PRIMARY RESEARCH

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Site Visit

The team visited the Native Canadian Center of Toronto for our primary research. The manager of the Center - Eric Johnson conducted a presentation in the ‘Talking Room’. His presentation revolved around the history of Indigenous population in Canada and their historic relationship with the British and French colonizers and later with the Government of Canada. 

He followed that grim and grounding talk with a Sacred Indigineous Cultural Song full of Hope and Light. Songs are very, very important to the indigineous community. These sacred songs and their cultural food habits have acted as the medium for transfer of knowledge and culture for over a millenia. Each community has their own unique songs and cuisine based on their unique lifestyles and cultural evolution.

 

Although Eric didn't speak directly about the high-rate of diabetes in the Akwesasne community, he spoke about the reasons for deterioration of standards for health & wellness. Few of the major factors causing this deterioration are history of colonization, change in lifestyle, change in hunting/cooking/eating habits, lack of access to education, lack of access to healthy food, climate change disrupting their relationship with the land and the wildlife.

 

“When I die I go to a place where time can't follow me.” - Indigenous Song

 

Interview with Tanya Chung-Tiam-Fook
(Admin @ Centre for Indigenous Innovation and Technology - Website)

 

Question: How does the geographical borders between the two communities across the US-Canada Border work?

 

Answer: It’s a very complicated situation due to a long history of that region. The region is known as the Three Nations Crossing and it is one of the most complicated border crossings on the US-Canada border.

 

Q: Is border crossing still a part of their daily life and does it impede their use of time?

 

A: Absolutely. The border crossing and customs are major hindrance in mobility for individuals as well as businesses.

 

Q: What are the food habits of the Akwesasne community?

 

A: Well, unfortunately I haven't had the chance to work on the ground with the akwesasne community. I was hoping to do that when I joined Evergreen but I have to confess that the opportunity has not presented itself. Currently I’m in a parachuting mode analysing the needs of the community

 

Q: How do people get around in Akwesasne to buy their food? The houses look very far apart on the maps. Is there public transportation?

 

A: It’s tough to get around in the community as there is no public transportation and not everyone in the community has access to a personal vehicle.

 

Q: What ways can the western medicine approach to control/prevent diabetes be redesigned to make it more palatable to the community.

 

A: That’s a tough one to answer as there has been a loss of trust over the years and the reconciliation process is an ongoing one. This knowledge will be more palatable if it is  disseminated by the elders in the community. That being said, the culture has evolved to a point where modern knowledge sometimes does flow from bottom to the top. Spreading awareness through knowledge access and building trust with the youth in the community could be of great help.

 

“Fighting oppression is not a job, it’s a lifestyle.”

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SECONDARY RESEARCH

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For our Primary research the team did not have physical access to the community’s geographic location due to time and budget constraints, so a lot of our research comes through the Secondary research.

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DIABETES BY NUMBERS

• An estimated 366 million people around the world have diabetes, or about 5.2 percent of the global population.

• There are 4.6 million diabetes-related deaths each year.

• The Centers for Disease Control and Prevention estimates that 215,000 children and teens now have diabetes.

• Diabetes does not affect all Indigenous peoples equally, as First Nations populations carry a considerably larger burden of the disease compared to Inuit and Métis populations.

• First Nations are considered among the most at-risk populations for developing diabetes and related complications in Canada

• Type 2 is the most common form of diabetes, constituting 90-95% of cases.

• Approximately 50% of all youth-onset type 2 diabetes mellitus (T2DM) in Canada occurs in Indigenous children.

 

FACTORS CAUSING TYPE-2 DIABETES IN THE COMMUNITY

 

• There is a need to re-examine all policies that affect the multiple factors that heighten the vulnerability of First Nations peoples and communities to poor health and affect their ability to choose healthier life options. This includes addressing the underlying social and physical challenges to healthy eating and physical activity in First Nations communities, including socio-economic marginalization, limited opportunities for physical activity, geographic constraints to affordable and healthy foods, mental health and substance abuse, lack of community capacity to organize and run diabetes prevention programs and activities, as well as inequitable and unsustainable funding for prevention programs. 

• Inequities in the social, cultural, historical, economic and political determinants of health, lack of access to nutritionally adequate food and barriers to proper health care play major roles in the diabetes epidemic in Indigenous populations

• John LaForme tested positive for Type 2 diabetes while he was living on the streets in Toronto. He has a long family history with it.  "My reservation, we only have one convenience store," LaForme said. "All our food is either grown or we go to a convenience store where you can buy non-healthy stuff."

