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LIVING WELL:ABORIGINAL WOMEN, CULTURAL

IDENTITY AND WELLNESSAlex Wilson

Project #79

Living Well: Aboriginal Women, Cultural Identity and Wellness

March 2004

Alex Wilson

This project was directed and administered by the Manitoba AboriginalWomen’s Health Community Committee, and supported by the Prairie

Women’s Health Centre of Excellence.

The Prairie Women’s Health Centre of Excellence (PWHCE) is one of the Centres ofExcellence for Women’s Health, funded by the Women’s Health Bureau of Health

Canada. The PWHCE supports new knowledge and research on women’s health issues;and provides policy advice, analysis and information to governments, health

organizations and non-governmental organizations. The views expressed herein do notnecessarily represent the official policy of the PWHCE or Health Canada.

We can be reached at:

The Prairie Women’s Health Centre of Excellence56 The Promenade

Winnipeg, Manitoba R3B 3H9Telephone (204) 982-6630 Fax (204) 982-6637

[email protected]

This report is also available on our website:www.pwhce.ca

This is project #79 of the Prairie Women’s Health Centre of ExcellenceISBN 0-9735048-3-8


ABSTRACT

Traditional understandings of health and wellness in Manitoba’s Aboriginal communitiesare distinctly different from understandings that have conventionally prevailed in most ofthe province’s health care institutions. This research project, undertaken by an AboriginalWomen’s Health Research Committee supported by Prairie Women’s Health Centre ofExcellence (PWHCE), seeks to extend our understanding of the positive impact ofcultural identity on the wellness of Aboriginal women in Manitoba and our understandingof the ways that Aboriginal women have retained and drawn upon cultural values,teachings and knowledge in their efforts to heal themselves, their families, and theircommunities.

The report includes a review and analysis of current research relevant to Aboriginalwomen’s identity and wellness, and presents the results of group discussions andindividual interviews with Aboriginal women in Manitoba that focused on their personalexperiences and understandings of the relationship between identity and wellness.

The Aboriginal women who participated in this research project take care of their healthand wellness by attending to and maintaining balance between all aspects – physical,mental, emotional and spiritual – of their being. The women’s identities are inseparablefrom their family, history, community, place and spirituality, and understood in thecontext of their whole lives. Health care practitioners, providers and policy makers, aswell as federal and provincial governments, need to assist Aboriginal communities in thedevelopment of the infrastructure, human resources and administrative structures neededto create and control health care services that are rooted in the cultural practices andvalues of the Aboriginal women and men they are serving. Further research into theconnection between the well-being and identity of Aboriginal women, for exampleresearch that focuses on the identity and well-being of Aboriginal women in remotecommunities, will enhance our understanding.

Une bonne qualité de vie : les femmes autochtones, l’identité culturelle et le bien-être

RÉSUMÉ

La vision traditionnelle qu’ont les communautés autochtones du Manitoba de la santé etdu bien-être est nettement différente de la vision qui a été généralement dominante dansla plupart des établissements de santé de la province. Ce projet de recherche, entreprispar un comité de recherche sur la santé des femmes autochtones subventionné par leCentre d’excellence pour la santé des femmes – région des Prairies, vise à accroître notrecompréhension de l’incidence positive sur le bien-être des femmes autochtones auManitoba qu’exercent les facteurs suivants : l’identité culturelle, les moyens utilisés parles femmes autochtones pour conserver et mettre à profit les valeurs culturelles, lesconnaissances et les enseignements auxquels elles font appel pour se guérir et guérir leurfamille et les membres de leur communauté.

Le projet comprend l’examen et l’analyse de la recherche courante pertinente surl’identité et le bien-être des femmes autochtones. Il présente également les résultats dediscussions de groupe et d’entrevues individuelles menées avec des femmes autochtonesdu Manitoba axées sur leurs expériences personnelles et leur compréhension de larelation existant entre leur identité et leur bien-être.

