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Access to Health care on Aboriginal Reservations in Canada

Definition

Medicalization

Medicalization is a social process through which a human experience is culturally defined as pathological and treatable as a medical condition. (Merriam-Webster)

Indigeneity

Indigeneity is defined by the UN Working Group for Indigenous Peoples as: “(a) they are the descendants of groups, which were in the territory at the time when other groups of different cultures or ethnic origin arrived there; (b) …because of their isolation from…the country’s population they have almost preserved intact the customs and traditions of their ancestors which are similar to those characterized as indigenous; (c) they are…placed under a state structure which incorporates national, social and cultural characteristics alien to their own. (d) any individual who identified himself or herself as indigenous and was accepted by the group or the community as one of its members was to be regarded as an indigenous person” (UN/WGIP)

Overview of Aboriginal Peoples in Canada

Reservations in Canada

Reservations in Canada were created through colonial ideologies and government legislation that, “literately and figuratively, mapped Indigenous peoples out of British Columbia and onto Indian reserves” (Leeuw, Maurice, Holyk, Greenwood & Adam, 2012, 905). The creation of reservations has culminated in current tensions about everything from “jurisdictional privileges and laws, a lack of treaties, human rights violations, and unequal allocation of resources” (Leeuw, et. al, 2012, 904). Social determinants of health and intersectionality frameworks suggest that “social engineering, legislated disparities in access of services and resources, and forced colonial education have all directly and negatively impacted Indigenous peoples’ contemporary well-being” (Leeuw, et. al, 2012, 906).

Indian Act 1876

The federal 1876 Indian Act, produced classifications of “being” or “not being” Indian that are still relevant today by the institutionalizing marginalization of Indigenous peoples through legislation. Even today, Status Indians in British Columbia carry status cards to prove identity when accessing health services. (Leeuw, et. al, 2012, 905)

Health care on Reservations

Indigenous peoples in Canada “experience higher rates of morbidity, chronic illness, acute trauma from accidents and violence, suicide, addiction, mental health issues, unwanted teenage pregnancy, and exposure to high-risk environments” (Chambers, et. al, 105). The unequal and different treatment of First Nations people are entrenched in the structural foundations of Canada. The medical services provided by the federal government are designed to assimilate Indigenous people into the dominant society and services on-reserve are often underfunded (Chambers, et. al, 105). First Nations living on reserves in northern interior British Columbia are spatially and materially distant from services. According to Leeuw, et. al, “distances underpin a social distancing and a subsequent social construction and racialization of First Nations premised on imagined understandings of reserves as particular kinds of spaces, due to “uncommon ground,” or divisions between First Nations worldviews and biomedical models of health care” (Leeuw, et. al, 2012, 906). The federal government is responsible for those deemed to be "Indians" under the Indian Act, but provincial governments are responsible for health and social services, leaving a service gap for people on-reserve (Chambers, et. al, 105). “These health, economic, and social disparities have their origins in Canada's long history of settler colonialism, embodied in phenomena like the reserve system, the pass system, and residential schools” (Chambers, et. al, 104).

Women's Health care

Poor access to healthcare is especially difficult for intersectional beings, such as poor, Indigenous women (Stout & Harp, 2009, 47). For Indigenous women, this is particularly difficult due to the variety of healthcare needed, such as reproductive, maternal, etc. According to a study on the differences of pregnancy care and outcomes for on-reserve women, First Nations women with diabetes had less antenatal and post-partum care, and higher rates of preterm delivery, than non-First Nations women (Liu, et. al, 2012, 3). Due to the inability to receive adequate medical attention, Indigenous women die 5.2 years earlier than their non-Indigenous counterparts and status Indian women die over a year earlier than non-Indigenous men in the province (Chambers, et. al, 103). These poor health rates are explained through social determinants of health and intersectionality frameworks.

Men's Health care

Since 1992 Status Indian men maintained the lowest life expectancy of any group in the province, and die 7.4 years earlier than their non-indigenous counterparts. (Chambers, et. al, 103). STI and STDs such as Syphillus, Gonorrhea, etc. are more likely to affect Indigenous persons than non-Indigenous due to the difficulty to attain the proper health services and other preventative health measures (Douglas & Viliski, 2013,164).

Children's Health care

Child immunization rates on reserves are 20% lower than the general population, and access to health care is significantly lower than in urban areas. "Endemic malnutrition and poor access to health care cause many First Nations children to lose their lives or to live with chronic diseases more often than other Canadian children." (Chambers, et. al, 103) Infants born to First Nations women had higher birthweights, higher rates of jaundice, neonatal hypoglycaemia, and shoulder dystocia (Liu, et. al, 2012, 3).

Aboriginal Healing on Reserves

Medical Traditions in Aboriginal Cultures

Aboriginal medical systems are built upon coherent, rational understandings of the universe and people’s place within it, and saw disease as the product of both natural and supernatural occurrences. For example, while not having any knowledge of the existence of bacteria, they were aware of the need and means to reduce infection in wounds – many times using plant and herbal medicines to cure this. “Aboriginal terms of medicine actually refer to a much broader phenomenon than drugs or practice of healing” (Herring, et. al, 2000, 129). Many Aboriginal terms referred to a kind of “power”, something that was significant in the lives of people, difficult to fully comprehend, and that consequently required certain preventative actions to take place. Thus, many healers were also involved in religion (Herring, et. al, 2000, 130). This use of medical healing was and has been viewed as less than in comparison to Western medicine because of the predetermined marginalization of Indigenous culture and traditions.