• Indigenous food security is a key social determinant of health, given that Indigenous Peoples are more likely to be food insecure and also carry the highest burdens of ill health

• Diabetes in Indigenous populations globally is linked to a complex array of factors; however, a common thread is the shared history of colonization. The World Health Organization has recognized colonization as the most significant social determinant of health affecting Indigenous peoples worldwide.

• Nutrition transition -  transitioning to western processed food high in fat, salt, animal product and low on vegetables and quality nourishment

• Lowered hunting activity led to lack of physical activity leading to unhealthy lifestyle habits.

• The global toll of diabetes attributable to PM2·5 air pollution is significant. Reduction in exposure will yield substantial health benefits.

 

APPROACHES AND CONSIDERATIONS

• Interventions must be culturally appropriate and tailored to meet the specific needs of communities. This includes incorporating First Nations’ perspectives on health and healing and the root causes of diabetes, as well as drawing on the strengths and resilience of First Nations peoples, including the strengths of families, communities and cultures to support First Nations people in adopting healthy behaviours.

• Such strengths are important for reducing the stresses that can enhance disease susceptibility.

• Indigenous Peoples' food systems express sophisticated ecological places‐based knowledge, accumulated and adapted through generations, and emanating from Indigenous Peoples' connection with nurturing and life‐giving Mother Earth.

• Enhancing food security involves healing and protecting a limited land‐base for food production, integrating food production with community priorities for education, training, health, economic development, and scientific innovation.

• Food security is promoted through planting and producing food, and health and social programs that build food‐related skills and knowledge, and which coordinate income and social assistance. Increasingly, though small in number, Kahnawakehró:none are returning to planting gardens, animal husbandry, beekeeping, maple tree tapping, and fishing/hunting as primarily individual or family activities. 

• Today, wealthy entrepreneurs can purchase land titles from others, driving up prices, and few enforceable laws protect the collective interests of the community. This is related to the historical imposition of the individual land title system established through the Indian Act, and previous efforts that undermined customary laws of communal land use. Protecting existing arable, and other lands, is central to food security.

• Family and work are about relationships. Success in life is tied to the quality of our relationships and how much spirit we put into them. The Principles of Sken:nen (Peace), Kanikonriio (Good Mind), and Kasestensera (Strength) guide us.

• Respect, Integrity, Equality and Empowerment will be the basis for all that the Mohawk Council of Akwesasne endeavors to achieve. Respect for oneself, respect for others and ultimately respect for our Creator and all that the Creator provides.

 

CHALLENGES

• Straddling two provinces and a state, access to healthcare is complexly difficult for many. The Canadian domiciled Akwesasne population of 12,300 is evenly split between Ontario and Quebec. Those who live in the Ontario district are under the Ontario Health Insurance Program (OHIP), while those in the Quebec districts are under the Regie de l’Assurance Maladie program (RAMQ). The provincial health insurance programs have differing service levels. According to the Director of the Health Department for the MCA, these differences present challenges when trying to ensure follow up on diagnostic, secondary and tertiary services.

• BORDER: The political border of US-Canada enters another phase, the territory of a “third” nation - that of the Akwesasne Mohawk tribe. Here the USA/Canada boundary has a reduced significance at the local level. There are several roads that cross the international border on the Reservation, but at no point is this fact acknowledged with signage, Ports of Entry, or even visible monuments. Passage over the line is unrestricted. And there is no cut line on the forested portions of the Reservation.

• The geographical footprint of Akwesasne is unique and includes jurisdiction in Ontario and Quebec, and the state of New York. For many citizens, significant distances and travel times impact accessibility to services. This limits accessibility to fresh, healthy food. It limits access to facilities and infrastructure where physical health, fitness activities and training are provided.

• In 2015, two Akwesasne women tried to assert an “aboriginal right to mobility to travel freely” within the territory and claimed that having to check in at the Cornwall port-of-entry violated their Charter rights. The National Post reported that a Canadian judge ruled that issues of national security superseded any perceived right to a historical aboriginal right to freely travel within the Akwesasne territory. The judge added that any travel hardships were “self-imposed” by the Akwesasne people when they opposed the arming of CBSA officers at the port-of-entry when it was located on Cornwall Island. The Cornwall border crossing has a “proven history of smuggling of arms, people and contraband” and the Canada Border Services Agency’s mission is to ensure the security of Canada by managing the access of people and goods, the judge said.