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      Improving access to Indigenous medicine for patients in hospital-based settings: a challenge for health systems in northern Canada

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          ABSTRACT

          In this commentary, we argue that Indigenous patients in the Northwest Territories (NWT) have a right to access traditional medicine and related practitioners as a part of the continuum of medical care. Indigenous people make up over half of the NWT population, spread over vast geographic areas with representation from First Nations, Inuit and Métis (FNIM) people. Ensuring barrier-free access to traditional medicine and providers in a culturally respectful environment is a challenge that requires structural transformation in the territorial health system. The ongoing transmission of knowledge about Indigenous traditional medicine in Northern Canada and the collective survival of Northern peoples is a testament to the applicability of traditional medicines in a self-determined wellness system. Through a discussion of the barriers to policy development and implementation, this commentary aims to elevate Indigenous perspectives and offer recommendations for integrating traditional medicines into Northern health systems.

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          Disappearing, displaced, and undervalued: a call to action for Indigenous health worldwide.

          "What sets worlds in motion is the interplay of differences, their attractions and repulsions. Life is plurality, death is uniformity. By suppressing differences and peculiarities, by eliminating different civilisations and cultures, progress weakens life and favours death. The ideal of a single civilisation for everyone implicit in the cult of progress and technique, impoverishes and mutilates us. Every view of the world that becomes extinct, every culture that disappears, diminishes a possibility of life!"
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            Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study

            Background Cultural interventions offer the hope and promise of healing from addictions for Indigenous people.a However, there are few published studies specifically examining the type and impact of these interventions. Positioned within the Honouring Our Strengths: Culture as Intervention project, a scoping study was conducted to describe what is known about the characteristics of culture-based programs and to examine the outcomes collected and effects of these interventions on wellness. Methods This review followed established methods for scoping studies, including a final stage of consultation with stakeholders. The data search and extraction were also guided by the “PICO” (Patient/population, Intervention, Comparison, and Outcome) method, for which we defined each element, but did not require direct comparisons between treatment and control groups. Twelve databases from the scientific literature and 13 databases from the grey literature were searched up to October 26, 2012. Results The search strategy yielded 4,518 articles. Nineteen studies were included from the United States (58%) and Canada (42%), that involved residential programs (58%), and all (100%) integrated Western and culture-based treatment services. Seventeen types of cultural interventions were found, with sweat lodge ceremonies the most commonly (68%) enacted. Study samples ranged from 11 to 2,685 clients. Just over half of studies involved quasi-experimental designs (53%). Most articles (90%) measured physical wellness, with fewer (37%) examining spiritual health. Results show benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies. Conclusions Evidence from this scoping study suggests that the culture-based interventions used in addictions treatment for Indigenous people are beneficial to help improve client functioning in all areas of wellness. There is a need for well-designed studies to address the question of best relational or contextual fit of cultural practices given a particular place, time, and population group. Addiction researchers and treatment providers are encouraged to work together to make further inroads into expanding the study of culture-based interventions from multiple perspectives and locations.
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              Blending Aboriginal and Western healing methods to treat intergenerational trauma with substance use disorder in Aboriginal peoples who live in Northeastern Ontario, Canada

              As with many Indigenous groups around the world, Aboriginal communities in Canada face significant challenges with trauma and substance use. The complexity of symptoms that accompany intergenerational trauma and substance use disorders represents major challenges in the treatment of both disorders. There appears to be an underutilization of substance use and mental health services, substantial client dropout rates, and an increase in HIV infections in Aboriginal communities in Canada. The aim of this paper is to explore and evaluate current literature on how traditional Aboriginal healing methods and the Western treatment model “Seeking Safety” could be blended to help Aboriginal peoples heal from intergenerational trauma and substance use disorders. A literature search was conducted using the keywords: intergenerational trauma, historical trauma, Seeking Safety, substance use, Two-Eyed Seeing, Aboriginal spirituality, and Aboriginal traditional healing. Through a literature review of Indigenous knowledge, most Indigenous scholars proposed that the wellness of an Aboriginal community can only be adequately measured from within an Indigenous knowledge framework that is holistic, inclusive, and respectful of the balance between the spiritual, emotional, physical, and social realms of life. Their findings indicate that treatment interventions must honour the historical context and history of Indigenous peoples. Furthermore, there appears to be strong evidence that strengthening cultural identity, community integration, and political empowerment can enhance and improve mental health and substance use disorders in Aboriginal populations. In addition, Seeking Safety was highlighted as a well-studied model with most populations, resulting in healing. The provided recommendations seek to improve the treatment and healing of Aboriginal peoples presenting with intergenerational trauma and addiction. Other recommendations include the input of qualitative and quantitative research as well as studies encouraging Aboriginal peoples to explore treatments that could specifically enhance health in their respective communities.
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                Author and article information

                Journal
                Int J Circumpolar Health
                Int J Circumpolar Health
                ZICH
                zich20
                International Journal of Circumpolar Health
                Taylor & Francis
                1239-9736
                2242-3982
                2019
                11 February 2019
                : 78
                : 1
                : 1577093
                Affiliations
                [a ]Arctic Indigenous Wellness Foundation , Yellowknife, NT, Canada
                [b ]Institute for Circumpolar Health Research , Yellowknife, NT, Canada
                Author notes
                CONTACT Nicole Redvers dr.redvers@ 123456gaiand.com Arctic Indigenous Wellness Foundation , Box 603, Yellowknife, NTX1A 2N5, Canada

                Notice of Correction: This article was incorrectly published into the regular issue 1 of 2019. The article has been republished into the correct Special Issue: Collaborative approaches to wellness and health equity in the Circumpolar North: Proceedings of the 2017 Northern, Rural, and Remote Health conference with the DOI: 10.1080/22423982.2019.1589208, Volume 78, Number 02.

                Article
                1577093
                10.1080/22423982.2019.1577093
                6493304
                30744519
                0e4a39e6-26ba-4a7b-99c3-79e22b1baea7
                © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 March 2018
                : 13 January 2019
                : 17 January 2019
                Page count
                Tables: 1, References: 21, Pages: 1
                Funding
                Funded by: The Loran Scholars Foundation
                Funded by: Institute for Circumpolar Health Research and the Arctic Indigenous Wellness Foundation
                None.
                Categories
                Short Communication

                Medicine
                indigenous health,aboriginal health,traditional medicine,healing,northwest territories,health systems

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