Finding a Place for Traditional Aboriginal Medicine in the Canadian Health Care
Abstract
The Aboriginal population of Canada has much poorer health in comparison to the rest of Canadians. The cultural climate of Canada is largely defined by dominant white middle-class ideals rooted in a history established by European peoples that colonized the nation. The values and beliefs of marginalized cultural populations such as First Nations, or Aboriginals, have largely been ignored as Europeanized perspectives determine cultural norms. This paper attempts to address the questions how can traditional Aboriginal medicine be integrated into the Canadian health care system and what is the nurse’s role in this process as they are the most populous branch of primary public healthcare providers?
There is a current desire to return to traditional healing methods to both revitalize the culture and shift western ideologies of the biomedical model of medicine. It is apparent that there are many differences existing between the health paradigms of traditional medicine and western medicine resulting in many barriers to change. Three primary barriers discussed were the rigidity of the biomedical model, the cultural barriers stemming from the marginalization of Aboriginal peoples in Canada and the commoditization of traditional health methods. In contrast the facilitating factors discussed were current shifts in public views of health, the role of the nurse as a holistic primary health care giver and lastly, the increased desire of Aboriginal peoples to regain their culture. The ability of nurses to provide care with adequate understanding of Aboriginal health traditions is essential to both the improvement of Aboriginal health as well as to re-establishing important pieces of their culture allowing nurses to be at the forefront of the integration of traditional healing practices into the western health care system. Both the Aboriginal Nurses Association as well as Health Canada support these views facilitating positive progression of the biomedical model currently dominating Canadian health care.
Introduction
The cultural climate of Canada as a modern nation is largely defined by dominant white middle-class ideals rooted in a history established by European peoples that colonized the nation. The values and beliefs of marginalized cultural populations such as First Nations, or Aboriginals, have largely been ignored as Europeanized perspectives determine cultural norms. Subsequently modern western culture has placed many restrictions on the cultural practices of Aboriginal people of Canada. The Aboriginal population of Canada has much poorer health in comparison to the rest of Canadians. Many researchers believe that this cultural stifling has unfortunately led to the attrition of traditional medicine practices in favour of Europeanized practices (Browne & Smye, 2002; Fiske & Browne, 2006).
The Canadian health care system is largely dominated and informed by the biomedical model which places emphasis on technology, efficiency, empiricism, objectivity and standardized care. There is little room for inclusion of alternative ideologies in medicine and health care, especially those of minority ethnic groups (Frideres, 1994). Current research demonstrates that many of the health inequalities prevalent in Aboriginal peoples within Canada may be attributed to the erosion of Aboriginal culture itself (Letendre, 2002; Shestowsky, 1995). The central question that needs to be asked is how can traditional Aboriginal medicine be integrated into the Canadian health care system? Similarly, what is the nurse’s role in this process as they are the most populous branch of primary public healthcare providers?
Upon examining Aboriginal medicine as written about in current academia it is apparent that there are many differences existing between the health paradigms of traditional medicine and western medicine. In order to improve Aboriginal health there needs to be a reexamination of the contributions of traditional aboriginal medicine to aboriginal culture. To adequately explore this issue the goal of this paper is twofold. Firstly, there must be an examination of the importance and significance of the role of traditional medicine to both Aboriginal peoples in Canada and to the Canadian health care system as a whole. Secondly, to demonstrate the significance to nursing in particular there must be an exploration of how nurses can both facilitate and hinder integration of traditional medicine within Canada. Through conducting extensive literature reviews as well as by searching nursing organization websites that examine Aboriginal traditional medicine in North American healthcare systems these two goals will attempt to be accomplished within the scope of this paper.
Background
Although today the social norms and mores of Canadian are largely determined by white middle-class values these norms infringed on those of the Aboriginal people that previously settled this nation. The history of Canada is built on colonization. Historically large numbers of Europeans began to settle in North America, forever shaping and changing the social and political climate of what we now recognize as Canadian society (Browne, & Smye, 2002). While settlers gained control of the land and resources of Canada the native peoples were forced to adjust from a lifestyle they were accustomed to, one governed by the laws of nature, to a lifestyle governed by the economic marketplace (Letendre, 2002).
