Test 2 Flashcards
What are the three G’s of colonialism from the age of discovery?
God, gold, glory
When were the first and second waves of colonialism historically? What is each wave called?
First wave - Age of discovery in the 15th century; colonization of North and South America
Second wave - Scramble for Africa in the 19th century; divided up Africa
Define internalization of oppression
Structure that allows for the maintenance and ongoing oppression to occur
Define neocolonialism
the use of economic, political, cultural, or other pressures to control or influence other countries, especially former dependencies.
Countries may not use physical force or conquer land, but they use other structural forms like economics or politics to exploit another country
List five health disparities that Indigenous people experience
- Lower life expectancy
- Higher infant and child mortality
- Higher maternal mortality
- Higher rates of infectious diseases
- Higher rates of substance abuse and depression
How are TB and HIV related?
TB is a leading killer of HIV-positive people.
HIV increases the likelihood of progressing from latent to active TB and TB infection increases the likelihood of HIV progressing to AIDS
Often, individuals who have TB will also have HIV
What percentage of individuals have access to ARV drugs?
Only 40%
What is the UNAIDS 90-90-90
Wanted 90% to know their status
90% to receive treatment
90% have a low viral count
How was TB introduced in Canada?
Introduced to indigenous people through colonization
Is TB higher in Indigenous populations in Canada?
In Canada incidence rates are 41 times higher in Indigenous populations when compared to non-Indigenous Canadian born people
Over-crowding is one of the predominant reasons why it is so prevalent in Inuit
In addition, the remote nature of the community restricts access to services
What happened with BCG vaccines and medical experimentation?
Indigenous people in North America were experimented on to determine BCG efficacy in the 1930s and 40s
Community members were not informed that they were participating in a trial
Vaccine used for TB and used amongst indigenous people
Used without complete informed consent and used to treat/determine effectiveness of TB
How well is Canada meeting 90-90-90 for HIV?
87% know they are positive
85% are treated
94% have a low viral count
Is HIV higher amongst Indigenous populations?
Yes
What are the 6 structural determinants of health related to HIV?
Colonialism, globalization, migration, access to health care, poverty, and self-determination
What is UNDRIP?
Defined the individual and collective rights of Indigenous peoples to their ownership rights to cultural and ceremonial expression, identity, language, employment, health, education, and other issues.
Emphasized the right to self-determination
A human rights document
What group experiences the impacts of climate change first? How does this worsen issues for them?
Indigenous peoples
Climate change will make the problems that already exist in Indigenous communities worse
What are the four Rs of the indigenous holistic framework
- Respect - Respecting all who live on the planet
- Relevance - Developing a relationship with nature that has personal meaning
- Reciprocity - Replenishing what we take from Mother Earth
- Being a steward for the Earth and the 7 generations to come
How can indigenous groups help find climate change solutions?
Being key to informing how to create change to ameliorate the problem
Indigenous knowledge systems can inform climate change adaptation in three ways - social, structural, and institutional adaptation
Define social adaptation for indigenous climate solutions
weather forecasting, farming activities, water conservation and irrigation processes, soil improvement practices, social cohesion, communal pooling, resource preservation
Define structural adaptation for indigenous climate solutions
Cultivation, housing, and ecosystem-based strategies
Define institutional adaptation for indigenous climate solutions
agricultural strategies, trading strategies
Are there similarities between colonialism, globalization, and global nursing work?
Yes, global health nursing has occurred in parallel to globalization
Similarities between colonialism, globalization and global nursing work
Nursing work has the capacity to unduly influence beneficiaries of international work into abandoning their own beliefs to secure material benefits
How have nurses historically played a role in imposing colonialism in Indigenous peoples?
nurses were on the frontlines of imposing the settler colonial agenda on Indigenous peoples and have been active contributors to the structural violence inflicted on Indigenous peoples.
Such examples, include residential schools and sterilization rooted in Christian views
How to Florence Nightingale perpetuate colonialism?
Counselled many political figures and was a strong supporter of British colonialism.
She believe that Indigenous lives were a small price to pay for the expansion of the British Empire
She concluded that the high rates of death of Indigenous people in colonial schools and hospitals reflected the hast of British authorities to assimilate them
What is cultural imperialism in healthcare?
Providing care or services in such a way that it forces potential recipients of those services to choose between accessing the care being offered that would be unavailable otherwise that violates traditional norms and practices, or not receiving assistance
Often, care that is available is often misaligned with culture or values
Therefore, individuals have to either accept care that does not align with beliefs/culture or not receive care at all
Has roots in the colonial era, when Western nations set out to conquer and rule territories in North America, Asia and Africa for the dual purpose of exploiting their national resources and “civilizing” their inhabitants
What are the three key features of cultural imperialism in health care?
