Chronic Disease and Wholistic Health in First Nations Communities my view of the world as a white privileged male working with Indigenous people for more than 25 years

1. Moonias Perspective working in
First Nations Communities
Chronic Disease and Wholistic Health in First Nations Communities
February 14th, 2018
Greg Riehl RN BScN MA - Indigenous Nursing Student Advisor

2. Where am I and Why am I
here, again???
• I ask myself this every day, and I also ask those who I am working with from time to
time…
• I would like to acknowledge Treaty 6

3. Treaty Six Acknowledgment
• Who is here today?
• I would like to acknowledge the elders, traditional knowledge keepers, leaders, the youth, …
• And I would also like to acknowledge the prisoners, vacationers, keeners and experts also here with
us today!
• Welcome everyone!

4. Let’s start with an Icebreaker

5. môniya:s or moonias
 Especially among North American Indians in Canada: a newcomer.
 Origin - Late 19th century; earliest use found in Dictionary Canadianisms. From Plains Cree
môniya:s non-Indian, white person, diminutive of môniya:w from Southern Algonquian
mo:niya:winini from mo:niya Montreal + -inini man.

6. Perspective

7. Perspective
Upstream
Downstream
Linear
Vertical
Non-linear
Directions?

8. “If you have come to help me, you
are wasting your time; but if you are
here because your liberation is
bound up with mine, then let us
work together.”
- Lilla Watson, Aboriginal Elder, activist, educator
(Australia)

9. Western Medicine Western Research
 What is the problem, what is the question?
 How can we get rid of the problem? How can we fix it?
 What is the answer to the question?

10. Cultural Appropriation or Cultural Appreciation
“the only route to gaining a better appreciation of the different cultures in
Canada is through regular exposure, asking questions and expressing
opinions – even if those opinions are wrong.
Michael Taube on May 16, 2017 Troy Media

11. Chief Jo Mathias
“We walk into the future backwards because we are looking to
our Ancestors, listening to our Elders, and learning our traditions
and cultures”

12. “What we see, we do not see.”
 Archie Weenie

13. Ally Bill of Responsibility
Written by Dr. Lynn Gehl, Algonquin Anishinaabe-kwe
 How can I be a responsible Ally?
http://www.lynngehl.com/uploads/5/0/0/4/5004954/ally_bill_of_responsibilities_poster.pdf

15. How to Be an Informed Aboriginal Ally
by Madison Burns
 Being an ally is not part of my identity but is part of an action or a practice that I take
 Allies should seek to spread equity for the sake of justice and ensure that everyone is treated with
the same levels of support and protection.
 Being an “ally” means recognizing your privileges and expressing solidarity with groups that are
marginalized or oppressed
 Allies operate behind the scenes, it is not about taking credit, it is about giving and supporting
credit

16. Recognizing my privilege.
 Firstly, to be an effective ally I need to recognize the privileges I may (unknowingly) be benefitting
from.
 As a true ally I am aware of my privilege and I am willing to speak up about it without taking
attention away from those who are marginalized.
 As a true ally this can only be decided by those who I am working with, that is, it is not up to me
at all.
 Really, I am aligning myself with others, it is an action, and an act of doing something, and not
something to be turned on or off when it is convenient.

18. Being an Ally means…
 shhhhhhhhhhhhhhhh

20. Feeling Uncomfortable
 This may mean I am not invited, or I am asked to leave… and sometimes that is hard… but that
means I have done my job as an ally.
 This means constant education, and constant reflection, and allowing time…

21. Allies in Research
 Indigenous research will be joined by allied researchers
 Always include wise people
 Number of elders on the team >2
 Need to link local to national programs if available or possible
 Ground up, bottom up, not top down
 Circles, not squares, not lines.
 Land based, seasonality, balanced.

22. The Nightmare Before
Christmas
“If you’re going to learn about other people’s cultures and traditions, approach it from a place of
respect. Go to the people who live that life and treat them as the experts. Listen to others if they say
you’re stepping over your bounds. Show humility. Ask questions in a respectful way. Don’t try to
“improve” cultural elements just because that’s easier than understanding it fully. Above all, practice
empathy. And that’s a pretty good lesson for us at any age.” Katie Schenkel

23. Best or Wise Practices
 Indigenous Knowledge Transfer (IKT) Indigenous Knowledge (IK) Knowledge Translation (KT)
 Need to support Indigenous ways of knowing, need to link to ceremony/s
 Wellbriety versus sobriety, wholistic…
 Nutritional harm reduction
 Community Identifies needs: system or institution identifying needs, points to consider as
opposed to weaknesses
 UNDRIP principles – how to evaluate IK using Indigenous frameworks – needs specificity, # of
interviews, # of interventions
 Informed by the TRC and community consultations

24. How to Build and Support Trust
 Three biggest institutions of historical trauma and mistrust
 Justice, health, education
 Honorariums – clarity/equity between all participants’ youth to elder, childcare, transportation
 Indigenous students traumatized and suffering, deficit based
 Partners - is the partner Indigenous?
 A University is not Indigenous.