While the values of native peoples were being displaced in exchanged for dominant European ideals there were concurrently being geographically displaced from their natural habitat in which all facets where influenced by the environment, pushed to reserves and settlements with limited means of economic prosperity. The compounding of this philosophical and geographical displacement ultimately led to high poverty, fostering the slow erosion of the culture (Waldram, 1994). The transference of this sociopolitical climate of what has come to be known as Canadian society has pushed Aboriginal medicine to the margins without consideration to the multifaceted costs to the population that these ideologies were designed to serve.
When European settlers began to arrive in Canada they quickly became the dominant culture, forcing their ideologies of health and medicine on the Aboriginal peoples already settled across Canada (Cass, 2004). Thus, the loss of traditional medicine has resulted in devastating consequences for the Aboriginal peoples as evidenced by the inappropriate attempts and subsequent failures of modern medicine to improve health status of the Aboriginal community (Cass, 2004; Letendre, 2002).
Shifts in Ideologies: The Impacts of European Culture
There are important differences between traditional medicine and western medicine with respect to the development and implementation of each. Within the scope of this paper western medicine is defined as all the dimensions of health care that fall under the jurisdiction of the federal government of Canada and which are executed through the policies and agencies supported by Health and Welfare Canada (Statistics Canada, 2001). Underlying the cultural mismanagement of traditional Aboriginal health beliefs by the dominant European culture is the misconception that the health needs of Aboriginal peoples are similar to theirs. Letendre (2002) outlines the primary areas of difference between western and Aboriginal health care ideologies as health care philosophy, structural components of health care delivery and the guiding principles of each knowledge system. The forced shift in ideologies that began with European settlement displaced the more natural holistic native practices to more individualistic western medical practices resulting in a loss of Aboriginal traditional medicine and ultimately important components of the culture.
Significance of the Issue
Research demonstrates that Aboriginal culture is reproduced through oral transmission of knowledge such as through transferring that deemed necessary to practice the skills of a medicine man who is elected by popular consensus or passing of traditions such as sweats and smudging (Browne, & Smye, 2002; Bucharski, Reutter, & Ogilvie, 2006; ). This knowledge is passed down verbally through generations demonstrating that this method of knowledge transference is an intricate part of the culture. Oral tradition is intricately tied into aspects of traditional Aboriginal culture such as philosophy, religion, and spirituality thus upholding this tradition has allowed the preservation of Aboriginal healing practices (Shestowski, 1993). The central role that traditional healing methods play within the Aboriginal cultures of Canada has led to recent trends demonstrating the desire for preservation of the culture leading to steps taken to revitalize traditional medicine and its health practices (Kirmayer, Simpson, & Cargo, 2003; Letendre, 2002).
From the historical perspective, as European settlers became the dominant cultural group in Canada their health care system was established as the default standard for Canadian society. Modern medicine is based on the belief that health and illness can be isolated and physically reduced to individual body parts. Traditional medicine practices, that support a more holistic component of healing, were at best viewed as secondary means to health and at worst completely ignore and thus lost (Letendre, 2002). After years of westernized healthcare firmly establishing and reiterating itself as the best practice standard many traditional practices have been forgotten (Fisher, 1986; Letendre, 2002). Traditional medicine was thrown to the margins and the practice was essentially forgotten by many First Nations cultural groups with the enforcement of the new Canadian system.
When considering the voice of Aboriginal populations there is a desire to revitalize these traditional practices in a large scale movement to reestablish the traditions of the culture to foster positive change for aboriginal peoples (Kirmayer, Simpson & Cargo, 2003). It is necessary to examine how this reestablishment can contribute to the preservation of the culture and the role of traditional medicine plays in Aboriginal society. Current literature establishes a reciprocal relationship between traditional medicine and aboriginal culture. Because of the nature of aboriginal medicine acting as a mode of providing expression and preservation of aboriginal culture it is vital that this be fostered and encouraged. Further, as healthcare providers it can be construed that the nurse’s role is vital in helping encourage this reestablishment because the primary health provider role.
The Role of Nursing: Regaining Traditional Health Ideologies
It may be argued that understanding the unique contributions of traditional medicine to Aboriginal culture is essential if the Aboriginal people are to have significant health improvements. The nurse’s role is pivotal because they are often primary care providers in rural and reservation areas populated by Aboriginal peoples in Canada (Toth, Moyah, & Ralph-Campbell, 2005). There are vital characteristics of traditional medicine that reflect the central characteristics of Aboriginal people in Canada. The role of the nurse is paramount to recognizing how awareness of traditional medicine plays a role in establishing the importance of the value in considering this healing system when searching for viable solutions for improved health of Aboriginal people.
