ch 4 First Nations Health

Question 1

how manyd ifferent nations are there in canada and how are they divided up in terms of their leadership. is this helpful or no

Answer 1

• Are 634 First Nations in Canada, great diversity
• Further divided into tribal councils, which provide unity and greater political power as well as combined resources amoung nations

Question 2

what 3 overall groups are included in “aboriginal” in canada and how many language families are there

Answer 2

• Aboriginal = metis, inuit + first nations  of these originate from 11 language families

Question 3

why are indians called that

Answer 3

• Term Indian regers to early explorers of N.A. who thought they had discovered India

Question 4

what was the intention of the indian act of 1876 and what did it outline
Does this act still exist today
how were indians kept track of bureaucratically

Answer 4

o Designed to administer programs to “Indians” for the purpose of assimilating them into Canadian society
o Determined who was legally defined as an Indian
o Many amendments since
o Each Indian has registration number to reflect her or his population number within her or his and or First Nations community

Question 5

what does it mean to have treaty indian status?
what treaties are they referring to?
were these rights standardized?

Answer 5

• Treaty Indian Status = persons who belong to a First Nation that signed a treaty with the Crown
o Treaties negotiated before + after Confederation in 1867
o Gives rights and benefits to Treaty First Nations (ex: ownerships of land, wildlife harvesting rights, participation in land, wildlife + enviro management, financial payments, resource revenue sharing, self-government, etc)
o Rights vary between nations

Question 6

within treaty indian status what did FN leadership gain thru the traty process

Answer 6

guaranteed the right to be born and live as First Nations people

Question 7

how was the indigenous peoples connection tot he land seen by colonizers

Answer 7

• Indigenous people’s connection to land used as ‘expression of primitiveness’

Question 8

according to this book relationships between the FN and French and after British was
A: immediately confrontational and aggressive
B: started respectfuly on both sides

Answer 8

o Unlike US, initial relationship between FN and French (then British) was one of mutual tolerance and respect, each thought of other as distinct and autonomous – this reflected how FN already related to one another

Question 9

did the colonizers immediately try and govern FN internal affairs

Answer 9

according to this book they didnt

Question 10

what did the roryal proclamation of 1763 lay out and who did it involve

Answer 10

o Cooperation reflected in Royal Proclamation of 1763: partnership bt FN and British Crown –> in exchange for cooperation in partnership, king of England extended royal protection to FN lands + political autonomy

Question 11

what was the intention of the indain act

Answer 11

o The Indian Act was the legislative vehicle for implementing policies to civilize, protect, and assimilate the Indian people (PROTECT??!!)

Question 12

what single event marked the start of colonization

Answer 12

o No single event marked the beginning of colonization… the attitudes of the time laid a foundation

Question 13

the indian act gave rise to reserve system. what was the intention with this

Answer 13

“social laboratory designed to enable FN communities to adopt European Values – isolated, fixed locations where they could be converted to Christianisy, educated, and transformed into farmers

Question 14

what was the assumption/intentions in relation to the reserve system

Answer 14

“social laboratory designed to enable FN communities to adopt European Values – isolated, fixed locations where they could be converted to Christianisy, educated, and transformed into farmers

Question 15

what does it mean for a FN person to become enfranchised

Answer 15

(legal process for terminating a person’s Indian status and conferring full Canadian citizenship)

Question 16

what were the requirements for FN to becoem enfranchised

Answer 16

person needed to be educated, free from debt, and of good moral character. If fit criteria, was awarded 20 hectares land and “accompanying rights” as citizen (including right to vote).

Question 17

what act put FN and the land reserved for them under federal authority

Answer 17

the British North America Act of 1967

Question 18

under the amended indian act how was the status of reserved lands eroded

Answer 18

• 1984 reserve land owned by disabled, widows, orphans or others who could not cultivate it taken away + leased to European settlers
• 1918: only tracts of reserve land being cultivated by FN could remain in their power – occurred in violation of treaty agreements

Question 19

how much control did FN have over their elections

once elected was their leadership safe and how restricted was the leader

Answer 19

• Superintendent of Indian Affairs determined when, where, and manner in which
• Governor could remove chief or counsilor from office if thought leader was dishonest, intemperate or immoral elections took place
• Nature of concerned in which chief + council would make decisions was preset + all decisions were subject to confirmation by the governor

basically everything was controlled

Question 20

how did the indian act suppress FN tradtions and values

Answer 20

• Laws enacted to ban all traditional ceremonies + control Indian movement from one reserve to another
• Thought intertribal gatherings were primary obstacles to Indian people becoming Christians  1885 Indian people prohibited from travelling off reserve w/o written authorization of Indian agent on the reserve
• Potlatch + traditional dance prohibited

Question 21

how much different are the present healthcare and govt systems in terms of what theyre founded on

Answer 21

• Present healthcare + gov’t systems exist on foundation of protection, civilization, and assimilation – reflects colonial system

Question 22

around what time did the cultural resurence begin in which FN demanded right to set own cultural course and what happened

Answer 22

around 1951-1960s
• In 1960s, FN demnde right to set own cultural course
…now began task of developing political organizations or strengthen + improve situation of FN people

Question 23

were female FN able to be enfranchised

Answer 23

arbitrary enfranchisement to Indian woman who married someone not registered as Indian. Within a family unit, women’s status as band members could cease demanding on whom the female siblings married.

