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EIGHTEEN

Native Population

The present ‘health’ care system appears incapable of dealing with the ever-increasing symptoms of social breakdown within Indian communities. To live a life that is totally out of one’s own control is a source of constant stress, and eventually leads to demoralization of an entire population. The Indian people have been forced into coerced dependence upon paternalistic and ever-shifting federal policy, and denied means of gaining a livelihood, and this situation now results in the manifestations of social ill health now seen: alcohol and drug abuse, family breakdowns, suicides, accidents and violent deaths.”

“Alcohol and drug abuse is the number one health problem our people face. Like all diseases, it is a symptom of more deep-rooted problems within our communities. It is a major cause of physical and mental disability, affecting all age groups.”

“The solution will come in seeking out and recognizing the social economic, occupational, environmental, nutritional, and spiritual causes of disease, and to become directly involved in the eradication of these causes. The solution will come in educating people how to stay will and healthy, and therefore, now to prevent disease and disability.”

114

ESTABLISH NATIONAL ADVISORY BODY ON COMMUNITY SERVICES FOR DISABLED INDIAN PERSONS

RECOMMENDATION:

That the Federal Government direct the Department of Indian Affairs and Northern Development to provide financial and technical assistance for the establishment of a national advisory body on community services affecting disabled Indian people, similar in concept and format to the National Commission Inquiry on Indian Health.

Past Failure: Too often the Federal Government has created policies and programs affecting the lives of Indians without consulting first with the representatives of these people. This has resulted in ineffective programs, lowered morale among Indian communities, and strained relations between Indians and the Federal Government. It is crucial, therefore, that all matters related to services for disabled Indians be subject to prior consultation, within a formal advisory mechanism.

Success: Consultation works when it is formalized. In 1978, the National Commission Inquiry on Indian Health was established. This body now serves as a forum through which seventeen provincial and territorial Indian organizations express their views on health policies and programs of the Federal Government. A similar advisory body should now be established to deal with services provided to disabled Indians.

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Too often the Federal Government has created policies and programs affecting the lives of Indians without consulting first with the representatives of these people. This has resulted in ineffective programs, lowered morale among Indian communities, and strained relations between Indians and the Federal Government.

115

EXPAND THE ROLE OF FRIENDSHIP CENTRES FOR DISABLED NATIVE PEOPLE

RECOMMENDATION:

That the Federal Government expand the role of Friendship Centres to include an urban-based referral program providing liaison and assistance to migrant Natives who are disabled.

On the Move: Unemployment among Native people runs between 35% and 75% of the Native work force, depending on the locale and the time of year. Many Native people, therefore, are forced to move frequently, or continually, from one urban centre to another looking for work. Among these transient or migrating people are disabled persons who require treatment and assistance in order to be able to function at all.

Barriers: A number of barriers prevent disabled Natives from receiving the help they need. Language barriers prevent information on available services from reaching the disabled person. Cultural barriers prevent disabled persons from accepting "outside help" from non-Native people. Distance barriers prevent access to the limited number of centres where these services are provided.

“Friendship Centres”: Native people trust and make use of information which comes from their own people. Information about Government services to disabled people, therefore, must be channeled through organizations which Native people operate for themselves. Such organizations already exist in the form of "Friendship Centres" in several Canadian towns and cities. A Friendship Centre is a facility, governed by Native people in an urban centre, which provides vital information to other Native persons who are newly arrived or passing through. These Centres should be expanded in number and in the scope of information they provide. A leading participant in this endeavour should be the Native Council of Canada. Their recently completed health project, mandate and operational experiences are grounds upon which this recommendation can be developed.

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116

CONSIDER TRANSFER OF HEALTH SERVICES TO DEPARTMENT OF INDIAN AFFAIRS

RECOMMENDATION:

That the Federal Government determine the feasibility of transferring Indian Health Services from the Department of National Health and Welfare to the Department of Indian Affairs and Northern Development, and determine the direct and indirect advantages of such a transfer to the Indian and Inuit people who are disabled.

Confused: Indian and Inuit people do not understand or appreciate the concept of different government departments. Their own communities are small and unified, and the notion of huge, separate bureaucracies is foreign to their traditions and daily experience. They become confused by a situation in which it takes several major organizations to provide several minor services. They become discouraged when poor coordination among these organizations means that promised services are not delivered, or are delivered badly.

