When talking about the best public health care systems in the world, it is inevitable that Canada will be mentioned somewhere in the top rankings.
Just recently, a survey of 20,000 global citizens, conducted by U.S News and Wharton School of Pennsylvania, demonstrated that people around the world perceive Canada as No. 1 overall for providing a good quality of life to its citizens, and 5th in the world for possessing the best well-developed public health care systems.
Unfortunately, many Indigenous individuals would argue that this view is far from reality when looking at the health of their communities. When comparing health outcomes between indigenous and non-Indigenous Canadians, a grim picture emerges. Significant gaps exist and persist.
In addition to a life expectancy that is reduced by up to 15 years, Indigenous people also have a higher prevalence of chronic conditions such diabetes. When compared to the national average, the diabetes rate is actually four times higher for First Nations on living on reserve.
Similarly, hypertension, obesity and arthritis plague First Nations, Metis and Inuit communities more profusely. Even easily preventable and treatable diseases are rampant. For example, data suggests that tuberculosis rates are up to 270 times higher for Inuit individuals. Such abysmal levels of health and disproportionate burdens of disease in Indigenous communities are associated with various social, economic and political inequities. These inequities have been birthed from years of systemic social suffering, colonialism and racism – factors we now identify as “distal determinants of health”.
Various solutions have been suggested to improve the health outcomes of Indigenous peoples in Canada today, and realistically, a complex, multi-pronged approach is needed. Amidst all these solutions is the call to restore and respect traditional ways of healing.
The words “traditional healing” can invoke a plethora of negative sentiments, especially from the biomedical community. Historically, many healthcare providers and researchers have shunned these methods, viewing them as primitive and of little use in the age of conventional medicine. Such paternalistic opinions overlook the fact that for thousands of years, prior to European contact, Indigenous peoples had fully functioning, effective and robust systems of health.
While traditional healing is as varied and diverse as Indigenous communities themselves, the common belief is the view of health as a holistic entity. Traditional beliefs dictate that health is a marriage of physical, mental and social wellbeing. Thus maintaining good health is an act of balance and caring for one’s spiritual self.
Past research has indicated that simply increasing health programs or access to healthcare is not enough to close the health outcome gap for indigenous people. For example, data from a dialysis initiative in the Saskatoon Health Region demonstrated that despite a majority of dialysis patients being First Nations people, they had significantly low participation rates in the educational programming designed to help individuals manage diabetes and avoid renal failure.
Similarly, research conducted by the former Health Council of Canada, revealed that many health care environments can alienate indigenous people, especially when they reject traditional healing approaches and instead, view Western credentials and health systems as superior.
Making health services work for indigenous people requires a genuine integration of their traditional healing practices and ways of knowing. In recent years, as a result of the hard work and activism of Indigenous academics, healers and communities themselves, there have been increased efforts to integrate traditional healing practices within health care delivery in Canada.
For example, in the province of British Columbia, the First Nation Health Authority (FNHA), the first of its kind, was established in 2011. Since then, the FNHA has been instrumental in ensuring the uptake of traditional healing practices in the healthcare sector. In fact, just this Oct. 11, a culturally safe space, known as the “All Nations Room”, was officially opened for First Nation families at West Coast General Hospital. Despite such successes, there is still along way to go.
Ensuring that Canada’s health system is not only one of the most well-developed in the world, but also truly equitable, requires continued acceptance of Indigenous cultural approaches to healing.
février 20, 2020
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