoples into mainstream society, which included controlling their reproductive rights Sterilization was also used as a population control method during the era of the Sixties Scoop, when thousands of Indigenous children were taken from their families and placed in foster care or adopted by non-Indigenous families. In this context, sterilizing Indigenous women was seen as a way to limit the growth of the Indigenous population, consistent with broader colonial policies aimed at eradicating Indigenous cultures and communities 5. 1980s-1990s: Legal Challenges and Continued Sterilization. fi. fi.. fi. s. t. ). s. Despite growing awareness of the human rights abuses associated with forced sterilization, reports of coerced sterilization of Indigenous women persisted into the 1990s 1995 Class Action Lawsuit: In Alberta, a class-action lawsuit was led against the government on behalf of over 700 survivors of forced sterilization, including Indigenous women. Many survivors were sterilized under the now-repealed Alberta Sexual Sterilization Act. The lawsuit helped bring attention to the history of forced sterilization in Canada and eventually led to nancial compensation for some of the survivors Continued Sterilizations: Even after sterilization legislation was repealed in Alberta and British Columbia, Indigenous women continued to report cases of coerced sterilization. These reports often involved coercion during or after childbirth, with health care providers pressuring women to undergo the procedure without fully informed consent 6. 21st Century: Ongoing Reports and Legal Battle 2017-2018 Saskatchewan Case: A group of Indigenous women in Saskatchewan came forward with allegations that they had been coerced into sterilization in recent decades. Some women reported being pressured to sign consent forms for sterilization shortly after childbirth, often while they were still in pain or disoriented from anesthesia. These cases gained signi cant media attention and led to calls for a national inquiry 2019 Class Action Lawsuit: In 2019, a class-action lawsuit was launched on behalf of Indigenous women who had been coerced into sterilization in Saskatchewan and across Canada. The lawsuit accused health authorities, doctors, and governments of systemic discrimination and violating the women’s reproductive rights The persistence of these cases into the 21st century highlights the continuing legacy of colonialism and systemic racism in Canada’s health care system. Indigenous women continue to face disproportionate barriers to accessing culturally safe and respectful care, and their reproductive rights have been repeatedly violated 7. Government Responses and Apologie The federal government and various provincial governments have acknowledged the historical wrongs of forced sterilization, though critics argue that more needs to be done to address ongoing issues In 2018, Prime Minister Justin Trudeau condemned forced sterilization as a human rights violation, and Indigenous leaders and advocates have called for stronger legal protections and accountability measures to prevent further abuses The Truth and Reconciliation Commission (TRC) called for systemic changes in health care, including cultural competency training for health care providers and policies that ensure Indigenous Peoples’ rights to health and autonomy are respected 8. The Intersection of Racism and Reproductive Right The forced sterilization of Indigenous women is part of a broader pattern of reproductive injustice that includes the removal of Indigenous children from their families (the Sixties Scoop) and ongoing issues such as high rates of infant mortality and inadequate prenatal and postnatal care for Indigenous mothers. fi. fi. s... s s fi.... At its core, this history re ects a colonial desire to control Indigenous bodies and diminish Indigenous populations, all while justifying these actions through racist and paternalistic ideologies. This legacy continues to impact Indigenous women’s health and rights in Canada today Conclusio The forced sterilization of Indigenous women in Canada is a tragic example of how colonial policies and systemic racism have targeted Indigenous communities, particularly Indigenous women, in an effort to control their reproduction and limit their populations. Although these practices have been publicly condemned, their legacy persists in ongoing reports of coerced sterilization and continued systemic barriers to accessing equitable, respectful, and culturally safe health care. Constitutional Rights and Section 3 The Constitution Act, 1982, through Section 35, recognizes and af rms the existing Aboriginal and treaty rights of Indigenous Peoples. While this section does not explicitly mention health care, it forms the basis for Indigenous rights claims, including the right to culturally appropriate health services Key Points: Section 35 is a critical legal framework for asserting Indigenous rights, including health- related ones Indigenous Peoples are advocating