Les femmes autochtones qui ont participé à ce projet prennent soin de leur santé et deleur bien-être en prêtant attention à tous les aspects de leur être — physique, mental,affectif et spirituel — et en maintenant un équilibre entre eux. L’identité des femmes estinséparable de leur famille, de leur histoire, de leur collectivité, de leur place et de leurspiritualité, et doit être étudiée à partir du contexte de leur vie globale. Lesprofessionnels de la santé, les fournisseurs de soins de santé et les décideurs du secteur,ainsi que les gouvernements fédéral et provinciaux, doivent aider les collectivitésautochtones à mettre en œuvre une infrastructure et des structures administratives et àformer des ressources humaines qui prennent racine dans les pratiques et les valeursculturelles des femmes et des hommes autochtones desservis. De plus amples recherchessur le lien existant entre le bien-être et l’identité des femmes autochtones, par exemple lestravaux qui se concentrent sur l’identité et le bien-être des femmes autochtones dans lescollectivités éloignées, augmenteront notre compréhension de cette question.

TABLE OF CONTENTS

1.0 INTRODUCTION……………………………………………. 1

2.0 LITERATURE REVIEW ………………………………………… 2

3.0 METHODOLOGY…………………………………………… 6

4.0 FINDINGS………………………………………………….…. 9 The Practice of Personal Well-Being ………………………… 10

Contributing to Community Wellness ………………………. 14Strengthening Aboriginal Women in their Communities …… 16A Vision of Aboriginal Women’s Wellness …………………. 20

5.0 CONCLUSION………..……………………………………….. 21

6.0 POLICY RECOMMENDATIONS ……………………………… 24

REFERENCES ………………………………………………………….. 28

APPENDIX …………………………………………………………… 29


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1.0 INTRODUCTION

Traditional understandings of health andwellness in Manitoba’s Aboriginalcommunities are distinctly different fromunderstandings that have conventionallyprevailed in most of the province’shealth care institutions: “Aboriginalconcepts of health and healing start fromthe position that all elements of life andliving are interdependent. By extension,well-being flows from balance andharmony among all elements of personaland collective life.”1 Fortunately, healthcare organizations in Manitoba today areincreasingly aware of the inseparabilityof cultural identity and health andwellness and attempting to bring a moretraditional holistic understanding ofhealth and wellness to their institutionalpractices and policies.2

This research project, undertaken by theAboriginal Women’s Health ResearchCommittee with support from the PrairieWomen’s Health Centre of Excellence(PWHCE), seeks to extend ourunderstanding of the positive impact ofcultural identity on the wellness ofAboriginal women in Manitoba and ourunderstanding of the ways thatAboriginal women have retained and

1 Royal Commission on Aboriginal Peoples.Highlights from the Report of the RoyalCommission on Aboriginal Peoples. Ottawa:Ministry of Supply and Services, 1996.2 For example, the Winnipeg Regional HealthAuthority, in consultation with the Aboriginalcommunity, is currently developing a Continuumof Care that will enhance the health status ofAboriginal people in Manitoba.

drawn upon cultural values, teachingsand knowledge in their efforts to healthemselves, their families, and theircommunities. It includes a review andanalysis of current research relevant toAboriginal women’s identity andwellness, and presents the results ofgroup discussions and individualinterviews with Aboriginal women inManitoba that focused on their personalexperiences and understandings of therelationship between identity andwellness. The project reflects PWHCE’scommitment (as part of the Centres ofExcellence for Women’s Health) to“identify and track positive healthindicators, including resiliency,spirituality, everyday health strategiesand ‘defining moments’ in Aboriginalwomen’s lives.”3

3 Madeleine Dion Stout, Gregory D. Kipling andRoberta Stout. Aboriginal Women’s HealthResearch Synthesis Project: Final Report.Winnipeg: Centres of Excellence for Women’sHealth, May 2001, p. 36.


