REHEARSING FOR REALITY:
THE NEED FOR INNOVATION
IN ABORIGINAL YOUTH HEALTH
Dr. Jo-Ann Episkenew, IPHRC, University of
Regina
Dr. Carrie Bourassa, IPHRC, First Nations
University of Canada
THE NEED FOR HEALTH EQUITY
“Life expectancy has
risen for Aboriginal
Peoples, but on this
and on virtually every
health status measure
and for every health
condition, the health
of First Nations, Inuit
and Métis is worse than
that of the overall
Canadian population”
(CIHI, 2004, p. 80).
P.Y.L.L. AND YOUTH CHOICES
The largest cause of Potential Years of Life Lost (PYLL)
for First Nations on-reserve is injuries:
 4,909 years of life lost per 100,000 population,
compared with 1,271 years of life lost in the Canadian
population as a whole.
 Injuries include:
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suicide and self-inflicted injury,
motor vehicle accidents,
drowning and submersion,
death from fire,
homicide, and
accidental poisoning by drugs. (CIHI, 2004, p. 80)
IT ALL COMES BACK TO THE LAND.
“WE HAVE LOST EVERYTHING...
OUR LAND, OUR
LANGUAGE, OUR
CULTURE. ALL WE
ARE LEFT WITH ARE
CRUMBS” (Joe
O’Watch, Nakota
Elder, 2011).
WE’RE REMINDED DAILY OF
WHAT WE HAVE LOST.
“For Europeans,
ownership of land is a
dominant value. For
American Indians,
land, plants, and
animals are
considered sacred
relatives, far beyond a
concept of property.
Their loss became a
source of grief”
(Yellow Horse Brave
Heart and DeBruyn,
1998, p. 63).
HISTORICAL TRAUMA
“Historical trauma (HT) is cumulative
emotional and psychological wounding
over the lifespan and across generations,
emanating from massive group trauma
experiences; the historical trauma
response (HTR) is the constellation of
features in reaction to this trauma. The
HTR often includes depression, selfdestructive behavior, suicidal thoughts
and gestures, anxiety, low self-esteem,
anger, and difficulty recognizing and
expressing emotions. It may include
substance abuse, often an attempt to
avoid painful feelings through selfmedication. Historical unresolved grief is
the associated affect that accompanies
HTR; this grief may be considered fixated,
impaired, delayed, and/or
disenfranchised” (Yellow Horse Brave
Heart, 2003).
WHAT IS THE POLICY CONTEXT?
Public policy
founded on an
assumption of
settler
superiority and
the inevitability
of settler
dominance.
CANADA’S WORST POLICY EVER
“An amendment to the Indian act in
1920 made it mandatory for every child
between the ages of seven and fifteen
to attend [residential] school. Section
10 set out the mechanics for
enforcement; truant officers, and ‘on
summary conviction,’ penalties of fines
or imprisonment for non-compliance”
(Milloy, 1999, pp. 70-1).
INDIGENOUS IMAGINATIONS AS ENEMIES OF
THE STATE
Modeled after institutions for
delinquent children, Canada’s
Indian residential schools were
designed to create new physical
and social worlds for Indian
children, to be “a circle – an allencompassing environment of
resocialization. The curriculum
was not simply an academic
schedule or practical trades
training but comprised the
whole life of the child in the
school. One culture was to be
replaced by another through
the work of the surrogate
parent, the teacher” (Milloy,
1999, p. 33).
OBEY,
CONFORM,
SURRENDER
“Bells and whistles, gongs and clappers represent everything
connected with sound management – order, authority, discipline,
efficiency, system, organization, schedule, regimentation, conformity
– and may in themselves be necessary and desirable. But they also
symbolize conditions, harmony and states that must be established in
order to have efficient management: obedience, conformity,
dependence, subservience, uniformity, docility, surrender. In the end
it is the individual who must be made to conform, who must be made
to bend to the will of another” (Johnston , 1988, pp. 43).
BUT THERE WERE CONSEQUENCES!
“The missionary says something in the language and everyone
goes silent. They look at the children and slowly nod their
heads. Their father tells them they’re going to school to learn
to read and write. He doesn’t tell them where or for how long,
and they don’t ask. . . .
