22. We call upon those who can effect change within the Canadian health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients.
Truth and Reconciliation Commission of Canada1
Among the 94 calls to action made by the Truth and Reconciliation Commission of Canada in 2015, Call to Action 22 reminds us of the importance of partnerships when trying to address the inequities of health between Indigenous and non-Indigenous populations.2-4 These collaborations have been shown to be beneficial in improving the health of Indigenous people.5,6
In this article we describe a cultural program developed by Lac La Ronge Indian Band Health Services in northern Saskatchewan to focus on traditional healing practices and knowledge of the Woodland Cree peoples. The cultural program was built from a strong desire for self-determination and to give Woodland Cree peoples the option of engaging with their own cultural approaches to healing. Re-establishing these healing systems so that they can be accessed alongside allopathic medical practices is an important aspect of self-determination for the Lac La Ronge Indian Band.
An allopathic medical clinic also services the local population, including members of the Lac La Ronge Indian Band, with family physicians practising full-scope primary care. In recognition of Call to Action 22, members of the medical clinic and the cultural program co-designed the research question for this study: How can the cultural program and the medical clinic work together to support the health of the local population? The findings from their research illustrate how relationships between community organizations can develop into long-term partnerships and transformation that includes clinical changes.
Methods
This project grew over numerous visits between co-authors from the cultural program (L.S.) and from the medical clinic (S.S.) over time. We sought to shift the approach to health and wellness from deficit-driven to strength-based by integrating the practices of traditional healing and allopathic medicine. The co-created research question evolved from these gatherings.
Conversation interviewing, which is a 2-way discussion where both the interviewer and the interviewee freely exchange ideas and information, was undertaken by L.S. and S.S. to explore the research question. These were recorded on a mobile device and an inductive, participatory-thematic analysis of both the series of dialogues and the reflections on them was undertaken.
The study was approved initially by the Health Director of the Lac La Ronge Indian Band and subsequently by the University of Saskatchewan’s Behavioural Research Ethics Board (Beh ID 3864).
Findings
Self-healing. Miss Sanderson stated that traditional pathways to health have a spiritual basis, requiring belief and commitment to the healing process, which keeps patients engaged in their healing. She believes that colonization created a dependency among the Woodland Cree peoples on systems, whether First Nation or colonial. However, reclaiming traditional knowledge offers people a pathway out of this dependency. This pathway can help people live not as victims of their circumstances but as creators of their beliefs and understandings, taking on an empowered role in self-healing that builds the capacity for sovereignty of First Nations.
Building relationships. Mutual respect and understanding are essential for collaboration. Traditional ways of knowing need to be recognized as offering valuable insights and pathways to healing. Meetings between both organizations should be held regularly to build relationships, provide education, and create awareness about the services being offered by both sides. Miss Sanderson recognizes that medical issues can go beyond the scope of traditional knowledge, and that this is when traditional healers can refer patients to their allopathic partners. However, she states that traditional healers need to feel confident that the people they refer are cared for in a way that will contribute to their health and wellness. Two-way communication and trust can additionally be improved by the creation of a referral system from the medical clinic to the cultural program.
Addressing stigma. Miss Sanderson has experienced resistance from both First Nations and settler populations. Traditional healing methods are seen as strange when observed from a purely scientific and colonial worldview. The expression of these beliefs strengthens colonized thinking and invalidates traditional healing. Capacity building takes time and commitment by motivated individuals. An awareness and valuing of healing services can begin to create the momentum and space needed for a thriving traditional healing clinic.
Holistic healing. The Woodland Cree peoples emphasize the use of the medicine wheel to guide their healing, identifying the connection between the emotional, spiritual, physical, and mental selves. Miss Sanderson questions whether allopathic medicine acknowledges this relationship or instead puts too much focus on the physical aspect. She believes this imbalance does not allow for complete healing and might discourage some Woodland Cree persons from seeking allopathic treatment.
Beneficiaries of a traditional approach. Some groups of patients were identified as those who might benefit most from a traditional approach. These included the following groups:
patients who are unwilling to use conventional medicine due to fear and mistrust from the legacy of colonization;
patients who are disengaged from their chronic disease management;
patients with mental health or substance use disorders;
patients suffering from somatization of mental and emotional pain;
patients without a clear diagnosis that explains all their symptoms; and
patients who have trialled several allopathic medicines without adequate relief or improvement.
Discussion and conclusions
Colonized thinking can impair genuine collaboration. Allyship and dissolving the “us-versus-them” mentality will be instrumental to moving forward. Genuine respect for traditional ways of knowing, the gifted nature of healers, and values of those who access cultural services is essential to decolonizing relationships. Traditional knowledge should be destigmatized and recognized for its value to the Woodland Cree peoples. By working together, engaging in mutual learning,7,8 and communicating around challenging issues, we have found that these discussions have opened a path for co-creation and collaboration.
Acknowledgment
The authors thank Dr Veronica McKinney, Director, Northern Medical Services, at the University of Saskatchewan, for her valuable input into this work and for her ongoing advocacy for the people of northern Saskatchewan.
Notes
Hypothesis is a quarterly series in Canadian Family Physician (CFP), coordinated by the Section of Researchers of the College of Family Physicians of Canada. The goal is to explore clinically relevant research concepts for all CFP readers. Submissions are invited from researchers and nonresearchers. Ideas or submissions can be submitted online at https://mc.manuscriptcentral.com/cfp or through the CFP website https://www.cfp.ca under “Authors and Reviewers.”
Footnotes
Competing interests
None declared
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