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2.0 LITERATURE REVIEW

The physical health status of Aboriginalpeople in Manitoba has been thoroughlydescribed. For example, the ManitobaFirst Nations Regional Health Survey (ajoint initiative of the Assembly ofManitoba Chiefs, the ManitobaKeewatinowi Okimakanak, and theNorthern Health Research Unit at theUniversity of Manitoba) was completedin 1997.4 Although this large-scalequantitative survey produced extensivedata characterizing the health status,health behaviour, community healthconcerns, healing and wellness, andhealth service utilization of Manitoba’sFirst Nations’ people, the final report onthe survey analyzes gender only withrespect to four health indicators (self-reported health status, high bloodpressure, diabetes and suicidal feelings).Only one of the recommendations in thefinal report directly addresses the healthcare needs of Aboriginal women, withthe statement that, “First Nations womenrequire diabetes prevention programsaddressing their particular needs.”5 Thisfailure to more fully acknowledge orexplore the health care status, practices,needs and concerns of Aboriginalwomen in this report is disappointing,particularly because, with respect to

4Manitoba First Nations Regional HealthSurvey: Final Report. Assembly of ManitobaChiefs, Manitoba Keewatinowi Okimakanak andthe Northern Health Research Unit, September,1998.5Manitoba First Nations Regional HealthSurvey: Final Report, p. 10.

these areas, significant differencesbetween Aboriginal women and menhave been recorded.6 As Madeleine DionStout, a noted researcher on Aboriginalwomen’s health, has declared,“Aboriginal women’s health values,beliefs and practices cannot simply besubsumed under those of Aboriginalmen.”7

At a federal level, the health status ofAboriginal women has beencharacterized more fully. Statisticspresenting Aboriginal women’s lowerlife expectancy, elevated mortality ratedue to violence, elevated morbidity ratesfor conditions such as circulatory andrespiratory problems, diabetes,hypertension, cancer of the cervix andHIV/AIDS, and elevated suicide rate(relative to the general Canadian female

6For example, see Sherry L. Grace. “A Reviewof Aboriginal Women’s Physical and MentalHealth Status in Ontario,” Canadian Journal ofPublic Health, 94 (3), 2003, 173-175. The articlestates that, in one survey, Aboriginal women inOntario reported higher occurrences of 10 out of12 surveyed health problems than did Aboriginalmen. Additionally, the 1999 Report of the FirstNations and Inuit Regional Health Survey foundthat Aboriginal and Inuit women report poorerhealth and develop chronic conditions earlier inlife than do Aboriginal and Inuit men (Cited inLissa Donner, Women, Income and Health inManitoba: An overview and ideas for action,Winnipeg: Women’s Health Clinic, 2000).7 Madeleine Dion Stout. Aboriginal Canada:Women and Health, Developed for the Canada-U.S.A. Women’s Health Forum, August 8-10,1996.


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population) are easy to find.8 Such amedicalized representation of health,however, is incongruous with the holisticdefinition of health that prevails in mostAboriginal communities in Canada, andwherein health or wellness is understoodto be a balance between the physical,emotional, mental and spiritual aspectsof a person or community.9 As DionStout argues, “Aboriginal women'srelatively poor health status (whencompared to that of non-AboriginalCanadian women) can only beunderstood in the context of a range ofhealth determinants, including socio-economic status, education andemployment conditions; social supportnetworks; physical environment; healthychild development and access to healthservices.”10