for the interpretation of Section 35 to encompass the right to health care, cultural safety, and traditional healing practices Jordan's Principle Health care in Canada is a complex, multi-jurisdictional issue. While health care delivery is primarily a provincial/territorial responsibility, the federal government has speci c responsibilities for Indigenous health, particularly for First Nations and Inuit communities, through Indigenous Services Canada (ISC) Jordan River Anderson, of Norway House Reserve in Manitoba, fell ill with Carey Fineman Ziter syndrome, a treatable muscular disorder when he was 2 years old. His complex medical needs could not be met on reserve, so he was admitted to hospital in Winnipeg for treatment and was eventually cleared to return to his community provided that he received appropriate home care. But over the course of 2 years, the federal and provincial governments were in dispute over who should pay for his care and Jordan passed away in hospital at the age of 5 in 2005 (Douglas, 2013).. n... fl 5.. fi fi The response to this tragedy was a national debate over the treatment of Indigenous peoples and accusations of racism of both the provincial and federal governments. In 2007, the House of Commons unanimously passed Motion-296, enacting Jordan’s Principle, named in Jordan Anderson’s memory. The Principle aims to ensure that First Nations children can access all public services and children do not experience any service denials, delays or disruptions because they are Indigenous. Jordan’s Principle seeks to address the administrative barriers to accessing services, and eliminate service denials, delays and disruptions by stipulating that governments must pay for services first and seek reimbursement later (Douglas, 2013). The lack of clarity between federal and provincial jurisdictions has been referred to by the Supreme Court of Canada as a "jurisdictional wasteland."20 When jurisdictional responsibilities are unclear, it can result in denials of essential services. For example, Jordan River Anderson was a Cree child who spent his short life in hospital where he died while the governments of Manitoba and Canada disagreed over which order of government should pay for his athome care. In 2007, the House of Commons unanimously adopted a motion called Jordan's Principle to address jurisdictional confusion.21 Under Jordan's Principle, if a jurisdictional dispute arises between two government parties or between two departments of the same government regarding payment for services guaranteed to First Nations children, the agency rst contacted must pay for the services without delay or interruption, while the two levels of government resolve who is responsible for the cost only after the services have been provided Environmental Assessment Act Impact Assessment Act he Impact Assessment Act (IAA), enacted in Canada in 2019, replaced the Canadian Environmental Assessment Act of 2012. It aims to assess the environmental, social, and economic impacts of proposed projects before they proceed. Here’s how the Act works and its implications for Indigenous Peoples Overview of the Impact Assessment Ac 1. Purpose: The IAA aims to ensure that environmental, health, social, and economic factors are considered in project assessments, promoting sustainable development. 2. Scope: It applies to a wide range of projects, including resource extraction, infrastructure development, and other activities that may signi cantly affect the environment and communities. 3. Assessment Process: The Act establishes a framework for assessing potential impacts, including public consultations, scienti c studies, and the evaluation of alternatives to proposed projects. : fi fi t fi. Impact on Indigenous People 1. Indigenous Rights and Consultation ◦ Recognition of Rights: The IAA recognizes the rights of Indigenous Peoples as outlined in the Constitution and international agreements, emphasizing the need for meaningful consultation ◦ Involvement in Assessments: Indigenous communities are to be included in the assessment process, allowing them to express concerns and perspectives related to potential impacts on their lands, resources, and cultures 2. Cultural Considerations ◦ Assessment of Cultural Impact: The Act requires assessments to consider impacts on Indigenous cultures, traditional practices, and ways of life, which can help protect Indigenous heritage and values 3. Capacity Building ◦ Support for Participation: The Act provides for funding and support to help Indigenous communities participate effectively in the assessment process, enhancing their capacity to engage in discussions and decision-making 4. Monitoring and Follow-Up ◦ Long-Term Engagement: The IAA includes provisions for monitoring the impacts of projects after approval, ensuring that Indigenous communities can continue to engage in oversight and advocate for their rights and interests 5. Potential Challenges ◦ Implementation and Consistency: There can be challenges in ensuring