In our previous blogs, we have discussed the unique challenges that people in rural communities face in accessing healthcare. About 50% of Canada’s Indigenous population lives in rural and remote areas, but they face additional challenges involving racism and harmful stereotyping. A common stereotype about Indigenous people is that they are more prone to addiction, which leads them to being more “destructive”. Assumptions like these feed into negative stigma, especially in the medical field. Often, healthcare workers do not take the time to properly listen to concerns of Indigenous patients, which leaves them without proper care. Additionally, many healthcare workers are unaware of and do not understand Indigenous issues and stressors, making it challenging to correctly diagnose and provide the care they need. Most people feel extremely vulnerable when they are sick, and it's a time when people deserve attention. However, many Indigenous people often feel so uncomfortable with the treatment they receive, that they avoid care as an option when they are sick.
Historically, the relationship between the government and western healthcare has been forceful and traumatic for Indigenous people. For example, the forced sterilization of Indigenous women from 1928-1972 with Alberta’s Sexual Sterilization Act. This eugenics policy took away reproductive control of Indigenous women and disabled people and is just one of the atrocities in Canada’s history. However, the pressure to consent to sterilization, especially in medical situations, still occurs to this day.
It is important to address the mistreatment of Indigenous people in our healthcare system if Canadians want to stand for change. As mentioned above, negative stigmas are present in everyday life around Indigenous people. Something that everyone should take the time to do is read, research, and listen to Indigenous voices. The University of Alberta offers a 12 week Massive Open Online Course called “Indigenous Canada” which anyone can register in for free by clicking this link. This course highlights the history and complex experiences of Indigenous communities in Canada and is geared towards those who have not yet explored Indigenous studies. Becoming aware is a small, simple step that anyone can take to be more mindful of the mistreatment of Indigenous peoples in Canada.
Before going any further into this blog, we felt that we needed to mention that the research for this blog post was conflicting. It is important to us that we accurately explain traditional practices without portraying ourselves as experts. The last thing we want to do is talk over people who know much more about these deeply personal and cultural traditions. This blog has been a learning experience, and we are eager to share this knowledge with all of you.
With the help of Alisha Androschuk, a second-year Native Studies major and History minor at the University of Alberta, Tele-Rehab 2.0 is looking towards expanding our services to Indigenous communities. Alisha identifies as Métis, with Métis roots on both the maternal and paternal sides of her family. Growing up knowing she was Métis but unaware of what that meant left Alisha searching for answers about her family and culture in adulthood. While researching her family’s history, she also began to uncover the dark histories underlying modern day Canada. This led her to pursue a degree that would allow her to explore the truth of Canada’s history and immerse herself in the Métis community. She was a summer student at the lab this past summer and has been working towards integrating Tele-Rehabilitation 2.0 in Indigenous communities. Her drive to advocate for Indigenous peoples continuously grows as she explores her identity and culture.
With this project, we hope to help close the gaps that prevent Indigenous people from receiving the care they deserve. While working on delivering Tele-Rehab 2.0 to Indigenous communities, we are also addressing the Truth and Reconciliation’s Call to action #22. The Truth and Reconciliation committee calls on those who can create change in the current healthcare system, and acknowledge the importance of traditional healing practices. We hope to integrate Indigenous knowledge with Western standard practices to move towards a better healthcare experience for Indigenous peoples.
First, it’s important to understand both traditional and western healthcare practices. Western medicine has its place, but has often neglected Indigenous communities. Traditional practices allow Indigenous people to connect with their culture and land, and find comfort in the healing process. Our goal is to integrate these practices to bring the best of both worlds together.
Let’s start off with a bit of background on traditional Indigenous healthcare practices. Indigenous traditional healthcare focuses more on spiritual, holistic aspects of the body, rather than solely the physical symptoms of an illness. Health is seen as a whole, with your body, mind, and spirit all working together. Elders are knowledge keepers of the community, passing down wisdom, teachings, and practices, and are typically healers. A deep connection to the land and community is incorporated into their healing practices. When Alisha told us more about the holistic side, she mentioned the medicine wheel. The medicine wheel is a traditional way of healing for many Indigenous communities. Although specific beliefs can vary, the medicine wheel is believed to be essential for balance and interconnectedness with yourself and the world. The number four is considered sacred and is seen in how life is separated. This is seen with seasons, stages of life and the medicine wheel. The 4 pieces of the wheel represent the aspects of health: spiritual, mental, physical and emotional.
Unlike many traditional Indigenous practices, Western medicine is focused on scientific knowledge that has been mainly developed by European scientists. Instead of focusing on root causes of health issues and the person as a whole, a Western approach typically focuses solely on signs and symptoms. When taking this approach, solutions are often focused on alleviating symptoms with drugs or other therapies, instead of the root cause. While this treatment can be effective, and at times necessary, the holistic experience is eliminated in this process. Due to the emphasis on scientific evidence, doctors often miss out on the “bigger picture” side of healing with the patient becoming seen as their symptom, and not a whole person.
When meeting with Alisha, she compared Western medicine to a band-aid. So, what exactly does this mean? Let’s pretend that a water pipe has a small hole in it. To prevent water from leaking, we decide to put a band-aid on to cover up the hole. There is no more water leaking, but did we actually fix the pipe? No, we just found something temporary (band-aid) to fix the problem (hole in the water pipe). What we really need to do is fill the hole in the water pipe more permanently. Now, let’s think about our body as the water pipe. When there is imbalance in our body, we can’t just slap on a bunch of band-aids and expect the issue to go away. There needs to be a deeper dive into treating the person as a whole, not just as their symptoms, as it is ultimately not solving the underlying issue.
Now that we’ve differentiated between Western and Indigenous ways of medicine practice, let’s take a look at how we can combine both of them to benefit Indigenous communities through Tele-Health. Alisha’s goal is to set up some of our technology to give Indigenous communities access to virtual healthcare. In the past, Western approaches have been invasive and harmful to several Indigenous communities; therefore, it is important to build trust. Without trust, there cannot be a harmonious union between traditional practices and our virtual healthcare system. Alisha explained the importance of listening to the needs of Indigenous communities as they will communicate with us on what works best for their community.
During the summer, Alisha was able to connect with a lot of people, including Elders, students, professors, and healthcare workers. Either meeting in person or talking over the phone, Alisha received advice on how to best connect with Indigenous communities. There were many different opinions, falling into two approaches: be direct and dive into communities, or start small, valuing relationship building before expansion. Alisha decided to try both to see which one felt right for her. Starting small with an emphasis on relationships was the way to go! This relationship building is extremely vital to this project and will take time to develop. With that said, making strong connections will build the foundation of this project, ensuring trust and a smooth integration of traditional healthcare practices with virtual technology. Summer seems to be a busy time for many people, therefore the initial stage of reaching out was slower than anticipated. However, we are thankful for the connections we have made so far, and are excited for those yet to come!
So, what do we do now? Well, Alisha is back at it with her studies, but is still open to any opportunities that come her way regarding Tele-Rehab in Indigenous communities. We have applied for funding to pursue this work further, and have recently established a site next to a major Albertan reserve in the south. We are hoping to learn and grow with our project and bring accessible care that is appropriate to Indigenous ways of life to their communities, and on their terms.
To learn more about our work in this area or to connect about getting a site in your community, Indigenous or otherwise, please email frmrobot@ualberta.ca.