Familiar: The Department of Indian Affairs and Northern Development has a special relationship to Indian and Inuit people. It provides a broad spectrum of programs directly affecting the health and lifestyles of disabled Indian and Inuit people. Indian leaders are unanimous in calling for Indian Health Services to be returned to the Department of Indian Affairs and Northern Development. They believe that nothing short of this transfer will effectively improve community services to disabled Indians.

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Indian and Inuit people do not understand or appreciate the concept of different government departments. Their own communities are small and unified, and the notion of huge, separate bureaucracies is foreign to their traditions and daily experience. They become confused by a situation in which it takes several major organizations to provide several minor services.

117

ESTABLISH DATA ON PROBLEMS OF DISABLED INDIAN AND INUIT PEOPLE

RECOMMENDATION:

That the Federal Government direct the Department of Indian Affairs and Northern Development to undertake community-based surveys to supplement program data presently available regarding the extent and nature of problems facing disabled Indian and Inuit peoples.

Ignorance: Little is known about the unique needs of disabled Indian and Inuit peoples in Canada. National figures on frequency and types of disabling conditions among Indian/ Inuit populations are lacking.

Big Problems: Everyday experience, however, indicates that disability is a much bigger problem among these people than among other Canadians. New services and assistance are badly needed, but without proper data, it is difficult to deliver help in an effective manner. At the same time, special care must be taken in the way that information is gathered. Indians and Inuit are naturally reluctant to answer questions about themselves unless they can be sure that the resulting information will be used for their benefit.

Existing Routes: Data-collection must involve researchers who are Indian and Inuit themselves. At the present time, two Departments-National Health and Welfare and Indian Affairs and Northern Development-have some data on hand. Although this information is incomplete, with the help of Indian and Inuit organizations, it can be used as a starting point for a comprehensive data bank..

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The life expectancy for Indians is less than that of non-Indian Canadians. Indian babies die at twice the national rate. Those who survive the ravages of pneumonia, bronchitis and parasitic diseases frequently suffer from malnutrition, unhealthy living conditions and family breaddown. Sickness and despair result from living in overcrowded housing, with no running water, no sewage or regular garbage disposal, and totally inadequate heating systems.

118

EXPAND HEALTH PROFESSION OPPORTUNITIES FOR NATIVE PERSONS

RECOMMENDATION:

That the Federal Government direct the Department of Indian Affairs and Northern Development, and the Department of National Health and Welfare to expand Native career development plans in order to attract Native people to the health professions and, in particular, to the fields of health education and promotion.

Conditions: The life expectancy for Indians is less than that of non-Indian Canadians. Indian babies die at twice the national rate. Those who survive the ravages of pneumonia, bronchitis and parasitic diseases frequently suffer from malnutrition, unhealthy living conditions and family breakdown.

Sickness and despair result from living in overcrowded housing, with no running water, no sewage or regular garbage disposal, and totally inadequate heating systems.

Prevention: The easiest disability to care for is one which does not occur in the first place. Many disabilities among Native populations could be prevented as a result of widespread health education. This education can only occur in an environment which incorporates the language, customs and lifestyles of Indian, Metis and Inuit people The instructors must be Native themselves.

Breakthrough: The biggest breakthrough in providing health services to Native people will come when significant numbers of Native people become professional health workers. This is the only route by which the most serious problems of disease and sickness can be solved.

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Good intentions and technical expertise are not enough for dealing effectively with Native people on a personal basis. An understanding of the history, values and perceptions of Native groups is needed by all public servants who work with them. Unfortunately, orientation programs are often treated as a luxury rather than as an integral part of staff training.

119

EDUCATE PUBLIC SERVANTS ON NEEDS OF DISABLED NATIVE PEOPLE

RECOMMENDATION:

That the Federal Government, in cooperation with Native organizations, give a higher priority to the provision of orientation programs for public servants involved in the delivery of services affecting disabled Native persons.

Down The Drain: A government service is counterproductive if it is not accepted by the people for whom it is intended. Many well-intentioned Federal Government programs for Native persons have gone down the drain because they did not relate to the culture and history of these people.

Knowledge Essential: Good intentions and technical expertise are not enough for dealing effectively with Native people on a personal basis.

An understanding of the history, values and perceptions of Native groups is needed by all public servants who work with them. Unfortunately, orientation programs are often treated as a luxury rather than as an integral part of staff training. The Committee recommends that "cultural orientation" become an essential element of management career development in all Government organizations which provide services to Native people.

