High rates of chronic diseases in First Nations tied to trauma

In our First Nations communities, the growing rates of chronic diseases including HIV, hepatitis C and diabetes are damaging lives. Chief and councils and provincial and federal leaders need to start on adequate solutions to deal with these very real problems in our communities. A major solution is helping people to address life trauma.

This past week, I attended a symposium to listen in on a speech about conflict and dysfunction in the workplace. What I didn’t expect was sitting in on the next session… a trio of doctors who spoke about their work with populations vulnerable to HIV. One of the doctors worked with HIV patients in East African nations and the other two doctors with patients in Saskatchewan. The first of these doctors, Dr. Larry Gelmon, pointed out that there are 3.7 million people living with HIV around the world and 2.1 million new people affected annually. Of the Canadian provinces, numbers of HIV cases are the highest in Saskatchewan, with Indigenous people having a 25% risk of getting infected compared to non-Indigenous people. The doctors estimate that 42% of people with HIV don’t even know they are infected.

Today, the rates of HIV cases by health region are 16.6% in Saskatoon, 61.2% in the Prince Albert area, and 30.6% farther north in Saskatchewan’s remote communities. These days, HIV cases are increasing in Saskatchewan’s remote and rural communities. As I listened to the situations being described I felt saddened as an Indigenous person with family and numerous relatives living in remote communities. The first question I thought of was what is making so much Indigenous people susceptible to HIV infection? And what can be done to deal with this?

Two of the main factors that are causing the growth in HIV are sexual transmission and an increase in cocaine use, especially when it is injected with needles. I hear everyday stories of cocaine being widely used in our First Nations communities. Addictions are clearly a huge problem. One of the doctors, Dr. Stewart Skinner said access to addictions treatment is needed and more addiction programs. Dr. Stephen Sanche agreed that mental health problems contribute to the high rates of addictions in First Nations communities. “I think what we’re seeing is a fall-out from the result of colonialism, affects of residential school. We need to pay attention to the social determinants of health in order to address all of this,” he said.

Some things that prevent the adequate treatment of HIV are medical health services not covering certain types of medication that are sorely needed and not affordable to Indigenous patients, poor access to methadone doses, people with HIV not getting tested due to lacking transportation to urban areas where testing is offered, or waiting until they are near death to get the care they need. Another crucial issue is the tendency of health workers to stick to the current medical model with no desire to adapt it to what Indigenous people need. “The current medical model is not effective in treating chronic diseases,” Dr. Skinner commented. “We need to change it to something that works.” He hears the common excuses of ‘no time for this’ or ‘it is impossible to reach everyone who needs help’. However, with more attention to more successful measures such as those used in Big River and Ahtahkakoop, they say it is possible. In 2010, the health region partnered with Big River, Health Canada, clinicians and the Province to develop a testing lab for blood testing right in the community. They had a group of health workers go into the school to educate young people, and transported patients to do blood testing at the lab. In Ahtahkakoop, people who need treatment are also transported and health workers stay connected with patients through technology, mainly through text messaging with cell phones.

The three doctors suggest health and medical workers partner with leaders in First Nation communities to develop solutions, be open to including traditional First Nations cultural practices, better communicate with First Nations patients, allow access to mental health therapists and methadone treatment, and set up HIV blood testing stations on-reserves.

It is enlightening to see that doctors are recognizing that there is a need for change and that they are making slight changes with good results. It’s good that they recognize the root of the problems, that addictions need to be addressed and our communities need to start acting to help people deal with on-going trauma.

Healing would help address the crisis with health problems. There is a tendency for people to point to choices in addictions, that people choosing a lifestyle of addiction have a personal choice to get out of it. As someone with no drug or alcohol addiction but still addressing traumatic life situations, I have made the choice to seek a better lifestyle but it is hard with few supports. Sometimes it seems hopeless and I can see how people with addictions just give up and fall deeper into despair.

My company, Free the Spirit Consulting Inc. may help with addressing some of these problems. For example, we can give people a space to address some of the residual effects of trauma with access to cultural teachings and helping them to identify ways to cope with stressful life circumstances. With this health crisis growing and with the increasingly young Indigenous populations, it’s important to act now. I believe that there’s hope in our children’s future and that right now from within our own people, we can start the action to make things better.

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