25. Traditional Questions
 Stigmatizing disease, illnesses, Western medicine always wants to FIX something
 What are you trying to fix?
 Lateral violence as opposed to lateral kindness - Lateral violence focuses on deficits not strengths
 Advisory board oversees what? Terms Of Reference (TOR) needs to indicate what?
 Do you even need a TOR
 Good governance structure or model developed and supported by elder and community input

26. Strength Based Research
 Strengths based as opposed to deficit based approaches
 Interviews – How are the interviews being conducted, sharing circles, elder involvement, shared
power, equal voice,
 Knowledge gaps, what is being addressed, be specific, need to identify
 Responding to suicide through community and culture
 Responding to communities and families with low or no self harm
 Researchers receive training from the community, focus on a balanced team
 Support for non – Indigenous mentors, all mentors receive support

27. To For With
 Western thought – increase awareness of effects of colonialism BUT most Indigenous populations
already know about the effects
 Resiliency – bouncing back hopefully more than that – thriving, striving, more than just surviving
 Means, variable, and interests need to be defined
 Actively recruit the underrepresented – gender, sexuality, those with low opportunity hard to
reach, often this population is not represented
 Avoid Broad statements – this will benefit a lot of people and be used with other people – need
to be more specific

28. What about Research - Methods
 Decolonizing Methodologies vs Indigenous Methodology – Indigenizing vs reconciling, deliberate
dialogue
 Two-eyed Seeing approach, good to add to this
 Multi directional learning KTE throughout the process/phases
 Code of ethics practice working with Indigenous researchers CMT
 Bidirectional Knowledge exchange between mentors and mentees, both have knowledge,
culturally grounded mentorship – Four pillars of CIHR
 Teaching into action, How will it be delivered and translated out, catalyst for the future

29. So what about Research?
 Knowledge Generation (KG) –local elders, scholars, knowledge keepers,
 KT are articles co-authored with community members
 What are you going to evaluate or inventory
 Knowledge Holder (KH) for anything document versus Knowledge User
 Ethnography – who owns our observations?
 OCAP – ownership, control, access, possession
 Sharing circle – how will this be evaluated

30. OCAP
 What happens after the program, intervention?
 Cultural Teachings – drumming, singing, smudge, tobacco, whole family, storytelling, sharing/talking circles,
 Cultural lens – more Indigenous and cultural approaches
 Cultural Continuity & Transformation Research, Social Continuity, and Change
 Do not focus on the development of the research; do focus on the development of the members of the Indigenous
people
 Project Scope, ultimate benefits,
 Data collection, how to analyze multi methods of collection modalities
 GIS – mapping – OCAP, community should get software and own it and use it and maintain this data and tools
 Indicators or markers of success – what will the program add to

31. Trends
 Cultural Competency is out, Cultural Safety yes, Cultural Humility very good
 Cultural competence focuses on service provider’s cultural safety and humility focuses on clients
 Humans not at the top of the hierarchy, focus on balance with all creatures
 land based programs and interventions
 Mentors mentees (the land is a mentor) are co-learners
 Cultural and ecological wellness need to be defined

32. Outputs
 Tri Council Statement Chapter 9 http://www.pre.ethics.gc.ca/eng/policy-politique/initiatives/tcps2-
eptc2/chapter9-chapitre9/
 Community Oversight committee very important
 Village of wellness methodology http://thevillagemethod.org/our-method/
http://vchnews.ca/across-vch/2016/10/12/n%D3%99camat-2016-downtown-eastside-aboriginal-
womens-village-wellness/#.WMr9Wbi1vRY
 Direct money and funding toward the community

33. Dos and do nots (mmmmmm donuts!)
 Budget describes activities; these activities need to be in the proposal
 Separation between those providing services and those evaluating, separate implementers from
evaluators
 From the community for the community
 Can we come up with a different term/inology for train-the-trainer
 Concern that $ is going directly to grad students, PIs, etc
 Letters or interest, support from the community, not a form letter, letters of support need to
focus on the project not the institution or researcher
 350 page submissions, 20 years of research, uhmmm no…

34. examples
 Angela Snowshoe and Noel Starblanket 4 blankets of Indigenous Horse-Based Healing
framework http://journalindigenouswellbeing.com/media/2016/12/50.43.Eyininiw-mistatimwak-
The-role-of-the-Lac-La-Croix-Indigenous-Pony-for-First-Nations-youth-mental-wellness.pdf
 Traditional Environmental knowledge (TEK)
http://nafaforestry.org/forest_home/documents/TKdefs-FH-19dec06.pdf
 Miro Matisiwin
http://www.rcaaq.info/images/M%C3%A9moire_RCAAQ_inclusion_sociale_anglais.pdf &
http://www.pimatisiwin.com/uploads/jan_20112/10ManitowabiShawande.pdf
 Unifying features of the black spruce, extending diversity and unity

35. “Reconciliation is about forging
and maintaining respectful
relationships.
There are no shortcuts.”
Justice Murray Sinclair

36. What is my role in research?
 I need to understand myself, my place, my invisible knapsack or worldview, my assumptions and
understanding of myself and of others and relationships and power dynamics.
 What is the goal of research? as a Moonias it is often about learning more about myself as
opposed to the outcomes, results, the data or findings of the other.
 We all need to be a bit more self-reflexive

37. & DonT be arfaid to
kame mit sakes
Ask questions, listen, and then ask more questions.

38. Lateral Kindness
 Please be kind to each other
 Respectful and responsible relationships, there are no apps for that.
 Be Grateful
 Be Great!

39. Contact information
Greg Riehl RN BScN MA
Indigenous Nursing Student Advisor
Indigenous Nursing Success Strategy
Saskatchewan Polytechnic
Regina Campus
Email: greg.riehl@saskpolytech.ca