Health Information

Nunavut to hold inquest into suicides

Padma
Suramala, a registered nurse and Nunavut’s chief coroner, has called for
an inquest into the overwhelmingly high rate of suicide in the
territory, after 45 people took their own lives in 2013 — the highest
number of annual suicides since the territory’s creation in 1999.
Suramala announced the inquest at a news conference on Jan. 16 in
Iqaluit. She plans to convene a jury of six people to examine two or
three of the 2013 deaths, selected at random from the 45 suicides, the
youngest being an 11-year-old boy in Repulse Bay and the oldest was 72. 
“We would like to highlight the risk factors and the warning signs,
raise public awareness and make recommendations on how to prevent these
preventable deaths,” Suramala told CMAJ . The majority of those who
killed themselves in the territory last year were young men between the
ages of 15 and 25. Males accounted for 33 of the suicides. Given
Nunavut’s small population of approximately 31 000, the deaths have a
devastating impact on communities, from the family and friends of those
who die to front-line workers.

 


Sinclair inquest moves onto waiting times in ER

The
inquest into the death of Brian Sinclair, an Aboriginal man who waited
34 hours in the emergency room at Winnipeg’s Health Sciences Centre in
September 2008, has now moved into the next phase, which is the broader
subject of hospital overcrowding and delays. Sinclair, a double-amputee,
had been viewed by staff as a homeless person seeking shelter and was
left unattended despite his deteriorating health status. Sinclair’s
family wants the inquest, led by Judge Tim Preston, to examine the
racism that led to lack of care. However, Preston says his mandate does
not include that aspect but instead is to look at the delays in the
waiting room and what can be done to remedy the situation. The inquest
is scheduled to resume sitting Feb. 18 for two weeks and then for
another week in June before it wraps up. The inquest began in the summer
and has sat periodically since then.


MN-S launch youth suicide prevention program

Métis
Nation-Saskatachwan has launched a blue ribbon campaign aimed at
training trainers to help prevent suicide amongst Metis youth. “This
program has been created to support the unique needs of our Métis
communities and expands the capacity that already exists,” said Sandra
Youngchief, interim director of MN-S Health, in a news release. A
training manual and tool kit has been developed as the vehicles for
taking the program into communities and raising awareness around the
issue of youth suicide. A blue ribbon will represent the campaign and be
distributed to raise awareness of the program and its goals. Suicide
rates have been identified as one of the top priorities in the Métis
Health and Well Being Strategy.



Needs of homeless Inuit addressed with service point expansion

The
first service point for the homeless has been expanded to five downtown
metro stations in Montreal for a three-year period. Positive results of
Phase 1, which was launched in December 2012, led to the extension of
this service. Expanding the service points for the homeless will bolster
the support provided to people living on the street. “Homelessness
among Inuit living in the city is one of the serious consequences of the
housing crisis in Nunavik and one that calls for immediate special
attention,” said Jobie Tukkiapik, Makivik’s president, in a news
release. Makivik is one of the partners in this extension of services.
“We plan to continue implementing the strategy aimed at preventing Inuit
homelessness in Montreal.”



Baseline report for cancer in First Nations

The
recently released First Nations Cancer Control in Canada Baseline
Report provides a baseline against which progress can be measured over
the coming years. It also looks at the patient experience from screening
and diagnosis through to survivorship or palliative care, as well as
challenges experienced by First Nations patients through their cancer
journey. “First Nations view health from a holistic perspective, so when
we are presented with a problem, we look at it using many different
lenses,” said Dr. Evan Adams, board member for the Canadian Partnership
Against Cancer, in a news release. In 2014, the partnership will release
separate baseline reports for the Inuit and Métis baseline which will
further examine emerging priorities for action among these communities.
The majority of information within the series of baseline reports for
First Nations, Inuit and Métis cancer control are sourced from
environmental scans completed in 2012.


Odawa Aboriginal Community Justice Program

Elder Terry McKay and Program Coordinator Mark Marsolais who are with the Odawa Aboriginal Community Justice Program, Odawa Friendship Centre in Ottawa.

Healing the focus of justice program

Barb Nahwegahbow - Windspeaker Contributor
OTTAWA

On April 19, the Odawa Friendship Centre held a thanksgiving and unveiling ceremony at Ottawa’s Elgin Street courthouse attended by about 300 people.

“We wanted to publicly acknowledge our partnership with the courts and give thanks to them, the Crown Attorney’s Office and all our other supporters,” said Mark Marsolais, a citizen of Whitefish River Ojibway First Nation in Ontario with over 20 years’ experience in the justice system.

Marsolais is also the coordinator with the Odawa Aboriginal Community Justice Program (OACJP), a diversion program for First Nations, Métis and Inuit people charged with summary conviction offences in Ottawa. The maximum penalty for such offences is six months imprisonment, a fine of $5,000 or both.
Three years ago, the Odawa Centre decided to tackle the problem of Aboriginal over-representation in the criminal justice system. Discussions with the Crown Attorney’s office resulted in the OACJP.

“The individual is pulled from the collective justice system and into our diversion program and their charges are dealt with through a traditional justice program.”

The focus is on healing rather than punishment, he stressed.

Read more: http://www.ammsa.com/publications/windspeaker/healing-focus-justice-program


FNHA takes over delivery of health services in BC

As of Oct. 1, the First Nations Health Authority will take over all duties previously assigned to Health Canada in British Columbia. FNHA chair Lydia Hwitsum said her organization is committed to providing more access to primary care for Aboriginal people in rural and remote parts of the province, including the north. “I think we can do it better by working together on priorities of First Nations,” she told the Prince George Citizen. “We would not be doing this if we didn’t think we could do it better.” Years in the making, the FNHA began assuming some of the responsibilities previously held by the federal government in July. Under the Canadian Constitution, the federal government has held the responsibility for providing health care to Aboriginal people, while provincial governments are responsible for delivering it to the rest of the population. The phased transition started with the FNHA taking over policy and planning activities as well as the non-insured health benefit headquarters. In October, FNHA takes over service delivery. To make the transition easier, the FNHA is hiring about 250 former federal government employees. Those hires will join the existing staff of about 60 people and will be able to provide stability as the new leadership team takes over.


Nunavut gets voice on CMA

The Ontario Medical Association has agreed to sponsor a delegate from Nunavut at the Canadian Medical Association, the national body representing Canadian physicians. “I’m very pleased that Ontario can step forward and help bring greater attention to the needs and concerns of Nunavut’s medical community,” said Dr. Scott Wooder, president of the Ontario Medical Association, in a news release. “Ontario doctors have always participated in the treatment of Nunavut patients, so it’s fitting that physicians from both jurisdictions are now formally linked. The relationship will benefit patients in this underserved area.” The Inuit people of Nunavut have the highest infant mortality in Canada, a cancer death rate that is three times that of the national average, a TB rate that has been reported as 64 times the national average, and a suicide rate that is dramatically higher than that of the rest of Canada, said Dr. Katherine Canil, a surgeon in the territory for the past 18 years. Through the CMA, Canil said, Nunavut physicians hope to bring focus and leadership to these and many other Inuit health issues.


Socio-economic status plays role in violence against women

A new study conducted by researchers at St. Michael’s Hospital in Toronto indicates that the socio-economic position is a major factor influencing risks of abuse for Aboriginal women. The study indicates that if Aboriginal women had the same income and education levels as non-Aboriginal women, their risk of being abused by a partner could drop by 40 per cent. Dr. Janet Smylie and Dr. Nihaya Daoud’s findings appear online in the Canadian Journal of Public Health. The study used data from the 2006-07 Canadian Maternity Experiences Survey representing more than 50,000 Canadian-born women, including more than 3,000 off-reserve First Nations, Inuit and Métis mothers. Researchers collaborated with the Native Women’s Association of Canada. Poverty can lead to violence through financial and social stress, as well as alcohol or drug-abuse to cope with these stressors. The cost of moving or living alone can prevent Aboriginal women from leaving violent situations. The authors believe this is the first quantitative study to examine socio-economic position as a factor explaining high rates of gender violence among Aboriginal women.


Province kicks in funding for Membertou sports centre

The Membertou Sports and Wellness Centre has received funding from the Nova Scotia government. The project, a 1,250-seat arena plus an indoor walking track and a 3,000-square foot community fitness centre, will help promote the health and wellness of people living in the community. There is room to add a second ice surface. “I am absolutely delighted that government thinks this is an important project for Membertou and the whole area,” said Chief Terrance Paul, in a news release. “This is a tremendous boost for the fundraising for the arena and entire project.” The province is contributing a $3 million grant over three years toward the $18 million project. The funding supports the Mi’kmaw physical activity leadership program memorandum, announced in February, between the province and five Mi’kmaw communities, including Membertou.


New health program created through partnership

The Canadian Jewish Humanitarian and Relief Committee has embarked on a new health initiative in conjunction with seven First Nations communities in Kenora, Ont. Bri’ut is designed to improve the long-term physical and mental health of Aboriginal populations by strengthening the delivery of community-based health promotion programs. This summer, the organization received a grant of $238,500 from the Ontario Trillium Foundation in support of implementing the program with Aboriginal communities in Canada over a four-year period. “It is my experience that individuals and communities benefit greatly when they are directly engaged with issues related to their health and well-being, and when they are invited to contribute to creative strategies to address health issues of concern in a manner that is community-focused and sustainable,” Chief Joe Barnes, executive director of the Kenora Chiefs Advisory, said in a statement.


Jordan’s Principle decision has far-reaching implications

Shari Narine - Windspeaker Contributor
PICTOU LANDING FIRST NATION, N.S.

The successful argument of Jordan’s Principle in federal court could have major implications for other battles First Nations are waging for equity in funding and service.

On April 4, the Federal Court of Canada ruled that Jordan’s Principle is legally enforceable and not simply a policy, as the federal government had been claiming.

“The court agreed with our arguments that it is a responsibility that the federal government has assumed and therefore they can be held accountable,” said Paul Champs, lawyer for the Pictou Landing Band and Maurina Beadle.

The band and Beadle challenged the federal government to support Beadle’s son Jeremy Meawasige, a severely disabled youth, at the same level of support Jeremy would receive if he were living off reserve. Jeremy lives with his mother Maurina on Pictou Landing First Nation. Champs invoked Jordan’s Principle, a concept which received unanimous support from the House of Commons in 2007. Jordan’s Principle was developed in response to a Manitoba case involving Jordan Anderson, a severely disabled First Nations child who remained in hospital due to jurisdictional disputes between the federal and provincial governments over payment of home care services.  Jordan died at age five without being able to live in a family environment.

“It’s absolutely an awesome, awesome decision for us. It’s like justice has finally been done in this situation,” said Philippa Pictou, director of Pictou Landing Health Centre.

The commitment to funding ensures that the First Nation can provide Jeremy’s care.

“Having that security makes a huge difference. Up until now we’re constantly under threat of not being able to provide (funding and care),” said Pictou.

Jeremy’s situation came to the fore when his mother suffered a stroke in 2010 and couldn’t care for him. The band stepped in to provide the services so Jeremy could remain at home and would not need to be institutionalized outside of his community. The band asked the federal government to reimburse its costs. Aboriginal Affair and Northern Development Canada refused to provide funding at an equivalent rate.

Read more: http://www.ammsa.com/publications/windspeaker/jordan%E2%80%99s-principle-decision-has-far-reaching-implications



AIDS/HIV

Just the facts about AIDS

HIV and AIDS have become a growing concern among First Nations people, and education has proven to be the most effective way to prevent this fatal disease.

HIV is a communicable disease which can be transmitted from one person to another through certain behaviors. There is no cure, only medications that slow the obset of full blown AIDS.

AIDS is caused by HIV over time weakening the immune system, leaving the body an easy target for illnesses and diseases.

What is HIV?
· Human Immunodeficiency Virus - The virus that causes AIDS. It weakens the immune system making it difficult, and over time impossible, to fight infections and diseases.

What is AIDS?
· Acquired Immunodeficiency Syndrome - The advanced stage of HIV infection.

How do I know if I'm infected?
· Overtime, the body produces antibodies to fight the HIV virus. A blood test can tell if you have these antibodies which show you are infecteed.

· It can take up to six months after infection for these antibodies to show. After infection, some people may not feel or look sick for years, but they can still pass the virus to someone else.

· Over time, the nervous and immune systems become damaged and HIV-infected people become sick with different illnesses.
· People with AIDS are more suseptible to diseases such as infections or cancers, which can kill them.

Is there a cure?
· No. Progress has been made, but prevention is still our only defence.

Who's at risk?
· You.

· Everyone can be affected by HIV/AIDS. Male, female, young, old, rich or poor.

How can I get AIDs?
· Sharing needles or syringes with an infected person. Blood contains a high amount of HIV, so any blood rituals including tattooing or piercing is risky if equipment such as razors, knives or piercing needles that are not sterilized or cleaned properly between individuals.

· Unprotected (without a condom) anal or vaginal intercourse with an infected person.

· Performing oral sex on an infected person is a low risk activity. However, open sores on the lips or inside the mouth and bleeding gums increases the risk.

· An HIV positive woman can pass the infection to her child during pregnancy, delivery or through breast feeding.

· Receiving infected blood or blood products (since 1985 in Canada, all blood and blood products are tested for HIV antibodies).

How do I protect myself?
· Abstaining from sexual intercourse and injection drug use, including steroids is the most effective way to protect yourself.

· Do not share needles or equipment. Use clean needles and equipment at all times. If this is not possible, clean with bleach. Fill the syringe with bleach three times, then rinse with water three times. Also use bleach to clean other equipment. Remember to rinse with water.

· Always use a new latex condom for vaginal or anal intercourse. Any lubricant used must be water-based, like K-Y jelly. Oil-based products like Vaseline, hand lotions or massage oils can cause the condom to break during intercourse. Do not use novelty condoms, they will not protect you from HIV infection.

