25 September 2020

We Are Indigenous: ‘Culture Meets Care’ Essential for Indigenous Healthcare and Revitalization

There are an estimated 476 million indigenous peoples in the world, living across 90 countries. They speak an overwhelming majority of the world’s estimated 7,000 languages and represent 5,000 different cultures.

COVID-19 has posed a grave threat to Indigenous peoples around the world, who already lack access to healthcare and other essential services. Yet, Indigenous peoples are seeking their own solutions in their own languages, using traditional and innovative knowledge, practices and preventive measures to fight the pandemic.

In the We Are Indigenous series, United Nations Academic Impact (UNAI) speaks with Indigenous academics and activists to learn how the global Indigenous community’s contributions are building a healthier and more sustainable future for us all.

Indigenous peoples experience higher rates of ill health, disability and reduced quality of life, with a much shorter life expectancy compared to other citizens in the same countries. Their health status is severely affected by their living conditions, employment and income levels, and access to food, water and sanitation services. Geographic isolation, poverty, discrimination and a lack of cultural understanding further contribute to major structural barriers for Indigenous populations to access health care.

In order to improve Indigenous peoples’ social and economic outcomes and bridge the wellness gap between Indigenous and non-Indigenous populations, access to quality healthcare must remain a leading priority. Following the “culture meets care” principle, Indigenous medical professionals are promoting healing and empowerment through a multifaceted practice using traditional wellness practices such as speaking circles and the smudging of sacred medicines. As these leaders commit to fighting for the right to healthcare through a combination of study and activism that advocates for community-based self-determination, Indigenous communities can develop culturally relevant health care initiatives that serve their own unique needs.

Dr. Michelle Johnson-Jennings is a Choctaw Nation Tribal Member and an Associate Professor of Phycology at the University of Minnesota. She is also an Indigenous Clinical Health Psychologist and serves as a member of the COVID-19 Native Scientists Expert Panel of the National Institute of Health (NIH) in the United States.

Dr. Johnson-Jennings’s home community, the Choctaw Nation of Oklahoma on Turtle Island, has been heavily impacted by COVID-19 like many other Indigenous communities. Dr. Johnson-Jennings has been working closely with other Indigenous colleagues to address the COVID-19 related disparities faced by Indigenous groups and how best to inform risks, prevention and treatment.

 “COVID-19 has been disproportionately impacting Indigenous, Black and other communities of color, with government support slowed or stalled for many,” said Dr. Johnson-Jennings. In her community alone, “We are losing our elders, first language speakers, and knowledge keepers at frightening and heartbreaking rates. We are further fearful that our children's health will be compromised, given that the Indigenous youth also suffer from higher rates of obesity, type II diabetes, asthma and other risks factors.”

To protect these at-risk populations, Indigenous communities have put in place prevention measures to slow the spread of COVID-19. Dr. Johnson-Jennings observed, “Many Indigenous communities, including my own, are further indigenizing mask wearing and social distancing, holding virtual powwows, showing public service announcement videos and closing public venues to visitors of the reservations.” In addition, some Indigenous communities are holding traditional healing sessions and community drives for food and supplies for members in need of help, such as elders and those in isolation or quarantine. Knowledge keepers and elders have been retelling prophecies related to the pandemic and re-instilling ancestral knowledge about how to care for oneself and others, which is important for the wellbeing and mental health of the community.  

Speaking about her research, Dr. Johnson-Jennings said that she chose to pursue a career path that would best assist her community, as their needs are “first and foremost” in her mind. She situates her health interventions in the cultural context of Indigenous knowledge and utilizes Western medicine theories and practices as complementary which creates a more welcoming environment for Indigenous people, rather than an alienating experience. “Ultimately, it is through linking health care work with the culture, history and stories of the community that researchers and healthcare providers can appropriately move forward,” said Dr. Johnson-Jennings. “Therefore, I work closely with community members, elders, and other knowledge keepers to inform and co-develop approaches and research.”

Dr. Jaris Swidrovich obtained his Doctor of Pharmacy from the University of Toronto. His current research and practice cover the areas of HIV/AIDS, LGBTQ health, substance abuse disorders and Indigenous health. Identifying himself as a Two Spirit Saulteaux and Ukrainian man from Yellow Quill First Nation, Dr. Swidrovich said that when medical professionals try to understand and identify Indigenous health determinants, it is paramount to look at the entire picture, including the colonial history and incredibly challenging living circumstances that the Indigenous population endure: “We cannot just fix people without properly acknowledging the history of colonial trauma and how that lives within their own selves, their families and their communities.”

For example, before COVID-19 Dr. Swidrovich started working on a community-based substance abuse initiative, with over half of the local population in this study being active drug users. His research has proven that drug use was not an issue until the community was forcefully displaced from their community by rampant forest fires a few years ago, which illuminated an important link between Indigenous health and the environment. Land-based healing methods including re-learning original languages, attending sweat lodges, gathering traditional medicines from the land, smudging, and engaging in long-established song and dance are key components of the treatment plan that Dr. Swidrovich identified for the community, which were also used to help them collectively recover from COVID-19.

The acronym 2SLGBTQ+, (Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer) is unique to Northern American Indigenous groups, as it includes their own unique understanding of having both a feminine and masculine spirit. Members of the 2SLGBTQ+ community face discrimination and intolerance at disproportionate rates, which makes them particularly vulnerable as COVID-19 amplifies the existing social inequalities. Dr. Swidrovich highlighted the intrinsic link between mental health and physical health, calling for increased support for the 2SLGBTQ+ groups. Addressing mental health services, he noted that “Depending on the location, there are usually regionally funded networks that offer resources, information and connections,” and many networks now offer services online, some of them free, in response to COVID-19. While this does eliminate an element of in-person contact, it also increases accessibility of services for rural Indigenous people.

When asked what advice he would give to Indigenous youth looking to work in health care, Dr. Swidrovich quickly responded, “I would tell them to call me!” He recalled a lack of mentorship within his specialized field as he explored the studies between the Indigenous culture and Western medicine and expressed his willingness to support aspiring young medical students. In terms of career choices, Dr. Swidrovich identified pharmacists as the most accessible urban and rural health professionals. It is not uncommon for Indigenous community members to have to wait several weeks to see a doctor or psychiatrist. However, pharmacists, located right across the counter, are immediately available to provide information and temporary support for those suffering from physical and mental illnesses. Therefore, he finds it important for policymakers to invest more in pharmacy studies, “Rather than closing that door to the community members who need it most.”

Despite the harm caused by COVID-19, many Indigenous communities with few economic resources remain strong in their rich cultural knowledge and practices providing an ongoing spring of hope for their future. Increased funding and support for localized research initiatives are urgently needed to help Indigenous peoples better manage their unique needs, as they continue to demonstrate an immeasurable commitment to caring for continued community revitalization despite the odds.

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