Organizations such as the Aboriginal Nurses Association of Canada (Aboriginal Nurses Association of Canada, 2008) and the British Columbia Government (British Columbia Ministry of Health, 2008) have both recognized and began to actively support the notion of integrating traditional healing methods into the established western health care system. The ultimate goal is recognized as not replacing the current system but rather improving it through more holistic approaches such as inclusion of spiritual health within the hospital system (British Columbia Ministry of Health, 2008).
There is an intimate relationship between the nature of Aboriginal medicine and the philosophies of the culture which easily explains that inadequacies of western medicine as the primary model of health care for the Aboriginal community. Nurses may be best able to address this mismatch of goals between biomedical model and the real needs of Aboriginal peoples to address their health issues from a traditional health perspective in order to make connections to what may be considered their lost culture (Toth, E, Moyah, and Ralph-Campbell, 2005). Further, as front line health care providers nurses can address issues of cultural sensitivity and awareness among the greater population of Canada through health teaching and promotion (Letendre, 2002). Nurses are a very well trust and visible health care population large in number which allows them to carry some power in changing stereotypical views of marginalized First Nations populations.
Barriers to Implementing Change
One barrier is that western medicine utilizes an approach that is analytic in nature treating the mind and body as separate entities. The philosophy behind traditional medicine is holistic. Western medicine ignores religious and spiritual ideologies. Traditional medicine is delivered in a much less formal or structured environment than the dominant biomedical model. The rationale behind this is that it is necessary to connect with the spirits of nature that are believed to be responsible for powers of health possessed by medicine men. Western medicine takes place in formal institutionalized settings such as hospitals and doctors offices. This methods of care delivery must be addressed to decrease rigidity of the current medical model and allow for a more open holistic approach.
Another major barrier to integration of traditional hearing methods are a cultural component of a little understood and historically and socially marginalized group. The majority of knowledge that is produced about Aboriginal medicine is not academically researched and if it is often not available to wide populations (Cass, 2004). Many areas of traditional medicine are misunderstood, for example, within traditional medicine, although the medicine man is viewed as having power, this power is believe to come from that Creator and the healing power given to the medicine man. Within western medicine the doctor is viewed as the healer, supported by the fact that many display their credentials proudly on their office walls. The disjointing of these practices leaves much room for health care professionals such as nurses to build a bridge to increased understanding.
Lastly, perhaps one of the biggest concerns when attempting to teach and learn about aboriginal medicine is that with popularization traditional medicine may become popularized within westernized cultures. A critical debate taking place within Indigenous communities on a global scale involves concerns over the transformation of ceremony, ritual and healing into commodities (Browne, & Smye, 2002; Kirmayer, Simpson, & Cargo, 2003). This era is filled with the commoditization of what was traditionally considered sacred knowledge offered to all for a fee. When these sacred ceremonies are bought and sold in the market place this again superimposes westernized values onto a culture that places emphasis on using gift giving as offering of gratitude to traditional health practitioners. With shifting views of Canadians becoming more curious about traditional healing practices perhaps it is beneficial for nurses to possess a basis of cultural knowledge to accompany the practices to insure understanding of the meaning to the beliefs of Aboriginal people.
Strategies to Facilitate Integration of Traditional Aboriginal Medicine
Within the past century there has been new attention given to the importance of reestablishing traditional health into Aboriginal culture in order to make health gains as well as strengthening the culture itself. The role of the nurse is pivotal in facilitating the inclusion of traditional Aboriginal medicine into the overarching westernized medical model of healthcare. The goal of alternative therapy is to help people understand how to sustain wellness, including their environment. Therapy also provides a spiritual component. To effectively embrace traditional Aboriginal nursing a more holistic view of nursing is necessary meaning that there must be recognition that healing the person as a whole is the ultimate goal.
Similarly, the inclusion of Aboriginal medicine into the western ideology allows a more holistic perspective to be given to health. The use and acceptance of alternative therapies are increasing with the general public. When nurses demonstrate holistic nursing, one thing they should keep in mind is that alternative nursing interventions are adjuncts and not substitutes for traditional care. Technological advances and economic, social, and cultural conditions have created a climate of change in the health care arena. The re-emergence of the holistic health care paradigms has begun to induce a revolution in the Canadian health care system (Letendre, 2002). New roles and approaches are developing in relation to a holistic health movement. Perhaps this is pivotal factor in allowing a place for Aboriginal healing.
