Star Phoenix – Doug Cuthand
The provincial plan to amalgamate all the regional health boards into one provincial board is an opportunity for First Nations to have input into health policy and lay the foundation for future development.
Health is one of those jurisdictional issues that have been a source of frustration among First Nations for generations.
The relationship dates back to the treaties and the British North America Act. The BNA Act states that the Federal government has the responsibility for “Indians and lands reserved for Indians.” However the same legislation gives the responsibility for health to the provinces.
Treaty number six states “That a medicine chest shall be kept at the house of each Indian Agent for the use and benefit of the Indians …”
This medicine chest clause has been interpreted by our people as universal medical care. The Chiefs who negotiated the Treaty told the crowns representatives that they were concerned for the coming influx of settlers and requested that the government provide medical care.
Our people had experienced the devastating plague of smallpox that killed over half the population of the indigenous plains people. Next would come tuberculosis, the Spanish flu in 1918, and later diabetes and social pathologies such as drug and alcohol abuse and suicide.
Treaty number six was negotiated and signed in 1876 and modern medicine was in the formative stages and subject to change as knowledge and technology increased. The treaties were negotiated in perpetuity so they must grow and adapt to changing times. A medicine chest in 1876 has evolved to today’s modern medicine.
In the 1960s when the province adopted medicare they charged premiums to all Saskatchewan citizens, however the idea of paying premiums flew in the face of the treaty right to health care as promised in the treaties. The Chiefs at the time vowed to boycott medicare and refuse to pay premiums. The result was a battle between the First Nations and the province that finally came to an end when premiums were dropped for everyone.
I also recall at that time the Indian Hospital at North Battleford was closed and the federal government supported the Battlefords Union Hospital. The hospital received one million dollars and the facility was increased by one bed.
In spite of constitutional recognition of our treaty and aboriginal rights successive governments have refused to recognize health care as a Treaty right.
The FSIN has come out advocating for a separate health care system for First Nations people.
This might be problematic with the expense and shortage of specialized treatment but there are areas that First Nations people need special attention.
Diabetes for example leads to kidney failure and the need for dialysis several times a week. For people living on a rural reserve simply travelling to a city several times a week ends up taking up most of a person’s time.
Dialysis clinics should be set up on reserves and serve a group of reserves within a much shorter radius.
Diabetes is a multi-faceted disease that affects the limbs, heart, kidneys and so on. It results in amputations, heart disease and kidney failure. Diabetes is our modern plague and needs special attention from the health system. Also it is a preventable disease and there needs to be public education and increased screening.
First Nations people have to take control of their health care much like we took control of our education system. We need an integrated but parallel system that provides meaningful care to our people. We need to allow for traditional medicine to combine with modern medicine.
Our traditional healers provide both herbal medicines and spiritual guidance to people in pain.
One area that also needs some review is the need for an Indigenous approach to palliative care. When people are with their loved ones at the end of life we require sage or Sweetgrass which are forbidden in most hospitals, also ceremonies are performed to send the spirit on the way to the next world and hospitals with their institutional environment are not conducive to the process.
Our people have special needs based on our Treaty Right to health, our culture and the overarching plagues such as diabetes. The provinces realignment to a single provincial health board has to review the health care our people are receiving and make it more relevant.