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Western Medicine advancements have been significant in recent years, but sensitivity in respect to culture and consideration regarding health care delivery, are not proving to value the culture and tradition of medicine for Indigenous populations. For many reasons, Indigenous Peoples are hesitant to pursue treatment in some cases as it pertains to mental health, specifically PTSD, childbirth, and cancer treatment. The cultural implications of Indigenous Peoples in the health care setting is essential for congruent care among patients; furthermore, taking a holistic approach in the care of an Indigenous patient would include the integration of traditional Indigenous medicine with Western Medicine, recognizing the importance of the patient’s spiritual and medical needs as a whole, and taking the time to study their culture of medicine.
Health practices specific to Native American culture include spiritual development through harmony with nature, meditation and fasting, and nature’s medicines. Nature’s medicines would include plant and herb-based medicines with or without approaching a healer. Other examples of health care delivery include a variety of practices, ceremonies and craft that connect the individual patient with their part or entire community. Some examples of this would be sweat lodge ceremonies, drumming circles, canoe journey, gift giving, grass ceremony, mind mapping, tobacco sessions, and traditional crafting (beading, making masks, canoe building, and dream catcher weaving).
The concepts of birth and death are closely intertwined because both are considered close to spirits within the spirit world. As the text states, “Native American elders pass on to children the notion that their own life-force carries the spirits of their ancestors”. In representing birth and death, children and elders are highly valued within tribes due to their nearness to the spiritual world and the wisdom the spirits give them; members of the tribes seek the counsel of the elders and the insight of children. Elders, also known as the Keepers of Wisdom, carry the knowledge and experience of the sacred ways: placing them as the head of the tribe, in which they participate in multiple roles, “parent, teacher, community leader, and spiritual guide”. While the roles of tribal men include hunting for food, defending the tribe from outside threats, and leading the tribe, tribal women roles include household chores, farming and gathering food, and raising children.
The Rites of Passage are rituals which were established to help young men make the transition of leaving his family home to prove himself; to show that not only can he survive on his own but overcome challenges he may face by using the teachings from his elders. The Vision Quest, one of the most common rites of passage within Native North American tribes, is believed to lead to a distinct form of guidance from “forces of nature”; isolating oneself through fasting and prayer away from civilization. The challenges and experiences a boy encounters on his vision quest, heavily influences the man he will grow into.
A tribal woman’s rite of passage into adulthood, and another form of a rite of passage for tribal men, was marriage and birthing children. However, due to modern-American culturalization, Native American’s main indicator of reaching adulthood is closely linked to financial independence. Modern-day rite of passage into Tribal groups have dramatically changed from self-discovering quests to Native Americans proving their cultural identity by measuring their blood quantum, the percentage of blood they have from a specific tribe, and carrying an “Indian card” proving their blood quantum. In addition, Native communities do not allow members to be in multiple tribes, even if an individual has multiple bloodlines within their DNA.
Cultural traditions of Indigenous populations impact health care delivery systems in Western Medicine in a few different ways. First, there has been a history of mistrust between tribal communities and health care providers due to their historically negative relationship and current mistreatment. Statistically, Indigenous people have poor cancer survival rates because they are less likely to receive optimal cancer care or surgery. Their rates of mental health illness are 1.5 times higher compared to American populations and they are 2 times more likely to have PTSD and be dependent on alcohol. Cultural impact on delivery systems now include providers learning more about Indigenous people, recognizing the importance of their culture, and incorporating Indigenous health beliefs into their practice. According to Lewis & Myhra, “Providers learned culturally appropriate interpersonal behaviors, which included talking less, becoming comfortable with silence, taking more time with their patients, and performing self-critique of their inherent biases and beliefs”.
According to Indigenous Peoples, there is a spiritual connection to health and wellness; which, when admitting and caring for a traditional Native patient, the approach health care professionals need to take is one that is inclusive of that patient’s spiritual and medical needs. Overall health and wellness of the client is considered to be directly linked to the client’s balance and harmony at a physical, mental, soul or emotional, and spiritual level. Any form of imbalance between these levels results in disease and unwellness; which, can be alarming and troubling to Native American clients. The main cultural facets of Native American healthcare is the incorporation of spirituality and religion while delivering care to the patient. According to Karen Hill, “‘Traditional medicine is a system of medicine in the same way that Western medicine is a system, in the same way naturopathic medicine is a system,’…who shares a practice with traditional healer Elva Jamieson on the Six Nations of the Grand River First Nation in Ohsweken, Ont. ‘Because it doesn’t look the same, I think physicians don’t know how to receive it’”.
The importance of integrated medicine for indigenous peoples can be invaluable and it provides them a means to reclaim their wholeness as a people. ‘More and more people are coming to understand that you can have a blend,’ says McKinney, who is the director of Northern Medical Services at the University of Saskatchewan. ‘I have a number of patients where this is the case, and I support that”. She goes on to say that it is more about trusting their own medicines the way they have for centuries before Western Medicine and how important it is for the medical community to start building that relationship.
The implementation of integrated medicine still has a long way to go but the need for change has been recognized and the results of these changes have been proven and documented. Integrated medicine has a lot to teach Western Medicine and may end up not only being beneficial to the Indigenous populations but quite possibly could be beneficial for other ethnicities as well. Building trust on a medical level will not only reduce fatality due to lack of treatment but it will build a bridge between holistic approaches and Western Medicine for generations to come.
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