· Avoid alcohol and drugs, or at least use in moderation. They will affect our ability to make wise and healthy choices.

I CAN'T get infected by:
· Casual, everyday contact
· Shaking hands
· Hugging or kissing
· Coughing or sneezing
· Giving blood
· Using swimming pools or toilet seats
· Sharing bed linen, eating utensils or food
· Mosquitos and other insects, or animals

Will my identity be protected if I want to get tested?

· Yes. There are anoynomous test sites available, however you need to make that request to your doctor.

Who will help me cope with the results?
· There is counselling available before and after testing at anoynmous test sites.

Where do I go if I have more questions?
· Your local health unit or community centre
· Your local AIDS organizations
· AIDS hotlines
· Your doctor
· Your family planning clinic

We regret to inform you that the Canadian HIV/AIDS Information Centre, a program of the Canadian Public Health Association (CPHA), has ceased operations, effective March 31, 2008.

As of April 1, 2008, you may contact the Canadian AIDS Treatment Information Exchange (CATIE) for all your HIV/AIDS resource needs at:

Canadian AIDS Treatment Information Exchange (CATIE)
555 Richmond Street West, Suite 505, Box 1104
Toronto, Ontario M5V 3B1
1.800.263.1638 [toll-free]
Fax: 416.203.8242
E-mail: info@catie.ca
www.catie.ca



AIDS danger made real for Aboriginal youth with video
By Julie Black
Windspeaker Contributor
CALGARY

"Open your eyes and be aware, baby." If you hear young people rapping these lyrics, you can thank Ken Ward, the Enoch Spirit Fire Ensemble and rapper Conway Kootney for raising their awareness to the consequences of HIV and AIDS.

The music video Be Aware follows the story of a young woman on the powwow trail who enjoys the parties and the tipi creeping, but doesn't know how to protect herself from HIV.

Using traditional and modern symbols and storytelling, the video depicts her anguish about who will raise her young daughter when she's gone.

"The video shows what really happens," explained youth participant Michelle White. "It would be easier to say don't do sex, drugs or alcohol, but that's not realistic. It's about responsibility. We're not saying that sex will kill you, it's about unprotected sex," she said.

This music video project was the brainchild of long-time AIDS activist Ken Ward. As the first Aboriginal person to go public with his HIV status, Ward has long been innovative and courageous in his goal of encouraging Aboriginal communities to accept the new challenges of the AIDS epidemic.

"Young people want this information, in this form and fashion," Ward said. "We can't really set up a booth at the powwows and distribute condoms, but this video can bring the message that tipi creeping can get out of hand."

Based on Ward's script and Conway Kootney's song, the video was designed by participants in the Spirit Fire youth at-risk program in Enoch, Alta. Taught video technology, storyboarding, public speaking and the issues surrounding HIV/AIDS, the young people were encouraged to design the video in ways that would reach other Aboriginal youth.

The result is a dynamic video, but equally important, the project increased the self-confidence of the young videographers.

"You hear kids at school singing it, and it makes you feel good," said White.

"We've changed a lot," agreed youth participant Robby Thomas. "We've come a long way and coming to this conference was our first goal."

Thomas was referring to the Alberta Aboriginal HIV/AIDS Conference held in Calgary where the video was presented. Be Aware was shown first to the local community of Enoch.

In hopes of a wider distribution, the video has been submitted to MuchMusic, YTV and the new Aboriginal Peoples Television Network.

Drawing from the success of this pilot project, Ward hopes to run the Spirit Fire youth at-risk program again with other Aboriginal youth, this time in an urban setting.

"Young people really need us," explained Ward. "They need lots of emotional support in terms of the issues and the challenges in their lives. It's an intense experience, but you see moments where they balloon."

Be Aware is available from Duvall House Publishing in Edmonton at (780) 488-1390.

 


 

Ken Ward AIDS video is released
By Yvonne Irene Gladue
EDMONTON

Nine years ago when a doctor told him he was HIV positive, Ken Ward told his family and friends he had cancer. He hid from the disease and the effects it would have on his life.

Today, Ward has full-blown AIDS, but he no longer hides it. He is an outspoken advocate in the awareness campaign against the disease.

Ward, a member of the Enoch Cree Nation, west of Edmonton, has toured communities, schools, prisons, giving heart-felt messages about the disease.

He has already written a book titled And Who Will Hear Their Cries which contains a collection of poems Ward has written about his battle with the illness and now he has unveiled a new movie, chronicling his life with AIDS.
On Sept. 25, Edmonton's Sacred Heart Church played host to the screening of the video I Will Not Cry Alone, a documentary of Ward's struggle to deal with the disease and create awareness to the public about AIDS.

The film, made with the assistance of the National Film Board of Canada and Bibby Productions focuses on the challenges, friendships and heartache Ward has gone through while carrying the disease.

However, through the help of caring and understanding people ,Ward came forward and disclosed his illness.
The movie shows how Ward eventually came to grips with the disease. It shows how important it is to have people accept you for who you are, and how personal courage can come with that acceptance.

"Today, more than ever, it is necessary to demonstrate that "acceptance can go a long way in life, no matter who you are, even if you are someone with HIV/AIDS, "Ward said to a room full of people ready to watch the emotion-filled chronicle of his struggle.

Like the chilly overcast day outside the church, the atmosphere indoors was also bleak.

As the film played, it was easy to see that the video touched the audience as many struggled to remain composed. Some wept openly.

Ward candidly spoke about the effects of his illness, fears and hurt.

He described the symptoms a person with AIDS goes through, the weight loss, chills, and the depression. He spoke about how people react to the disease and how some AIDS carriers are sometimes ostracized in their communities.

"The pain is great at times," Ward said, "not just physically but emotionally as well."

Ward said he has come a long way since 1989, and he's had his fair share of disappointments, but he's decided to use his illness as a tool to help people understand the dangers of contracting it. His presentations are raw. He tells it like it is, and he won't apologize for that.

"I go out there to tell a story, not to do a show" said Ward.

That raw, natural tone was evident in a poem he read to the audience following the video screening. The poem, entitled "Share The Journey," is about an Aboriginal man who chose suicide to end the pain of AIDS. Ward's voice shook with emotion as he explained that people with AIDS are people too, just like everyone else. Ward stressed that communities should find a way to help their members with AIDS, instead of abandoning them.

His main message throughout the screening was to tell his Aboriginal brothers and sisters who have HIV/AIDS that there is support for them. That support is available from either his own lectures, book or video, or through the larger awareness he is helping to create.

The screening included an opening prayer by Elder Eva Ladouceur and an honor song by The River Cree Drum Group from the Enoch Band.

For information on the video or Ward's book, contact Marcel Pelletier at (403) 422-3052.


Still searching for peace
By Sabrina Whyatt
Windspeaker Staff Writer
ENOCH CREE NATION, Alta.

Ken Ward won't die peacefully. At least not until Aboriginal communities, as a whole, begin addressing issues that will help fight the growing battle with AIDS.
"We have a disease here in Indian Country and it has to be dealt with," said the 41-year-old AIDS victim.

Dealing with drugs, alcohol and sexual abuse by eliminating ignorance, and learning from victims, are key factors in fighting this battle, he said.

"I wish I could sit back and say my life is at peace, but realistically, I have to contend with this disease. There are so many issues and factors involved. I don't wanna die on this reserve, simply because it's too stressful to die here," said Ward, a band member of the Enoch Cree Nation, located west of Edmonton.

"As a person with AIDS, I need an advocate and to feel secure that our leaders in power are going to act as my advocate. We (AIDS victims) have to use all our energy to do it ourselves," he said expressing concern of leaders' role in addressing issues pertaining to the virus.

Diagnosed with HIV in 1989 and developing AIDS two years ago, Ward was the first Aboriginal in Canada with the disease to go public. Since then, he's visited Aboriginal communities all over the country sharing his story, written a book of poetry entitled And Who Will Hear Their Cries, and directed a film I Will Not Cry Alone, to be released next month. Through these and other projects, he's dedicated his life to educating people about prevention.

With his physical state deteriorating, Ward is more determined than ever to get the message across that leaders of Aboriginal communities have to come forward and take a major role in AIDS awareness and join with the rest of the community to prevent it from spreading.
"It has to be a community effort including the leadership, and we have to cater to the attitude issue. Community denial is still there, strong and breathing. Those who are prone to be at high risk think it's not going to happen to them. People have to recognize their path towards leading to self destruction and decide to change their habits. But there has to be opportunity to do so. If they don't have that opportunity, they won't see this [disease] as a threat," he said.

Ward recognizes that gang problems, alcohol and drug abuse amongst youth at Enoch and other Aboriginal communities, and anticipates such behavior patterns as eventually leading to the not-so-wonderful world of AIDS.
"As an ex-user, I see the patterns. I can see these people being potential sitting ducks, setting themselves up for this disease. We do have a drug and alcohol problem and we need to focus on that."

Raped at 13, Ward knows first-hand how sexual abuse can lead to low self esteem and self-destruction. It was this horrible incident that led to a life of drug abuse that he said "brought death knocking at my door."

As a result, he's convinced sexual abuse has to be dealt with through education in conjunction with proper communication within families.

"Parents, your kids go home from an AIDS workshop and they're armed with information, but they have questions about sexuality and relationships. If the parents close them down and say I don't want to talk about it or it's evil, that circle of education is broken and the kids are left hanging with all these questions. We have a bad communication problem here," he said with frustration.

Initially, fear of rejection forced Ward to lie about his illness, telling people he had cancer. Coming to the reality he was going to die, he broke the news to his brother and the rest of his family. With ongoing support from Elders and other members of the community, he went public promising to educate himself and others about the disease, and for some time he lived in a home for AIDS sufferers.

"That was best thing I ever did, to go live amongst my peers and see what they were doing to survive."

The next step was forgiveness. Ward stresses this is a very important step for any AIDS victim.

"I accept I have this disease and I need to forgive myself because I was responsible for setting myself up for this. I was a junkie years ago. I remember banging (needles) one time with this guy in a hotel room. I remember the phrase one bang won't hurt you - well this one certainly did."

There was an initial struggle about whether to choose modern medicine to treat his illness, but strong positive forces from the Native community led Ken toward traditional methods.

"The journey of cultural and traditional beliefs has certainly been a positive experience for me. This ceremonial walk was important in giving me balance. But you have to be committed to it for the rest of your life," he explained.

After his immune system began to deteriorate in 1995, he chose "white man's medicine." Last year, the drug began to lose its effect and he discontinued use after pondering the fact there was a possibility of becoming very ill.

"I don't know how long I have. To be honest, I'd be surprised if I live past this year. That would be a miracle. I can feel it right now, forgetfulness is happening and the energy level is not there as it used to be," he said.
Although he still continues to work on projects to fight AIDS, including a plan to visit jails where the disease is rapidly spreading, Ward's biggest search now is to find somewhere to spend his final days.

"I have to be realistic and find a home where I can die in peace. I want to die with dignity. Many end up overdosing and I can understand why, but not me.
I am not giving up hope. Hope never dies for me."
Ward said one of his biggest regrets is never having a wife and kids.

 


NOTE:
Ken Ward is member of the Enoch First Nations located near Edmonton, Alberta. Ken has been living with AIDS for several years and regularly speaks with people promoting Aids Awareness. Each month in Windspeaker, Ken shares with readers his thoughts and feelings of living with such a disease. Sometimes Ken is up sometimes he is down, but he is always compassionate and insightful.

 

Wilting away, bit by bit

Dear Creator:
I thank you for this day. Lately, I have been examining my fears, trying to be realistic. Acknowledging that, just perhaps, I will die someday is no problem, however it's the process of wilting away that has me concerned.
I recently turned down an opportunity to attend a conference hosted by Rainy River Nation, Man. As we scooted to the airport, fear started swelling, my mind raced, worried about boarding that plane. My thoughts dwelled on the 'what if's,' and recalled my friend's flight's experience - turbulence, malfunctions. Then I realized it was the fear of dying that was at the core of my issue. I offer my deepest regrets to Al Hunter and the committee. Please forgive me.

Just recently, I ran into a friend and his wife. I knew that he was not as open as he is usually. As I proceeded to sit down, his wife spoke to me. He has dementia now (infection to the brain) and he is slowly losing his thought processing ability and his memory, she told me. The HIV virus promotes dementia, then the brain activity becomes hyperactive. He had had no sleep for four days, had become somewhat paranoid and his speech was slower. Dependency becomes the issue, but his wife is there for him. I admire you.

They managed to raise some funds to take him to see the ocean. He had never seen the waters before. I pray that he will have the opportunity, before his time is up.
This is why it's so important to do something memorable while we are alive. To remember a person for their achievements is a healthy part of the grieving process for all.

Incidentally, he went off the same medications I did, and at the same time. The process of deterioration could affect me as well, with changes coming rapidly. This is my reality. Gotta keep on moving. No questions asked, just answers to find . . .

I have never professed to be a strong person, Creator. I only believed that the meek will survive. I do hope I earned that status. I'm just another human being trying to enjoy life while I can.

I am excited and most appreciative that the Lac Ste. Anne Pilgrimage Committee (see Make the most page 30.)

(Continued from page 29.) has endorsed a special evening for those afflicted by this illness HIV/AIDS. For more information call: Sacred Heart Parish of First Peoples in Edmonton, Alberta (403-422-3052). Ask for Marcel Pelletier.

I realize that time is precious in my life and I should take the time to accomplish my goals - now. The journey is not done yet, is it Creator? I believed in my heart that I helped in some ways for you, the readers, of my personal insight of this disease. It's time to mark my journey in another form. I thank you for your comments about this column. I thank Windspeaker for the opportunity just to share.

