Past experiences enhance the future. Health care providers gaining expertise in creative thinking, traditional medicine, spirituality, and cultural sensitivity is an essential requirement for 21st century health care. We must stay mindful that poverty, isolation, and rural living may create new forms of social exclusion because of lack of communication and rapidly changing technology. Conversely, sensory overload resulting from a faster paced lifestyle and rapid enhancements in technology may cause increased tension and stress. This article reviews successes that may offer the reader ideas on coping with the provision of health care services in such a volatile changing environment, while honoring tradition and cultural competency.
This ethnographic study explored the question, How do urban-based First Nations peoples use healing traditions to address their health issues? The objectives were to examine how Aboriginal traditions addressed health issues and explore the link between such traditions and holism in nursing practice. Data collection consisted of individual interviews, participant observations, and field notes. Three major categories that emerged from the data analysis were: following a cultural path, gaining balance, and sharing in the circle of life. The global theme of healing holistically included following a cultural path by regaining culture through the use of healing traditions; gaining balance in the four realms of spiritual, emotional, mental, and physical health; and sharing in the circle of life by cultural interactions between Aboriginal peoples and non-Aboriginal health professionals. Implications for practice include incorporating the concepts of balance, holism, and cultural healing into the health care services for diverse Aboriginal peoples.
For demographic reasons and as a result of a number of high profile health incidents in recent years, much of the health research and policy focus is on the younger cohorts of Aboriginal peoples in Canada. A critical examination of recent demographic trends reveals, however, that older cohorts of the Aboriginal population are increasing at a faster rate than younger cohorts, primarily due to improvements in life expectancy and declining fertility rates. Yet, there are surprisingly few health studies that have recognized the aging of the Aboriginal population. The overall goal of this paper is to examine differences in health status, use of conventional health care and traditional approaches to healing between older and younger cohorts of the Aboriginal population as well as to examine the importance of age as a determinant of health and health care use. Using data from the 2001 Statistics Canada Aboriginal Peoples Survey and contingency tables and logistic regression, the results demonstrate that older Aboriginal people face unique challenges - e.g. loss of traditional approaches to healing, geographic isolation, identity politics, constitutional and legal divisions within the Aboriginal community - with respect to their health and access to health services. These outcomes result from a colonial past and contemporary policies that affect all Aboriginal people.
In Thailand, where abortion is still illegal, abortion services (health services) outside Bangkok, and outside hospitals or clinics, are provided by non-physician practitioners. In the studies reported here, those practitioners were interviewed in 1978 and 1981 about their methods and the characteristics of their clients. The first study revealed that massage is the method most widely used by rural practitioners and that uterine injection with different solutions comes second. The second study was in agreement with these findings. The health consequences of these induced abortions were studied by interviewing the clients of the rural practitioners in 1980 and 1981. In Sweden, where abortion has been legal for quite a long time, all women who need an abortion have access to safe and convenient health services throughout the country.
Abortion is not condoned in Jamaica. Its meaning is linked to the meanings of kinship and parenthood, which are expressed through procreation and involve altruism and the assumption of responsibility for the well-being of others. Abortion subverts these ideals but indigenous methods for it are known and are secretly used. The inconsistencies between abortion talk and abortion practice are examined, and the structural functions of abortion (and of its culturally constructed, ideological meaning) are discussed. The distinction--and the overlap--between abortion as such and menstrual regulation is explored. The use of the culturally constructed 'witchcraft baby' syndrome to justify abortion is also investigated. Traditional abortion techniques follow from (and can illuminate) general health practices, which focus on inducing the ejection of 'blockages' and toxins, and from ethnophysiological beliefs about procreation and reproductive health, which easily allow for menstrual delays not caused by conception. The latter understanding and the similarity between abortifacients, emmenagogues and general purgatives allows women flexibility in interpreting the meanings of their missed periods and the physical effects of the remedy.
As genomic researchers are encouraged to engage in broad genomic data sharing, American Indian/Alaska Native/Native Hawaiian (AI/AN/NH) leaders have raised questions about ownership of data and biospecimens and concerns over emerging challenges and potential threats to tribal sovereignty. Using a community-engaged research approach, we conducted 42 semi-structured interviews with tribal leaders, clinicians, researchers, policy makers, and tribal research review board members about their perspectives on ethical issues related to genetics in AI/AN/NH communities. We report findings related to perspectives on genetic research, data sharing, and envisioning stronger oversight and management of data. In particular, participants voiced concerns about different models of data sharing, infrastructure and logistics for housing data, and who should have authority to grant access to data. The results will ultimately guide policy-making and the creation of guidelines and new strategies for tribes to drive the research agenda and promote ethically and culturally appropriate research.
This paper examines the question of access to traditional Indian medical systems in the western Canadian city of Saskatoon. The data demonstrate that many Natives desire such access, and do not see difficulties in having Indian healers available in Western-style biomedical clinics. A variety of language variables proved to be the best predictors of access questions, indicating that those with the greatest cultural adherence were most likely to want a more formal access. It is argued that a lack of access to traditional Indian medical services represents a legitimate health need. Considerations for the implementation of such a formal access to traditional Indian medicine are discussed.
It has been my great fortune to have spent this past summer traveling across North America with my husband. We left our home state of New Hampshire in June and, in late July, arrived in the 49th state, Alaska, where we have settled in for the winter. From Manitoulin Island and the shores of Lake Huron to the Black Hills of South Dakota and on through the Canadian Rockies, we traveled through a number of North American Native communities. It is this experience and my recent introduction to Alaskan Native culture and peoples that are the impetus for this feature, where I will explore the historical and re-emerging use of art to promote health and healing in Native communities.
Cree traditional medicine is commonly used concomitantly with prescribed drugs to treat health problems related to type II diabetes (T2D) that is endemic in the Cree population. However, the safety of traditional Cree medicines with respect to drug metabolism is unknown.
Seventeen anti-diabetic plant extracts were screened for their potential inhibition of 11 isoforms of the drug-metabolizing cytochrome P450s (CYPs), and flavin-containing monooxygenase 3 (FMO3) in fluorometric plate reader assays. Comparative analyses were conducted to determine if particular extracts were more inhibitory, or if particular enzymes were more inhibited.
Many anti-diabetic plant extracts inhibited the CYPs, with CYP2C and 3A isoforms being most prone to inhibition. The order of inhibition for the enzymes by the Cree plant extracts was: 2C19>3A7>3A5>3A4>2C9>2C8>FMO3>1A2>2E1>19>2D6>2B6. Extracts from Rhododendron groenlandicum, Sorbus decora, and Kalmia angustifolia were identified as having strong inhibition towards many CYP isoforms.
These findings demonstrate that extracts from most plant species examined have the potential to affect CYP2C- and 3A4-mediated metabolism, and have the potential to affect the bioavailability and pharmacokinetics of conventional and traditional medicines during concomitant use.