This is a guest blog post written by the Indigenous Health Interest Group (IHIG) at Dalhousie University.
IHIG is an interdisciplinary group of health professions students that share a common goal of improving the health of Indigenous peoples. Please join us for a panel event at the Halifax Central Library, March 2nd, 6:30pm. For more information, follow Indigenous Health Interest Group – Dalhousie on Facebook.
Indigenous medicine encompasses a holistic worldview. This has only recently become the more progressive understanding of health in Western medicine, where health is more accurately defined as “physical, mental, social and spiritual wellbeing” rather than simply the absence of sickness.
This conception of health is nothing new to Indigenous peoples, but is unfortunately not an ideal that is realized in many Indigenous communities today. In Canada, there are striking inequities in health outcomes for Indigenous people compared to the general population, like reduced life expectancies of 5 to 10 years. This reflects the effects of history combined with the social determinants of health. This history – which continues today – includes colonization, forced displacement and environmental degradation. The social determinants of health were grimly summarized by the Royal Commission on Aboriginal Peoples, which stated that “Aboriginal people endure ill health, run-down and overcrowded housing, polluted water, inadequate schools, poverty and family breakdown at rates found more often in developing countries than in Canada”.
It is in this context that many Indigenous communities in Canada are successfully re-building, reviving or reinforcing their cultures and practices – including Indigenous medicine. This presents an opportunity to improve care for Indigenous patients, by tackling what has historically been the total exclusion of Indigenous medicine from the mainstream healthcare system. Actively facilitating blended models that offer both Indigenous and allopathic options is one way to make the healthcare system more inclusive, effective and safe.
There are a small but growing number of examples in Canada that show how Indigenous medicine can work in parallel with the mainstream healthcare system to benefit Indigenous patients. These include the multi-disciplinary teams at Anishnawbe Health Toronto Community Health Center and the research action centre Well Living House, which provide patients a more comprehensive package of culturally-based services to meet their needs.
Dr. Margaret Chan, Director-General of the World Health Organization, summarizes the opportunity well: “The two systems of traditional and Western medicine need not clash. Within the context of primary health care, they can blend together in a beneficial harmony, using the best features of each system, and compensating for certain weaknesses in each.”
For all patients, healthcare providers should be sensitive of, and responsive to, their needs and preferences. It is also important for patients to have the opportunity to decide what health services work best for them. For many Indigenous people, healthcare may include some aspect of traditional medicine or Indigenous knowledge. Having these options available – and having them respected by non-Indigenous health providers – is important for Indigenous patients’ health and health outcomes. This is especially true because many report negative experiences with the healthcare system including anxiety, stereotyping/stigmatization and racism.
The healthcare system can become more inclusive and more effective by opening the door to Indigenous healing systems, cross cultural communication and reciprocal knowledge sharing. As current students, we can be part of this movement by engaging in discussion, learning from Indigenous communities, and building our own awareness and cultural competency. Doing so will equip us to support a more inclusive healthcare system in our future roles as providers, leaders, policy makers, and gatekeepers.
Is this relevant to Nova Scotia? In a word, yes. Whether or not we are aware, willing or able, we will provide healthcare to Indigenous patients, because:
- Indigenous people comprise about 3% of the total population of Nova Scotia today
- There are 42 reserve locations across Nova Scotia, but nearly half of the Indigenous population in Nova Scotia live off-reserve – in cities around the Province
- There are not enough Indigenous health practitioners to be the sole healthcare providers for Indigenous communities