Conclusion
The cultural climate of Canada as a modern nation is largely defined by dominant white middle-class ideals rooted in a history established by European peoples that colonized the nation. The values and beliefs of marginalized cultural populations such as First Nations, or Aboriginals, have largely been ignored as Europeanized perspectives determine cultural norms. The Aboriginal population of Canada has much poorer health in comparison to the rest of Canadians.
The Canadian health care system is largely dominated and informed by the biomedical model which places emphasis on technology, efficiency, empiricism, objectivity and standardized care. There is little room for inclusion of alternative ideologies in medicine and health care, especially those of minority ethnic groups (Frideres, 1994). In this paper I attempted attempted to address the questions: how can traditional Aboriginal medicine be integrated into the Canadian health care system, and what is the nurse’s role in this process as they are the most populous branch of primary public healthcare providers?
The social significance of the issue is apparent upon examining Aboriginal medicine as written about in current academia because of the current desire to return to traditional healing methods to both revitalize the culture and shift western ideologies of the biomedical model of medicine. In order to adequately improve Aboriginal health there needs to be a reexamination of the contributions of traditional aboriginal medicine to aboriginal culture. It is apparent that there are many differences existing between the health paradigms of traditional medicine and western medicine resulting in many barriers to the successful integration.
Three primary barriers discussed were the deeply entrenched rigidity of the biomedical model, the cultural barriers stemming from the marginalization of Aboriginal peoples in Canada and the commoditization of traditional health methods. In contrast the facilitating factors discussed were current shifts in public views of health, the role of the nurse as a holistic primary health care giver and lastly, the increased desire of Aboriginal peoples to regain their culture. The ability of nurses to provide holistic, culturally sensitive care with adequate understanding of Aboriginal health traditions is essential to both the improvement of Aboriginal health as well as to re-establishing important pieces of their culture. Further this allows nurses to be at the forefront of the integration of traditional healing practices into the western health care system. Both the Aboriginal Nurses Association as well as Health Canada supports this view which aides in facilitating positive progression and change of the biomedical model currently dominating Canadian health care into a more holistically focused approach.
References
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The Aboriginal population of Canada has much poorer health in comparison to the rest of Canadians. The cultural climate of Canada is largely defined by dominant white middle-class ideals rooted in a history established by European peoples that colonized the nation. The values and beliefs of marginalized cultural populations such as First Nations, or Aboriginals, have largely been ignored as Europeanized perspectives determine cultural norms. This paper attempts to address the questions how can traditional Aboriginal medicine be integrated into the Canadian health care system and what is the nurse’s role in this process as they are the most populous branch of primary public healthcare providers?
There is a current desire to return to traditional healing methods to both revitalize the culture and shift western ideologies of the biomedical model of medicine. It is apparent that there are many differences existing between the health paradigms of traditional medicine and western medicine resulting in many barriers to change. Three primary barriers discussed were the rigidity of the biomedical model, the cultural barriers stemming from the marginalization of Aboriginal peoples in Canada and the commoditization of traditional health methods. In contrast the facilitating factors discussed were current shifts in public views of health, the role of the nurse as a holistic primary health care giver and lastly, the increased desire of Aboriginal peoples to regain their culture. The ability of nurses to provide care with adequate understanding of Aboriginal health traditions is essential to both the improvement of Aboriginal health as well as to re-establishing important pieces of their culture allowing nurses to be at the forefront of the integration of traditional healing practices into the western health care system. Both the Aboriginal Nurses Association as well as Health Canada support these views facilitating positive progression of the biomedical model currently dominating Canadian health care.
Introduction
The cultural climate of Canada as a modern nation is largely defined by dominant white middle-class ideals rooted in a history established by European peoples that colonized the nation. The values and beliefs of marginalized cultural populations such as First Nations, or Aboriginals, have largely been ignored as Europeanized perspectives determine cultural norms. Subsequently modern western culture has placed many restrictions on the cultural practices of Aboriginal people of Canada. The Aboriginal population of Canada has much poorer health in comparison to the rest of Canadians. Many researchers believe that this cultural stifling has unfortunately led to the attrition of traditional medicine practices in favour of Europeanized practices (Browne & Smye, 2002; Fiske & Browne, 2006).