In her 1996 overview of issues, concernsand trends affecting the health ofAboriginal women in Canada, DionStout calls for “a sustained commitmenton the part of all parties, includingwomen and men as well as health careproviders and governments, to tackle not 8 Health Canada, The Health of AboriginalWomen. Internet Address: http://www.hc-sc.gc.ca/english/women/facts_issues/facts_aborig.htm.9 Connie Deiter and Linda Otway. Sharing OurStories on Promoting Health and CommunityHealing: An Aboriginal Women’s HealthProject. Winnipeg: Prairie Women’s HealthCentre of Excellence, 2001; M. Dion Stout,1996; Madeleine Dion Stout, Gregory D. Kiplingand Roberta Stout. Aboriginal Women’s HealthResearch Synthesis Project: Final Report.Winnipeg: Centres of Excellence for Women’sHealth, May 2001; Janet Smylie, SOGC PolicyStatement: A Guide for Health ProfessionalsWorking with Aboriginal Peoples. RogersMedia: Toronto, 2001; Roxanne Struthers, “Theartistry and ability of traditional women healers,”Health Care for Women International, 24:340-354.10 Dion Stout, 1996, p.1.

merely the effects of ill health, but alsoits underlying causes.”11 She refers tothe “great resilience and strength ofspirit [of individual Aboriginal women]in the face of what are often highlyadverse circumstances,” qualitiesevidenced in the hard work thatAboriginal women, as individuals andcommunities, have done to restore theirhealth.12 In the Aboriginal approach tohealth, with its emphasis on balance,wellness is prioritized over illness. DionStout advocates the integration oftraditional medicine and the holisticunderstanding of health that prevails inthe Aboriginal community withscientific approaches to health andhealing. More recently, Dion Stout andothers completed the AboriginalWomen’s Health Research SynthesisProject: Final Report for the Centres ofExcellence for Women’s Health.13

Again, the researchers caution policymakers about misdirecting their attemptsto address the health inequities faced byAboriginal women, with the statementthat, “much of the work beingundertaken remains narrowly focusedand is often tangential to the underlyingcauses of Aboriginal women’smarginalization and oppression.”14 Theresearchers point out that Aboriginalwomen’s definition of health does notsimply “fit into discrete categories as‘absence of disease,’ ‘goodhealth/feeling well,’ or ‘beingpsychologically fit.’ ”15 Aboriginal

11 Ibid.12 Dion Stout, 1996, p. 8.13 Madeleine Dion Stout, Gregory D. Kipling andRoberta Stout. Aboriginal Women’s HealthResearch Synthesis Project: Final Report.Winnipeg: Centres of Excellence for Women’sHealth, May 2001.14 Dion Stout et al, 2001, p. 17.15 Dion Stout et al, 2001, p. 22.


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women themselves are calling forresearch into their own health-seekingand promoting strategies and behaviours,research that is “more reflective ofAboriginal women’s own lifeexperiences, as well as more grounded intraditional or grass-roots approaches toknowledge and learning.”16

Fortunately, an ever-increasingproportion of the research, analysis andpolicy work on Aboriginal women’shealth in Manitoba is incorporating aholistic understanding of health. ThePrairie Women’s Health Centre ofExcellence supported a research studytitled Living in Balance: Gender,structural inequalities, and healthpromoting behaviors in Manitoba FirstNation Communities.17 Using dataderived from the Manitoba First NationsRegional Health Survey, the studyexamines differences between the healthbehaviours (including more physicalactivity, positive dietary changes,quitting smoking and stopping drinkingfor some time) of Manitoba First Nationwomen and men, to “develop a morebalanced understanding of health andhealth behaviours in First Nationcommunities.”18 The study reveals thatFirst Nation women are more likely thanmen to make health-promoting changesand advocates that health promotionincorporate a “multidimensionalapproach to advance a balanced way oflife.”19 The Women’s Health Clinic in

16 Dion Stout et al, 2001, p. 30.17 Brenda Elias, Audrey Leader, DoreenSanderson, and John O’Neil, Living in Balance:Gender, structural inequalities, and healthpromoting behaviours in Manitoba First NationCommunities, Winnipeg: Northern HealthResearch Unit, 2000.18 Elias et al, 2000.19 Elias et al, 2000.