As I recall, a stranger knocked on my motel room. He entered and shared his appreciation for the work I'd done at a men's wellness conference in Saskatchewan. I was touched by his sincerity. I was touched by the hand drum he passed to me.

"Someday you will earn the victory song and someday you will sing for us," he said. I thank you my new brother in La Ronge, Sask.

My column maybe final but the journey is not. I will sing this song before my time comes. I will sing for you . . . and my Creator.

Peace for Life
Ken Ward


Simple goal for 1998 - LIVE!

Dear Creator:
New Year's has come and once again I wonder what will it bring for me. Many nights of thinking of my personal goals. Have they been met. What new challenges should I welcome? 1997 was a busy year what with promoting AIDS Awareness, participating in conferences, producing a video and book of poetry. Come to think of it, I average 75 to 100 community presentations a year. And to think dear readers, I have AIDS. So what's holding you back in the goals that you seek to achieve?
While there is a desperate search on to find a cure for AIDS, I decided that prayer and the will to survive would show through my work. It certainly has kept my sicknesses at bay.
1997 was the year when I chose to involve myself in bringing the concerns of inmates and prostitutes in regards to HIV and AIDS to your attention. What stories I have gathered! I tell you I am very honored and blessed that I am trusted to hear from you all while being on the road.

My goal for this year is to contend with this disease. Somewhere out there is a medicine person for me. I must keep looking.

There is a very frightening hold that grips our people, even on the reserves. It is the rapid growth of HIV infection in cities as big as Vancouver and as remote as to Prince Albert, Sask. The rise in numbers of people infected with HIV is related to drug use.

You see Creator, I am angry at one particular drug. I allowed it to control me, and my family is affected by cocaine use. I had to let go of my partner who went back to using the drug. I can't fall in love with a needle that has no soul. It's sad because I really loved the person.
One band member calls it, "Devil's dandruff" and it's so true. I can only suggest that a hard core drug treatment centre be developed in the prairies. A blunt straight-forward awareness campaign about the dangers of hard core drugs use, of it's symptoms and the negative effects and consequences of drug use needs to be addressed. Enough is enough - WE HAVE A DRUG PROBLEM people.
With the numbers of people infected with HIV/AIDS in the Aboriginal community and the widespread use of drugs, I wonder when are we to take a stand.

I am at war with this "Devil's Dandruff." When the RCMP tell me young kids are being introduced to cocaine on reserve's as young as 11 and 12 years old, while those who heartlessly prey on children to sell their bodies and feed the drugs to them. I am angry.

Maybe the pimps, the pushers may not like or hear what I do, but lives are at stake.
In good spirit. In good life.

Eagle Boy. Ken Ward


Living in a world of many colors

Dear Creator:
It's been a week-and-a-half since I took myself off these protease inhibitors. It was causing the runs. Hope I don't offend you. I understand that the HIV antibodies will mutate quickly and this ritonavir will no longer be of use to me anymore. Perhaps a surge of sickness could take hold of me. Perhaps death itself. Only you know?
This journey continues with uncertainties. Speaking of uncertainties, I have just returned from Vancouver, the city with the colorful life. The city that prairie Indians go to with hopes and dreams of finding Hollywood North. A city with some notoriety - the capital of North America as the fastest growth daily of HIV. Some reports say that about 1,000 people test positive per month. Drugs and needles have a firm grip on this city. It was quite clear to me how one's life can be swept into the darkness of hopelessness there.

I found it an angry city and greedy. Trying desperately to find some solace or a glimmer of hope, I had to search through this mist of darkness, but I found them. How unique and how special they are.

You see Creator, I have met many warm faces and warm hearts. . . young and old. I believe everyone has touched my heart dearly, including my adopted brother Joshua Bird in La Ronge, Sask.

The rich deprive the poor. The rich despise the poor. How tragic and noticeable in Vancouver. However, I look at the warriors, survivors who find someone to belong to.
For example: At the Greater Vancouver Native Cultural Society I was welcomed and accepted with loving hearts. Despite working with and surviving on a very low income of $500, this special group manages to find some sense in it all by recognizing "unity" and believing in cultural identity. Iris, Alicia, Connie, Bryon, Holly Bear, special friends like Brian Racette, Guy and Doug all contribute. Laurie MacDonald, ironically, is the founder from my home, the Enoch Cree Nation. I am so proud of you all and of the shows that you perform. I was deeply moved.
In the two-spirited world I have stumbled on, I found that this group maintains a sense of family and a sense of dignity. Yes, despite that others condemn them, despite that some of them are forced to live poorly and survive on the streets in the drug world and trade in prostitution, you have managed to keep your heads held high, despite uncertainty.

We do have something in common. You struggle on the cold streets of Vancouver. That is part of your journey. Mine is the search for traditional medicines. We are human and I pray for those who crave for more. Everyone in the world of many colors has one thing in common - our hearts. The heart is unique. It generates life in partnership with the spirit. If the two are neatly balanced, blessed ever so gently by the Creator, life has fulfillment.

I can only ask that prayers for our people on the cold streets of the city, who struggle from the negative forces of drugs and prostitution, that they not spend Christmas alone. For the others who are the rich, perhaps you are not as fortunate as some are.

To those who acknowledge my writings, I thank you. Where there is life... there is always hope.

Merry Christmas to you all.
Ken Ward

Diabetes

Cases of Diabetes expected to triple

By Louise Elliott
Windspeaker Contributor
SAN DIEGO, California

Fear about the spread of diabetes in Canadian Aboriginal communities and hope for their prevention were served up in equal measure by participants at the Fourth International Conference on Diabetes and Indigenous Peoples held Oct. 8 to 11 in San Diego.
Medical experts from Manitoba sounded the alarm about the number of Aboriginal adults with diabetes, which in that province is expected to triple by the year 2016. They stressed the disease is also starting to appear in children as young as six years old.

Type 2 diabetes - non-insulin dependent diabetes - is showing up in First Nations children in Ontario, Manitoba, and Saskatchewan at an increasing rate, and health experts are not equipped to address the problem, said Dr. Heather Dean of the Children's Hospital in Winnipeg. The disease had traditionally been thought to affect only adults, she said, and the new development has physicians and health care workers baffled as to how to treat it.

"Most physicians are disbelievers. It's important to help them understand this exists," she said, adding she saw her first child patient with Type 2 diabetes in 1983. Since then provincial health records show 58 cases have been detected in children under 14 in Manitoba. The number of new cases has risen from one or two per year to 11 in 1996, she said.

Type 1 diabetes patients display dramatic symptoms which are treatable by insulin injection, Dean said, while Type 2 cases go undetected or are often misdiagnosed by physicians. The error can lead to blindness, amputations, kidney failure and heart disease in young adulthood.

Bertha Flett, a First Nations registered nurse from Manitoba, described the experience of her daughter, who was misdiagnosed with Type 1 diabetes in 1981 at the age of eight. In 1995 at the age of 22, the woman went blind and developed end-stage renal disease (kidney failure).

"She always says, 'now I'm in dialysis, I'm going to die,'" Flett said. Flett is now working with Native children in Manitoba to try to develop better prevention and treatment strategies.

Another report, presented by Winnipeg epidemiologist Chris Green, estimated that the number of Native people with diabetes in Manitoba will triple to 20,000 from 6,700 by the year 2016, or from 16 to 27 per cent. A similar study cannot be conducted in other provinces, Green said, because most provincial patient records do not designate whether a patient is First Nations or non-First Nations.

The conference, which included 600 delegates from Canada, the United State, Australia and New Zealand, featured solutions ranging from successful community-based programs like Canada's Kahnawake Schools Prevention Project, to medical intervention programs such as the American Indian Health Service's staged management system, an American nationally-standardized care program. Canadian presentations dominated the conference agenda, occupying two full days of plenary sessions.

A presentation by representatives of Ontario's Sandy Lake First Nation focused on that community's efforts to stop the spread of the disease. Sandy Lake First Nation Deputy Chief Harry Meekis described how his community initiated a diabetes study which found Sandy Lake to have a diabetes rate of 26 per cent - the third highest rate in the world.

"The fact that Sandy Lake holds a record, of sorts, as having the third highest prevalence of diabetes in the world is more a tragedy than a source of prestige," Meekis told more than 250 delegates. "It is imperative that we salvage the next generation from the ravages that are plaguing this generation. The preventable nature of this complex combination of physical and social calamity demands action."

Meekis stressed the importance of prevention measures such as a change toward lower-fat, lower-sugar diets and more active lifestyles, in order to decrease the impact of the disease on both older and younger generations.
"The most cost-effective approach to addressing the issue of declining health of a population would be to fund changes in lifestyle through early counselling and support," he said. "Treatment facilities alone are not sufficient to address the complex problem."

The prevention stage of the project is now underway, Meekis said, after having received funding in July. It will include a Grade 4 education program as well as an adult education program.

In a keynote address, Brenda Thomas of the Assembly of First Nations emphasized that only a combined effort by all members of Canadian Native communities would stop the spread of the disease to younger generations.

"As First Nations people, we have a responsibility to ourselves, our loved ones and our children now and in future generations, to help each other in our journey to wellness," she said. "We can do this by informing and educating each other, sharing information, healing strategies, and re-gaining the traditional knowledge of our forefathers."

Diabetic dilemma: Traditional or Western medicine?

By Joan Black
Windspeaker Contributor
EDMONTON

Although there is no cure for diabetes, people who have it can improve their chances of living an almost normal life by taking responsibility for their health. The trouble is, by the time you notice the symptoms and are worried enough to see a doctor, you may already be very sick.

Maybe you've heard there are herbal remedies or "natural" medicines around. Somebody wants to put you in touch with a medicine man or woman. Or maybe you have already put your faith in Indian medicine and have been feeling all right. Now suddenly you're having complications, and your family wants you to see "a real doctor." Is it safe to keep taking your herbs along with insulin?

Windspeaker talked to three traditional medicine people, as well as to representatives of the Canadian Diabetes Association, the Aboriginal Diabetes Association, the Aboriginal Diabetes Wellness Centre at the Royal Alexandra Hospital site in Edmonton, and others who counsel diabetic clients.

They all said diabetes is a serious disease with no cure and no single plan of treatment to fit everybody. But most observed a degree of caution in expressing their opinions for publication in areas they know are controversial. There is a gulf of misunderstanding and, in some instances, misrepresentation of the aims and methods of "the other side", whether Western or traditional. All those who would go on record, however, were unanimous in saying that diabetic clients on pills or insulin should never, ever change or stop taking their medication without a doctor's advice.

Maryann Hopkins, a nurse who works in Ottawa, spoke about herbal remedies at a diabetes conference in Calgary last October. She says until that time, "I was not familiar with the Aboriginal approach to wellness and I did not understand it."

Hopkins said she considers complementary medicines to be exercise and diet. She sees only a minor role for "herbals," and says some of the "alternative" products can be classified as "traditional herbs" if they have gone through a rigorous process of certification, but even then "the indication has to be for something minor."

Hopkins said the reason for this is that there are a lot of "fly by night" companies, and said she knows of one example where blue-green algae was being sold as an anti-oxidant and health promoting product, when it had high toxin levels in it. In addition, she said there may be five different brands of a herbal on health store shelves, but there is no quality assurance or "checking" of the stores or origins of the products.

Hopkins said that in Canada, products which "fall under the rules" can display a DIN number allocated by the Health Protection Branch, which means "someone is looking at the information provided by companies and is doing post-marketing surveillance." The fact that Health Protection Branch has been publicly criticized for what prominent scientists who formerly worked there say is improper approval of some drugs doesn't sway Hopkins.

"Normally, by the time Type 2 diabetes is diagnosed, usually the eyes are affected. [These people] can't be helped by herbals," Hopkins said.

This attitude frustrates 49-year-old Russell Willier, a Cree healer from northern Alberta, who has been treating a variety of ailments with herbal treatments for 20 years. On the one hand, Willier wants recognition for the value of what he and others like him do, yet he does not keep written records of his treatments. Similar to most other traditional medicine people, he will not reveal the exact ingredients in his herbal "combinations," either.

In the mid-1980s, Willier participated in a research project with anthropologists from the University of Alberta to show that Indian medicine works. David Young, who is retiring as head of Anthropology at the university, said there is no doubt in his mind that Willier is able to help some people. He said he has seen patients respond very well to Willier's treatment of leg ulcers, for instance.

That the medical profession was not persuaded that the healer's methods work may be because of the limitations of the research project itself. They kept one foot in the boat throughout: the test was only designed to treat psoriasis, a chronic and sometimes serious skin disease, which sometimes affects diabetic patients. Skin ulcers resulting from impaired circulation, on the other hand, which are a frequent complication of diabetes, were deemed too dangerous to allow Willier to treat in a controlled setting.

In addition, Willier stresses the component of belief and respect for the teachings that accompany the use of plants is as important as their medical benefit. That view is central to the teaching of the other medicine people too. Yet Willier was unable to get any Aboriginal people to volunteer for the project. All 13 were non-Natives. Two were test cases; of the main sample of 11 people, one dropped out at the beginning. The anthropologists' reports indicate that many, if not all the subjects, stopped using all their topical medicines some of the time because of the bad smell. In addition, treatments were conducted in Edmonton instead of in Willier's home, which curtailed his normal way of doing things and in some instances probably shortened the treatment he could offer. In addition, the sweat lodge ceremony was delayed. In the end, the anthropologists' report said six people benefited from treatment to varying degrees.

Willier once hoped to get a healing centre started, so he could have others handle the paperwork while he doctored full time. That dream is all but gone now; his letter sent out to all of Alberta's chiefs and councils did not elicit one reply, he said. Still, he treats about 40 people a year all over Alberta, British Columbia, the Northwest Territories and Yukon. In 1997, he was invited to explain Aboriginal medicine at Queen's University in Kingston, Ont. In addition, Willier has taught apprentices from the Alexander reserve in Alberta and from Isle la Crosse in Saskatchewan. But most of the time, he finds himself "working around the doctors," even when family members ask him to visit their relatives in hospital. Sometimes patients ask him for his herbal drink, which he says has regulated blood sugar when Western medicine has failed.