The Canadian health care system is largely dominated and informed by the biomedical model which places emphasis on technology, efficiency, empiricism, objectivity and standardized care. There is little room for inclusion of alternative ideologies in medicine and health care, especially those of minority ethnic groups (Frideres, 1994). Current research demonstrates that many of the health inequalities prevalent in Aboriginal peoples within Canada may be attributed to the erosion of Aboriginal culture itself (Letendre, 2002; Shestowsky, 1995). The central question that needs to be asked is how can traditional Aboriginal medicine be integrated into the Canadian health care system? Similarly, what is the nurse’s role in this process as they are the most populous branch of primary public healthcare providers?
Upon examining Aboriginal medicine as written about in current academia it is apparent that there are many differences existing between the health paradigms of traditional medicine and western medicine. In order to improve Aboriginal health there needs to be a reexamination of the contributions of traditional aboriginal medicine to aboriginal culture. To adequately explore this issue the goal of this paper is twofold. Firstly, there must be an examination of the importance and significance of the role of traditional medicine to both Aboriginal peoples in Canada and to the Canadian health care system as a whole. Secondly, to demonstrate the significance to nursing in particular there must be an exploration of how nurses can both facilitate and hinder integration of traditional medicine within Canada. Through conducting extensive literature reviews as well as by searching nursing organization websites that examine Aboriginal traditional medicine in North American healthcare systems these two goals will attempt to be accomplished within the scope of this paper.
Background
Although today the social norms and mores of Canadian are largely determined by white middle-class values these norms infringed on those of the Aboriginal people that previously settled this nation. The history of Canada is built on colonization. Historically large numbers of Europeans began to settle in North America, forever shaping and changing the social and political climate of what we now recognize as Canadian society (Browne, & Smye, 2002). While settlers gained control of the land and resources of Canada the native peoples were forced to adjust from a lifestyle they were accustomed to, one governed by the laws of nature, to a lifestyle governed by the economic marketplace (Letendre, 2002).
While the values of native peoples were being displaced in exchanged for dominant European ideals there were concurrently being geographically displaced from their natural habitat in which all facets where influenced by the environment, pushed to reserves and settlements with limited means of economic prosperity. The compounding of this philosophical and geographical displacement ultimately led to high poverty, fostering the slow erosion of the culture (Waldram, 1994). The transference of this sociopolitical climate of what has come to be known as Canadian society has pushed Aboriginal medicine to the margins without consideration to the multifaceted costs to the population that these ideologies were designed to serve.
When European settlers began to arrive in Canada they quickly became the dominant culture, forcing their ideologies of health and medicine on the Aboriginal peoples already settled across Canada (Cass, 2004). Thus, the loss of traditional medicine has resulted in devastating consequences for the Aboriginal peoples as evidenced by the inappropriate attempts and subsequent failures of modern medicine to improve health status of the Aboriginal community (Cass, 2004; Letendre, 2002).
Shifts in Ideologies: The Impacts of European Culture
There are important differences between traditional medicine and western medicine with respect to the development and implementation of each. Within the scope of this paper western medicine is defined as all the dimensions of health care that fall under the jurisdiction of the federal government of Canada and which are executed through the policies and agencies supported by Health and Welfare Canada (Statistics Canada, 2001). Underlying the cultural mismanagement of traditional Aboriginal health beliefs by the dominant European culture is the misconception that the health needs of Aboriginal peoples are similar to theirs. Letendre (2002) outlines the primary areas of difference between western and Aboriginal health care ideologies as health care philosophy, structural components of health care delivery and the guiding principles of each knowledge system. The forced shift in ideologies that began with European settlement displaced the more natural holistic native practices to more individualistic western medical practices resulting in a loss of Aboriginal traditional medicine and ultimately important components of the culture.
Significance of the Issue
Research demonstrates that Aboriginal culture is reproduced through oral transmission of knowledge such as through transferring that deemed necessary to practice the skills of a medicine man who is elected by popular consensus or passing of traditions such as sweats and smudging (Browne, & Smye, 2002; Bucharski, Reutter, & Ogilvie, 2006; ). This knowledge is passed down verbally through generations demonstrating that this method of knowledge transference is an intricate part of the culture. Oral tradition is intricately tied into aspects of traditional Aboriginal culture such as philosophy, religion, and spirituality thus upholding this tradition has allowed the preservation of Aboriginal healing practices (Shestowski, 1993). The central role that traditional healing methods play within the Aboriginal cultures of Canada has led to recent trends demonstrating the desire for preservation of the culture leading to steps taken to revitalize traditional medicine and its health practices (Kirmayer, Simpson, & Cargo, 2003; Letendre, 2002).