Winnipeg recently released a reportexamining the link between poverty andpoor health for women in Manitoba.20

The report’s author notes that“Aboriginal women have higher povertyrates than either Aboriginal men or Non-Aboriginal women or men.”21 Amongthe findings of this research are that“Aboriginal women [who are poor] tendto think in terms of their children’s andfamilies’ health, more often than that oftheir own health,”22 and that the effectsof poverty, such as inadequate housing,poor nutrition, high levels of stress andsusceptibility to gambling addictions,have consequences for the mental,physical, emotional and spiritual healthof Aboriginal women.

Sharing Our Stories on PromotingHealth and Community Healing: AnAboriginal women’s health projectpresents the results of qualitativeresearch focusing on the health ofAboriginal women in Manitoba andSaskatchewan.23 The study documentsAboriginal women’s health experiencesand health promotion strategies, andclarifies the cultural frameworks andworldviews from which they approachand promote health and well-being. Thereport includes a review of the healthhistory of Aboriginal people in Canadaand considers the effect that colonizationhas had on the health and well-being ofAboriginal women. Qualitative research

20 Lissa Donner, Women, Income and Health inManitoba: An overview and ideas for action,Winnipeg: Women’s Health Clinic, 2000.21 Donner, 2000, p. 9.22 Donner, 2000, p. 9.23 Connie Deiter and Linda Otway, Sharing OurStories on Promoting Health and CommunityHealing: An Aboriginal women’s health project,Winnipeg: Prairie Women’s Health Centre ofExcellence, 2001.


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conducted for the study consists of oralhistory interviews with 5 elderly womenand a survey distributed to a samplegroup of 98 women. The authorsincorporated traditional Aboriginalresearch practices into theirmethodology, such as offering gifts oftobacco to the elders who shared theirknowledge with them.24 Elders in thestudy emphasized the relationshipbetween a person’s physical problemsand their spiritual and emotional state,linking their own childhood experienceof trauma in residential school to theirhealth problems later in life. The elderssaw healing and wellness as a lifetimeprocess that spiritual practices contributeto. They spoke of their ownresponsibility to contribute to the well-being of others in the community, suchas youth and other elders, and of thecommunity at large. Survey participantshad a holistic understanding of health assomething that is “not only physical, butincludes emotional and spiritual… if oneis out of balance with any of thedomains, then she is unhealthy.Sickness, illness results from animbalance.” They felt that, in addition tobeing addiction- and violence-free, witha clean environment, active people andadequate health and recreation services,a healthy community is “one whereeveryone worked together and took careof another.”25 Only a few of the womenfelt that they lived in a healthycommunity. Respondents recognizedthat the health of a community isinseparable from the health of theindividuals in it: “Health is both acommunity and individual 24 “Research as a Spiritual Contract: AnAboriginal Women’s Health Project”, Centres ofExcellence for Women’s Health ResearchBulletin, 2(3), 2002, p. 14-15.25 Deiter and Otway, 2001, p. 19.

responsibility… One person’s healthaffects others in the community…Individual responsibility for health [is]the start to a healthy community.”26 Inrecognition of the fact that the wayhealth is practiced and promoted in acommunity should reflect thecommunity’s understanding of health,the study recommends “that the federal,provincial and municipal governments ofCanada recognize and accept anAboriginal concept of health and healingby working towards wellness throughholistic health approaches.”27 The studyalso acknowledges the underlying causesand contributors to the poor health statusof Aboriginal women in itsrecommendation “that Aboriginal,federal, provincial and municipalgovernments maintain and increasefunding for Aboriginal women toachieve higher education, better payingemployment, adequate housing andaffordable day-care and family supportservices, all of which will contribute toimproving their health and well-being.”28

26 Deiter and Otway, 2001, p. 23.27 Deiter and Otway, 2001, p. 24.28 Ibid.


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3.0 METHODOLOGY

The primary research questions of thisproject are: What contributes to thehealth and well-being of Aboriginalwomen, and what has influenced theidentity of Aboriginal women? As thenecessarily brief literature reviewindicates, very little research has beenconducted that relates to the impact ofcultural identity on Aboriginal women’swellness. The research team wanted tobegin to fill this gap by rooting theirexploration of cultural identity andwellness in the everyday life experiencesand personal understandings ofAboriginal women in Manitoba. Thequalitative research methods of focusgroup discussions and individualinterviews with Aboriginal women wereidentified as the most appropriate waysto gain such an understanding.