- Imperialists intent to both dominate and reform the cultural beliefs and practices of another people
- Imperialists feel they are entitled to do so because they believe Western culture is superior
- Imperialists carry about their task coercively, with the aid of significant economic and military resources
Define necropolitics as outlined by Larocque
Living in a space between life and death
Populations are in a dying state
Communities are in a space of being not quite living and not quite dead (Not living life to the fullest)
Structural violence, oppression, etc. play into this state
Define necropower as discussed by Larocque
the struggle against death
Always facing death (i.e., using substances to cope and knowing that any next use could be death)
How do nurses participate in necropower? As discussed by Larocque
Embeddedness in colonialism and colonial processes is foundational to the pervasive racism
in healthcare and nursing
Perpetuating the biomedical model, ‘frequent flyer’, etc.
What are six ways that Canadian health care sustains colonization?
- Designing and delivering services that are focused on micro, individualistic and eurocentric perspectives on the SDH;
- Denying and minimizing Indigenous ways of healing;
- Racism at point-of-care;
- Failing to make cultural safety a national, policy-based priority in health and human services
- Failing to develop national standards for embedding cultural safety in the educational curriculums of health professional education programs, and
- Failure of health-related professional licensing bodies to systematically integrate cultural safety in their professional codes of ethics, so that practice licenses are tethered to cultural safety competence.
Define a humanitarian crisis
A humanitarian crisis is defined as a singular event or a series of events that are threatening in terms of health, safety or well-being of a community or large group of people.
Can be either natural or man-made disasters
What are six implications of humanitarian crises/complex emergencies?
- Extensive violence and loss of life
- Displacements of populations
- Widespread damage to societies and economies
- The need for large-scale, multi-faceted humanitarian assistance
- The hindrance or prevention of humanitarian assistance by political and military constraints
- Significant security risks for humanitarian relief workers in some areas
Define humanitarian aid
Intended to save lives, alleviate suffering and maintain human dignity during and after man-made crises and disasters caused by natural hazards, as well as to prevent and strengthen preparedness for when such situations occur
Short-term and focused on maximizing lives saved
What three organizations are involved in humanitarian aid?
Multilateral organizations - UN, WHO
Bilateral organizations - Global Affairs Canada
NGOs
Out of all the organizations involved in humanitarian aid, which is the most involved?
A large portion of humanitarian aid provided is done through NGOs
What is a critique of humanitarian aid?
It is often very short-term and does not focus on sustainable development; only provides short-term protection/assistance
How do natural disasters affect water?
Often, natural disasters lead to compromised water and sanitation systems, which leads to significant health impacts (i.e., cholera)
How has the number of war deaths changed?
Seen a decrease in war deaths since WWII, but we see increased conflict now
What are five general health implications of armed conflict?
- Violence (wounds, injuries, sexual violence)
- Death/grieving
- Anxiety, psychological trauma
- Child soldiers
- Destruction of infrastructure (roads, public transport, clean water supplies, etc.)
List the 3 types of displacement
Internal displacement, asylum seekers, and refugees
Define internal displacement
An individual who has been forced or obliged to flee from their home or place of habitual residence in particular, as a result of or in order to avoid the effects of armed conflicts, situations of generalized violence, violations of human rights, or natural/human-made disasters, and who have not crossed an internationally recognized state border
Define asylum seekers
An individual who is seeking international protection. In countries with individualized procedures, an asylum-seeker is someone whose claim has not yet been finally decided on by the country in which the claim is submitted. Not every asylum-seeker will ultimately be recognized as a refugee, but every refugee was initially an asylum-seeker.
Define refugees
A person who meets the eligibility criteria under the applicable refugee definition, as provided for by international or regional instruments, under UNHCR’s mandate, and/or in national legislation
Define the triple burden of disease
Increases in malnutrition, dehydration, diarrhea, communicable diseases (cholera, measles, typhoid)
Non-communicable diseases
Mental illness- loss, disassociation, flashbacks, anxiety, depression, PTSD
What does the triple burden of disease arise from?
Displacement
List the 4 humanitarian principles
- Humanity
- Impartiality
- Neutrality
- Independence
Define the humanitarian principle of humanity
Human suffering must be addressed wherever it is found. The purpose of humanitarian action is to protect life and health and ensure respect for human beings.
Try and do the greatest good for the most people we can and providing care based on need alone
Addressing suffering and triage
Define the humanitarian principle of impartiality
Humanitarian action must be carried out on the basis of need alone, giving priority to the most urgent cases of distress and making no distinctions on the basis of nationality, race, gender, religious belief, class or political opinions.
Regardless of who you are, what side of conflict you are on, the people with greatest need will be treated
Define the humanitarian principle of neutrality
Humanitarian actors must not take sides in hostilities or engage in controversies of a political, racial, religious or ideological nature.
