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While the Indian education system has had some success in graduating Indian students as educators at various levels, lawyers, social workers and other specialties, health career development has regrettably lagged behind. Some educational institutions in Saskatchewan and other parts of Canada, with support from the Indian and Inuit Health Careers Program, Medical Services Branch, H.W.C., are attempting to alleviate this situation.
The association of Indian and Inuit Nurses of Canada is a part of this trend. This group, conceived in 1974 amid the preparation for International Women's Year, was originally called the Registered Nurses of Canadian Indian Ancestry, and was the first native professional organization in Canada. From the beginning, we had a deep concern for the health status of native people in Canada. As well, we were concerned with developing and maintaining a registry of Registered Nurses of native ancestry, with attracting more native students into nursing and other health professions, and with establishing a mechanism to work for and lobby on behalf of better health care in Indian and Inuit communities.
BACKGROUND TO INDIAN HEALTH ISSUES
Since the implementation of the Medical Health Insurance Plan in 1967-68, initiated in Saskatchewan, the average Canadian has enjoyed and appreciated benefits envied by most developed and developing countries. Most Canadian citizens believe they have the right to best available healthcare. To the Indian people of Canada, health care has always been a highly political issue, which stems from treaties signed with the federal government in most areas of the country during the 1800's. In particular, the Indian people have relied on a "Medicine Chest Clause" plus other promises concerning medical care. These were understood to mean, as part of the treaty agreements, that medical services would be provided to Indian people whenever they might need them, and be appropriate for the type of medical care available at the time. They believe that this that a comprehensive health care plan, incorporating all aspects of present day health care should be available - curative, mental health care and preventative services, essential medications, hospital care, ambulance services, diagnostic services, optometric and dental care, and medical appliances - at least as widely as they are to other Canadians.
Although this treaty clause has been interpreted differently by legal experts, federal bureaucrats, and Indian and non-Indian politicians, the Indian people maintain our right to health care is based on an historic belief that the government has an inherent, legal responsibility to provide health services in lieu of the land and resources surrendered throughout this country.
What is not open to dispute is the fact that by the beginning of the 20th century, Indian people had been reduced to almost complete destitution and dependence. Several studies that indicate the basis for these concerns have appeared in medical and nursing journals.
The Medical Services Branch of Health and Welfare Canada has been responsible for ad ministering to the medical needs of native peoples. In terms of conventional diagnosis and treatments, the Medical Services Branch has achieved a notable measure of success. Many diseases that ravaged Indian communities in the past have been brought under control - although not completely; for example, tuberculosis is by no means eradicated. Diabetes is now rampant in nearly every Indian community in Canada. Alcohol and Drug Abuse is one of the prime causes of physical and mental disorders.
Indian leaders, especially during the last two decades, have taken an increasingly active role in trying to improve the status of their people. For example, most Indian reserves in Canada have their own government structure with a chief, a council, and an administrator who conducts the business of a community. At the band level, health is only one aspect of a whole range of issues and is often not a priority. However, because health issues can lead to crises, such as epidemics, violence related to alcohol or drug abuse, or medical emergencies, it can quickly become a hot political issue.
THE ROLE OF THE IINC
Most members of the Indian and Inuit Nurses of Canada have experienced the rigors of life on reserves, have faced discrimination and lack of support in the Canadian educational and health care system associated with the need to meet increasingly high standards in health care and in education. Some of these difficulties arise from within the nursing profession itself, such as the emphasis on the baccalaureate for entry when many young native men and women are having difficulty in achieving and financing higher education.
Members of the association have been aware of and active in al these and many other political areas since its inception - listening, watching, and working in whatever capacity required within our profession, yet ever mindful of what is happening to families, friends, and nursing colleagues. A vital role has been the support for young native men and women to gain entry to the health professions.
Despite a lack of support, and even active discouragement, from some government officials, we eventually identified 80 political members with the help of some non-native colleagues. In August 1975, a group of 40 met in Montreal to launch the association. The first chairman was Tom Dignan, a Mohawk from the Six Nations Reserve, Ontario, who had been in the United States Marines before becoming a nurse and later achieving a baccalaureate. The election of a male president during International Women's Year was questioned by feminists, but we persevered because we believed he had the qualities the group wished in a leader.
