First Nations Diabetes Programs
By Susan Judith Ship and Judi Jacobs
[Community- Based Programs]
[Second-Level Care and Treatment]
[Strengthening Social Supports]
[Healing the Spirit]
[Organizations]This article offers a range of interesting and innovative community programs and approaches in diabetes prevention, treatment and care, aimed primarily but not exclusively at elders. Programs are listed according to their focus - physical, mental-emotional, social and spiritual dimensions of diabetes.
Living Well … With Diabetes
Primary Prevention aims to reduce the risk or prevent the occurrence of Type 2 diabetes by promoting healthy lifestyles through individual, family and community-wide efforts. Developing and maintaining a healthy lifestyle and a healthy body weight by balancing healthy eating and active living, as well as regular screening for high-risk individuals and groups are major objectives. Here is a sample of innovative community-based programs.
Horticultural Learning and Resource Centre was set up by Iowne Anderson of Six Nations of the Grand River. She encourages community members to grow their own food through a seed exchange program.
Contact: (519) 445-2454.
Elders were involved in developing the Nuxalk Food and Nutrition Handbook, a community project aimed at promoting the benefits of traditional foods for nutrition and lifestyle. While special attention is given to traditional foods of the Nuxalk people of Bella Coola, there is much practical information such as gardening of traditional foods, safe food preservation, and good nutrition practices, that is valuable to all First Nations people.
Contact: (604) 799-5441.
The Health Blitz in the Algonquin community of Pikogan is an annual intergenerational event that was instituted in an effort to reduce the number of Type 2 diabetes cases. Activities promotes healthy weights, balanced eating and active living as well as providing group workshops and individual counselling for people diagnosed with diabetes.
Contact: (819) 732-9096.
The Union of Ontario Indians developed the AHNEE (A Healthy Native Eating Education) as a diabetes prevention program. AHNEE emphasizes weight reduction and healthy weight maintenance through exercise and balanced eating. AHNEE stresses the health and nutritional benefits of traditional foods and includes a recipe book. Elders of the communities involved were an important resource for this information.
Contact: (705) 657-9383.
Penny Williams, CHR and Seniors Fitness Instructor at Walpole Island, promotes healthier living through participation in the 100 Mile Club, which has been incorporated into their diabetes education programs. Many elders in the community are involved and serve as role models. Monthly mileage activities include walking, jogging, running, biking, swimming, wheelchair, stationary bike, treadmill and/or aerobics.
Contact: (519) 627-0765.
The Oneidas of Wisconsin have a Seniors Fitness Program. Michelle Mielke, a Seniors Fitness Instructor, has set up a one-to-one program emphasizing the development of gradual flexibility and strength training exercises, including weights, for elders confined to wheelchairs and those using walkers.
Contact: (920) 490-6870.
The Elders Program, an on-going series of workshops, sponsored by the Four Worlds Development Project at the University of Lethbridge, aims to improve the health and fitness of First Nations elders so they may become better role models and teachers in their communities. Elders live on campus, exercise daily and eat a special diet based on their own specific traditional foods. This program has been successful in assisting elders in losing weight and find new energy.
Contact: (403) 329-2184.
The Nokee Kwe Adult Education Centre in London has set up a health promotion program, using a wholistic and culturally appropriate approach. It emphasizes being physically active not simply as a means of reducing weight but also in building strength, traditionally valued by many First Nations cultures.
Contact: Mary Deleary (519) 667-7088.
Sioux Valley Diabetes Prevention Project - Fitness Program provides a diversity of recreational and physical activities for community members of all ages in order to prevent Type 2 diabetes and postpone complications. Activities include nutrition sessions, healthy baby programs, healthy weekend retreats, collective kitchen groups, shopping tours, and weight loss classes, in addition to fitness programs.
Elders played an important role in the development of the Kahnawake Schools Diabetes Prevention Project. This project provides Kahnawake children basic knowledge, skills and family and community support to engage in lifestyle changes that will prevent diabetes as they grow into adulthood.
Contact: Alex McComber or Rhonda Lynn Kirby (514) 635-4374.
Second-Level Care and Treatment
Early detection of Type 2 diabetes, effective intervention and care for elders with diabetes, as well as regular screening for complications, are goals of second level care and treatment for elders with diabetes. Here is a sample of community-based programs.The Pima of Gila River Indian Community in Arizona, where 50 per cent of the adult population has diabetes, have developed a multi-level community-based diabetes prevention and care program. Elders Services include a Well Elders Program, Home Health Care as well as Renal, Eye and Foot Clinics.
