Treaty Presentations

Health Care and First Nations

Presentation to NWCC Nursing Program, Nov. 21, 2007

Good Afternoon, it’s my pleasure to share this time with you. I’m the Chief Negotiator for five Tsimshian First Nations (TFN Treaty Society). I’ve had the opportunity to serve as Chair for a regional structure called the First Nations Health Committee which has given me some additional insight to health issues and health services here in British Columbia.

First Nations require health services – the same as any other segment of society. However that is one of the few similarities when it comes to First Nation or Aboriginal people and health. By now I assume you will know:

• There are ~197 “Indian Act Bands’ in BC;
• There are Status Indians, non-status and now ‘Treaty Indians’
• Canada through Health Canada and the province both have responsibility for health services to Aboriginal people in BC;
• The First Nation population in Northwestern BC is much higher than the provincial norm – may be the highest percentile in the province;
• If we use the NWCC student enrolment as an indicator, we certainly are the highest in BC;
• Aboriginal people die younger, incur more accidents, suffer higher levels of domestic, chemical and alcohol abuse than any other segment of society in the northern portion of the province;
• Our normal household income is below average;
• Our houses are overcrowded in efforts to shelter whole families;
• Our children are not succeeding in the school system at the same level as with the non-native families;
• At least one-half of most village populations reside ‘off-Reserve’;
• The Aboriginal population is the youngest and fastest growing in BC;



So What Does This Mean?

If you are an Aboriginal person living in British Columbia, your standard of living is likely to be 20 per cent below the provincial average, based on measures such as income, employment, educational attainment, and housing adequacy. Think of any disease or health condition – from diabetes, pneumonia, or HIV/AIDS to injuries caused by a motor vehicle crash – and your chance of experiencing it will be greater than your non-Aboriginal counterparts. As a result, if you are a Status Indian, you can expect to live 7.5 years less than other British Columbians (life expectancy estimates are not available for Aboriginal people other than Status Indians). (2001 Provincial Health Officers Annual Report)

While there have been improvements, little has changed in the since that report, and those facts were published. Something is wrong! Health statistics only confirm a problem – it doesn’t answer the questions of WHY! (and I have no answer for that; but each of the factors above contributes and has effect).

The Efforts to Improve

Aboriginal people are survivors with a will to improve overall living and social conditions that affect them. From my perspective we seek:

• Political structures and support to look out for ourselves – be Self-Governing. In part, this will allow First Nations as affected to identify issues on the ground and deal with them directly, not as a result of someone else’s perspective that is meant to generalize for all of society;
• Political will from British Columbia and Canada to recognize and support the requirement of Self-Government;
• Specifically targeted programs that will prevent health detriments. To provide efficient and effective support and treatment services which will be accessible to our people;
• One element of preventative services is education. Education in the classic school-room environment as well as education about life skill requirements – parenting, alcohol effects, social conduct, etc.
• Another level of education, and on a very proactive front, is that of professional and care-giver training and recruitment – there are many fine doctors, nurses (& in training!) and other health workers helping – to have more of our own will be a much larger step up in addressing aboriginal health issues;
• I hesitate to include more research; however our leaders at every level must recognize the problems and issues faced in making change. This will require continued data collection and sharing of that information to create and maintain awareness. Most of us would be skeptical of a politician’s willingness to reach out and help if their noses aren’t rubbed in the ills of the problem on a consistent basis;
• Retention of our history – cultural integrity and pride in who we are and where we’ve come from – this will help with the mental strengthening and readiness amongst First Nations;
• An economy to support the political realities;
• Land – as land provides the root of First Nation’s survival and it can provide the economic platform for an emerging and stable first nation economy;
• Work with BC and Canada to coordinate services and resources – quit competing and start complementing! We need a plan, one that First Nations themselves play a role in crafting. Not just on a global level but region by region and perhaps even community by community. The intent and requirement is for a very holistic and inclusive outcome whether it is for the planning, action or assessment and evaluation. Key components to consider should include housing, economic initiatives and educational standards;
• At the community level, more attention must be paid to how we live with each other—for example, First Nation people from Kitsumkalum and from Kitselas are always going to have the citizens of Terrace as neighbours. We will have more in common than not – we should be exploring realities and finding ways to cooperate on services for this area (the expansion of the city transit is a small but visible result of this).