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120

ESTABLISH SPECIAL LIAISON AND RESEARCH OFFICE DEALING WITH NEEDS OF DISABLED NATIVE PEOPLE

RECOMMENDATION:

That the Federal Government instruct the Department of the Secretary of State through its Native Program to facilitate research and liaison through a special office relating to the needs of disabled Native people.

Little Feedback: Many Government Departments and private agencies administer programs which affect the lives of disabled Native people. Few of these programs are based on accurate feedback from the communities they serve. There is no organization which ensures that the positions and needs of Native people are considered. It is not surprising that these programs often miss the mark.

Keep in Touch: The Committee recommends that a Federal Office be established which keeps Government and private service organizations in touch with the status and needs of Native disabled persons.

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Many Government Departments and private agencies administer programs which affect the lives of disabled Native people. Few of these programs are based on accurate feedback from the communities they serve. There is no organization which ensures that the positions and needs of Native people are considered. It is not surprising that these programs often miss the mark.

121

APPOINT NATIVE REPRESENTATIVE TO INTERNATIONAL YEAR COMMITTEE

RECOMMENDATION:

That the Federal Government appoint a representative of Native peoples to the Canadian Organizing Committee for the International Year of Disabled Persons.

Special Concern: Among all Canadians, the problems of disability are worst among Native peoples. Any Canadian participation in the International Year of Disabled Persons must consciously reflect this fact. The Committee recommends that a representative of Native Peoples be appointed immediately to the Canadian Organizing Committee for the International Year.

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122

INCREASE FINANCIAL SUPPORT FOR NATIONAL NATIVE ALCOHOL ABUSE

PROGRAM

RECOMMENDATION:

That the Federal Government direct the Department of Indian Affairs and Northern Development, and the Department of National Health and Welfare, to substantially increase their financial support for the National Native Alcohol Abuse Program and to ensure that the evaluation mechanism for the program involves members of those communities for which the program is intended.

Terrible Problem: Native leaders agree that their most critical community problems result from alcohol abuse. Fully one-third of all deaths among Status Indians and Inuit are alcohol-related, while over 60% of the Indian "children in care" arrive in that situation as a direct result of alcohol abuse. Total costs attributable to Indian and Inuit alcohol abuse approach $150 million per year. The social costs are inestimable. This is the harsh reality which so many non-Native people cannot appreciate, and from which the disabled Native person cannot escape.

Deeper Causes: Alcohol abuse is only symptomatic of deeper problems in the Native community. The impact of modern Canadian society on the Canadian Native has been devastating. People have become dislocated from family and friends. Juvenile crime, child neglect, social tension and communicable diseases have become major social problems. Unfortunately, many Native people turn to alcohol as an escape from a grim future. Alcohol is a major and increasing cause of handicap and disability among Native people, especially among children who are born with fetal alcohol syndrome.

Hope: In 1975, the National Native Alcohol Abuse Program (NNAAP) was established to arrest and reverse the debilitating effects of alcohol abuse within Native communities. It responds to community initiatives with financial support for projects covering prevention, treatment and rehabilitative activities. Each project is developed in concert with members of the community being served.

Speed-Up: The results of this unique funding program have been encouraging. However, only 50% of the Indian on-reserve population, and a few Inuit and Metis communities, have been reached by NNAAP. There is a great need to speed up the program on a long-term basis, and to encourage provincial initiatives in the same field.

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123

ENSURE ACCESS TO REHABILITATION SERVICES FOR STATUS INDIANS

RECOMMENDATION:

That the Federal Government direct the Department of Indian Affairs and Northern Development, and the Department of National Health and Welfare in consultation with the Provinces and Status Indians and their associations, to develop a suitable mechanism to ensure that disabled Status Indians have access to a full range of rehabilitation services.

Federal Responsibility: Under the British North America Act, the Federal Government has direct responsibility for the affairs of Status Indians. In the matter of rehabilitation and vocational services for Status Indians who are disabled, however, Ottawa has relied until now upon the Provinces to provide the necessary services. There have been considerable disagreements and legal debates regarding the jurisdiction of the Federal and Provincial Governments, and in the payment for the services. As a result, the Status Indians have not received the services that they need. Two problems must, therefore, be solved. First, the Status Indians must be assured of rehabilitation and vocational services, regardless of the legal responsibility. Secondly, the ultimate responsibility and administration of these services should be decided by consulting all parties, especially Indian

people.

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Alcohol abuse is only symptomatic of deeper problems in the Native community. The impact of modern Canadian society on the Canadian Native has been devastating. People have become dislocated from family and friends. Juvenile crime, child neglect, social tension and communicable disease have become major social problems.