NGOs and humanitarian providers cannot pick sides and must be neutral
Define the humanitarian principle of independence
Humanitarian action must be autonomous from the political, economic, military or other objectives that any actor may hold with regard to areas where humanitarian action is being implemented
Organizations should not be backed by a particular government
NGOs should be acting independently from any government
What are two primary risks of humanitarian crises to nurses?
- Physical danger - The need for humanitarian nursing is often greatest in dangerous locations, including war zones, refugee camps, and remote locations with few resources.
- Psychological stress - The stress of emergency conditions can place humanitarian nurses at risk for burnout, and exposure to suffering can lead to depression.
Define an emergency
Emergency - Any situation, whether imminent or one that is already in progress, that requires a rapid and skilled response to protect the health, safety, and wellness of individuals and to limit damage to property or the environment and that can be managed by a community’s existing resources
Define a disaster
The outcome of a natural event or a result of human action or error, whether malicious or unintentional, that negatively affects society or the environment and exceeds the capacity of the community to response with existing resources
Describe the difference between an emergency and a disaster
Emergencies can be managed by a community’s existing resources
Disasters exceed the capacity of the community to response with existing resources
What are the 5 types of disasters?
- Natural
- Epidemic/Pandemic
- Man-made
- Conflict/complex crisis
- Technological
Why have the number of recorded natural disasters from 1900 to 2023 gone up?
Largely reflects increases in data reporting
We can’t assume that disasters were zero back in the 1900s, but the ability to report and track them was not significant or viable
Where is the first climate change famine currently happening?
Madagascar - high dependence on rain for crops and experiencing a longstanding drought
What are the 5 groups of people considered as vulnerable populations in natural disasters?
- Children/youth
- Women
- Older adults
- Mentally ill
- Cultural and ethnic groups (Significant language and cultural differences may cause barriers or challenges)
How are inequities and disasters related?
Inequities exacerbate consequences during times of disasters… And disasters exacerbate inequities
Due to - social exclusion,
disruption of health services, breakdown of social supports,
physical barriers,
inaccessible information,
access to resources, etc
Discuss ebola, factors related to its outbreak in Liberia
They believe that Ebola comes from planetary health challenges
Zoonotic disease spread person to person through contact with blood and body fluids of an infected person.
Caused by poor local surveillance systems,
poor public health infrastructure, globalization/Urbanization, deforestation, and cultural and traditional practices (traditional open funerals, unprotected contact, eating specific animals)
What are six potential health effects of disasters?
Immediate Effects
Short term effects
Long term effects
The Social Determinants of Health
Vulnerable populations
Environmental Damage
What are the four stages of the disaster management continuum?
- Mitigation
- Preparedness
- Response
- Recovery
What is the goal of the disaster management continuum?
save lives, preserve the environment, and protect Property and the economy”
Define the mitigation/prevention stage of the continuum
To eliminate or reduce the impact or consequences of disasters.
Involved anticipation of the risk and the potential outcomes and measures are put into place before the disaster to minimize or limit the effect.
(e.g. flood mapping, building codes, material usage, land-use planning, insurance incentives, dyke construction)
What are 7 nursing roles in mitigation stage?
- Identifying risks (for individuals and communities)
- Community needs assessments
- Helping to shape public policy
- Be aware of (and inform) vulnerable persons
- Organizing and collaborating with community partners
- Addressing environmental hazards
- Mass prophylaxis campaigns
Define the preparedness stage
To be prepared ahead of time and to be ready to respond and manage situations when disaster does strike. Ideally, response has been planned and practiced so that it becomes automatic.
i.e., Practicing mass casualty simulations is both mitigation and preparedness
List 11 nursing roles in preparedness
- Personal/family plan (i.e. disaster kits)
- Assist in the creation of emergency and response plans for self/home/hospital/community
- Understanding of emergency/disaster plans in community and workplace
- Response training
- Capacity-building
- Leadership roles
- Promotion of, and compliance with, emergency operations plan testing
- Knowledge of PPE
- Plans should be simple, clear, and realistic
- Develop trust and credibility within the community
- Identify and educate vulnerable populations
Define the response stage
To act during or immediately before or after a disaster to manage its consequences through such things as emergency communication, search and rescue, triage, evacuation, etc. Focused mainly on mobilizing responders to offer relief.
How will children often react to disasters?
Regressive behaviours (bedwetting, thumb-sucking, crying, clinging to parents)
Fantasies that disasters didn’t occur
Nightmares
School-related problems, including inability to concentrate and refusal to go back to school
List 10 nursing roles in the response stage
- Providing physical care
- Providing mental care
- Management of scarce resources
- Coordinating care
- Identifying critical needs
- Monitoring of survivors for mental health implications
- Advocacy of survivors and families
- Training of volunteers
- Ongoing identification of patterns of illness and diseases (collect data for analysis)
- Facilitate effective communication