TRC calls to action

What will this presentation discuss?:

An overview

Overview

In this presentation I am going to focus on calls to action 18 and 19 which both deal with Indigenous health. I am going to discuss issues surrounding Indigenous health that resulted from colonialism and residential schools to give context to these calls. Then, I will discuss the significance of calls 18 and 19 and the implications of them. I will then suggest restorative practices that could address these calls and will highlight how they respect Indigenous culture and traditional ways of knowing.

Call to Action 18

"We call upon the federal, provincial, territorial, and Aboriginal governments to acknowledge that the current state of Aboriginal health in Canada is a direct result of previous Canadian government policies, including residential schools, and to recognize and implement the health-care rights of Aboriginal people as identified in international law, constitutional law, and under the Treaties" (Truth and Reconciliation Commission of Canada, 2015)

Call to Action 19

"We call upon the federal government, in consultation with Aboriginal peoples, to establish measurable goals to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities, and to publish annual progress reports and assess long-term trends. Such efforts would focus on indicators such as: infant mortality, maternal health, suicide, mental health, addictions, life expectancy, birth rates, infant and child health issues, chronic diseases, illness and injury incidence, and the availability of appropriate health services" (Truth and Reconciliation Commission of Canada, 2015)

Indigenous Health

Indigenous Health

What Indigenous health issues are these calls addressing? What are they asking the government to do?

Call 18: Call 18 addresses how current Indigenous health issues are the result of government policies that stem from colonialism. The government is being asked to acknowledge how this history has impacted Indigenous health and to respect the healthcare rights of Indigenous peoples as outlined in various laws and treaty agreements.

Call 19: Call 19 addresses how there are gaps in health outcomes for Indigenous people compared to non-Indigenous people that need to be closed. The government is being asked to identify and measure these gaps, publish progress reports and assess trends, and work towards closing these gaps and provide data to show this is being done.

(Truth and Reconciliation Commission of Canada, 2015)

Click to explore a timeline of significant events in Indigenous Canadian history

Timeline

Colonialism

How did colonialism affect Indigenous health?

Colonialism

Colonial agendas involved inhabiting Indigenous land, stripping away Indigenous culture and spirituality, and forcing these people to assimilate to settler ways of life. Settlers introduced new processed and refined foods to Indigenous diets and traded alcohol for other goods. Settler contact also exposed Indigenous peoples to infections diseases, such as smallpox, that could not be treated with their traditional medicines.

(Wesley- Esquimaux & Smolewski, 2004)

Residential Schools

How did residential schools affect Indigenous health?

Residential Schools

Residential schools contributed negatively to both physical health and mental health. Smith, Varcoe and Edwards (2005) refer to the "legacy of broken families, broken culture and broken spirit" resulting from residential schools (p. 39).

Residential schools were plagued by poor healthcare facilities, unsanitary conditions, and inadequate diets (Boyer, 2017). These factors contributed to poor health and even death (Boyer, 2017).

Residential schools inflicted severe trauma on students which has then been passed down through generations.

Addictions in Indigenous Communities

Addictions issues amongst Indigenous peoples can be traced back to initial contact when settlers traded alcohol to Indigenous peoples in exchange for various goods.

King, Smith and Gracey (2009) discuss how addictive behaviors such as drinking or drug use can be used a method of self-medicating. They discuss how people may not just be medicating to conceal the intergenerational trauma of colonization but also the resulting social issues such as poverty, unemployment, and family instability (King, Smith & Gracey, 2009)

Addictions

Significantly Worse Mental Health and Higher Suicide Rates

Mental Health & Suicide

Data shows that Indigenous populations suffer from significantly worse mental health and higher rates of suicide than non-Indigenous populations. One article states that suicide rates for First Nations youth are 5-6 times higher than that of non-Indigenous youth and the rate for Inuit youth is 11 times the national suicide rate (Boyer, 2017).

The trauma experienced by previous generations as well as the outcomes of such trauma including family disintegration, family violence, multiple forms of abuse and loss of identity have contributed to the current poor state of Indigenous mental health.

According to statistics Canada, only about 15% of respondents to a survey on use of healthcare services had accessed a psychologist, social worker or counsellor in the past year (Statistics Canada, 2012a). This does not mean Indigenous people aren't in need of mental health services, it means that they are not accessing them for various reasons.