Contact: (520) 562-3311.
The Battleford Tribal Council Indian Health Services has set up a Lower Extremity Clinic for Diabetes to prevent foot complications and amputations by providing foot screening and care based on the LEAP program.
Contact: Joan Wentworth (306) 445-8876.
The Sto:lo Tribal Council Diabetes Education Program is a culturally sensitive program providing basic information about diabetes self-care that includes four two-hour sessions for people with diabetes, accompanied by a family member. The nurse and CHR work in cooperation with the client, the family, the family doctor and a nutritionist. CHRs also attend a four-day training session to enhance their knowledge, understanding and application of diabetes teaching.
Contact: (604) 858-3366.This program also includes a Diabetes Daycare for First Nations, a one-day hospital or community-based clinic for First Nations people with diabetes.
Contact: (604) 595-9200.
Indianbrook First Nation community supports satellite diabetes education clinics by covering the travel expenses of a dietitian and nurse to these "visiting" health clinics which are free of charge and serviced every three weeks by the Colchester Hospital diabetes staff in Truro, NS. Native and non-native individuals who attend the clinic receive group diabetes education, individual counselling, get bloodwork done and have breakfast together.
Contact: (902) 426-8053.
Developing awareness of the disease process and empowering individuals, the family and community to choose a healthier lifestyle are central to the Akwesasne Diabetes Prevention Program. It also includes a clinic to monitor blood sugar, weight, blood pressure and feet, stressing the importance of praise, support, health suggestions and referrals. The community has a walking program, line dancing and water aerobics.
Contact: (613) 575-2576.
Sioux Lookout Zone - Diabetic Education Program brings four people with diabetes and a health worker from outlying communities for a period of five days each month for diabetes education, management and self-care. The long-range goal is to remove the learning process from the acute care setting and return it to the familiar surroundings of people's own communities.
Contact: (807) 737-4011 or 1-800-842-0681.
In Ontario, the Whitefish Bay Reserve Diabetic Clinic is usually held once a month. Invitations are sent one week before the event to each person with diabetes and their families. The activities includes check-ups, Food Bingoes with small prizes and nutritious lunches of traditional food.
Contact: Toni White (807) 226-1164 fax or Lillian Henry (807) 226-5389.
The community health team of the Siksika Nation in Alberta is developing a diabetes program that is run by diabetics for diabetics. Their goal is to meet regularly and to educate and support each other.
Contact: Marlene Solway (403) 734-3054.
In Fisher River, Manitoba, where prevention is a priority, there have been successful walking projects and people take more care planning food events, meals and menus. The weekly diabetes clinic largely runs itself while the health team is confidently responding to the needs of the people in the community.
Contact: (204) 645-2689.
In many communities across Saskatchewan, an annual event is the Diabetes Awareness Day. Planned by the health staff and the community, the day is a time to bring members of the community together to learn and share. Evaluations of past experiences stress practical information and culturally appropriate tips on how to manage diabetes, and emphasize the benefits of mutual support.
Contact: (306) 780-5427.
At the Yukon Elder Wellness Centre, Ida Calmegane, a retired community health representative from Cargross, hosts traditional tea gatherings where people with Type 2 diabetes can meet and talk about diabetes. Madge McRee made a presentation at the 4th International Conference on Diabetes and Indigenous Peoples on traditional foods and incorporating traditional teaching styles in diabetes education.
Developing a Positive Attitude
Research on the Health Beliefs of the Mohawk people from the Bay of Quinte and the Cree of Moose Factory looks at the social and emotional dimensions of living with diabetes. Researchers found that people feel that being a diabetic sets limits on their lifestyle, which is embarrassing to them and also interferes with many employment situations and traditional activities. Here are some culturally relevant materials and programs that address some of the emotional and attitudinal dimensions of diabetes:
Nanabush and the Stranger
This booklet, directed to all First Nations people with diabetes, their families and health care providers, tells of an Ojibway legend to explain diabetes and how it can be managed. Symptoms of diabetes are translated into culturally relevant terms.
Contact: Anishnawbe Health Toronto (416) 360-0486.
An Elder Named Mary
This booklet focuses on the importance of a healthy lifestyle; it also provides general diet-related survival rules for patients on oral hypoglycemic agents. The story addresses what is going on in the body of a person with diabetes, and talks of traditional native beliefs around chronic illness.
Contact: Northern Diabetes Health Network (NE) 1-800-357-6341 or
(NW) 1-800-565-3740.