Willier's main complaint is with the approach of Western doctors. He suggests they are not prepared to put the time into healing obstinate chronic conditions.

"They want to cut [legs off] to prevent gangrene spreading or when ulcerative conditions are almost at the gangrene stage," he said.

Other than to say they use "a traditional approach," nobody at Edmonton's Diabetes Wellness Centre wanted to talk about the traditional medicine. Spokespeople there said it was "political," and deferred to the Elders on staff, who they said might or might not want to talk to the press.

One did. Madge McCree, from Slave Lake, looks after the spiritual aspects and leaves the doctoring to others. She said circles are held at the wellness centre, where people can express themselves, and prayer is part of each day.

"We teach them - we plant the seed to take responsibility for themselves," McCree explained. "We start by awakening the spirit, then the mind works." The difference is that the centre" [doesn't] teach fear-based, AKA Western, medicine," she said. Instead they "work on the seven grandfathers" to create the balance she said is missing from people's lives.

McCree said some Elders think diabetes among Aboriginal people is caused by "a lot of things in the past - grieving," from a lot of the hurt they have been through since the Europeans got here. Still, she leaves the choice about whether or not to take Indian medicine up to the individual, and "we never tell them not to take [insulin]" she said.

Sometimes, McCree added, if they see clients before they become insulin-dependent, traditional medicines can help them avoid it.

"We advise them if they take traditional medicine, check their sugar more often." The healers have consensus on this point, as all said that traditional medicines often lessen the need for insulin or Western oral medications.
The big difference between her approach and that of Western herbalists, McCree added, is prayer. She said she has seen that even if someone takes the same medicines Aboriginal people use, that they obtained commercially, more success occurs where "protocol - the offering of tobacco - is observed and the client "wants something from the heart.

"If the sacredness is gone, healing stops," McCree concluded.

That is the view of Derrick Pitawanakwat of Manitoulin Island in Ontario, too. He also relies on the seven grandfathers to treat illness. But Pitawanakwat seems to have the respect of the doctors, dietitians and others with whom he works on the island and who sometimes give him referrals. There he is welcomed to treat in the hospital when Aboriginal patients request it. Like Willier, he uses internal and external medicines.

His brew to help cardiovascular complications does not remove plaque in arteries, he said, but it prevents clots and permits better blood flow. He also treats psoriasis and other skin conditions with four herbs in an external application. The past five years, Pitawanakwat said, he has restricted his medicine to the treatment of diabetes and has 152 clients whom he sees regularly. He only treats Aboriginal people and thinks genetics is the main cause of diabetes among them.

Unlike Hopkins, Pitawanakwat does not see proper diet and exercise as "complementary" aids to diabetes treatment, but an essential component of it. Like Willier, he said "Western doctors' only solution to gangrene is to cut the leg off."

Pitawanakwat took training for more than a year as a diabetes educator at a community college in Ontario, and has adapted that knowledge to suit the ways Aboriginal people learn. The 61-year-old healer has taught about 80 students and currently has eight, he said. He has a proposal before the minister of health to hire nurses and do more teaching and follow-up.

"If I can get them to understand they need to change their lifestyle, even tough cases will respond," Pitiawanakwat said of his methods. Like McCree and Willier, he stresses , that belief and the proper respect for the gifts from the Creator make all the difference.

Irene Csotonyi, who operates a herbal remedy store in Edmonton, disputes the statement of many doctors, nurses and pharmacists that most natural medicines are sold by uninformed lay people who may put your health at risk. She stresses that people need to take the responsibility to research and learn and ask questions before deciding on herbal remedies. Like the other interviewees, Csotonyi said there is no "quick fix" for diabetes and no one remedy for everybody. Although she does not work with physicians, Csotonyi said she was trained as a medical doctor in her Native Hungary and has taken training in natural medicines by correspondence and other means here in Canada.

Csotonyi described in detail several products that she can offer to help regulate blood sugar, reduce the need for insulin, boost the immune system and increase energy. Still, she said "Diet is the most important thing. Look at diet first.

"Self-diagnosis is out," Csotonyi added; "I always recommend they see a doctor first."

The businesswoman adds that she is not opposed to government getting involved to better regulate natural products, provided "they hire people in the Health Protection Branch who have had training in and understanding of natural medicines." 

Healing Trail promotes diabetes awareness

Cheryl Petten,
Windspeaker Staff Writer,
Dryden Ontario

The Healing Trail program has been up and running for less than a year, but has already met and exceeded many of its goals.

The program, a three-year pilot project funded through Health Canada, was launched in June. The program is aimed at Aboriginal and Métis people in the Dryden area, but everything being done through the program is designed to be adopted and adapted by other communities.

Each project is developed, then run in the Dryden area and, if it's deemed successful,
it's made available to other communities to use.

"Our philosophy is not to reinvent wheels. Too much of that has been happening, and its leaving us with no resources," said Vicki Scherban, community liaison with The Healing Trail program.

"The project is well on its way. It's actually exceeded its goals and objectives in six months, so it's going very, very well," Scherban said.

"It started with a very unique partnership with the Ontario Métis Aboriginal Association, the Dryden Native Friendship Centre, and the

Dryden Regional Health Centre, which is the hospital that serves the district, and the Dryden Diabetes Centre. And the four organizations grouped together to develop a promotion/prevention program, which is funded by Health Canada, under their Mohawk program."

One of the goals of the program is to increase awareness about diabetes among the Aboriginal community. This has been done through a poster campaign, a radio campaign, articles in local newspapers, and through participation in community trade shows.

The program has also recently opened an office, which is open three days a week.

The Healing Trail has had a lot of success in reaching its target audience, and getting its message out.

"We've reached over 110 individuals just through community workshops. We had over 3,500 visit our booth at a trade show. Just in this area, this small region. We're optimistic that the word is getting out there. We have phone calls coming in continuously," Scherban said.

A number of different projects have been launched through The Healing Trail, many done in partnership with community organizations, or corporations.

"We're in the process of launching, in partnership with Lifescan Canada, which is the Johnson and Johnson company, another partnership in providing meters to urban Aboriginals and Métis. And in doing that, we receive dollars back from registering them and monitoring them, from Lifescan, to develop more resources. Because resources are far and few between. A lot of one-time printings, and then the resource dies off. So we're trying to develop some sort of partnerships where we have some revenue to continue to develop our materials," Scherban said.

One of those resource materials being developed is a "how-to" community manual.

"It's going to consist of eight workshops for nutrition, and eight workshops in the prevention of diabetes and the understanding of Type II diabetes. And so there'll be 16 community workshops. And it's being developed and ready for market by March, we're hoping, for other communities or organizations to implement in their communities. We've tested them in ours, and they've gone well. They consist of a lot of Aboriginal content. So that's what we're trying to do. Because there's very little of that. There's lots of Type II diabetes information, but with respect to Aboriginal and incorporating the thrifty gene, etc., you know, we're doing all of those things," Scherban said.

Another initiative launched through The Healing Trail is an Aboriginal diabetes outreach worker program, being offered through the local hospital. The first offering of the program has seven participants, representing a number of Aboriginal organizations, including the Ontario
Métis Aboriginal Association, the Métis Nation of Ontario, the Dryden Native Friendship Centre, and the Red Lake Ontario Métis Aboriginal Association.

"We are training outreach workers that work for urban Aboriginal organizations in their current positions, in either long term care or community health outreach. And it started in September. It runs through until March, and it will provide them with a really solid foundation in diabetes education. And The Healing Trail felt that was probably one of the key areas to address, because those organizations then can take some ownership in ongoing prevention programs."

If the first offering of the outreach training program is successful, it could form the basis of an apprenticeship program for use in communities across the province, Scherban said.

"We have had preliminary discussions with the Ministry of Education and Trade regarding an apprenticeship program. We would like to proceed in that area once we have tried this trial. We are creating a new curriculum that is Aboriginal-sensitive and culturally appropriate. So again, we are going to have another model that can again be mirrored in other communities by simply obtaining an RN or RD, a Registered Nurse or a Registered Dietitian, and an Elder to deliver the program.
"Our reserves are very close to our communities. We have about six communities we're focusing on here. And then the reserves are minutes apart from these, and we have four reserves in this area, directly. And this is just a small urban project. What we would like to do is partner with them to do an assessment across the board, to come up with some hard, fast numbers so we know where to start directing our attention.

"Sandy Lake's not far from here, so we know that if the statistics are 29 per cent or more in Sandy Lake, those numbers are probably not far off most of the Aboriginals residing in northwestern Ontario, this far anyway. But we really would like to do an assessment, and they agree that that would probably be a good area to go towards, to focus on," she said.

"We're walking before we run. We want to complete our first year pilot. But to date, we've totally exceeded expectations, both of our community and Health Canada," Scherban said.

As for the long term, she'd like to see the program create a number of resources that will continue to be available once the pilot project has ended.

"I think the long term goal would be to have raised enough awareness that we have changed the way that we're eating in our communities, and our activity levels. But most importantly, is that we've developed the resources that could be accessible, and be able to market those resources to become self-sustainable to continue to provide these services. Because they have to be ongoing. We just can't do a news flash. It just doesn't work. And I mean, we're diagnosing them as young as five out here. So we have a serious epidemic facing us. So I think it has to be an ongoing process. And that's why we've always directed our resources at developing items that could be either marketed or renewed easily and cost effectively."

For more information about The Healing Trail program, visit the program Web site at www.diabeteshealingtrail.ca or call 807-223-8238.

"So we're trying to, in the same time, look to our neighboring communities that have not created a program yet. All of these programs will be set up so that they can be utilized in other communities," Scherban said.

Another project being launched by The Healing Trail is aimed at getting diabetes information out to Aboriginal youth. The new pilot project is being launched at Wabigoon school. The urban school is located in Wabigoon, a community about 15 minutes east of Dryden that has a high Aboriginal population.

"We will be attempting to screen the children there, in partnership with the Dryden Diabetes Centre. And we will also be providing workshops toward adopting healthy lunch programs. And we will also have materials and programs implemented into their class curriculum that are Aboriginal appropriate again, and culturally appropriate," Scherban said.

Scherban indicated there is no statistical information available regarding the prevalence of diabetes among the area's Aboriginal community. That, she said, was another thing the program hoped to address.

"We know the statistics are high. We don't have any data. I had just had a discussion with Health Canada with respect to, in our last three or four months, accessing some sort of resources to do an assessment off-reserve and on-reserve.

"Our reserves are very close to our communities. We have about six communities we're focusing on here. And then the reserves are minutes apart from these, and we have four reserves in this area, directly. And this is just a small urban project. What we would like to do is partner with them to do an assessment across the board, to come up with some hard, fast numbers so we know where to start directing our attention.

"Sandy Lake's not far from here, so we know that if the statistics are 29 per cent or more in Sandy Lake, those numbers are probably not far off most of the Aboriginals residing in northwestern Ontario, this far anyway. But we really would like to do an assessment, and they agree that that would probably be a good area to go towards, to focus on," she said.

"We're walking before we run. We want to complete our first year pilot. But to date, we've totally exceeded expectations, both of our community and Health Canada," Scherban said.

As for the long term, she'd like to see the program create a number of resources that will continue to be available once the pilot project has ended.

"I think the long term goal would be to have raised enough awareness that we have changed the way that we're eating in our communities, and our activity levels. But most importantly, is that we've developed the resources that could be accessible, and be able to market those resources to become self-sustainable to continue to provide these services. Because they have to be ongoing. We just can't do a news flash. It just doesn't work. And I mean, we're diagnosing them as young as five out here. So we have a serious epidemic facing us. So I think it has to be an ongoing process. And that's why we've always directed our resources at developing items that could be either marketed or renewed easily and cost effectively."

For more information about The Healing Trail program, visit the program Web site at www.diabeteshealingtrail.ca or call 807-223-8238.

Heart disease trend alarms doctors

By Joan Taillon
Windspeaker Staff Writer
TORONTO

Hospitalizations for ischemic heart disease in Native people have doubled in the past two decades, while the rate has decreased for others, according to a study published in the June 26 issue of the Archives of Internal Medicine. Toronto doctors who conducted the 17-year Ontario heart study are calling these findings an "alarming trend in Native health," which urgently requires "further research and targeted intervention."

The biggest contributing risk factor for heart disease is diabetes, they say. The rate of diabetes among Native people is currently at least three times higher than for the general population and is believed to be associated with a sedentary lifestyle and high-fat diet.

Dr. Bernard Zinman was one of the heart study's principal researchers, along with doctors Baiju R. Shah and Janet E. Hux . All three are associated with the department of medicine at the University of Toronto and major Toronto teaching hospitals.

Zinman explained that ischemic heart disease is a general term that encompasses all kinds of heart disease resulting from atherosclerosis or hardening of the arteries. Ischemia refers to decreased blood flow to the heart when coronary arteries are blocked.

"What we are shocked to find is that the rates for those Native communities (covered by the study) were much lower in 1980 and 1982 compared to the provincial average, almost half for heart attack rates, but now they've surpassed everybody and are far above the provincial average," Zinman said from Mount Sinai Hospital on July 4.

What's to blame?

"It's almost all diabetes," said Zinman.

He said they examined the health records of 41 communities, 39 of which were in Northern Ontario, that identified a Native population of at least 95 per cent. They found heart disease rates among Native people rose to 186 per 10,000 hospital admissions in 1995 from 76 per 10,000 in 1984.

In the general population in Northern Ontario, the rate decreased from 129 per 10,000 to 110 per 10,000 during the same period.

The rate for all of Ontario currently is 82 per 10,000.

The downward trend among non-Natives is a "common story," Zinman said.