The research process was guided byprinciples that reflect the values andbeliefs of local Aboriginal communities.These principles, which have beenformalized and used by other Aboriginalresearchers, are:29

1. The communality of knowledge andreciprocity. This principle reminds usthat as researchers, we are theinterpreters – not the originators orowners – of knowledge. It states thatresearch findings must be relevant,useful, and accessible to thecommunities that are involved in ourresearch.

29 Shawn Wilson. Unpublished doctoraldissertation. Australia: Monash University, 2003.

2. The acknowledgement of spiritualconnections. This principle reminds usthat we should make every attempt torespect and adhere to personal, local andcommunity protocols throughout theresearch process.

3. Relational accountability. Thisprinciple reminds us that, as researchers,we are accountable for the process andoutcome of our project.

4. Holism. This principle reminds us thatthe concept of holism should beincorporated throughout the researchprocess, from design to final report.

In focus group discussions, participants,with the assistance of a facilitator, hold adiscussion around a certain topic. Therelatively open format of a focus groupallows a research question to be exploredin depth, and group participants canpresent any aspect of their experiencesand ideas that they feel is relevant to thetopic under discussion. The groupfacilitator, rather than simply observingor recording, is encouraged to share,attend to and learn from the experiencesand ideas being presented. Thesefeatures of focus groups give communitymembers both voice and agency. Theprocess of a focus group (in whichparticipants open themselves up, sharetheir experiences and knowledge and arefree to present what matters most tothem about a particular topic) can be asvaluable for individuals andcommunities as any “results” produced


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by the method. The process also reflectsthe Aboriginal research principles of thecommunality of knowledge (in thatfocus group researchers interpretknowledge that is presented to them byor originates with the group participants)and relational accountability (in that theresearchers are not directly in control ofthe contributions participants make, butinstead must be accountable for creatingand preserving a space in whichparticipants can share knowledge).30

The focus group discussions andinterviews were conducted in fourManitoba communities March and June2003. The communities included a largeurban centre, a First Nations communityin Northern Manitoba, a small southerncity and a community relatively close toseveral First Nations in NorthernManitoba. When selecting thecommunities, the research team soughtto represent a spectrum of the conditionsin which Aboriginal women in Manitobalive and the cultures and communities towhich they belong. Four to sixAboriginal women participated in eachof the four focus group discussions.Participants were invited to the groupdiscussions by community members whowork for local health care providers andcommunity organizations. As it turnedout, many of the participants eitherworked in health care or communityorganizations, or were students. Theparticipants ranged from young adults toseniors, and included women who wereCree, Ojibway, Saulteaux and Métis,status and non-status, and two-spirit.Some of the participants had beenrecruited by invited participants, who

30 Alex Wilson and Janet Sarson. Focus Groupsfor Social Change: A User’s Handbook. Duluth,MN: Praxis International, 2003 (in press).

brought along women whom theythought might be interested in andcontribute to the discussions. Askinglocal community members to recruitparticipants enabled them to exercisesome control over the research andacknowledged the importance of theirknowledge of the community,community members and local andcommunity protocols.

