Pilot project involves community

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A pilot project being run on the Siksika First Nation is quickly becoming a model for other First Nations and rural communities across Canada that want an effective and community-based approach to addressing Fetal Alcohol Syndrome (FAS).

The Siksika Awakening FAS Prevention Program started in October 1999 and is scheduled to run until March 2002. The pilot project is one of three currently running in Alberta through the Alberta partnership on fetal alcohol syndrome, and the only one operating in a First Nations community.

Marcia Medicine Shield is co-ordinator of the Siksika project. She said the main goal of the program is reducing incidences of FAS in the community.

Medicine Shield said that before the pilot project began there were few community resources for addressing issues surrounding FAS. One of her roles, therefore, has been to locate and deliver resources to those providing intervention and support services for children and adults with FAS.

Medicine Shield has also been providing training for all service providers in the community, as well as being a resource person for teachers, social workers, child welfare workers, counsellors, parents, and high-risk mothers. She teaches them about prevention and providing support for those with FAS.

Although Medicine Shield doesn't have any statistics regarding how many people in the community have FAS, results from a survey done involving 200 women in the community showed 97 per cent admitted to drinking alcohol during their pregnancy. Medicine Shield hopes to have a tracking system in place in the future to determine the number of FAS cases in the community. In the meantime, the health centre has been looking into cases where they suspect FAS, she said.

Medicine Shield added that since theirs is the only First Nation community with this pilot project, other First Nations across Canada have been requesting advocacy, resources and training from Siksika.

The program is becoming a model for First Nations and other small and rural communities that want to learn ways to deal with FAS, she said.

What Medicine Shield and the community members are doing is using what has worked within the Nation traditionally and culturally.

"What I've been implementing is instead of having this individual or child taken out of the home, keeping the child in the home and providing supports as far as having clan meetings, where the whole family takes responsibility in providing support, follow up, for this one individual," Medicine Shield explained. During the meetings, an Elder explains the roles and responsibilities of everyone involved.

"And that's been very successful."

Other traditional approaches used by the project include having families adopt, "in the Indian way," mothers who don't have families to provide support for them during their pregnancies. As well, a handful of Elders have become involved. They provide support and counselling for men in the community, rather than having them referred to an addictions worker.

"The men seem more comfortable in having that opportunity to go see an Elder," Medicine Shield said, saying that the program tries to eliminate or lessen barriers that might keep the men from approaching the Elders.

"And that has really been working, where the men are taking that responsibility and saying, 'well, I do have a role in this, and this is what my role is in my family,'" she said.

Medicine Shield has received a lot of support from the community in her efforts. A 45-member working committee has been established from among Siksika's service providers.

Medicine Shield is also looking at community capacity building and streamlining of services required by those with FAS, so that the whole community is prepared to take over their responsibility to the FAS individual. The goal is to have the supports continue long after the pilot project ends.

"I think the most important thing with this is that what I've been doing is advocating for other First Nations communities" she said, providing materials and resources, which many of the First Nations say they've never seen before.

Medicine Shield also links First Nations with the regional FAS committees, "so they can have have a voice in the decisions that are being made," she said. "And that has been opening doors for a lot of the First Nations communities."

Medicine Shield has also been making her own voice heard, drawing attention to some issues of concern to the Native community, such as the prevalent use of Native children in FAS educational material. FAS is not just a First Nations problem, it exists across the board. "This is not something the Elders like to see," she said.

She also points to some of the tools used in diagnosing FAS, suggesting some of the testing is culturally biased and not relevant to First Nations people, especially those in isolated areas.

She cited an example she witnessed, where a little girl scored low on her test because she was asked to describe a picture of a ball and she said it was a ball, when the testers had wanted her to say it was a big, red ball.

"To us a ball is a ball," she said.

"And so you can see the need that is out there for First Nations people to be in this field, and to be advocating for them," she said. "And the positive thing about it is all the other regional co-ordinating committees and the province have been coming to me and saying, 'How can we work with this First Nations community?' or 'What can we do?' So now they've recognized my voice as being able to speak up on behalf of our nation and other First Nation communities, only because of the requests that have been made to Siksika," Medicine Shield said.

"What I found was that there was a lot of non-Native people standing up and saying, 'Well, I'm speaking on behalf of this Aboriginal community or this First Nations community,' and giving their opinions on what this community needs, and for me, I'm standing up and saying, 'No, as a First Nations person, I would like to addres that,' and set the record straight a lot of times."

Medicine Shield said outsiders often assume they know what is best for First Nations and try to tell them what they need without visiting their community.

"And that has been the success of my program, going into our community, and going with what works, not (with) what doesn't work."