that the provisions of the IAA are consistently applied and respected by federal and provincial authorities, leading to concerns about the effectiveness of Indigenous consultation ◦ Resource Limitations: Some Indigenous communities may face limitations in resources or capacity, which can hinder their ability to participate fully in the assessment process Conclusio The Impact Assessment Act is signi cant for Indigenous Peoples in Canada as it seeks to incorporate their rights, knowledge, and concerns into environmental decision-making processes. While the Act represents progress in recognizing Indigenous perspectives, the effectiveness of its implementation and the genuine engagement of Indigenous communities remain critical to achieving meaningful outcomes in protecting their rights and interests Oka Crise s. n. : : :. : fi s :..... Métis Health Accord (2019 The Métis Health Accord (2019) is a signi cant agreement between the federal government of Canada and the Métis Nation that aims to improve health outcomes for Métis people across the country. Here’s an overview of the Accord and its impacts on Indigenous Peoples, particularly Métis communities Overview of the Métis Health Accor 1. Purpose: The Accord was created to address the unique health needs and disparities faced by Métis individuals and communities, acknowledging that Métis people experience speci c health challenges and outcomes compared to both non-Indigenous Canadians and other Indigenous groups. 2. Funding Commitment: The federal government committed to providing $300 million over ten years to support the implementation of health initiatives outlined in the Accord, aimed at enhancing health services and addressing health inequities. 3. Focus Areas: The Accord emphasizes several key areas, including ◦ Culturally Safe Health Services: Promoting access to health services that are respectful of Métis culture, traditions, and values ◦ Chronic Disease Prevention: Addressing chronic health conditions prevalent in Métis populations, such as diabetes, heart disease, and mental health issues ◦ Mental Health and Addictions: Supporting initiatives aimed at improving mental health services and addressing substance use challenges within Métis communities ◦ Data and Research: Enhancing data collection and research speci c to Métis health needs to better inform policies and programs Impact on Indigenous People 1. Recognition of Métis Rights: The Accord acknowledges the distinct identity and rights of Métis people, af rming their place within the broader Indigenous context in Canada. This recognition is vital for promoting self-determination in health care. 2. Improved Access to Health Services: By focusing on culturally safe and relevant health care, the Accord aims to reduce barriers that Métis people face in accessing health services, leading to better health outcomes. 3. Community Empowerment: The Accord encourages Métis communities to take a lead role in health planning and decision-making, fostering empowerment and ensuring that. fi fi : ) s fi d.. fi :. health initiatives align with community needs and priorities. 4. Collaboration and Partnerships: The Accord promotes collaboration between Métis organizations, governments, and health care providers, which can enhance the effectiveness of health programs and services tailored for Métis populations. 5. Focus on Holistic Health: By addressing not only physical health but also mental health and social determinants of health, the Accord supports a more comprehensive approach to wellness that resonates with Métis cultural practices and perspectives. Conclusio The Métis Health Accord (2019) represents a signi cant step toward addressing health disparities faced by Métis people in Canada. It emphasizes the importance of culturally relevant health care, community involvement, and targeted funding. While the Accord holds promise for improving health outcomes, its successful implementation will depend on ongoing collaboration, monitoring, and responsiveness to the evolving needs of Métis communities Indigenous Health Policy (2018 The Indigenous Health Policy (2018) is a framework developed by Health Canada to guide the government’s approach to improving health outcomes for Indigenous Peoples in Canada, including First Nations, Métis, and Inuit. Here’s an overview of the policy and its impacts Overview of the Indigenous Health Policy (2018 1. Purpose: The policy aims to provide a comprehensive, equitable, and culturally safe health care system that recognizes the distinct needs and rights of Indigenous Peoples. 