The Significance of Canada Day and Indigenous Peoples

The Pink Project

Media from Wix

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Introduction

July 1st marks a day of celebration among many Canadians as they honour Canada’s history and accomplishments. One such accomplishment that Canada prides itself on is its universal health care system - the Canada Health Act (CHA) - which enables publicly funded health care insurance (Government of Canada, 2020). The goal of the CHA is "to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers" (Government of Canada, 2020). However, not all Canadian citizens can say that they have equal access to quality healthcare.

Indigenous peoples continue to face health inequities and disparities such as long commutes to care, unwanted relocations to urban areas for lengthier treatments, racially-segregated hospitals and forced sterilization treatments.

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Indigenous Cancer Care - Study Spotlight

While much of past research has taken an epidemiological approach in understanding the experiences of Indigenous patients living with cancer (ex: determining diagnostic and survival rates), not much has been investigated about the patient-provider and patient-treatment relationships or improvements in Indigenous patient experiences with the health care system (Carr et al., 2020).

The study by Carr et al. (2020) aimed to investigate how the themes of trust and worldview shape how Indigenous patients and their families experience/experienced cancer and the health care services for cancer treatment. The sample size of nine cancer care participants who self-identified as First Nations or Métis and five family members resided in Saskatoon. (Carr et al., 2020). The participants of this study were invited to take part in a sharing circle - a cultural practice in some Indigenous communities that allow individuals to share their opinions - where they openly explained their experiences with cancer, without being guided by specific questions (Carr et al., 2020).

After analyzing participants’ interview transcripts, 8 sub-themes were identified. Trust was categorized as mistrust with diagnosis, protection of Indigenous medicine, physician expertise with treatment recommendations and mistrust of Western treatment after cancer therapy (Carr et al., 2020). Worldview was described as the best of both worlds, spiritual beliefs, required to be strong for family and the importance of knowing Indigenous survivors (Carr et al., 2020).

The 8 sub-themes that were identified after the analysis of the patient’s transcripts (Carr et al., 2020)

Trust

Researchers identified both trust and a lack of trust in the health care system when Indigenous patients are seeking cancer treatment (Carr et al., 2020). For instance, patients residing in remote areas of northern Saskatchewan were more willing to wholeheartedly trust the opinions and instructions of health care providers (Carr et al., 2020).

“And, I did what I had to do because I didn’t know what else there was to do. I figured the doctors, they’re the experts; they know what’s best for me. And, I believed in them; I trusted them.’” [Patient 9] (Carr et al., 2020).

However, for other participants, it was not so easy to fully trust the health care system. Some verbalized their trust in using traditional medicinal practices for healing over Westernized medicine. With that being said, many revealed a hesitancy to share the use of their traditional practices with their health care provider, in the fear that they would be discriminated against or that their traditional medicines would be at risk of commercialization (Carr et al., 2020). Notably, only once the health care provider agreed with their patients using traditional healing practices alternative to or in conjunction with Western medicine, did a stronger patient-provider relationship form, as with trust (Carr et al., 2020). One participant stated the following regarding their hesitancy to use Western medicine during their second encounter with cancer:

“I said, ‘I want to live, I want to live. I want the best quality of life and I don’t think chemo is quality of life.’ To have to go through the pain and everything, I wanted to give up halfway through my first bout of chemo. ... So when I was diagnosed a second time, it was — no I know I’m not doing chemo. No. Two years ago and it’s back again, I’m going to try something else.” [Patient 9]

Worldview

When assessing participants’ world views, it was clear that traditional beliefs, family relationships, and community are highly valued in the healing process.

“These things that we believe in — an eagle feather can help a person in the hospital, just have it by the pillow or a bag of sweet grass, makes them feel good and stronger. So I try to share that.” [Family member 1] (Carr et al., 2020).

“And I needed to be strong for my kids, I didn’t have time to panic, but I was panicking. I’m strong. I’m a strong, beautiful Indigenous woman with a strong voice, and I will use that voice to help all of us for our children and our grandchildren. Because, we need to be there for them. We need to set this foundation for them, we need to show them and we need to lead the way.” [Patient 6] (Carr et al., 2020).

“And I just remember being in such despair and just feeling hopeless. And then I just thought I had to — I just got strong about something and I just thought, ‘[names self], there’s survivors. There’s survivors.’ And that’s when it hit me, this is not a death sentence. People have survived it. Then I got hope and then I just took off from there and, spoke to people.” [Patient 4] (Carr et al., 2020).

These words from participants in the study provide insight as to how medication alone cannot help one heal. Rather, Indigenous patients have found strength in themselves through belief - belief in the Creator, belief in playing an important role in their family, and belief in the experiences of other Indigenous survivors. It is extremely uplifting for patients when they feel that their providers understand these ways of coping with difficult times. Importantly, researchers noted that when health care providers acknowledged Indigenous world views, patients’ trust appeared to grow (Carr et al., 2020).

Implication

The results of this study reveal the need for a change in how the healthcare system and providers operate. Specifically, to build trust, providers should be more open about discussing whether Indigenous patients are comfortable with Westernized medicine or would prefer more traditional healing practices. Traditional practices should not be discouraged, but instead accepted and protected. Providers should also be aware of the role of tradition, family and community in the healing process and thus encourage the mental well-being of patients. The healthcare system must promote diversity in its staff and patients. As stated in Carr et al.’s study: "One participant noted how comforting it would have been to 'see a brown face' at the cancer facility."

To learn more individual experiences of Indigenous individuals with cancer: click here

Re-evaluating the Celebration of Canada Day

Past and present manifestations of colonialism continue to promote health disparities and inequities for Indigenous people in the health care system (Allan & Smylie, 2015). Health inequities such as those described above are only a small part of the injustices faced by Indigenous people in Canada. Accordingly, Canadians must continue to advocate for and support Indigenous rights. Rather than a day of celebration, Canada day should be a time of reflection - to question what the day should represent and how our past mistakes and current injustices should not be overlooked.

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References

Allan, B., & Smylie, J. (2015). First Peoples, Second Class Treatment: The role of racism in the health and well-being of Indigenous peoples in Canada. https://www.wellesleyinstitute.com/wp-content/uploads/2015/02/Summary-First-Peoples-Second-Class-Treatment-Final.pdf

Carr T, Arcand L, Roberts R, Sedgewick J, Ali A, Groot G. The experiences of Indigenous people with cancer in Saskatchewan: a patient-oriented qualitative study using a sharing circle. CMAJ Open. 2020 Dec 10;8(4):E852-E859. doi: 10.9778/cmajo.20200012. PMID: 33303571; PMCID: PMC7881746.

Government of Canada. (2020, February 24). Canada Health Act. Canada.ca. Retrieved July 20, 2022, from https://www.canada.ca/en/health-canada/services/health-care-system/canada-health-care-system-medicare/canada-health-act.html