We continued to stress the need to establish networks for ourselves on the common grounds of education, cultural background, and mutual concerns.
Financial support was obtained from the Native Women's program, Native Citizens Director ate, Secretary of State to provide regular funding for one board meeting and a national conference yearly. In the early 1980's, financial support was received from the Medical Services Branch of Health and Welfare Canada for special projects and later for administrative and staff costs.
Despite setbacks and opposition, however, the association continued to put forth its ideas on better health care for native peoples and to encourage native men and women to enter the profession. Ii repeatedly lobbied government departments, using the knowledge gained from members nursing experiences, to describe health conditions and to recommend new approaches to health care for native communities.
In 1982, the association moved its head office to Ottawa; it 1983, the name was changed to Indian and Inuit Nurses of Canada (IINC) and the membership was opened to Inuit nurses.
As IINC grew and established its reputation as a professional organization support came first of all from other organization of health professionals, such as the Canadian Nurses Association, the Canadian Association of University Schools of Nursing, various provincial nurses associations, the Canadian Public Health Association, the Indian and Inuit Health Committee of the Canadian Pediatric Society.
THE IINC IN 1989
The Indian and Inuit Nurse: of Canada is governed by an elected vice-president, a secretary-treasurer) and a 13-member board (representatives from Northern and Southern Ontario and one from each of the other nine provinces and two territories). Elections are carried out every two years at an annual meeting, which also includes sessions on nursing education and on Indian and Inuit health issues. These meetings are held in a different center each year, preferably at or near an Indian community.
Potential membership has now grown to approximately 300 native nurses. Associate membership, approved in 1986, allows participation by nurses who are not of Canadian Indian or Inuit ancestry but who support the objectives of the association; associate members can not vote, however.
The association has an executive director and one other staff person in Ottawa to manage day to day affairs. Communication is carried out through a newsletter published twice a year and through distribution of reports on special work-shops held throughout the year.
Funding comes from membership fees and from grants and donations to the association. Baxter Corporation of Toronto provides an annual scholarship of $5,000 each for two native nursing students who wish to pursue a career in northern communities. Members also raise money for the organization through sale of promotional materials such as sweat shirts, T-shirts, and pins, and through rattles and other activities throughout the year.
Only one province - Manitoba - has a provincial association, although some initial meetings have been held in Saskatchewan and B.C.
Executive and board members frequently act as advisors or resource persons to other organizations and groups such as the Assembly of First Nations' Health Commission and to Bands on request. As well, they meet regularly with representatives of government departments and agencies and other professional associations. In particular, the IINC has been working closely with university and college nursing programs across Canada to help with entry of native students.
Because of their role advocates for an improved health care system in native communities and for increased numbers of native professionals, IINC members must be aware of the political implications and keep abreast of current issues.
Efforts by the IINC were least partially responsible for Indian and Inuit Health Care Program that was launched by Medical Services Branch in 1984.
As members have become more visible and have come to recognized for their abilities, the demand for our services and expertise has increased dramatically. We do not have the numbers to meet the requests from Chiefs for their communities, from academic institutions, and from urban and rural health-care agencies for well-prepared native nurses.
Today's nurses in Indian health services are confronted with a range of very serious issues. In recent years, Indian people have become increasingly aware of their right to effective, that Indian students need support which includes peers, parents, and members of the communities, who, in turn, must be made to understand why it takes to long to become community health nurses.
Increased recognition and appreciation for tradition and culture in the curricula of a number of newly established Health Career Programs for native students is most gratifying. Native nurses also need a grasp of the differences in values and customs among the many tribes and regions in North America. Traditional practices in the United States are not applicable in Canada, and beliefs and practices of the Iroquois and other eastern tribe in Canada may not correspond those on the Prairies and West Coast.
Our most fervent hope is that a growing number of graduate In health professionals will be in a position to fill the cultural gap that tends to be one of the main causes of the misunderstandings and of difficulties we have had with Western medical practices. Then native students can have the best of all possible world by combining strengths of traditional and Western medicine.