Tee Cha Chitl (Getting Well Again) is a family-centered program that was developed in response to requests from the Nuu-chah-nulth people to understand and manage diabetes in their families and in their communities, based on their own culture. Elders support and teachings are the backbone of the learning sessions.
Contact: Jeannette Watts (250) 724-3232 or 723-1223.
The Haida Gwaii Diabetes Project, a partnership between researchers from UBC's Department of Family Practice, CHRs, family physicians and the Old Massett and Skidegate communities, focused on the Haida experiences of Type 2 diabetes in the context of cultural and lifestyle change. Six themes emerged; grief and loss, fear, control, food and eating, traditional ways, and providing guidelines for a culturally relevant approach to understanding, managing, and preventing diabetes. The project resulted in monthly meetings, support groups, traditional medicine and foods teachings, and the development of the Getting Stronger program on weight training.
Contact: Diane Brown (604) 559-4610.
Strengthening Social Supports
The local community is the most appropriate and effective level for home and social supports to assist in the treatment and care of elders with diabetes, enhancing the quality of their lives, as well as for diabetes prevention and education. Here is a sample of community-based programs.
Lawrence Commanda Diabetes Education and Resource Centre sponsors Complicated Coffee, an interactive community diabetes awareness event where participants "feel" the effects of long-term diabetes complications. They learn how these can be delayed or prevented and share their experiences during 'coffee' (a nutritious refreshment break) with an educator available to answer questions. Blood glucose screening is made available in the community or workplace.
Contact: T (705) 735-3355 or F (705) 753-4116.
The Southern Ontario Aboriginal Diabetes Initiative (SOADI) provides funding to communities to develop awareness and prevention activities aimed at individuals and families with diabetes and diabetes education training courses for health workers. Programs funded include Munsee-Delaware Nation Diabetes Program, Onyota'a:ka First Nation, Niagara Regional Native Centre and the Moravian Delaware First Nation.
Contact: Mona Rice at (705) 756-1165 or fax at (705) 756 3754.
The Munsee-Delaware Nation Diabetes Program provides monthly workshops, individual counselling and initiated a Moccasin Trail Walking Program. 'Choose a Healthy Lifestyle'. It has produced culturally relevant pamphlets that emphasise the seriousness of diabetes while explaining its symptoms and complications.
Contact: (518) 289-5475.
The Niagara Regional Native Centre sponsors the Silver Fox Club, a social and recreational club that meets weekly for participants aged 50 and up. Activities include the Featherweight Club, a Fitness Club that features a "Sweat to the Oldies" exercise program, and monthly guest speakers on health and fitness. Members decided they wanted to be monitored for blood sugar levels and blood pressure.
Contact: (905) 641-4498.
Workshops on traditional herbs and medicines, diabetes awareness and monitored foot care clinics are held at Moravian Delaware First Nation. Information goes out regularly in the newsletter to the community.
Contact: (519) 692-3969.
The community health workers at Onyota'a:ka First Nation developed educational calendars, posters and pamphlets for diabetes awareness and prevention, with an emphasis on proper foot care to reduce amputations. The community has a successful foot care clinic, line dancing and aerobics classes, a Moccasin Trail Walking Program, as well as workshops with a herbalist.
Contact: (519) 652-0600.
"Netum Anishnabe Chapter" is the first Aboriginal Chapter of the Canadian Diabetes Association in Ontario, established in 1985 at Nippissing First Nation. Its objectives are to promote diabetes self-care and social support to diabetics through education and services. Six Nations and Manitoulin Island have set up chapters.
Kchaiak, (the Elders Club), was set up by elders in the community of Odanak. The club hosts an elders brunch once a month on Saturdays at the ALNO BAI WI (the Indian Way) Community Centre, with guest speakers invited to talk about health issues such as diabetes, heart disease and alternative medicine.
Contact: (514) 568-6717.
Sioux Valley Dakota First Nation in Manitoba holds a Winter Festival to get people out of their homes in the middle of winter to participate in fun-filled community activities. They include a community breakfast, ragball and volleyball tournaments, nutrition displays, nutri-bingo, moccasin games, and a fitness challenge.
Contact: (204) 855-2690.
The Sandy Lake Health and Diabetes Project was set up in 1992. Its community-based intervention strategy to prevent diabetes and its complications emphasizes three main types of activities: community education using local media and special events; a program to foster the selection of low-fat foods in partnership with the Northern store; and a school lunch and health program.