Their parents and grandparents don’t know it, but
someone or something has ripped out their hearts. They
watch as their hearts slowly stop beating, then look up to see
the boat disappear. They don’t know it, but they’re going to
think about their children every minute of every hour of every
day until they return. If they don’t return – and some or them
won’t – they’ll remember them forever. They wonder if they
could’ve prevented it. They could’ve, but by then, it’ll be too
late” (Alexie, 2002, pp. 9-10)
INTERNAL/EXTERNAL LOCUS OF CONTROL
“Something is happening
to them, but they don’t
know it. They are
developing a routine and
someone else is making
decisions for them.
Somewhere in the far
distant future, they will be
unable to make decisions
for themselves and will rely
on others to do it for them”
(Alexie, 2002, p. 29).
“The ability to act, to have
agency, is dependent on
having a well-developed
imagination. Before taking
action one must first
imagine what change might
look like and then, secondly,
imagine the steps required
to achieve that change. The
children and grandchildren
of residential school
survivors were raised in an
environment where often
their imaginations were
feared and repressed“
(Goulet, Linds, Episkenew,
Schmidt 2011).
RELATIONSHIP BETWEEN
AGENCY & IMAGINATION
CONCEPTUAL FRAMEWORK FOR PATHWAYS TO
HEALTH EQUITY FOR ABORIGINAL PEOPLES: A
CIHR ROADMAP SIGNATURE INITIATIVE
 Amalgamation of Indigenous knowledge with
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western science would enhance the academic
pursuit of knowledge;
Researcher-community engagement;
Capacity development and utilization;
Partnership and relationship building;
Knowledge translation and exchange; and
Support for research on significant challenges to
FN/I/M well-being. (King et al, 2011, p. 3)
PATHWAYS TO HEALTH EQUITY FOR
ABORIGINAL PEOPLE: KEY DIRECTIONS
 Increasing the capacity of FN/I/M communities to be
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involved in research agenda development and act as
partners in research,
Reflecting the importance of community-owned
knowledge;
Increasing knowledge translation and promoting a holistic
model of health;
Partnerships and collaborations to address FN/I/M health
issues from an inter-sectoral, multidisciplinary approach;
and
Strengthening the knowledge base with a focus on
intervention/action research. (King et al, 2011, p. 2)
CENTRALITY OF COMMUNITY-BASED
RESEARCH
 Emphasizes respect for the individual and a
commitment to social change and is emerging
as a way to enable research to empower
communities;
 Philosophy of “with, by and for” Aboriginal
people rather than “on or to”;
 Historical mistrust of research as it rarely
benefitted Aboriginal communities and often
served to further marginalize them.
AN ISSUE OF TRUST
“Research involving Aboriginal
peoples in Canada has been defined
and carried out primarily by nonAboriginal researchers. The
approaches used have not generally
reflected Aboriginal world views,
and the research has not necessarily
benefited Aboriginal peoples or
communities. As a result, Aboriginal
peoples continue to regard
research, particularly research
originating outside their
communities, with a certain
apprehension or mistrust” (TCPS 2,
2010).
RESEARCH, POLITICS, POWER
“The gathering of information and its
subsequent use are inherently political.
In the past, Aboriginal people have not
been consulted about what
information should be collected, who
should gather that information, who
should maintain it, and who should
have access to it. The information
gathered may or may not have been
relevant to the questions, priorities
and concerns of Aboriginal peoples.
Because data gathering has frequently
been imposed by outside authorities, it
has met with resistance in many
quarters” (RCAP, Vol. 3, Chpt. 5, 1996).
AND NOW FOR SOMETHING COMPLETELY
DIFFERENT!
 In 2005, the university researchers and File Hills
Qu’Appelle Tribal Council Health Educator began a
collaborative research project with support from an
IPHRC Partnership/Network Development Grant.
 FHQTC Chiefs had identified youth health as a priority for
all tribal council programs and services.
 In 2009, Canadian Institutes of Health Research awarded
this project an Operating Grant to apply theatre to
investigate health issues, leadership, and decision
making of Indigenous youth.
 Project employs theatre techniques that David Diamond
(2007) adapted from Augusto Boal’s Theatre of the
Oppressed (1979).