"In the United States and Canada, the rates of heart disease are going down, whereas in this community (Native people) they're going in the opposite direction, and based on other information from other studies, you don't get heart disease if you're a Native unless you have diabetes. It would be very unusual.

"And that is why (Native people) were protected previously," Zinman said. "They almost had lower rates. And so diabetes seems to be the major risk factor for Native people, whereas, Caucasian people-diabetes is a risk factor, so is smoking, so is a bunch of other things.

"So if went into a unit where there were 100 Caucasian people with heart attacks, I would find that about 20 to 25 per cent had diabetes. But if I went into the Native population where there were 100 Native people with heart attacks, I would find that about 80 to 85 per cent had diabetes," Zinman said.

To turn it around, he said a three-pronged intervention is needed.

"One, you've got to try to prevent diabetes," by improving diet and increasing exercise, Zinman said.
"But, that's not enough, because there are lots of people that already have diabetes, so diabetes also has to be treated effectively.

"And the third thing is that people with heart disease must have appropriate access to the good therapies. Just because you have heart disease doesn't mean you are going to die. It means you need, maybe, bypass surgery, you need good drugs, you need effective therapy."

All three are probably deficient in northern communities, Zinman concluded.

Margot Geduld, a spokeswoman for Health Canada in Ottawa, said the government is aware of the study and is "concerned," but Health Canada's programs usually only address factors related to heart disease, such as non-traditional tobacco control and nutrition initiatives to improve diet "in collaboration and consultation with" Native people.

Whether the study will change the way Health Canada deals with the problem of heart disease in Native communities, Geduld said she's "not sure." She indicated they will likely only change what they pay for if Native communities redefine their own health priorities to the federal government.

Geduld pointed out that Health Canada funded a 28-month diabetes research project undertaken in the Sioux Lookout Zone of northwestern Ontario in 1991. Dr. Zinman and Dr. Stewart Harris, medical director of the zone hospital, spearheaded that work.

Sandy Lake First Nation, with a population of 1,500, was the base for the study that encompassed 30 communities.

Chief Ennis Fiddler of Sandy Lake said following the diabetes study they got some federal funding to hire two people to work on prevention programs that include a radio program.

The workers also have just completed a year-long program to develop an elementary school curriculum in conjunction with the school board in Sandy Lake.

The other thing the community has developed is a walking trail that surrounds their large reserve, as well as programs to encourage its use.

"And recently the program has ordered pedometers that record how many steps you take and how far you walk, the chief said. So far 160 are in use and the workers hope to order more.

Fiddler said it is not as difficult as it once was to get a selection of good food, since it is flown direct from Winnipeg. Food is still "twice as expensive" as it would be in Winnipeg, though, he said.

"I think people are starting to be aware about the diabetes itself and also what they can do to make themselves combat the disease," the chief said. "Ten years ago, people didn't care what they ate . . . all they knew was that today they were okay and they were eating this fat. Today people are starting to think about that. People are making a conscientious effort to make sure they no longer eat that kind of diet." He said foods like cheese and vegetables are becoming more popular, but the community still has work to do on getting people to leave their vehicle behind and walk.

Fiddler said he is concerned they still have nothing to offer community members who are already seriously affected by diabetes and whose mobililty may be limited. He said the community has set its sights on getting kidney dialysis set up in Sandy Lake and maybe establishing a nursing home. Currently band members have to move to Sandy Lake or Thunder Bay, 200 and 500 km away, for dialysis.

The chief was aware a study had recently been concluded on heart disease and said the findings would be shared with the community when they got the report.

One of the Sandy Lake diabetes workers, Roderick Fiddler, had also heard of the heart study but had not yet seen it. He said the community was becoming more aware of both diabetes and heart disease and prevention.

He said they have an "ongoing community intervention program" that involves home visits to teach about all aspects of diabetes. Also their hour-long weekly radio programs address different related topics, such as foot care, nutrition and wild game, and eye care.

"I think we're going in the right direction right now," Roderick Fiddler said.

Nation takes a healthy approach to fighing diabetes

Inna Dansereau,
Windspeaker Contributor,
Paul First Nation Alberta

Eighteen four-person teams came out to golf for a good cause despite the cold, windy weather on Sept. 7 -the second annual diabetes awareness golf scramble at the Paul First Nation.

The money goes to the Three Feathers Research Foundation, which is an extension of the Arnold J. Brant Scramble for Diabetes Golf Tournament organized by members of the Tyendinaga Mohawk Territory.

The mission of the foundation is to find and support research of clinical projects directly related to health issues affecting Aboriginal people.

"A Mohawk guy lost his brother to diabetes, and he started the foundation," said Henry Arcand, one of the organizers of the Paul First Nation tourney. In February, the foundation will be requesting proposals from different institutions, including the University of Alberta, for projects trying to stop the increasing diabetes problem in Aboriginal communities.

Assembly of First Nations vice-chief Wilson Bearhead was another organizer at the tournament at the Ironhead Golf Club, located west of Edmonton.

"For too long we've relied on the government to save us. From now and in the future we have to work together. We have to insure that those who have diabetes overcome it, and that our young people who don't have it now don't get it." Bearhead is diabetic.

"We came here (to the tournament) to support the foundation to fight this disease," he said. Victor Buffalo from Samson First Nation said the tournament was a very good initiative.

"My brother died in May of a heart attack; he was diabetic, so am I," he said.

According to the National Aboriginal Diabetes Association, the risk of diabetes among Aboriginal people is three times greater than among the general population. About two-thirds of the First Nations people with diabetes are women.

Recently, children aged five to eight have been diagnosed with Type II diabetes in central Canada. Diabetes occurs when the body can't control its blood sugar level. Symptoms of the disease include unusual thirst, frequent urination, unusual weight loss, lack of energy, blurred vision, frequent infections, numbness in hands or feet, and slow healing of cuts and bruises.

Sometimes, people don't show the symptoms. If left untreated, high blood sugar levels can damage blood vessels in the body, causing heart problems, high blood pressure, strokes, kidney disease, blindness, and limb amputations.

A healthy diet, weight control, exercise and stress reduction are prevention measures. Medications may be needed to assist the body in using insulin, which ensures energy needs are met.

Prevention needs to play a bigger role

By Marie Burke
Windspeaker Staff Writer
EDMONTON

Prevention is a key factor for First Nations in battling diabetes. At a time when First Nations people are five times more at risk than the general population to get the disease, awareness is important. The National Aboriginal Diabetes Association and the different Aboriginal Diabetes Wellness programs in each province believe prevention is the key.

"The comment we frequently hear is, 'I'm too old to be jumping around,'" said Linda Brazeau, manager of the National Aboriginal Diabetes Association. Brazeau has worked with the group Strategies for Undermining Glucose in Aboriginal Races that started in Manitoba in the early 1980s. The group saw a need in the Aboriginal communities for more awareness about diabetes.
The exercise factor in prevention does not need to be difficult. In terms of exercise it can be as simple as walking 30 minutes a day to prevent or improve a diabetic condition. Brazeau believes that a long time ago, Aboriginal people used to walk everywhere. They were healthier, stronger. People don't realize that even when you go shopping or take children out for a walk that it's exercise.

To Aboriginal people, family is a big thing and if a person with diabetes doesn't want to do it for themselves, then consider the family.

"The main risk factors for getting diabetes is obesity, the type of diet, and activity level of each individual," said Kathleen Cardinal, diabetes outreach worker at the Aboriginal Wellness Program in Edmonton.

Food plays a very important part in life. Being able to eat the food that could help in preventing diabetes seems simple. Yet diet is an outwhelming concern among health caregivers who deal with diabetes and prevention. The factors that affect eating habits with First Nations stem from their history. First Nations people were very active people. Their survival depended on it.

However, today, most Aboriginal people do not need to fish, hunt or trap to survive. The metabolism and make up of Aboriginal people has not changed, but their lifestyle has.

The changes that have happened to the traditional lifestyle of Aboriginal people can help them understand why they are more prone to diabetes.

We also need to understand that it is a disease that can be managed and prevented, said Cardinal. When people are under stress with life situations, food can become a source of comfort. Eating improperly and lack of exercise can lead to health complications such as diabetes.

Cardinal also noted that the different stress levels of each individual is a contributing factor in health. If a person is worrisome and fearful, it greatly their ability to cope with a disease like diabetes.

Scientists find diabetes link in Oji-Cree

By Joan Black
Windspeaker Contributor
SANDY LAKE, Man.

Scientists at the John P. Robarts Research Institute and spokesmen for the Sandy Lake First Nation announced a genetic discovery last month that may lead to better prediction and control of diabetes in Aboriginal people.

The doctors have discovered a genetic mutation in the Oji-Cree of Sandy Lake, Man. that may hold the answer to that population's diabetes epidemic. The new gene has so far only been seen in Sandy Lake people, although other Native groups have been tested. The Cree in the Sandy Lake area do not seem to have the genetic abnormality.

Dr. Robert Hegele, director of the Blackburn Cardiovascular Genetics Laboratory at Robarts, discovered the mutation. Other principal researchers were Dr. Stewart Harris from the Centre for Studies in Family Medicine at the University of Western Ontario, and Dr. Bernard Zinman from the Samuel Lunenfield Research Institute, Mount Sinai Hospital and University of Toronto. Also delivering presentations were former chief of Sandy Lake, Jonas Fiddler, who holds the band's health portfolio; Deputy Chief Harry Meekis; Dr. Mark Pozansky, president and scientific director of Robarts; and Robarts scientist Dr. Tom McDonald, past chairman of the Canadian Diabetes Association National Research Council.

Dr. Hegele hailed the discovery as "the strongest genetic effect on diabetes that I have seen in 15 years of research. I am unaware of any other diabetic population in the world that is so strongly affected by a single gene variant," he said.

The Oji-Cree of Sandy Lake have the third highest rate of Type 2 diabetes in the world. A 1992 survey showed that 25 to 30 per cent of the population has diabetes; at least another 10 per cent have impaired glucose tolerance, which means they are at greater risk of developing the disease. Complications of diabetes include blindness, heart disease and stroke, kidney failure and gangrene, which results in amputations.

"Until 80 years ago," Dr. Hegele said, "few Aboriginal people in the Sioux Lookout zone had diabetes. In the last 10 to 20 years, diabetes started to be expressed at an epidemic rate. A gene or tendency was always thought to be there, but we think that the change in food and lowering of physical activity - plus the gene - results in diabetes."

In 1990, the people of Sandy Lake were so alarmed at the high incidence of the disease among their population that they asked their chief and council to approach Dr. Harris in Sioux Lookout to investigate the problem. Dr. Harris contacted Dr. Zinman and they undertook the survey, which confirmed the Sandy Lake people have five times more diabetes cases than the national average. Setting up protocols and methodology for their study took them three to four years.

At that point, they asked Dr. Hegele to get involved in testing for a genetic link. Dr. Hegele thought the problem was in the people's DNA, so he tested one blood sample from each of the 728 band members who agreed to participate in the study.

The results were startling. Dr. Hegele's group found that a person who inherited one copy of the mutated gene from their parents was more than twice as likely to have diabetes as a person who did not inherit the mutation. If a person inherited two copies of the mutation, however, he was up to 15 times more likely to have diabetes.

They also found that people with one copy of the mutated gene tended to develop diabetes in their thirties. On average, people with two copies of the mutation developed diabetes in their twenties. The findings were published in the March issue of the Journal of Clinical Endocrinology and Metabolism.

The researchers don't claim to have all the answers. They want to know why some people who do not have diabetes have the variant gene, which could indicate they are predisposed to developing diabetes, Dr. Hegele said.

They also found that 50 per cent of the people in Sandy Lake who have diabetes don't have the genetic mutation. Doctors suspect there could be yet another gene connected to the puzzle.

Finally, they say that two additional studies showed more than 100 people had a variant form of the gene, raising still more questions. And no one can say why eight Inuit communities or the Ojibway of Manitoulin Island they tested do not have the gene, although a high rate of diabetes exists in these places too.

"This discovery is a major contribution to further our ongoing research," Dr. Harris said. "Diabetes is emerging as a major epidemic among First Nations . . . and there is an urgent need to develop (prevention) strategies."
Drs. Harris and Zinman and the people of Sandy Lake decided they needed to do more than conduct laboratory research to get this urgent problem under control. They consulted with anthropologists and nutritionists and, starting in 1995, they set up a prevention program, which is ongoing.

One thing they did was to start diabetes education for Grades 3 through 5. They also aired a "Dr. Diabetes" show on the radio. Even the community's Northern Store assisted the project by agreeing to identify healthy food choices through the use of icons, colors and syllabics on their products. Health workers also undertook home visits to treat and educate those with diabetes.

Dr. Zinman said of the gene mutation discovery that it is important "but not earth-shattering." While he sees it as "an important advance" in doctors' understanding of diabetes, he believes the emphasis will have to remain on prevention through education for a considerable time yet.

All the doctors agree that it could be years before an effective new treatment for diabetes is found. Right now, even the test for the aberrant gene is not available outside the research lab and it is not covered by any health care plan.

"This announcement today confirms the importance of committing research dollars to finding new solutions," Harry Meekis said.

 


Attention to culture extremely important
By Debora Lockyer
Staff Writer

The Canadian Diabetes Association's 2nd Professional Conference and Annual Meetings were held on Oct. 14 to 17 and about an hour-and-a-half of the three-day agenda was devoted specifically to Aboriginal people and the disease.

Diabetes, as you know, is a growing concern in many Aboriginal communities. Some communities report that a large percentage to the membership have been diagnosed with the illness. One such community is Sandy Lake First Nation in Ontario, where the diabetes rate is 26 per cent, the third highest rate in the world.

Diabetes care and prevention programs have had little success in Aboriginal communities in the past, because physicians and educators did not understand the cultural aspects that go hand in hand with the treatment of the disease.