The focus group meetings and individualinterviews were held in communityspaces, including the library of a FirstNation school, and Aboriginal health andwellness and drop-in centres. Thediscussions incorporated aspects of atalking circle, a protocol for groupdiscussions frequently used inManitoba’s Aboriginal communities.Participants seated themselves in acircular arrangement of chairs. To attendto the physical needs of participants,food and beverages were provided at themeetings and, to acknowledge the valueof their contribution to the research, eachparticipant was given an honorarium.Each participant signed a consent form,which included a commitment tomaintain the confidentiality of othergroup members (Appendix). The consentform also promised participants that anyidentifying information would beremoved from the transcripts andanalysis of the focus group meetings.The meetings, which lasted 1 to 2 hours,were audio-taped. Supplementary noteswere also recorded by a research teammember. Participants were given theopportunity to indicate whether theywould like to read and respond to theanalysis and findings of the researchproject and the majority requested a draftcopy of the report. By invitingparticipants to provide feedback to theresearch project report, the research team


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affirmed the principles of thecommunality of knowledge andreciprocity, and relational accountabilityin the research process. Participants whohad indicated that they would like toprovide feedback, as well as members ofthe Aboriginal Women’s HealthResearch Committee, were sent a draftversion of this report for comment.Participants provided feedback andsuggested recommendations that havebeen incorporated into the final sectionsof this report. Similarly, Committeemembers offered comments andsuggestions from their perspectives aspractitioners and leaders in the field ofAboriginal health.

A sequence of guiding questions wasused to focus the group discussions andindividual interviews on the primaryresearch questions (What contributes tothe health and well-being of Aboriginalwomen in Manitoba? What hasinfluenced their identities?). The guidingquestions were developed by the primaryresearcher, Alex Wilson, in conjunctionwith members of the AboriginalWomen’s Health Research Committee.After participants were asked tointroduce themselves (in whatever way

was comfortable for them), they werepresented with questions about how theymaintained their personal well-being(How do you practice well-being in yourdaily life? What are some ways that youtry to be healthy? What are some waysthat you take care of your own well-being or healing?). Next, they wereasked about the wellness of theircommunity (How is wellness a part ofyour community? What do you do on aday to day basis in your community thatcontributes to its wellness or healing?What are some ways that you take careof the wellness of healing of yourcommunity?). The final questions askedthe women to imagine changes to therelationship between wellness and theircommunity identities (What could yourcommunity do to strengthen Aboriginalwomen? What can we do as Aboriginalwomen to strengthen our communities?).When the notes, recordings and writtentranscripts of the focus groupdiscussions and interviews werereviewed and analyzed, a picture of thehealth, well-being and identity ofAboriginal women in Manitobaemerged. These findings are presentedon the following pages.


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4.0 FINDINGSIdentity

I’ve always known who I was as a Métis, asa mixed blood. I don’t know how I knewthat, because we had an opportunity tobasically hide that if we wanted to, but Ichose not to do that, and my identity hasbeen very, very strong. Been intact,basically, as a far as that is concerned. Sothere is Cree and Saulteaux background,and also Scottish and French in ourbackground. I think being from thatcommunity and having very strong Métisroots, and seeing my father and my motherliving that really influenced my identity a lotand basically made me who I am today.

Each focus group discussion orinterview began with the request thatparticipants introduce themselves, inwhatever way they were comfortable. Inresponse, the participants first offeredtheir name, followed by details thatdescribed who they are. For example,one participant stated her name, thendeclared the First Nation community inwhich she was born and the communitiesfrom which each of her parents came.She offered her family clan name andidentified the home community of herhusband. She spoke of her children,relating the age and gender of each one.In this and the other self-descriptionsthat were offered in the discussions andinterviews, the women revealedidentities that are inseparable from theirconnections to family, history,community, place and spirituality, andunderstood in the context of their wholelives.

In their introductions, every participantstated their current formal name. Oneparticipant identified herself with hername and a longer description of whoshe is, all spoken in her first language,Cree. Many also offered family names,clan names and traditional names. Oneparticipant, who presented her currentname, her maiden name, her nameduring her previous marriage and hertraditional name, began her introductionwith the statement that she had kept allof the names that she’d ever had,because they are so much of her identity.Like many of the other participants,who, to varying extents, sketched out thestories of their lives, her identityencompasses her life experiences.Participants referred to their parents,partners, children, grandchildren,grandparents and great grandparents intheir introductions, presenting identitiesdeeply seated in family. A participanttraced her family story through severalgenerations, relating that a grandparenton one side of her family and a great-grandparent on the other had died beforeher birth. These “gaps,” she said, hadalways influenced her identity: “I havethat thing about finding out about themissing pieces.”

