historical and scientific perspectives on the health of canada's first ...

matter what method, can lead to only marginal changes in the health status of
these peoples.... So, when Aboriginal peoples gain control of the health care
system, do their efforts produce a noticeable improvement in health status, or are
their efforts frustrated by problems within the larger socio-economic world within
which they live? 67
As the 20 th century drew to its close <strong>and</strong> the new millennium commenced it was seen by all
parties that the process of self-determination in health care is as irreversible process as it is
linked to the broader struggle for social <strong>and</strong> political self-determination by Aboriginal peoples.
In this new <strong>historical</strong> process, the evidence to date suggests that some major changes are
occurring. Nevertheless, there still remain some obvious problems. The dearth of Aboriginal
health professionals has led to a continuing reliance on non-Aboriginal people, <strong>and</strong> with the new
Aboriginal Health Human Resource Initiative (launched in 2005, with a $100 million funding
commitment over five years.) it is expected that this will be on a temporary basis. Funding
continues to be a perennial problem since in virtually all programs there remain financial
shortfalls, <strong>and</strong> funding seems to be becoming more difficult just as progress is being made.
“With local control, Aboriginal groups seem to be willing to keep the best of biomedicine <strong>and</strong>
complement it with more traditional programs.” Whether there is any significant change in heath
status is another question, one which the lack of data makes it presently impossible to address. 68
The Royal Commission on Aboriginal Peoples (RCAP) issued this statement in Vol. 3 Section
3.3.1 of its 1996 report Gathering Strength:
Aboriginal, federal, provincial <strong>and</strong> territorial governments, in developing policy
to support health, acknowledge the common underst<strong>and</strong>ing of the determinants of
health found in Aboriginal traditions <strong>and</strong> health sciences <strong>and</strong> endorse the
fundamental importance of:
holism, that is, attention to whole persons in their total environment;
equity, that is, equitable access to the means of achieving health <strong>and</strong>
rough equality of outcomes in health status;
control by Aboriginal people of the lifestyle choices, institutional
services <strong>and</strong> environmental conditions that support health; <strong>and</strong>
diversity, that is, accommodation of the cultures <strong>and</strong> histories of
First Nations, Inuit, <strong>and</strong> Métis people that make them distinctive
within Canadian society <strong>and</strong> that distinguish them from one another.
The issue here seems to revolve around the decisive question of what are the actual determinants
that will maintain health (prevention) <strong>and</strong> effectually restore health (treatment) on an holistic
basis. Is it medical services, or alternatively basic multi-sectoral factors such as an unpolluted
natural environment, potable water, whole foods free of chemical contamination, positive
psychological <strong>and</strong> spiritual attitudes stemming from having hope <strong>and</strong> a high purpose in life. The
question of preventive <strong>and</strong> treatment determinants will be afforded careful consideration in
Section II of this document.
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