GOOD MEDICINE

Renae Morriseau’s excellent comment begins to touch on the complexity of the First Nations experience with health and wellness. The diversity of issues here is somewhat staggering, and I invite you, our blog readers, to help me begin to define the breadth and scope of what we’re looking at. These issues are not exclusive to First Nations populations but they to reveal a scourge of problems that are rather systemic in nature.

As Renae points out we can begin with “High rates of Diabetes, the rates of youth suicide, clean water.” From there we can look at high occurrences of substance abuse, child mortality, domestic violence, instances of neglect, abandonment, gang activity, racial violence and victimisation.

Some of these issues are well documented in professional studies, while others make it into public consciousness through popular media. This begs the question whether the health stigma of aboriginal populations is a wholly accurate one or whether it is, in part, the result of a ghetto-isation of aboriginal culture in mainstream news media and in our popular psyche?

Discussions within our research group recalled the young toddlers that died of exposure on a reserve this past winter. The specific details in my mind are sketchy: they were aboriginal children; the father was drunk and passed out; they died on a reserve. I remember at the time there was much lament and outrage at how this could possibly be left to happen. The interesting thing is that I vaguely remember similar stories happening in the city to non-aboriginal families. These stories, however, don’t remain as actively engrained in popular memory. The city is too close to our own experience; a white family too similar to ours. It is something we tend to put out of our mind because it could, quite easily happen to us. But an aboriginal child, of a drunk father, who died on a reserve–this is safe, it is foreign, it happened to some ‘other’. We can afford to be outraged. We can afford to remember and we can afford to take score. The question is, how accurate is this score?

This brings me to a final thought in the tally of First Nations health issues: what about the successes? What about those elements of First Nations culture that actively promote community health? In the same way that I invite you to help itemise the systemic health problems inherent in First Nations communities, I ask that you help me build an understanding of the ways in which these communities excel at promoting healthy societies–healing circles, sweat lodges, concepts of holistic health and wellness, cross-generational care-giving…. How do these and other similar issues factor into the ways in which we gauge the health of a First Nations community?

Photography as a discipline emerged at an historical moment that witnessed the birth of what French situationist Guy Debord called “the society of the spectacle.” This phrase refers to an evolution of capitalism characterized by a commodity culture simultaneously privileging image, display and visuality (Abigail Solomon-Godeau 1992). Noted American photography critic Susan Sontag said that the photographic image has the power to capture and transform an individual into an object that symbolically can become the possession of another (1977). And Edward Said (1978), among others, has argued that colonial powers have used photography strategically to represent non-Western peoples as an exotic Other, in order to achieve political and economic dominance (Robert Hirsch 2000). This use of photography as a tool for collecting evidence and writing colonial narratives has become known as photo-colonialism, and the goal of the Good Medicine project is, at least in part–  designed to usurp this tradition. 

Culture and ethnicity affect health and wellness by influencing how people link with the health care system, their access to health information, and their lifestyle choices. Culture and ethnicity are products of both personal history and wider situational, social, political, geographic, and economic factors. Culture and ethnicity are important in shaping the way people interact with a health care system, their participation in programs of prevention and health promotion, access to health information, health related lifestyle choices, their understanding of health and illness, and their priorities. “Dominant” cultural values largely determine the social and economic environment of communities. The result: some people face greater health risks due to marginalization, loss/devaluation of culture and language, lack of access to culturally appropriate health services. Some persons or groups may face additional health risks due to socio-economic factors, which are largely determined by dominant cultural values that contribute to the perpetuation of these conditions.

Saturday, June 7, 2008

Medical care and social services are a fundamental part of any community. 

One practical way to promote health and wellness is to support a medical establishment that understands and appreciates the needs of the community it serves.

This can be achieved by facilitating education and opportunities for individuals to work within their own communities to promote health and wellness.

Healthy communities stay fit, like individuals stay fit, not through exercise, but through dialogue.

All communities have commonalities that bind them, but inside the commonalities are groups that set themselves apart. When these groups plan the future together, they promote a healthy environment of mutual investment where all stakeholders have a voice.

If groups within a community are not in dialogue, if they are unaware of what other groups are planning– of their needs, wants, and desires, assumptions are made, which are often false.

False assumptions lead to misconceptions, which lead to misrepresentations, which lead to misunderstandings and unhealthy relationships.

This is true for individuals, communities, countries, and on the world stage.

Planning for a shared future promotes mutual understanding, and allows groups to see each other as fully human, with similar needs, wants and desires.

If history has closed the door of communication between you and a colleague, a neighbor, a friend– knock on that door.

Whether it is across town, or across the hall, maintain open lines of communication. Say what’s on your mind, but listen.  Really listen.

Disagree, without being disagreeable. Work together. Seek compromise.

And if it feels like risk, it’s worth it. 

It will promote a freer, more egalitarian world. 

Close your eyes and imagine a healthy community. What do you see?

I see happy families, good friends, strong houses, safe neighborhoods, great schools, honest government, diversity, democracy, fresh air, clean water, good food, books, wine, the beach. I see creativity, humor, peace, and above all, I see love.

What do you see?

com·mu·ni·ty– noun, plural –ties
1. a social group of any size whose members reside in a specific locality, share government, and often have a common cultural and historical heritage.
2. a social, religious, occupational, or other group sharing common characteristics or interests and perceived or perceiving itself as distinct in some respect from the larger society within which it exists (usually prec. by the): the business community.
3. a group of associated nations sharing common interests or a common heritage: the community of Western Europe.
4. an assemblage of interacting populations occupying a given area.
5. joint possession, enjoyment, liability, etc.: community of property.
6. similar character; agreement; identity: community of interests.
7. the community, the public; society: the needs of the community.
—Synonyms 1. Community, hamlet, village, town, city are terms for groups of people living in somewhat close association, and usually under common rules. Community is a general term, and town is often loosely applied. A commonly accepted set of connotations envisages hamlet as a small group, village as a somewhat larger one, town still larger, and city as very large. Size is, however, not the true basis of differentiation, but properly sets off only hamlet. Incorporation, or the absence of it, and the type of government determine the classification of the others. 8. similarity, likeness.

health– noun
1. the general condition of the body or mind with reference to soundness and vigor: good health; poor health.
2. soundness of body or mind; freedom from disease or ailment: to have one’s health; to lose one’s health.
3. a polite or complimentary wish for a person’s health, happiness, etc., esp. as a toast: We drank a health to our guest of honor.
4. vigor; vitality: economic health.
—Synonyms 2. vigor, vitality, strength, fitness, stamina.

well·ness– noun
1. the quality or state of being healthy in body and mind, esp. as the result of deliberate effort.
2. an approach to healthcare that emphasizes preventing illness and prolonging life, as opposed to emphasizing treating diseases.

To answer the question or to even to explore the question what constitutes a healthy community, one must first distinguish that as individuals we not always a part of just one community; we are part of several. As a young Caucasian male my school, home, workplace they are all separate communities to which I belong. All these different communities have differences in beliefs that affect my individual thoughts and philosophies. As I would imagine a first nation individual might have a similar network of communities that effects their answer to this particular question. Or is a community just a group of people living in a particular area as some definitions express? is there a common thread of beliefs or is it just location that makes a community, because I am sure I have many differences with lots of people in my urban community.