2. Principles: It is grounded in several key principles, including ◦ Self-Determination: Recognizing the right of Indigenous communities to govern their health care and make decisions that re ect their values and priorities ◦ Cultural Safety: Emphasizing the need for health care services that are respectful of and responsive to Indigenous cultures and traditions ◦ Collaboration: Encouraging partnerships between Indigenous communities, health care providers, and government agencies to enhance health service delivery 3. Goals: The policy outlines speci c goals, such as ◦ Improving access to health services for Indigenous Peoples. n fi ) fl : fi.. ) :.. : ◦ Reducing health disparities between Indigenous and non-Indigenous populations ◦ Supporting mental health and well-being ◦ Enhancing health data collection and research speci c to Indigenous health issues Impact on Indigenous People 1. Culturally Safe Care: The policy aims to foster an environment where Indigenous patients feel respected and understood, which can lead to improved health outcomes and trust in the health care system. 2. Empowerment and Self-Governance: By promoting self-determination, the policy supports Indigenous communities in taking control of their health care systems, allowing for tailored approaches that re ect their unique needs and cultural contexts. 3. Access to Services: The focus on improving access to health services aims to address the barriers many Indigenous Peoples face, including geographic isolation, systemic discrimination, and underfunding. 4. Holistic Approach: The policy encourages a holistic understanding of health, integrating physical, mental, emotional, and spiritual well-being, which aligns with traditional Indigenous perspectives on health. 5. Data and Research: By emphasizing the importance of collecting accurate data and conducting research speci c to Indigenous health, the policy seeks to inform better health interventions and policies tailored to Indigenous populations. 6. Accountability and Monitoring: The policy includes mechanisms for accountability and monitoring progress toward health equity, allowing Indigenous communities to hold health authorities accountable for meeting their needs. Conclusio The Indigenous Health Policy (2018) represents a signi cant step toward addressing the health disparities faced by Indigenous Peoples in Canada. By prioritizing culturally safe care, self- determination, and collaboration, the policy aims to create a more equitable health care system that respects Indigenous rights and promotes better health outcomes. The successful implementation of this policy will depend on ongoing engagement with Indigenous communities and a commitment to addressing systemic barriers within the health care system Non-Insured Health Bene ts (NIHB) Program n fi fi fl s. fi fi... The Non-Insured Health Bene ts (NIHB) Program is a federal program in Canada that provides eligible First Nations and Inuit individuals with access to a range of health bene ts that are not covered by other health insurance plans. Here’s an overview of the program and its impacts on Indigenous Peoples Overview of the NIHB Progra 1. Purpose: The NIHB Program aims to ensure that First Nations and Inuit have access to necessary health services and bene ts that support their overall health and well-being, particularly those that are not covered by provincial or territorial health care plans. 2. Eligible Bene ts: The program covers a variety of services, including ◦ Prescription medications ◦ Dental care ◦ Vision care (including eye exams and eyewear) ◦ Medical supplies and equipment ◦ Mental health services ◦ Transportation to access medical services 3. Eligibility: To qualify for NIHB bene ts, individuals must be registered under the Indian Act or be recognized as Inuit. The program is designed to address health disparities faced by these groups. Impact on Indigenous People 1. Access to Essential Services: The NIHB Program provides critical access to health services that might otherwise be unaffordable for many First Nations and Inuit individuals. This helps improve health outcomes by ensuring that necessary treatments and services are accessible. 2. Cost Coverage: By covering costs for essential health services, the NIHB Program reduces nancial barriers that can prevent Indigenous Peoples from seeking care. This is particularly important for communities where poverty and limited resources may be prevalent. 3. Comprehensive Health Support: The range of services covered by the NIHB, including mental health and dental care, contributes to a more holistic approach to health, addressing various aspects of well-being beyond just physical health. 4. Challenges with Administration: While the program is vital, many users face challenges related to the administration of bene ts, including fi. fi.. : fi. fi fi s m fi.. : : fi ◦ Claims Processing: Delays in claims processing can result in dif culties accessing services ◦ Awareness and Information: Some individuals may lack information about what is covered, leading to missed opportunities for accessing bene ts ◦ Complexity: Navigating the application and approval processes can be complicated, creating additional barriers to care 5. Impact on Health Equity: The NIHB Program plays a crucial role in working toward health equity for Indigenous Peoples by addressing some of the systemic

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