But that is beginning to change, and evidence of that change was seen in a number of the presentations in the Native focus sessions at the conference.

Judi Whiting was with the Saskatoon Health District and is now working for the Canadian Diabetes Association. Her presentation, titled Diabetes Self-care Practices and Cultural Beliefs of Urban Dwelling Aboriginal People with Diabetes, revealed some interesting things about what people believe diabetes to be and how it is best treated.

Whiting explained that the prevalence rate of Aboriginal people with diabetes living in Saskatchewan is about 11.5 per cent of the Aboriginal population. That compares to 3.5 per cent of people with diabetes in the non-Aboriginal population. Aboriginal people make up about 7.5 per cent of the total population of Saskatoon, so, according to 1996 population numbers, as many as 1,800 Aboriginal people in Saskatoon may have diabetes.

The study began with 50 people, more women than men, with the average age of the study group being 51 years and the average length of time the participants had diabetes being 8.9 years. In Saskatchewan the average age of diagnoses for Type 2 diabetes is 49 years old in the Aboriginal community as compared to 62 years old in the non-Aboriginal community.

For the most part, the people in the study did not explain the cause of diabetes in cultural terms. One-third of those studied believed that Indian medicine could cure the disease. One-third had taken Indian medicine before, and 10 per cent of the people were taking Indian medicine at the time of the interview. Only eight per cent of those studied believed doctors could cure the disease.

The length of time living in an urban setting seemed to impact the participants' beliefs in the effectiveness of traditional medicines.

But that didn't mean the people were buying into a more conventional approach to treating their illness. In fact, in many cases, the people did not have the self-care skills to help them cope and survive with diabetes. While 75 per cent of the study participants knew the symptoms of low blood sugar, only 30 per cent knew how to treat those symptoms. Only 54 per cent were testing their blood sugar levels and only 33 per cent knew about nutrition.

This is a population at risk.

The next presentation, title A Grounded Theory Study of Type 2 Diabetes in First Nations Adults, was conducted with the participation of 10 people on a reserve in southwestern Ontario. Diabetes was uncommon in Aboriginal communities as late as the 1940s, said Cheri Ann Hernandez, but the disease has now reached epidemic proportions. Hernandez first step was to review existing literature to get an idea of what others had observed in Aboriginal people with diabetes. She found that while some people blamed European settlers for causing the disease because of changes to the food and the environment upon their arrival, others blamed lifestyle or spiritual weakness for the disease in Aboriginal people.

Hernandez's 10 subjects, however, did not blame early Europeans for bringing the illness. They blamed themselves and their own behavior, including alcohol consumption, inappropriate food choices and other lifestyle choices.

The participants went through three stages. Having diabetes was the first stage where they denied that anything was wrong with them, longed for their normal life to return and minimized the effects that diabetes was having on their lives. People were too busy to take care of themselves or learn about diabetes, or just refused to recognize the significance of the disease in their lives.

The second stage, the turning point, demonstrated that a number of factors led participants to finally focus on life with diabetes. One woman suffered a variety of complications before she fully realized the seriousness of the disease. It was when her sight was endangered that she came to terms with the condition. Diabetes can lead to blindness, amputations, kidney failure, heart disease and a myriad other afflictions. Individuals in the turning point stage were focused on their diabetes, learning about it and how to live with it. They were preoccupied with their illness.

The third stage was what Hernandez described as the 'science of one.' In this stage there was integration of the personal self (the self that existed prior to diabetes) and the diabetic self (the new entity that emerged after the diagnosis of diabetes). These individuals became experts in their own diabetes, tuned into (listening to) their bodies and made regimen adjustments based on these body cues. The focus was on living, but on living with their diabetes.

Another interesting aspect to the study was that participants were insistent it was important that diabetics receive advice about the illness from people who had the disease themselves. It was not even important that the educator be Aboriginal, the study noted, just that the educator have this experiential knowledge about the disease. A subsequent debate on what is causing the increases in diabetes seen in Aboriginal people over the years led to a variety of opinions and theories. The feast and famine theory, describing a differing genetic make-up for Aboriginal people, one more suited to the traditional lifestyle of hunting and gathering, including the physical effort it took to get the food, was but one of those opinions put forward. Loss of traditional food and replacement of that food with the "five white gifts" brought to Indian nations from European settlers - sugar, salt, flour, milk and lard - are slowly destroying Aboriginal people, said one woman. The group was reminded, however, that diabetes may not be rooted in the same cause for all Aboriginal people across the country.

General Health

Community engagement one key to improving Aboriginal health

By Shayne Morrow Windspeaker Contributor OTTAWA
Volume:  30 Issue:  2
Year: 2012

Dr. Carrie Bourassa, associate professor of Indigenous health studies at First Nations University of Canada (FNUniv), was one of 28 leaders invited to share their views on how to improve health at the Building on Strengths Roundtable Dialogue on Aboriginal health which took place at Rideau Hall on March 27.

One of the conclusions of the groups was that self-determination will play a huge role in improving health prospects for Canada’s Aboriginal communities.
The event was organized by the National Expert Commission and the Canadian Nurses Association, and was hosted by Sharon Johnston, wife of Governor General David Johnston.

“Their goal was to bring community members and leaders from both Aboriginal and non-Aboriginal com-munities, that were in various health fields, and they wanted to talk about the social and environmental determinants of health and how that impacted the health and well-being of Aboriginal Canadians. And also, to generate some solutions that would improve Aboriginal health,” Bourassa said.

Bourassa teaches Indigenous health studies at FNUniv, and serves as the nominated principal investigator for the Indigenous Peoples’ Health Research Centre. One message flowing from her work is that Canada’s Indigenous peoples face numerous systemic barriers within the health care system.

“Everybody around the table agreed that there is systemic racism [in the system] and that we will have to deal with it,” Bourassa said. “I work a lot around ‘culturally safe’ care and how to provide it. When you work in the communities, you hear the same thing over and over from First Nations and Metis peoples that they are not getting quality care, and a lot of that is around those systemic barriers.”

The cultural misunder-standings may be small, but cause considerable stress.

For example, when a critically ill First Nations person is in hospital, surrounded by family members, there is a tendency among non-Aboriginal hospital staff to see it as a space management problem, rather than as a sign of a caring community.

“You hear, ‘How come they always have so many people in the waiting room?’ They fail to understand how important it is for that family to be there,” Bourassa said.
Likewise, there was agreement on the need to address the proliferation of chronic diseases, such as diabetes among Canada’s Indigenous peoples. Bourassa said while the recent explosion in obesity and diabetes rates is North America-wide, the causes are compounded among First Nations, Métis and Inuit peoples.

“When you talk about chronic diseases, you have to talk about poverty,” Bourassa said. “If you have diabetes, you know you have to eat better, but it comes down to having access to healthy food.”

For people living in remote communities, fresh, healthy foods are often prohibitively expensive, if they are available at all. The problem isn’t in knowing what you should be eating. It’s being able to obtain it in the first place.

“People tell us, ‘We have a convenience store. There’s pop and chips and milk, and we’re lucky that they do have milk,’” Bourassa said. “You can’t label someone ‘non-compliant in their treatment program’ if they can’t afford to follow it.”

Bourassa said the result can be a sense of hopelessness that affects whole communities.

One of the solutions the roundtable agreed on was the need to recruit and train more Aboriginal health professionals, both physicians and nurses as well as academics to further the research necessary to implement changes in the system.

“There is a difficulty in attracting people to the health sciences and much more attention needs to be paid to it,” Bourassa said. “I have found some of the barriers are a feeling [among Aboriginal students] that they can’t do the math and sciences... even though they are perfectly capable of it.”

Roundtable participants agreed there is a need to break down existing bureaucratic barriers between policy, health care delivery and social services, and to create an integrated system that serves individuals, families and communities at the ground level.

Bourassa believes self-determination, at the national and community level, is the key to bringing about positive change for Canada’s First Nations, Metis and Inuit peoples.

“Where communities are engaged is where you see changes happen,” she said, citing one of her ongoing community health studies launched in 2003.

“We didn’t have any baseline health data for Metis in Saskatchewan. What we found right away was that there were high smoking rates and high rates of cardiovascular disease,” Bourassa said.

Rather than lecture smokers, Bourassa and her team launched the Green Light campaign.

“We gave a green light to each smoke-free home. They loved it. That was followed up with a second phase involving peer training on smoking cessation. This is a bit of self-determination for them, and the community is fully engaged,” she said. “We haven’t compiled the data to see how successful the program has been, but we ran out of green light bulbs.”

The National Expert Commission will now analyze the results of the roundtable to provide a report to the Canadian Nurses Association in June.

Cut the western diet and get moving

By Isha Thompson
Windspeaker Staff Writer
YELLOWKNIFE

Raising children on a traditional diet and staying away from “western” food is the answer to decreasing the alarming rate of diabetes in Aboriginal people, said nutritionist and diabetes educator Kevin White.

“It’s completely the western diet,” said White, who is diabetes educator for the Stanton Territorial Health Authority in the Northwest Territories.

Excessive amounts of processed foods, carbohydrates and sugar, which are very present in several of North America’s favorite feasts are to blame for childhood obesity in Aboriginal teenagers, he said. Diabetes is one of the many health risks that are associated with obesity.
The Assembly of First Nations (AFN) is determined to inform communities across the country about how to avoid the potentially fatal disease and to encourage healthy lifestyles of the people who have some of the worst habits, children.

A program the AFN rolled out on Oct. 15 challenges First Nation schools to engage their students in 30 minutes of physical activity each day. The Fitness Challenge contest will award top teams various prizes and will conclude on Nov. 14, World Diabetes Day.

AFN women’s council chair Kathleen McHugh is confident the challenge  is a crucial step to informing young people about the importance of exercising.

Cardiovascular activity is a necessary component to reducing the risk of developing type two diabetes. However, McHugh is aware that there are other components that are harder to control.

“We have to acknowledge the fact that poverty plays a large part in poor nutrition. Sometimes when parents feed their children, they buy the food that don’t have proper nutrients,” said McHugh.

She noted that the secluded communities located in Canada’s northern territory have particularly high prices for food that is often flown into the area.

As an educator who travels to a variety of small Aboriginal communities in the Northwest Territories, White confirmed that certain areas only receive a few shipments of supplies during the winter months.

He recalled walking into a food store in a small town that stocked their shelf with items that were far from healthy for those concerned with diabetes.

“There was probably only about six items that I would recommend to someone with diabetes, and then everything else in the store would likely contribute to their diabetes,” said White.

According to White, those with a steady diet of fresh or frozen vegetables and proteins found in a majority of traditional dishes, like caribou, trout and salmon, do not develop diabetes.

White is convinced that one of the biggest concerns for children is what they are being served in their school cafeteria and vending machines. Hearty stews in replacement of hot dogs and French fries is something he would like to see changed.

“I mean it makes no sense when the kids actually love caribou stew, but that’s not always what is being served because there is still a lack of awareness,” White explained.  “They’ll eat almost anything you put in front of them because they are teenagers.”

Between 2005 and 2006, there were more than 24,000 recorded cases of diabetes in children aged one to 19.

According to the 2008 Canada’s National Diabetes Surveillance System, both girls and boys with diagnosed diabetes in the one to 19 year age group had a 10 to 11 year reduction in life expectancy in 2005 to 2006.

A study specifically done in the Northwest Territories revealed that 44 per cent of people’s calories came from sugar-filled beverages, such as soda and juices.

Drop The Pop Northwest Territories is a campaign that began four years ago to help encourage schools in the province to educate their students on the importance of reducing the consumption of high-glucose drinks.

This year, almost $70,000 of grants are available for participating schools to create programs that encourage students to choose healthy alternatives.

Elise De Roose, territorial nutritionist for Northwest Territories, said programs where students are empowered to make smart choices are successful because they are fun for kids.

McHugh is confident the AFN fitness challenge will teach students about the positive relationship between physical activity and controlling diabetes.

“Empower them with healthy habits that they can carry with them throughout their lives” is the goal, she said.
Diabetes is a lifelong condition where a person’s body does not produce enough insulin or cannot use the insulin it produces.

Because diabetes increases the risk to damage the eyes, nerves, kidney and blood vessels, some diabetics become vulnerable to complications like blindness or amputations if the disease is not managed properly.

Rates of diabetes among Aboriginal people in Canada are three to five times higher than those of the general Canadian population.

It’s simple—Vaccinate—‘So you don’t get sick’


By Isha Thompson
Windspeaker Staff Writer

‘Get vaccinated.’

That was one of the main messages sent from the panel of the Virtual Summit on H1N1 in First Nations Communities that took place Nov. 10.

Health experts denounced any myths surrounding the shot, and encouraged everyone to get one, especially those people living in small communities like First Nations reserves.

“Most of us have very little immunity... Getting the vaccine is the best protection,” said Dr. David Butler Jones, Canada’s chief public health officer. He was one of three medical professionals who were part of the panel.
The summit was organized after a communications protocol was put in place by Assembly of First Nations (AFN), Health Canada and Indian and Northern Affairs. The objective of the online summit was to convey all the facts behind H1N1 to Aboriginal communities that may be secluded from mainstream media.

The two-hour summit was co-hosted by AFN National Chief Shawn Atleo and Health Minister Leona Aglukkaq. The event featured video of a couple of First Nations communities that had prepared for and were handling the H1N1 pandemic, but the majority of the time was allocated to answering some questions still lingering in the minds of people, like how safe the H1N1 vaccine really is.

All three doctors made a point to discount any concerns with the H1N1 vaccine and ended the summit by reassuring viewers that each panel member had plans to get the vaccine along with their families when the vaccine became available to them.

And so should everyone... right?

That depends on who you ask.

