Why do Indigenous cardiac patients in Manitoba get sicker and tend not to recover as well as the rest of the population, even after receiving medical treatment?
A team of contributors and researchers at St. Boniface Hospital and from the University of Manitoba have tried to find answers to that and other difficult questions related to a known health disparity among urban and rural members of First Nations communities.
Debwewin – The Truth of Our Hearts is a study that was started in October 2014 and will come to an end this year. It is funded by the Canadian Institutes of Health Research (CIHR): Institute of Indigenous Peoples’ Health.
Rates of heart disease among First Nations people were recorded to be roughly the same as the general population until about the late 1970s. Since then, there has been a growing divide.
“Indigenous people today are sicker, at younger ages, with higher rates of heart disease and they’re more likely to die,” explained Dr. Annette Schultz, Principal Investigator, Health Services & Structural Determinants of Health Research at St. Boniface Hospital.
For a long time, Western medicine was the only perspective that was brought into the dialogue. “This study invites us to consider a dialogue that is bigger than that: how some of these disparities we see today are a result of historical and ongoing colonialism and colonial practices,” said Schultz.
“The common explanation was about access and lifestyle. The fallback was always those narratives,” said Karen Throndson, MN, RN, Clinical Nurse Specialist, Cardiac Sciences Program, who initiated the study at St. Boniface Hospital.
“But I think when you’re around First Nations people enough, you begin to understand that’s not the full story, and you start looking beyond those easy explanations,” she said. “And that’s the beauty of research.”
“Our heart is the voice of spirit. When the heart is damaged, what does that tell you about the spirit?” asked Mary Wilson, a healer and elder who was invited to contribute to the Debwewin study.
The conversation now is that something valuable has been missed and needs to be corrected, said Wilson. “It’s an opportunity to take some time to heal the wrongs that are in the institutional landscape,” she said.
As an Indigenous woman, Project Coordinator Moneca Sinclaire, PhD, has focused her career on the health of her people. “My own family members have Type 2 diabetes and various health issues. I’ve wanted to know why that was happening,” she said.
“We have our own way of seeing what health means to us, as Indigenous people. There’s a lot of history of people entering hospitals. In our language, ‘hospital’ means ‘a place to die’,” she said. “That’s how our community has talked about the health care system.”
“This doesn’t just help Indigenous people, it helps all people coming to the Hospital.”
“Often, people feel like they aren’t welcomed into this environment,” continued Sinclaire. “Many of our people’s hearts have been broken because of residential schools and tuberculosis clinics. But none of that’s ever acknowledged in the health care system.”
“For me, I’ve approached this project…working toward the goals of making a place better for Indigenous people to enter and for non-Indigenous people to learn to welcome us into the health system.”
Debwewin (the Ojibwa word for “truth”) compared patients, treatments and outcomes.
This research story continues in the spring 2019 issue of Believe.
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