Treaty

Treaty making in BC is not new. In 1973 Canada established policy for the negotiation and settlement of aboriginal land claims. This was largely a result of the famous Calder Decision (SCC). I should point out that this policy and its implementation efforts have not been very fruitful to the majority.

Locally, the Tsimshian signed onto that process with the formation of the Tsimshian Tribal Council;

In 1993 the Tribal Council entered today’s BC Treaty Commission process by filing a Statement of Intent to negotiate with Canada and British Columbia. We have history among ourselves and not all of it positive – in 2004, the original Tribal Council structure was eliminated with five TFN’s forming the TFN Treaty Society to continue negotiations as a collective while at the same time, two others opted to step back and determine next steps. Lax Kw’Alaams as the largest community has since re-engaged on an individual basis.

The objective for the TFN Treaty Society is to “Work together to develop strong, healthy, self-sustaining Tsimshian First Nations through the negotiation and conclusion of treaties.”

You can’t have a healthy community or a healthy nation group if you don’t have healthy individuals and healthy families!

In 2005 TFN’s established guiding principles for negotiations including:

• Acknowledging the strength in the five Tsimshian First Nations working together;
• Recognition and respect for each others territories;
• Cherishing our common language, history and traditions;
• Respect for our elders;
• Protecting our children and future generations;
• Enhancing and protecting our political, social economic and territorial rights;
• Working towards self-government and greater self-determination in a manner that respects the will of the people through democratic principles and also respects the traditional system of governance;
• Entrenching our rights to food, clothing, shelter, health and education;

The main topics of TFN treaty negotiations include:

• Self-Government
• Eligibility and Enrolment
• Culture and Heritagev
• Lands, Access & Sub-surface Resources
• Parks and Protected Areas
• Water
• Forests
• Fisheries
• Wildlife & Migratory Birds
• Environmental Assessment & Environmental Protection
• Fiscal Relations, Taxation and Capital Transfers
• Ratification and Approvals

Topic issues related to health, education and family services fall under the category of Self-Government. Specifically, we are in pursuit of law-making authority, of program development and delivery and of mechanism to integrate or harmonize with provincial and federal structures. In a brief summary perspective – to place the Tsimshian First Nation communities in a position to individually and collectively as they may choose to address and act on each of the topics stated in the above ‘Efforts to Improve’.

Most will recognize that treaty making by itself will not assist our people as quickly or effectively as desired. Therefore we will continue other efforts—individual and collective, I provide the example of three other processes:

Individual TFN efforts to provide economic growth and stability as negotiations proceed. The Kitselas Canyon Tourism initiative, the Metlakatla Ferry Corporation, the Kitsumkalum Tempo Gas Bar are examples of activity being taken advantage of in what should be more common effort and success with the settlement of treaties;

The Northwest Tribal Treaty Nations which is a forum for First Nations across northern BC as established in 1991. A primary purpose is to provide the vehicle to bring us together on common issues such as health;

Politically, we seek assistance through the First Nations Summit and its offshoot the First Nations Chiefs’ Health Committee. The Health Committee Mission Statement is: To support the development of healthy and self-sufficient First Nations' communities by promoting traditional and cultural approaches to health and community development. The CHC will advocate First Nations' Self-determination when addressing policy and program issues with Canada and British Columbia.

These are some of the many efforts of First Nations locally and beyond.

Closing Comments

When it comes to health standards for Aboriginal people there is a need for change. Our people want that change to be positive and recognizable. The challenge is huge – and it will take more time than we wish.

We can talk to each other from opposite sides of the world in a millisecond, we have computer and internet capacity that knows no limits, man has reached the moon. Surely we can do more in our lifetime to help our fellow man, woman and child.

You as new health professionals can be a part of the solution – be understanding, be open to new ways of doing business, be creative, don’t be afraid to raise the level of service by asking questions and seeking what may be seen as a different way of providing your care.

Thank you for your attention.