From the first moment a vaccine for the H1N1 flu was discussed, critics came out of the woodwork with elaborate speculations on possible effects. Some conspiracy theorists were sure the shot would turn its victims into zombies; others simply felt the vaccination for the new flu strain was rushed and therefore unsafe.

Drug policy researcher Alan Casssels doesn’t denounce the vaccine, nor does he discourage others from lining up for their shot. However, he referred to the rhetoric of the physicians on the summit panel as “coercive.”

“The public health people have a much more exaggerated sense of the benefit of getting vaccinated. I’m not sure where that comes from,” said Cassels.

According to Cassels, it is still too early to know just how effective the H1N1 vaccine is. An “overblown fear of this flu,” is what is contributing the panic around obtaining the vaccine, he said. However, the University of Victoria professor offered up a reminder that a pandemic doesn’t necessarily indicate there is a serious danger. It means H1N1 is widespread.

Cassels agreed that many First Nations communities that are dealing with overcrowding are more susceptible to spreading the flu virus, but he questioned how money for the H1N1 campaign is being spent.

“I am not saying the flu vaccine is bad or good. I am saying we are spending lots of money on this,” said Cassels, who referred to a front-page Globe and Mail article published on Nov. 12 that reported $1.51billion has been spent on H1N1 vaccinations.

Cassels isn’t convinced Aboriginal communities necessarily need a quick dose to protect them from Swine flu, rather than a permanent solution to the underlying issues

“When you are talking about Aboriginal communities, I think there is lots of high priority things like better drinking water and more hygienic living conditions that are probably higher priority than wasting a billion and a half on a massive flu campaign that probably is a lot of nothing.”

Health Canada’s senior medical adviser Dr. Paul Gully was another medical expert on the panel of the H1N1 summit. He not only believes immunization should be promoted, he also referred to the opinions of critics who don’t completely support the vaccine as “worrying.”

During the summit, Gully said he feared the naysayers would scare members of the public away from being immunized.

One thing that both the medical panel and First Nation communities don’t seem to be worried about is being unprepared for the next wave of influenza.

The H1N1 summit showed video clips of First Nations that were successfully preparing their communities for a potential outbreak. The AFN’s public health advisor Dr. Kim Barker said the AFN was encouraging communication with First Nation communities, while Gully reassured listeners that on-reserve nurse practitioners have access to doctors and any other help that they may need.

Carolyne Neufeld, health director at Seabird Island Indian Band in British Columbia, said her clinic is prepared thanks to consistent attention they have received from their local health authority and Health Canada.

“I do thank Health Canada. They have been calling everyday... I can only say good things,” said Neufeld.

“We received all of the supplies we needed [and] we received vaccine we needed in a timely manner,” she added. However, Neufeld later revealed that her one criticism is that she wished her clinic had everything they needed sooner. An earlier shipment of the flu shot would have helped significantly, she said.

“At least 50 per cent of our staff has been off sick,” said Neufeld, who admitted that her staff was unable to watch the H1N1 summit because of how busy the clinic has been.

“Our clinic has been jammed with patients for weeks.”

Neufeld said the flu vaccine was shipped to her at the end of October, but she is confident if the clinic had received it a month earlier, it would have decreased the amount of patients that they are currently caring for.

The live broadcast of the H1N1 summit received just over 1,050 online hits. The AFN had originally planned to leave the recorded broadcast on their Web site for a couple of weeks; however, they have decided to leave it up until Dec. 31.

Life is worth the effort to make it something special


By Jennifer Hansford
Windspeaker Contributor

Prescription drug addiction is a challenge faced by many Aboriginal people. With those addictions there comes the possibility of overdosing.

A young Métis man, (who was featured in a article previously published in Windspeaker about prescription drug abuse and who prefers to remain anonymous) has experienced the symptoms of overdose many times, but has managed to survive. Some of his symptoms, he explains, were tiredness, numbness, breathing that became heavier and shorter, and vision that was blurry, wavy (as though objects were moving), and a very quick heart-beat.

He said his heart would beat so fast that it felt as though someone was hitting his chest.

Out of all the symptoms he experienced, he said, it was the tiredness that let him know he had taken too many pills.

“When the pills that usually keep me awake start to make me tired, I know something bad is going to happen,” he said, recalling those experiences.

Some people who misuse prescription medication have said the pills cause a sense of emotional numbness, but this was not the case for him.

“It made my emotions very sensitive and severe,” he said. Things that wouldn’t normally make him cry, upset him, and at times to an extreme level.

He also describes physical numbness after he took a certain amount of pills.

“My legs would fall asleep, my arms would fall asleep, and at times it felt like it was hard to even keep my head up. My head would keep falling to the side, forward or back and I would even pass out like that, waking up with a severe kink in my neck or shoulder pains and even knee pains.”

He says this would usually happen after he took 15 pills or more.

At least one of his near overdose experiences was a suicide attempt, as life’s circumstances began to overwhelm him. Rising debt, unpaid bills, and trying to feed his addiction while caring for an elderly and ailing friend, a priest, with whom he lives was taking its toll.

When creditors began to phone several times a day regarding non-payment of the bills, he would unplug the phone, and tell his friend that this was because telemarketers had been calling and he didn’t want the phone to bother him.

This added to his worries, which caused his addiction to get worse, and as his addiction increased, the friend he lives with had to start hiding his own pills in pillow cases or anywhere he could think of so they could not be found.

The situation became so bad that at one point the electricity and water were turned off, and they had to sell their belongings to pay the bills.

“We even had to sell things that were supposed to be in his will,” he said, referring to a boat that was supposed to be left to family members.

Reaching his breaking point, he went to a local beach so he could be by himself. He was there for about two hours and had taken 20 Percocet before a police officer showed up and asked him to leave, since it wasn’t swimming season and he was trespassing.

He complied with the officer’s request and found himself sitting in the empty parking lot of an arena.

“He made me feel as though I wasn’t welcome anywhere,” he said of the police encounter. This is when he took 15 more pills.

In the days leading up to these events, he said he had studied the affects of an overdose and found that most of the time people would just experience the tiredness, as he had also experienced, and die in their sleep. This is what he had planned would happen to him as well.
However, this is not what happened to him at all.

“I started to experience serious symptoms I never read about,” he explained. “Vigorous shaking, twitching, burning eyes, cold sweats and my eyes would blink repeatedly.

Experiencing these new symptoms scared him so much that he decided to drive himself to the hospital.

“I blew through tons of red lights, people were honking their horns, and I even went over the solid yellow line at times,” he recalls.

Even on his way to the hospital, he thought about the quickest way to end it all.

“I was even thinking of going down an embankment or crashing into a car that was coming in the opposite direction. My heart felt so black, I didn’t care if I took anybody with me.”

Throughout this ordeal (and the ones he continues to face now) he is grateful that his friend did not give up on him.

“No matter how high the bills got, or the secrets I kept from him, he never got angry, just disappointed, he said. He would still comfort him and assure him everything would be okay. ‘Just relax, don’t cry,’ is what his friend would tell him.

He is also very grateful to his mother, who made sure he had all the support and help he needed.

“I am the battery; he is the negative end and she is the positive end and if one of them is missing, the battery won’t work.” He adds, “I doubt very highly that there are other priests, deacons and bishops as forgiving as him.”

He feels remorse everyday for the things he has put the people he loves most through.

“It disappoints me, even today, that I did something so ruthless to such a nice man like him.”

These days he is working hard to stay clean and has been on a methadone treatment since April.

His friend proved that life is what you make it and that it is worth living.

Mothers talk about harmful effects of tobacco misuse

By Nancy Doukas
Windspeaker Contributor
LANTZVILLE, B.C.

Lillian Jones was sure that she had dodged a bullet when her second child Samantha was born at a healthy 7 lbs, 6 oz. and continued to eat and grow well. But at six months old Samantha caught a cold. She didn’t have just the usual symptoms of a stuffy, runny nose, crankiness and loss of appetite. Samantha also developed tremours.
Jones, concerned that something was seriously wrong, took Samantha to the hospital emergency department. Samantha spent the next month in hospital in an oxygen tent fighting for every breath and losing weight.
The nurse had difficulty inserting an intravenous tube due to dehydration. The baby’s little veins kept collapsing. It was on the tenth try that they finally got one in her foot.

Lilian Jones

 

Samantha was diagnosed with the common cold complicated by Respiratory Syncytial Virus (RSV). Most children are infected by RSV before the age of two, but don’t usually suffer anything more than the symptoms of the common cold.

Children who have compromised immune symptoms are the ones most likely to develop complications of the virus. Jones believes that Samantha developed the complications due to her smoking during her pregnancy.
Jones shares her story with viewers in a video entitled “A Mother’s Message.” The video was made through the involvement of residents at Tsow-Tun Le Lum treatment centre with the hope of helping other pregnant women deal with the long-term effects smoking has on the infants they are carrying.

Jay Niver, the communications director for the Alcohol-Drug Education Service in B.C., hopes that the video will eventually be shown across Canada in all First Nations treatment centres, friendship centres and health authority clinics.

“The producers are hopeful that the video will be adapted to reflect the resources available to each province,” Niver said.

As of now, distribution of the video will include being shown in supervised sessions on the reserve, in friendship centres and with support groups in clinics across B.C. only.

Ideally, it will be viewed anywhere young women and mothers meet in a health-related environment.
“The video is designed to promote awareness and provoke discussion,” said Niver, “and ultimately help mothers who smoke seek the assistance they need, be it online or elsewhere through programs and resources.”

Men also shared their stories of smoking in the video.
“We had anticipated involving only women,” said Niver, “after all, it’s about pregnancy and maternity. But when we arrived for the shoot, numerous Tsow-Tun Le Lum residents had come forth voluntarily, anxious to share their stories, including two men. It hadn’t occurred to us that they could contribute. After all, men don’t carry babies. But these gentlemen spoke to the topic of tobacco misuse in their own families, growing up as children, and continuing in their new families, via their own smoking,” he said.

What the men talked about was the message they were sending to their children, telling them through their actions that smoking was OK, and they talked about the impact their smoking was having on their children’s environment through second-hand smoke.

“It made us quickly realize that the smoking dynamic can be a family challenge with many interrelated factors, and all of them come to bear on the health of newborn and older children in the home.”

Marvin in the video speaks of his two children and how his eldest daughter has asthma. He tells us he smokes up to a pack and a half of cigarettes a day and that he used to smoke in the house and in his car with the children present.

The impact that smoking has had on his family has been difficult.

“We almost lost my eldest daughter three or four times because of asthma,” Marvin says. He smokes outside now.

The discussion of smoking is also dealt with by elders. Karen tells us the story of going outside for a smoke and having her grandson ask her why she does that. He pointed out to her that the cigarette package has an “X” on it, and that the “X” means poison.

He wanted to know why she was putting poison in herself. Karen has since quit smoking and credits her grandson in helping her to make the decision to do so.
The video has had some minor revisions since the initial filming in 2010, including a name change from “Now You HAVE to Quit” to “A Mother’s Message.” Niver tells us that there may still be more minor revisions coming with a possible introduction being made by an elder Aboriginal spokesperson.

All changes and distribution of the 1,250 copies will be completed before the end of March.

The video was made through a funding agreement with Health Canada and was written and edited by Ross Friesen and Jay Niver and produced by Alcohol-Drug Education Service and Letsgo Productions.

As for Samantha, she was diagnosed with asthma at the age of five and is on daily asthma medications to help control the disease. Running and exertion gets her winded and she has to rest. She also has to be vigilant against catching any colds and flu.

The video ends with the names of two agencies that are available for those wanting to quit smoking. Quitnow.ca is for those who reside in B.C. and quit4life.com is available to anyone in Canada.

Prevention the best way to deal with H1N1, advises chief medical health officer

Author:  Bernadette Friedmann-Conrad,
Sage Writer,
REGINA
Saskatchewan Sage
Volume:  13 Issue:  10
Year:  2009

The number of H1N1 Human Swine Flu cases increased substantially in Saskatchewan over the last month, and the World Health Organization declared the outbreak a pandemic. But the province's health officials say the best thing to do is not to panic, and to follow simple preventative measures to keep the disease from spreading.

"For this virus, the single best thing is to wash hands and wipe down surfaces that are used by many people, such as door knobs and computers," said Saskatchewan's Chief Medical Health Officer, Dr. Moira McKinnon.

"If you do get a cough or a cold see the health care worker quickly, and make sure you cough into your elbow not into your hand. This is basic infection control, but I know that can be difficult for some northern communities if they don't have running water," she said, adding that even though there has been a lot of media coverage about the H1N1 virus, most people experience only mild symptoms and fully recover.

And while there are stories of increased severity, the World Health Organization did not decide to raise the pandemic to level 6 because of the severity of cases, but more than anything because of the geographic spread.

There have been very few severe cases in the southern part of Saskatchewan and there is no indication that Aboriginal people are affected more severely, said Karen Hill, Media Relations Officer at the Saskatchewan Ministry of Health. "But the agency is keeping a close eye on the north."

"To the best of our knowledge, as of today, it is not affecting First Nations populations any differently. Of course we're increasing surveillance amongst northern communities specifically because of what's happening in Manitoba," she
added.

At the beginning of June, in the remote northern First Nation of St. Theresa Point, a number of residents were diagnosed with influenza-like illness and had to be evacuated to Winnipeg hospitals where they were put in intensive care and on respirators. Half of those in hospital were Aboriginal, said McKinnon.

"We know people from Saskatchewan have been visiting northern communities in Manitoba, and they are returning. What we need to do is look if Aboriginal people are more severely affected by the flu virus. Once we sort that out, we might need to change our policies in regard to treatment."

Saskatchewan's health officials were having difficulty assessing the situation because of the unclear data from Manitoba. Of the 55 cases in intensive care, only two were definitively confirmed as H1N1. Some of the patients, who had been in ICU for a month, could not be accurately tested because the virus might no longer have been present in the body. So it was hard to determine if these cases, in fact, were the serious form of H1N1 Human Swine Flu.