Contact: (807) 774-3421.Healing the Spirit
Good health is about "Attaining Wellness" and "Living in Balance." A healing process for elders with diabetes enables them to achieve balance and well-being physically, mentally, emotionally, socially and spiritually. Here is a sample of approaches and programs.The "Walking in Balance" Program was developed in 1991 at the Anishnabe Spiritual Centre. It uses the concept of the Medicine Wheel and the Decision Cycle Model during Circle Talks to facilitate the healing process for people with diabetes. The goal of the program is to empower people with diabetes to heal themselves by rediscovering their sense of self-worth and take control of their own health, changing their lifestyle and making a commitment to self-care.
The Aboriginal Diabetes Wellness Program was developed by Aboriginal people for Aboriginal people under the guidance of elders. The approach is holistic and cultural, offering people with diabetes a choice of traditional and / or western ways to wellness. The program also includes workshops on blood sugar testing, meal planning, foot care, medication use, and activity planning. Elders are available for cultural guidance.
Contact: (403) 477-4512.
The Traditional Medicine and Alternate Healing Program, under the direction of Emmy Mitchell, with Barbara Barnes as consultant, provides education to providers and health care recipients about the benefits of traditional and alternative medicine at Akwesasne. The program promotes dialogue between western and traditional practitioners to solve the outstanding issues related to the practice and use of traditional medicine. Elders help to define the roles of the practitioners and determine the support from the community for the reintroduction of traditional practices.
Contact: (613) 575-2570.
Drumming and Dancing workshops for First Nations people with diabetes are about healing and living in balance through a healthy lifestyle. This approach forms the basis for the Native Diabetes Project for Cree and Ojibwa people living in Toronto. Drumming and Dancing diabetes workshops have also been held at the Native Friendship Centre in Victoria."The drum must continue to beat to break the chain of diabetes for future generations of First Nations peoples and to improve the health of those who have it."
Canadian Diabetes Association
National Office
15 Toronto St., Suite 800
Toronto, Ontario M5C 2E3
Tel: (416) 363-3373
Fax: (416) 363-8335Association du diabète du Québec
5635 rue Sherbrooke Est.
Montréal, Québec H1N 1A2
Tel: 1-800-361-3504
(514) 259-3422
Fax: (514) 259-9286The Kidney Foundation of Canada
Eastern Ontario Branch
212-1335 Carling Avenue
Ottawa, Ontario K1Z 8N8
Tel: 1-800-724-9953
Fax: (613) 722-5907Heart and Stroke Foundation of Canada
160 George St., Suite 200
Ottawa, Ontario K1N 9M2
Tel: (613) 241-4361The Canadian National Institute for the Blind
National Office
1931 Bayview Ave.
Toronto, Ontario M4G 4C8
Tel: 1-800-465-4622Indian Health Service
Diabetes Program
2401 12th St. N. W. Room 211N
Alburquerque, New Mexico 87102
Tel: (505) 766-3980National Aboriginal Diabetes Association
P. O. Box 26093
116 Sherbrooke Street
Winnipeg, Manitoba R3C 4K9
Tel: (204) 775-3625
Fax: (204) 945-3105Northern Diabetes Health Network
1040 Lorne Street - Unit 5
Sudbury, Ontario P3C 4R9
Tel: 1-800-357-6341Native American Research and Training Centre
University of Arizona
1642 East Helen
Tucson, Arizona 85719
Tel: (602) 621-5560Southern Ontario Aboriginal Diabetes Initiative
P. O. Box 473
Parry Sound, Ontario P2A 2X5
Tel: (705) 746-7846
Fax: (705) 746-4730
TRI-DEC
Tri-Hospital Diabetes Education Centre
Womens' College Hospital
60 Grosvenor Street
Toronto, Ontario M5S 1B6
Tel: (416) 323-6170
Medical Services Branch Nutritionists
First Nations and Inuit Health Programs Directorate
Jeanne Mance Building, 11th Floor
Postal Locator 19 11 B
Tunney's Pasture, Ottawa, Ontario K1A 0L3
Tel: (613) 954-7757
Fax: (613) 954-8107
Brenda Chaddock, RN, CDE, Dip. Ed.
Lifescan Education Institute
Suite 234, 4170 Still Creek Drive
Burnaby, BC V5C 6C6
Tel: 1-800-663-5521
Vince Lamanna
Novo Nordisk Canada Inc.
2700 Matheson Blvd. East
3rd Floor, West Tower
Mississauga, Ontario L4W 4V9
Tel: 1-800-465-4334.
Copyright NIICHRO 1998