From the historical perspective, as European settlers became the dominant cultural group in Canada their health care system was established as the default standard for Canadian society. Modern medicine is based on the belief that health and illness can be isolated and physically reduced to individual body parts. Traditional medicine practices, that support a more holistic component of healing, were at best viewed as secondary means to health and at worst completely ignore and thus lost (Letendre, 2002). After years of westernized healthcare firmly establishing and reiterating itself as the best practice standard many traditional practices have been forgotten (Fisher, 1986; Letendre, 2002). Traditional medicine was thrown to the margins and the practice was essentially forgotten by many First Nations cultural groups with the enforcement of the new Canadian system.
When considering the voice of Aboriginal populations there is a desire to revitalize these traditional practices in a large scale movement to reestablish the traditions of the culture to foster positive change for aboriginal peoples (Kirmayer, Simpson & Cargo, 2003). It is necessary to examine how this reestablishment can contribute to the preservation of the culture and the role of traditional medicine plays in Aboriginal society. Current literature establishes a reciprocal relationship between traditional medicine and aboriginal culture. Because of the nature of aboriginal medicine acting as a mode of providing expression and preservation of aboriginal culture it is vital that this be fostered and encouraged. Further, as healthcare providers it can be construed that the nurse’s role is vital in helping encourage this reestablishment because the primary health provider role.
The Role of Nursing: Regaining Traditional Health Ideologies
It may be argued that understanding the unique contributions of traditional medicine to Aboriginal culture is essential if the Aboriginal people are to have significant health improvements. The nurse’s role is pivotal because they are often primary care providers in rural and reservation areas populated by Aboriginal peoples in Canada (Toth, Moyah, & Ralph-Campbell, 2005). There are vital characteristics of traditional medicine that reflect the central characteristics of Aboriginal people in Canada. The role of the nurse is paramount to recognizing how awareness of traditional medicine plays a role in establishing the importance of the value in considering this healing system when searching for viable solutions for improved health of Aboriginal people.
Organizations such as the Aboriginal Nurses Association of Canada (Aboriginal Nurses Association of Canada, 2008) and the British Columbia Government (British Columbia Ministry of Health, 2008) have both recognized and began to actively support the notion of integrating traditional healing methods into the established western health care system. The ultimate goal is recognized as not replacing the current system but rather improving it through more holistic approaches such as inclusion of spiritual health within the hospital system (British Columbia Ministry of Health, 2008).
There is an intimate relationship between the nature of Aboriginal medicine and the philosophies of the culture which easily explains that inadequacies of western medicine as the primary model of health care for the Aboriginal community. Nurses may be best able to address this mismatch of goals between biomedical model and the real needs of Aboriginal peoples to address their health issues from a traditional health perspective in order to make connections to what may be considered their lost culture (Toth, E, Moyah, and Ralph-Campbell, 2005). Further, as front line health care providers nurses can address issues of cultural sensitivity and awareness among the greater population of Canada through health teaching and promotion (Letendre, 2002). Nurses are a very well trust and visible health care population large in number which allows them to carry some power in changing stereotypical views of marginalized First Nations populations.
Barriers to Implementing Change
One barrier is that western medicine utilizes an approach that is analytic in nature treating the mind and body as separate entities. The philosophy behind traditional medicine is holistic. Western medicine ignores religious and spiritual ideologies. Traditional medicine is delivered in a much less formal or structured environment than the dominant biomedical model. The rationale behind this is that it is necessary to connect with the spirits of nature that are believed to be responsible for powers of health possessed by medicine men. Western medicine takes place in formal institutionalized settings such as hospitals and doctors offices. This methods of care delivery must be addressed to decrease rigidity of the current medical model and allow for a more open holistic approach.
Another major barrier to integration of traditional hearing methods are a cultural component of a little understood and historically and socially marginalized group. The majority of knowledge that is produced about Aboriginal medicine is not academically researched and if it is often not available to wide populations (Cass, 2004). Many areas of traditional medicine are misunderstood, for example, within traditional medicine, although the medicine man is viewed as having power, this power is believe to come from that Creator and the healing power given to the medicine man. Within western medicine the doctor is viewed as the healer, supported by the fact that many display their credentials proudly on their office walls. The disjointing of these practices leaves much room for health care professionals such as nurses to build a bridge to increased understanding.