Access to/ Use of Medical Professionals and Healthcare Services

Access to Health Services

Statistics Canada reports show that in 2012, 20% of Indigenous people did not have a regular doctor; out of that 20%, 5% had no doctor because none were available to them (Statistics Canada, 2012a). About 12% of respondents replied that they had required but not received necessary healthcare services in the last year (Statistics Canada, 2012a).

Why acknowledge the past?

#18

If we ignore the past when considering the current state of Indigenous health we risk blaming Indigenous people for their struggles. It has become commonplace to place blame into the hands of individuals in regards to addictions and homelessness; King, Smith, and Gracey (2009) utilize the term victim-blaming to refer to how people see addictions as a matter of personal failing or genetic inferiority. When we victim-blame, specifically in the case of Indigenous peoples, we rid the real perpetrators of any blame or guilt. However, we also then place the responsibility of fixing these issues into the hands of Indigenous peoples when in reality the government needs to take action. We need to acknowledge who is responsible for the current state of Indigenous health and this can only be done by acknowledging the past. We then need to make them responsible for enabling change. The calls to action require the government to accept this blame and responsibility for change (Truth and Reconciliation Commission of Canada, 2015).

Why publish data?

#19

Data holds people accountable and also brings awareness to issues. Because this call is requiring the government to publish progress reports and track trends, it is holding them accountable to ensure there are changes to report; if the government does not focus on closing the gap in health outcomes and there are no changes, this will be reflected in the data. Because these records will be published, public awareness can be drawn to the issues being presented.

While all of the sections of the calls to action are of great importance, I chose to focus on the calls around health because I believe that health issues and access to healthcare impact every Indigenous person on this earth and will continue to negatively affect future generations if action isn't taken.

Why I chose this area

How will implementing these changes affect the lives and health Indigenous peoples?

Indigenous Peoples

If these changes are implemented, it would have a lasting positive impact on Indigenous health for future generations. Related to call 19, the gap in health outcomes between Indigenous and non-Indigenous peoples could be drastically reduced if the government remains committed to these calls to action; this would mean that Indigenous people would no longer suffer from higher rates of physical illness, mental illness, suicide, addictions than the rest of the population. The goal is to provide equal access and quality of healthcare to all Canadian citizens.

How will implementing these changes affect the social work profession?

Social Workers

These calls to action would have a significant impact on social workers that work within the healthcare system. Upholding these calls to action would require social workers to act as advocate for Indigenous ways of knowing and traditional medicine. In order to do this, social workers would be required to remain knowledgeable about Indigenous ways of knowing, cultural determinants of health, and forms of traditional medicine.

Why should we incorporate traditional medicine into healthcare for Indigenous peoples?

Traditional Medicine

Indigenous cultures value traditional forms of medicine such as plant, animal and/or mineral based medicine and spiritual therapies (Cianconi, Lesmana, Ventriglio & Janiri, 2019).

When access to healthcare is limited due to geographic location or health benefits, traditional medicine can be used to fill these gaps and provide relief (Cianconi, Lesmana, Ventriglio & Janiri, 2019). However, I do not propose we value one over the other, but that we find a way to meld the two together in a way that respects Indigenous culture and provides the best possible healthcare and health outcomes.

How can we incorporate Indigenous values into healthcare practices?

Cultural Values

Indigenous peoples value balance, inter-connectedness, intra-connectedness and transcendence as critical components to healing (Wesley- Esquimaux & Smolewski, 2004). How can we incorporate these into healthcare?

• addressing physical and mental health as being connected
• allowing family members to remain connected while receiving services
• allowing traditional and cultural practices (smudging, ceremonies, traditional medicines) to take place within healthcare facilities

How do we respond to call #18 in a way that is restorative in nature and respects Indigenous ways of knowing?

#18

• Identifying and respecting human rights and specific Indigenous rights
• respect the right to self-governance and self-determination
• Beyond acknowledging the past, providing specific training to all medical students and staff on the history of Indigenous peoples in Canada, the resulting negative health outcomes, and ways to work for Indigenous people in the healthcare system that respects their culture and ways of knowing

How do we respond to call 19 in a way that is restorative in nature and respects Indigenous ways of knowing?

#19

• Allowing Indigenous people open access to data regarding Indigenous health
• Allow Indigenous people to determine what determinants of health are in their context
• Incorporating traditional medicine into modern medical practices in a way that respects it's value to Indigenous peoples
• providing specific training to all medical students and professionals on traditional medicine, developed and taught by Indigenous peoples