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Chapter

HLTC02H3 Chapter Notes -Health Promotion, Harm Reduction, Pediatrics


Department
Health Studies
Course Code
HLTC02H3
Professor
Denis Maxwell

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HLTC02 WINTER 2013
Week # 9: In Search of a Healing Place: Aboriginal Women in Vancouver’s Downtown East Side by
Cecilia Benoit, Dena Carroll and Munaza Chaudhry
Abstract
Aboriginal people face formidable barriers in accessing CULTURALLY appropriate and timely
care
Urban Aboriginal Health Centres (UAHCs) have emerged to address the unmet health concerns of
Aboriginal people in metropolitan areas
Purpose of Research: address gap of how health care concerns of AW are bing unmet by UAHCs
Case Study approach with 4 focus groups of aboriginal women (Vancouver Native Health Society,
Sheway and residents of Vancouver‟s Downtown East Side (DTES)
25 semistructred interviews were conducted with VNHS staff, health providers, government
representatives, and community leaders in health care
Aboriginal women have expressed a strong desire for a healing place, an integrated health centre
that serves to address their physical, mental, emotional and spiritual needs, incorporates both
Aboriginal and Western healing and medical practices
Introduction
1.1 million people claimed Aboriginal ancestry in 1996 approximately 4018,100 are women
Aboriginals are more likely to live in SINGLE parent families, have higher rates of
UNEMPLOYMENT, lower rates of HIGHSCHOOL COMPLETION, poor health status
Aboriginal people have lower life expectancies than the general population, more than half in
urban centres and over 66% percent in Western Canada, diverse, youthful and growing population
Urban aboriginal people have higher rates of homelessness, greater housing needs, higher rates of
suicide, at particularly high risk for substance abuse, TB, HIV/AIDS, or developing diabetes,
lower median average income compared to non-urban counterparts
Creation of Urban Aboriginal Health Centres (UAHCs) have emerged to address the unmet health
concerns of Aboriginal people living in large metropolitan areas
Strategies used: control and administration by a qualified team of Aboriginal people, recruitment
of Aboriginal health professionals, implementation of holistic philosophy of care that blends
traditional Aboriginal healing and Western Medicine
Long term goal of UAHCs is to improve service delivery and health outcomes for urban
Aboriginal people in Canada by increasing access to culturally suitable and appropriate health care
and social services
Purpose of this research is the address the gap in social science literature on how effectively
Aboriginal women‟s specific health concerns are being met by the innovative UAHCs in particular
Few reports available indicate Aboriginal women have inadequate access to reproductive care
services, access to pap smears, mammogram screening and abortion services
Bulk of this paper centers around the care Aboriginal Women receive from three different types of
services provided at VNHS The walk in clinic, the positive outlook program and Sheway
Research Design & Methods
Formulation of a Community Advisory Council comprising aboriginal and non-aboriginal
professionals who provided advice, direction and guidance regarding research goals, recruitment
strategies, interviewing and data analysis
Methods: participant observation, semi structured interviews and focus groups
Three focus groups
o Vancouver Native Health Society clients
o Clients of sister organization Sheway
o Non-affiliated Aboriginal women living in DTES
25 semi structured interviews with VNHS and Sheway staff, health professionals, government
health authorities and community health workers
Thematic analysis was used to analyze the data, direct representation of an individual‟s own point
of view and descriptions of experiences, beliefs, and perception; gives voice to those who are
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HLTC02 WINTER 2013
usually silenced; present the lived experiences and meaning of those who are the main focus of the
study
Constant Comparative Method compare thematic findings of focus group transcriptions with the
central themes emerging from the transcribed personal interview data
Qualitative studies limited in their ability to make generalizations about the entire population from
a small sample,
Self selection bias also present elderly and women not in crisis or those living in other
residential neighborhoods in Vancouver were not able to give their input
Strength of this study gives agency to participants whose needs are great and yet those voices are
seldom heard
Urban Ghetto: DTES
7%of Vancouver‟s residents are aboriginal people (28,000) people
Most DTES Aboriginal residents have been displaced or have migrated from other parts of
Canada; housing is shoddy, not appropriate, lack basic amenities (fridge, stove, private bathroom,
security, privacy and safety)
DTES overcrowded hotels and poor living conditions combined with substantial part of its
population having unprotected sex and dependence on addictive injection based drugs has led to
the highest rate of HIV/AIDS transmission in the Western world
Aboriginal Women in DTES
3 to 1 ratio of males to females in DTES, but in urban ghetto aboriginal population it is roughly
50-50
70% of DTES sex workers are Aboriginal, average aboriginal sex worker is 26, 3 or more children
and no high school education
Inadequate access to birth control, rising incidence of drug use and growing problem of AIDS are
all problems for Aboriginal women in DTES
Aboriginal women are more likely than male counterparts to share needles, second on the needle
and associate condom use or non use with important distinction between work and relational sex
Many women are migrants therefore are isolated, without a strong social support system or
cultural base to access when in crisis
Homelessness is symptomatic of larger problems including substance abuse, mental health issues,
family breakdown, underemployment, low income and racism
Aboriginal women are not merely voiceless victims of larger structural forces, they have sense of
agency, a vision of how to change their situation, improve their health and ensure a better life for
their children
Vancouver Native Health Society
VNHS is provincially funded, non profit society that serves 50% European descent, 40%
Aboriginal, and rest visible minority groups
Lack of qualified health professionals of Aboriginal heritage, poor representation of Aboriginals in
staff of VNHS
Initially, there was the vision to have an on-site Aboriginal Healing Centre (AHC) but it didn‟t
receive the ECONOMIC support needed, in addition, few traditional healers willing to work in
clinical setting (due to adequate remuneration, urban setting, government regulation of traditional
practices and threat to traditional knowledge contents)
Open Door Policy open to Aboriginal and non-Aboriginal people alike
o Yet it is not adequately meeting its mandate to serve Aboriginal People
o Lack of aboriginal staff, elders
Programs and services at VNHS: Walk In Medical Clinic, Positive Outlook (an HIV/AIDS Home
Health Care Program), The Sheway Project, Pre-recovery Empowerment Program (POP), TBSA
Outreach Program (TB services for Aboriginals), DTES Health Outreach Van Program, Youth
Safe House Project, & Inner City Foster Parents Project
POP Traditional healing approaches have been included, popular among the local population
afflicted with HIV/AIDS
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