Lastly, perhaps one of the biggest concerns when attempting to teach and learn about aboriginal medicine is that with popularization traditional medicine may become popularized within westernized cultures. A critical debate taking place within Indigenous communities on a global scale involves concerns over the transformation of ceremony, ritual and healing into commodities (Browne, & Smye, 2002; Kirmayer, Simpson, & Cargo, 2003). This era is filled with the commoditization of what was traditionally considered sacred knowledge offered to all for a fee. When these sacred ceremonies are bought and sold in the market place this again superimposes westernized values onto a culture that places emphasis on using gift giving as offering of gratitude to traditional health practitioners. With shifting views of Canadians becoming more curious about traditional healing practices perhaps it is beneficial for nurses to possess a basis of cultural knowledge to accompany the practices to insure understanding of the meaning to the beliefs of Aboriginal people.
Strategies to Facilitate Integration of Traditional Aboriginal Medicine
Within the past century there has been new attention given to the importance of reestablishing traditional health into Aboriginal culture in order to make health gains as well as strengthening the culture itself. The role of the nurse is pivotal in facilitating the inclusion of traditional Aboriginal medicine into the overarching westernized medical model of healthcare. The goal of alternative therapy is to help people understand how to sustain wellness, including their environment. Therapy also provides a spiritual component. To effectively embrace traditional Aboriginal nursing a more holistic view of nursing is necessary meaning that there must be recognition that healing the person as a whole is the ultimate goal.
Similarly, the inclusion of Aboriginal medicine into the western ideology allows a more holistic perspective to be given to health. The use and acceptance of alternative therapies are increasing with the general public. When nurses demonstrate holistic nursing, one thing they should keep in mind is that alternative nursing interventions are adjuncts and not substitutes for traditional care. Technological advances and economic, social, and cultural conditions have created a climate of change in the health care arena. The re-emergence of the holistic health care paradigms has begun to induce a revolution in the Canadian health care system (Letendre, 2002). New roles and approaches are developing in relation to a holistic health movement. Perhaps this is pivotal factor in allowing a place for Aboriginal healing.
Conclusion
The cultural climate of Canada as a modern nation is largely defined by dominant white middle-class ideals rooted in a history established by European peoples that colonized the nation. The values and beliefs of marginalized cultural populations such as First Nations, or Aboriginals, have largely been ignored as Europeanized perspectives determine cultural norms. The Aboriginal population of Canada has much poorer health in comparison to the rest of Canadians.
The Canadian health care system is largely dominated and informed by the biomedical model which places emphasis on technology, efficiency, empiricism, objectivity and standardized care. There is little room for inclusion of alternative ideologies in medicine and health care, especially those of minority ethnic groups (Frideres, 1994). In this paper I attempted attempted to address the questions: how can traditional Aboriginal medicine be integrated into the Canadian health care system, and what is the nurse’s role in this process as they are the most populous branch of primary public healthcare providers?
The social significance of the issue is apparent upon examining Aboriginal medicine as written about in current academia because of the current desire to return to traditional healing methods to both revitalize the culture and shift western ideologies of the biomedical model of medicine. In order to adequately improve Aboriginal health there needs to be a reexamination of the contributions of traditional aboriginal medicine to aboriginal culture. It is apparent that there are many differences existing between the health paradigms of traditional medicine and western medicine resulting in many barriers to the successful integration.
Three primary barriers discussed were the deeply entrenched rigidity of the biomedical model, the cultural barriers stemming from the marginalization of Aboriginal peoples in Canada and the commoditization of traditional health methods. In contrast the facilitating factors discussed were current shifts in public views of health, the role of the nurse as a holistic primary health care giver and lastly, the increased desire of Aboriginal peoples to regain their culture. The ability of nurses to provide holistic, culturally sensitive care with adequate understanding of Aboriginal health traditions is essential to both the improvement of Aboriginal health as well as to re-establishing important pieces of their culture. Further this allows nurses to be at the forefront of the integration of traditional healing practices into the western health care system. Both the Aboriginal Nurses Association as well as Health Canada supports this view which aides in facilitating positive progression and change of the biomedical model currently dominating Canadian health care into a more holistically focused approach.
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