McKinnon said although most cases in Saskatchewan have been mild, "if the communities in the north experience a different clinical picture, where they're getting much more ill more quickly, than we need to treat them earlier."

The isolation of northern communities may not help matters, she said. Crowded living conditions, high levels of diabetes, and inadequate nutrition could be contributing factors.

"Peoples' ability to fight off illness is always reduced with poor nutrition and poor living standards, and it spreads always much more quickly," she said.

For that reason, many First Nations communities across the province have developed pandemic plans, and the World Health Organization agrees that planning ahead to regulate communications, surveillance, vaccination, health care services, infection control, and anti-viral drugs has "immediate and lasting benefits, increasing overall response capacity for all threats to public health."

Meanwhile, on June 19 the Saskatchewan Ministry of Health advised that physicians, health clinics, and hospitals will only test patients for the H1N1 flu virus if severe flu-like symptoms are evident or if there are other clear medical reasons for testing.

According to the advisory, the growing number of confirmed cases in the province "reflect the unusually high number of specimens being submitted by physicians' offices, particularly in Regina. Changes in the numbers are not an indication of an increase in the severity ofÝflu symptoms in the community."

Testing patients with mild flu symptoms for H1N1, said the Ministry, is unlikely to affect the treatment. Therefore, patients should not be concerned if their health professional decides not to test for H1N1.

At the same time, the Ministry also changed its policy with regard to reporting confirmed cases of H1N1 in recent weeks. It no longer provides specific information on which Health Care Region new patients tested positive for the virus, but is now providing only the provincial total for confirmed cases.

"The H1N1 flu virus is present in Saskatchewan communities," stated the advisory. "Residents are encouraged to continue taking precautions against infection through frequent hand washing, coughing and sneezing into the arm, and staying home if feeling unwell."

Renal outreach clinic makes difference in fight against diabetes

Author:  By Rachel Lambert
Sweetgrass Writer
SIKSIKA FIRST NATION
Alberta Sweetgrass
Volume:  19 Issue:  10
Year:  2012

With an astonishing 15 per cent of Siksika residents suffering from diabetes, Melvin (Tyler) White, CEO for Siksika Health Services, knew something had to be done to prevent kidney disease or slow down its progression.

Now, eight years after Alberta Health Services brought its weekly renal outreach clinic to Siksika First Nation, over 100 people are being seen.

“The need to prevent the complications from diabetes early, to prevent the development of kidney failure, was the reason this program started. The focus was on management of patients in their home communities in contrast to most specialty clinics, which are only run in large cities,” said White, who gave the province the go-ahead to operate on Siksika, although First Nation health care falls under the jurisdiction of the federal government.

Nephrologist Dr. Brenda Hemmelgarn and Nurse Practioner Ellen Novak helped develop the outreach clinic for the Southern Alberta Renal Health Services.

“Aboriginal people are at high risk of developing kidney disease because there is a high prevalence of diabetes among this population,” said Novak.

Siksika is one of the top three communities in Alberta with the highest rate of diabetes.

Health Canada estimates Type 2 Diabetes rates are three to five times higher among First Nations people on reserves than among all other Canadians accounting for at least 90 per cent of diabetes cases.

Initially, the renal outreach clinic was run by a nurse, who would assess high-risk patients and communicate with a physician for medication changes and suggestions on management. The nurse would then implement the suggestions.

“Over time, we found that the communication…was delayed and patients were not receiving optimal care,” said Novak.

That realization prompted changes and since 2006, Novak has been assessing patients in the clinic independently and managing their blood pressure, diabetes and cholesterol, either making the necessary medication changes or initiating medications independently.

“I consult Dr Hemmelgarn as needed,” said Novak.

Patients requiring specific nephrologist expertise are referred by Novak to Hemmelgarn, who visits the clinic a few times a year to work with difficult cases.

Siksika has expanded services to the reserve schools with the assistance of pediatric nephrologist Dr. Susan Samuel. A school screening project identifies markers and risk factors for kidney disease and diabetes in school children.

“Research has shown us that if we manage patient’s blood pressure, cholesterol and diabetes and reach suggested targets, we can prevent kidney disease,” said Novak.

White noted they hope to expand the program to other First Nation communities. That expansion has already begun with Standoff, in the Blood First Nation, the newest site for a renal outreach clinic.

Said White, “I would definitely recommend this program to other First Nations wanting to make a difference and prevent this disease for future generations.”

Service gaps identified for low income Aboriginal families

Author: By Shari Narine
Sweetgrass Contributing Editor EDMONTON
Alberta Sweetgrass
Volume:  19 Issue:  10
Year:  2012

The findings of a study looking at the social determinants of health for Aboriginal families residing in Edmonton reflect similar circumstances for Aboriginal families living in other urban centres in Alberta.

“This being a trend in Edmonton, we would expect the same barriers in Calgary, for example, and partially because we also see it in our non-Aboriginal population,” said Dr. Laura Templeton, with the University of Alberta and one of three lead authors of the Families First Edmonton study, a community-university partnership.

While the report provides no “over-arching message,” said Templeton, it is clear that “around social determinants, we know there are so many correlates to eventual health for parents, children and families.”

The study followed low income families from December 2005 to June 2011. Because of recent interest expressed by the provincial government regarding low income urban Aboriginal families, Templeton said FFE pulled out the results pertaining to the 207 Aboriginal families that participated in the study and provided those to Alberta Centre for Child, Family and Community Research and Ministry of Human Services in June.

The study, which examined education, employment, housing, social inclusion and health information, identified definite gaps in service.

Settlement services for urban Aboriginals was one such need noted by FFE steering committee member Cheryl Whiskeyjack, executive director with Bent Arrow Traditional Healing Society.

“A lot of people do move to the city and they may lack social resources, kin connections to help them adjust to life in Edmonton,” said Templeton.

Edmonton has the second highest urban Aboriginal population in Canada.

In the fall of 2011, Bent Arrow combined with Boyle Street Community Services and Boyle Street Aboriginal Services, and with money from the provincial government opened the New In Town Aboriginal centre. The service provided by the centre, which connects people to available resources, is available to those who have lived in Edmonton for a year or less. Whiskey Jack said the service is expected to help 2,400 people annually.
Templeton noted that the First Nations families that took part in the survey indicated connections with 83 per cent of the First Nations spread across the province – as well as connections to First Nations in British Columbia, Saskatchewan, Manitoba, Ontario and the Northwest Territories – increasing the chance of relatives from any of these First Nations moving to Edmonton because of kin connection.

“Some (of the findings) were not specific to Aboriginal low income families,” said Templeton.

As with other low income families in Edmonton who participated in the study, the majority are single parent-led. For Aboriginal families, 96 per cent of single parent families are headed by women. Education is also low. Approximately half of the Aboriginal caregivers had less than a high school education. As well, child care provided a barrier, with approximately 75 per cent of Aboriginal caregivers not working for pay outside of the home. Housing was also an issue, with affordability, over-crowding and disrepair all being concerns for more than half of the Aboriginal families. Social isolation was also noted. Ninety-two per cent of Aboriginal families expressed a desire to get involved in the community but factors such as child care, lack of transportation, and awareness of what is available all make it difficult.

The mental health component of the survey was “quite revealing,” said Templeton. “We have a lot of people who have mental health concerns perhaps who aren’t receiving mental health services necessarily.”

Mental health findings indicate that both Aboriginal caregivers and children requiring mental health care, for such issues as depression or anxiety, are significantly greater than expected.
Of the 207 Aboriginal families who participated in the study, 60 per cent self-identified as First Nations and 40 per cent as Métis.
Templeton is hoping that the study will be used by social organizations and the government to fill the service gaps.

“This (report) can really speak to some of the hidden issues,” she said.

Templeton expects the study to go out to the university community as well as other government departments, such as Health Services and Education, shortly.

TB another big threat to communities

By Isha Thompson
Windspeaker Staff Writer
CROSS LAKE, Man.

H1N1 may be the hot topic at the moment, but it is only one of the many health issues that need immediate attention on First Nation reserves across the country, said Shawn Atleo, Assembly of First Nations (AFN) national chief.

Atleo referred to the H1N1 virus as "the tip of the iceberg" when it comes to major health issues like HIV/AIDS and Tuberculosis that First Nations people are suffering from at an alarming rate.

"I don't think the Canadian public understands how our people are impacted by TB," said Atleo. "We definitely have to open up the discussion and dialogue."

The national chief has been aggressive when it comes to ensuring secluded First Nation communities are well informed about H1N1.

Atleo, along with Minister of Health Leona Aglukkaq, signed a communications protocol in September that vowed to relay information and necessary resources to help First Nations defend themselves against the pandemic.

Atleo said his push for more attention on how severely the new flu strain is impacting Aboriginal communities was also a strategy to put the spotlight on living conditions that are also contributing to the escalating cases of TB.

"They're inextricably linked," said Atleo about the overcrowding and substandard housing that make First Nation communities more susceptible to H1N1, as well as TB. "That's why the work on H1N1 needs to be the first step, so we can tackle broader issues like TB."

Assembly of Manitoba Chiefs Grand Chief Ron Evans agreed with Atleo and firmly believes that root issues that are behind severe illnesses in First Nations communities must be addressed.

"Over-crowding, shortage of homes, moldy conditions; it all boils down to the living conditions of our people in the communities that lead to all the diseases that are of a respiratory nature," said Evans. He added that reserves in his province not only need additional housing, but homes that are higher quality.

Tuberculosis is an infectious disease that typically affects the lungs. As it progresses it can result in serious infections that, if left untreated, can result in death. TB on reserves where too many people are forced to live in a single home is a particular concern due to its easily contagious nature.

"It is not something you or I would want to experience," said Chief Evans.

The Lung Association of Manitoba said they too are aware of the high numbers of First Nations who are infected with TB. The association contributes by providing X-rays, free information brochures for nursing stations and occasionally with in-person visits by staff members, said executive director Margaret Bernhardt-Lowdon by E-mail.

Cross Lake First Nation is a Manitoba reserve that considers TB one of the biggest threats to its 6,000 band members.

Cross Lake First Nation Chief Garrison Settee said treating symptoms of TB is not helping. Instead, the newly elected chief echoed Evans by explaining that living conditions for First Nations across the country need to be improved.

"How can we live healthy lives if we live in Third World conditions," asked Chief Garrison, who explained that many of the households on his reserve have several families residing under one roof.

"When you don't have adequate housing, your health problems will continue to be there."

The AFN has joined forces with the Stop TB Partnership, which has vowed to put an end to the disease that affects the most vulnerable around the world.

Traditional diet leaves film-maker with a bounce in his step

Author:  By Jennifer Ashawasegai
Windspeaker Contributor
TORONTO
Windspeaker
Volume:  30 Issue:  5
Year:  2012

Bossy Ducharme lost a whopping 80 lbs when he decided to eat a diet made up of primarily traditional fare.

Ducharme feasted daily on berries, wild rice and fish.
One of the surprising things is that the 41-year old didn’t exercise while he was on the diet for more than a year.
Bossy decided to do something about his health after his doctor told him he was obese and headed for a heart attack. That was four years ago. Two years ago, he decided to go to film school, plus planned on documenting his diet.

“In my first film I was going to be like our Native ancestors for one year, and see what happens, and I did it,” said Ducharme.

Sticking to the diet and losing weight wasn’t very easy in the beginning. Ducharme said he had to adjust his eating habits to not allow himself to go hungry, plus there was a lot more thinking about what and how he would put food in his body. “I started having to prepare foods for a day, the day before. I never did that before. I was also cooking.”

The diet actually lasted nearly a year-and-a-half, from September 2010 to about the end of January 2012.
Ducharme said the change in his body was dramatic. Not only did he lose weight, he had really good energy, plus great skin.

Ducharme isn’t the first one to go back to his dietary roots. A documentary was done a few years ago, and it followed a handful of Namgis people in Alert Bay, B.C. That diet wasn’t nearly as strict as Ducharme’s though. It allowed for other fresh produce from local markets in addition to salmon and oolichan grease. Meat, eggs and cheese were also allowed. Starchy carbohydrates and sugar were really the only diet no-nos. After losing nearly 100 lbs, one diabetic dieter used less insulin.

Not only can obesity lead to heart disease, it can lead to Type 2 diabetes. According to the Canadian Obesity Network, the disease has become an epidemic in First Nation communities. A three-year research project has found that up to 40 per cent of First Nation adults on-reserve have Type 2 diabetes, versus seven per cent in the general population. Also, about a quarter of the people participating in the study were overweight and another quarter were obese, while a third were morbidly obese.

Losing weight for Ducharme while on his traditional diet may seem almost fast and easy, but there’s nothing to gaining weight. Since Ducharme has been filming his journey for his documentary, ‘A Good Day not to Die’, he allowed for a month to scrap the diet to find out what would happen.

“I returned to the typical North American diet, including fast and processed foods and gained about 30 lbs in that month.”

Not only did he gain nearly a third of the weight back, Bossy lost the bounce in his step. His energy level went down quite significantly and found he was also tired again much of the time.

“I think the physical changes of gaining weight, 30 lbs in 30 days, is a lot right there,” said Ducharme.

After that experience, Ducharme returned to his traditional diet, and has started to shed the pounds again and re-gain his energy.

While Ducharme lost a lot of weight on his diet, his doctor is cautious about recommending it to other people of Aboriginal heritage. Dr. Arbess says, “This is one case, and I can’t really comment. Typically when we make recommendations, it’s based on a clinical trial of numerous people. But I think anecdotally, this is very impressive.”

“I suspect that the traditional diet is much healthier than the typical western diet, which is high fat, high salt, processed foods. I think that’s what’s driven obesity epidemic in the general population as well as the Aboriginal population,” Arbess said.