HSCI220 Week 3

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School

Simon Fraser University *

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220

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Sociology

Date

Feb 20, 2024

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docx

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Uploaded by maylenechen818

HSCI220 Week 3: Reading notes: Our Story: The Made-in-BC Tripartite Health Transformation Journey 1) What are the responsibilities of the provinces to First Nations health? (50 words or more) All provinces must provide the following healthcare parameters for all residents:  healthcare coverage  portability of healthcare coverage (ex. if a provincial resident requires care while traveling outside said province)  accessible services: removal of barriers to services, financial and physical  comprehensiveness: coverage for all "medically necessary" services  administration: provinces can administer these health programs themselves or through an approved third-party 2) What are the responsibilities of the Federal government to First Nations health? (100 words or more) The federal government's responsibility to First Nations according to the Constitution is to provide health services to Status holders on-reserve, which it has done through the First Nation and Inuit Health Branch (FNIHB) to provide prevention-based healthcare and some primary care to eligible First Nations. In 1988 communities were given to option to have more control over their healthcare through the Indian Health Transfer Policy, in which the federal government relinquished the responsibilities of some health services, such as the issuing of non-insured health benefits (dental, vision, etc.), to First Nation and Territorial governments. 3) What’s the Non-Insured Health Benefits Program and how does it work with regard to First Nations? (50 words or more) The Non-Insured Health Benefits Program (NIHB) is available to eligible First Nations (ex. status, reserve residents) who are not covered by any other health benefits (private or public). This program covers vision, dental, equipment, medication, transport, and more. The program is either issued by the Federal government (FNHIB) or Territorial or First Nation governments depending on the province/territory 4) Why do you think that First Nations want to be involved in running their own health services and health system? (50 words or more) Because prior to colonization, we had our own health systems and beliefs; the knowledge of these systems still exists and they should be utilized to help the people thrive and to keep the knowledge and cultures alive. Relying on a genocidal government system that ascribes temporary treatments to achieve its own definitions of health has only traumatized and neglected entire generations. 5) Describe the important shift in governance relations among BC First Nations that happened in 2005 with the formation of the FNLC. (50 words or more) The BC Assembly of First Nations, the First Nations Summit, and the Union of BC Indian Chiefs formed the FNLC in 2005 with the goal of solving Title and Rights disputes with the government. It published the New Relationship document, which informed the government of its intentions to collaborate on addressing issues in First Nations communities, such as health and socio-economic gaps. 6) The FNLC consulted with First Nations to outline the main issue in health care. What were the main issues that First Nations people in BC said that they had in relation to healthcare? (50 word or more)

Limited access to dental care, especially serious in children; Limited financial means to travel for health and dental care; Critical need for inpatient and outpatient mental health and addiction treatment; Serious access barriers to women's health. Overall, these problems are exasperated in remote communities 7) For the Tripartite agreement to become a reality, the FNLC needed to work with many different partners. Describe the relationship between the Province and the FNLC through the stages required to negotiate the tripartite agreement. (100 words or more) In 2005, the FNLC and community leaders held an accord in Kelowna with Provincial leadership to improve government-to-government relationships. Later, this accord was cast aside by BC Conservative government after the Liberal government's fall, and replaced with the TCA (Transformative Change Accord), which brought forth a plan to bridge socio-economic outcomes in 10 years' time. This plan was expanded in 2006 to include a First Nations Health Plan with 29 action items in the following areas: governance, relationships, and accountability; health promotion; health services; and performance tracking. That year, the first Memorandum of Understanding was signed by provincial leadership, and later the federal government in 2012, intended to show commitment to the above action items. These actions involving the FNLC, and provincial and federal leadership are what preceded the Tripartite agreement in 2007. 8) What remaining questions do you have about the FNLC, FNHA or the Tripartite Agreement? 9) Please list any words or concepts that you think might be important but that you did not understand. In-class notes: “From Local Control to Sovereignty: Four Decades of Indigenous Health Governance” (Guest Lecture: John O’Neil) - “Medical anthropology”: related to sociology; studies social and cultural dynamics in communities and how these values influence their lives/health o How do they handle disease currently? What were their traditional approaches? What are their views of healing, health, and wellbeing? o Looked at patterns/transition of Inuit health systems: from self-reliance on the land, to federally established “nursing stations” - About nursing stations in Inuit communities: o Fed. Gov. hired young British nurses eager to “help” the natives “survive” (natives who thrived on the land for 1000’s of years) o Forced their teachings of “health” onto the locals, teachings intrenched in euro-centric beliefs of health (Nurse: “You people are sick because you need to eat more vegetables!” Inuit: “Ma’am, this is the Arctic…”) - Colonizing agents: residential/day schools, HBC, trading posts, government institutions, etc… But the health system was overlooked because it was perceived as a “good” institution that can do no harm. And it helped in some cases, but also has done deep harm that has yet to be addressed in many communities. - Indian Act: the basis of Indigenous-Federal Gov. relations since conception of “Canada”: began as a way to maintain relationship with Indigenous Nations, but turned into a tool for extermination and assimilation

- The majority of Indig. Communities in BC don’t have high rates of suicide (almost 2/3 have none whatsoever)… What is protecting these youth from dying by suicide? o FN bands of these communities have greater control over their education, law, and health services (ie. These communities were more self-sufficient) o Cultural support: access to traditional foods, medicines, lands, ceremonies, etc. o FN bands taking steps to establish Aboriginal Title, have strong political will  All these factors combined = protective factors , in that they result in a greater sense of community and cultural identity in Indigenous youth - Study on Full-transfer VS partial-transfer of health services: the full-transfer agreements revealed statistically signif results; revealed that when FN’s were fully in charge of their health systems that there were less hospitalizations proceeding the transfer (compared to partial-transfers) (Lyana’s lecture) - “Capacity-bridging” VS “empowering”: be careful with the word empower. Empowering implies that the subjects don’t possess the powers needed to fulfill their needs; the power is there, it’s the capacity and tools that are lacking, and these are things that can be bridged .

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