Question 24

was the white paper beneficial or harmful to FN and how did it change FN relationship to govt

Answer 24

• FN response to White Paper (Canadian gov’t policy that attempted to abolish all FN rights in 1969) changed nature of relationship of FN + gov’t

Question 25

what was the purpose of the Truth and Reconciliation COmmitsion of Canada

when did the rpime minister apologize

Answer 25

• Established 2008 to make impact of residential schools known and “guide a process of reconciliation between and with Aboriginal families, communities, churches, government + Canadians

june 2008

Question 26

wht does MIYUPIMAATISSIUM mean

Answer 26

being alive well

• Seen as interdependent relationship people have with the natural world and with keeping one’s spirit strong
• Culture, language, and traditions used to exprews concepts similar to that of being alive well vary from across FNs

Question 27

what can miyupimaatissium be rooted in

what can be seen as the ource of life according to this view

Answer 27

• Natural world is viewed as source of life + extends view of health beyond the biomedical or social lens + recognizes connections b/t ecosystems, equity + health

Question 28

what does it mean that the fed govt has fiduciary relationship with FN

do they acknowledge this relationship

Answer 28

• Fiduciary= a person to whom property or power is entrusted for the benefit of another.
• Fed gov’t recognizes the existence of fiduciary relationship and that fiduciary obligations are owing to FN peoples…but the nature of scope of this relationship and political, legal and financial mplcaitions have been great source of debate among FN, the Crown and court
• Fed Gov’t takes position that the provision of health services to FN is done as matter of policy only and not b/c of any fiduciary obligation or treaty right

Question 29

what problem spurred an interest in FN healt

Answer 29

• Concern with FN health really only came about with threat of TB epidemics spreading to general Canadian pop

Question 30

which HCPserved as the intro to western model of healthcare fro FN and which HCP continues to be the communities/ main point of contact w healthcare

Answer 30

nurses

Question 31

what % of nurses are employed by First Nation Council (band)

Answer 31

50%

Question 32

what ar the 3 pillars of the federal Indian Health Policy, a policy which was created in response to anger that the govt was trying to dec noninsured health benefits

Answer 32

1) Community devel is key strategy for improving FN health
2) The continuing special responsibility of fed gov’t for the health + well being of FN people
3) Essential contributions of all elements of the Canadian healthcare system including (but not limited to) to feder, prov/terr, municipal, FN jurisdictions

Question 33

• Under Indian Health Policy, fed gov’t made commitmen to greater participation of FNs in planning + delivering care but were there stipulations to this

Answer 33

yes the FN had to “prove” to the govt that they could manage their own affairs

Question 34

what was controversial about this indian health policy

Answer 34

some thought was just way for gov’t to reduce expenditures for this population (a violation of treaty rights and + fiduciary relationship) + did not represent positive departure from past or fundamental change in positon of fed gov’t regarding FN healthcare.

Fed Gov’t continued to refuse legal responsibility for FN health + this policy was ultimately an attempt to transfer responsibility to prov gov’ts. (Seen as similar to White Paper, which attempted to terminate Indian “status” and turn over program admin to provinces”

Question 35

are the majority of FN communities involved in getting control and administrative responsibility for their healthcare

Answer 35

yes 80% are taking responsibility for healthcare services through multi-community agencies or tribal associations

Question 36

if the community is self-gverning then who employs the healthcare personnel

Answer 36

the community duh

Question 37

• The key to restoring well-being among FN people originates from within FN cultures + proposed that enw Aboirignla health + healing systems embody these 4 essential elements:

what additional qualit is integral to dev of community healthcare systems

Answer 37

1) Pursuit of equity in access to health + health outcomes
2) Holism in approaches to problems and their treatment + prevention
3) Aboriginal authority over health systems and, where feasible, community control over services
4) Diversity in the design of systems and services to accommodate differences in culture + community realities

self-determination

Question 38

what are the 3 primary barriers faced by FN comunities in healthcare delivery

Answer 38

1) Recruiting and retaining nursing staff
2) Jurisdictional roles + responsibilities
3) Emphasis on curative services + physical health – not holistic care, or culturally based health programming

Question 39

why o FN communities have trouble recruiting and retaining nursing staff

Answer 39

Transfer agreements contain “non-enrichment clauses” that result in funding being based on expenditures the year before entering into the agreement…get locked into this level of funding and can’t keep up with salary + recruitment incentives offered to HC professionals who work under fed or provincial funds

Question 40

is it just feds who are responsible for healthcare to Fn

what is te result

Answer 40

b. Under Canada Health Act, prov gov’t required to provide equal access to healthcare for all people in province, including FN…but federal government also has responsibility for certain services for status Indians  results in fragmentation, service gaps, etc

Question 41

what level of approach can be used to address inequity eg individual, population

Answer 41

population health approach

Question 42

what are the demographic of Fn

Answer 42

FN communities are growing quickly and more youthful propotionally but ths pop will age w declining fertility rates and inc life expectancy

Question 43

what issues (3) do nurses identify when administration of healthcare is transferred to FN community for nursing service delivery

Answer 43

o Some feel they do not have respect of the community
o The retention of nurses depends on the quality of the practice enviro
o In many communities, the nurse’s ability to create linkages is necessary in order to facilitate client access for health services

Question 44

what qualities and approaches should nurse working with Fn use

Answer 44

strengths based approach
use postcolonialism
cultural competence

Question 45

what is a potential flaw with cultural cometence

Answer 45

o Cultural competency may overlook colonialism, and this very necessary for fostering the type of relationship the client may need to improve health