THE RESEARCH TEAM
 Dr. Linda Goulet, First Nations University of Canada
 Dr. Warren Linds, Concordia University
 Karen Schmidt, File Hills Qu’Appelle Health Services
 Jonathan Dewar, Aboriginal Healing Foundation, Co
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Investigator
Dr. Mary Hampton, Luther College, Co-Investigator
Dr. Varda Mann-Feder, Concordia, Co-Investigator
Heather Ritenburg, University Research Assistant
Dr. Caroline Tait, University of Saskatchewan, CoInvestigator
Allison Whiteman, Community Research Assistant
Dr. Felice Yuen, Concordia, Co-Investigator
REHEARSING FOR REALITY
``Our workshop process was designed to provide a performance-based, theatrical
structure for dialogue on significant social, cultural, and health issues and to create
imaginative `blueprints` for
possible healthy futures based on
appropriate interventions and
choices. The process developed
leadership skills as participants
began to question habitual
thinking, enabling them to
become aware that they have
power to produce knowledge and
take action, rather than believing
themselves to be passive
consumers of knowledge that
others produce and actions that
others prescribe`` (Goulet, Linds,
Episkenew, Schmidt 2011).
“Interactive drama offers youth
moments of decolonization as
they are drawn into the activities
through the playfulness of
games. In the dramatic space
created by the games and the
drama activities, they lose
themselves in the fun and their
bodies are able to let go and
move beyond the tightness of
oppressive relationships. They
feel what it is like to be a leader
and to make decisions. As they
experience the joy of freedom to
be, they are challenged to think
creatively, to express themselves
and create their own meanings”
(Goulet, Linds, Episkenew,
Schmidt 2011).
EMBODIED STORYTELLING &
LEADERSHIP
TRYING DIFFERENT CHOICES
(REMEMBER P.Y.L.L.?)
 Creating different
sets of images;
 Developing the
capacity to give
expression to
experience;
 Testing different
choices and
examining the
consequences
EPIPHANY No.1:
 External locus
of control
 Lack of agency
 Lack of volition
 “I don’t know.
We’re just
along for the
ride.”
WHATEVER!
EPIPHANY No. 2:
PLAY IS
IMPORTANT!
“But we don’t
want to make a
play. We just
want to play
those games!”
EPHANY NO.3: THE IMPORTANCE OF
MICRO-CONTEXTS
FILE HILLS FARM COLONY
“Founded in 1898 by Indian agent William Morris Graham, the
colony was established under what Ann Laura Stoler calls an
“administrative anxiety” over the “regression” of ex-pupils back
to traditional ways after completing residential school.1 The “resocialisation” and “re-education” of Aboriginal children was not
as quick or complete as the government had envisioned.
Consequently, Graham, predominantly with the collaboration of
Kate Gillespie at the File Hills boarding school and Father Joseph
Hugonard at the Qu’Appelle industrial school, selected “certain”
ex-pupils from various reserves to be settled on sub-divided land
allotments on Peepeekisis and live like non- Aboriginal
homestead farmers. . . . While the colony existed in government
records for approximately fifty years, its effects are still felt on
the Peepeekisis Reserve” (Bednasek, 2011, p. 53).
OTHER MICRO-CONTEXTS
Minnesota “Indian”
Wars (1864)
Cypress Hills Massacre
(1873)
Battle of the Little Big
Horn (1876)
Battle of Batoche
(1885)
WHY CONTEXT MATTERS
“Each community is
positioned within a
specific socio-cultural
history (Vgotsky, 1978;
Cole 1996) that affects
how it views health and
health research and
how it will participate in
the research process”
(Goulet, 2011).
“We see health for
Indigenous youth as a
decolonizing process in the
political act of healing: self
through the restoration of
autonomous decision
making and actions, peer
group through
development of healthy
relationships and shared
leadership, and community
through co-determined
leadership among
community members”
(Goulet, Linds, Episkenew,
Schmidt 2011).
ENGAGING INDIGENOUS
IMAGINATIONS
IF YOU DO WHAT YOU’VE ALWAYS DONE,
YOU’LL GET WHAT YOU’VE ALWAYS GOTTEN.
(Anonymous)
OUR RESEARCH IS SUPPORTED BY
CANADIAN INSTITUTES OF
HEALTH RESEARCH OPERATING
GRANTS.
References
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An Annual Journal of Research, Commentary, and Reviews, 37: pp. 53-70. Accessed
on 21 October 2011.
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Dissai;t. G. Erasmus, P.L.A.H. Chartrand, J.P. Meekison, V. Robinson, M. Sillette,
and B. Wilson.
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Regina, SK
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