Almost every participant stated theirhome community and/or the First Nationto which they belong. Severalparticipants also identified the homecommunities of their parents andgrandparents. Many participantsdescribed leaving their homecommunities and arriving where they


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now live, a process that sometimesinvolved a number of relocations.Several of those who had left their homecommunities added that they plan toreturn there. Clearly, the participantsstrongly identify with the places they --and their families -- are from. At thesame time, most of those who live awayfrom their home communities feel theyare in a place that makes sense for themat this time of their lives. As oneparticipant put it, “I come from manyplaces in a geographical sense, and I feelconnected to all of those places, so Ican’t just say that I’m from one placeand now I’m from here. That’s all part ofwho I am.” As with their family stories,the women’s stories of the places theyare from, have been, are now and willreturn to, express an identity thatencompasses the whole narrative of theirlives.

Participants also proclaimedmembership in communities that werenot tied to a physical place. One womanstated that:

I’m involved in many communities. I guessthe big community is the nations, the FirstNations, the Métis Nation. That’s really partof my life and community presence. Then,after or before or connected to, is all ofthese other communities that I’m part of. Ofcourse, it’s my home town as well. But it’salso the two-spirit community. That’s reallyimportant for me to say, because it is part ofmy life and it gives so much to me and thepeople that are in the two-spirit community.And the women that are part of that whoare First Nation, Métis, whatever. And thenmy business community.

Other women identified themselves asconnected to a community of colleagues,an international healing community, theFirst Nation community of their ex-

husband, their own small neighbour-hood, the urban Aboriginal community,a community of women, and themainstream community.

Many of the women included theiroccupations in their self-descriptions.The participants included women whowork with health care and communityorganizations, who are students, parentsand, as one woman described herself,domestic engineers. Every woman whoparticipated was occupied with serviceto her community and/or family. Manywomen also alluded to an active spirituallife, often simply by presenting theirtraditional names, which connect themnot just to family but also to a spiritualcommunity. One woman stated that,“My identity has been stronger than everin the past 20 years, because of myinvolvement in my spiritual roots.”Many women concluded theirpresentations of self with summarystatements that affirmed a deep level ofsatisfaction with who they are: “[I’m]busy and … happy these days,” “Thingsare going well for me now,” “[I’m] veryhappy with where I’m at.”

The Practice of Personal Well-Being

Wellness is balance in your life, physical,mental, emotional, spiritual. You always tryto balance those things in your life. Forexample, physically, I’m always puttingthings into my body that I shouldn’t be. Iwould be certainly out of balance in thoseother areas also. Or if emotionally ormentally something wasn’t right, I’d be outof balance. For me, I try to balance all theareas. If I’m eating right and getting enoughsleep, stuff like that, physically. Spiritually,whether or not you go to church or say your


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prayers, whatever. And talking to people. Tome, wellness starts with yourself, in yourinteractions or relationships with either yourfamily or your community or nation.

When asked how they practice well-being in their daily lives, most of theparticipants briefly described ways thatthey take care of their physical bodies,such as eating healthily, adhering to avegetarian diet, or avoiding junk food.Most of the women exercise regularly,taking walks, jogging, swimming orrollerblading. One woman happily statedthat she takes pride in her body and feelsgood about the way she looks and feels.Taking care of our bodies, however,requires more than careful eating orexercise regimes. As a participant put it,“What I’ve found in my life is thateverything is in our bodies. All the pain,all the sorrow and stress is in ourphysical bodies.” Like many otherparticipants, she has recognized thatexercise is particularly valuable as a wayto get rid of stress and anxieties. To takecare of our bodies, to be well, theparticipants reminded us, is to take careof all aspects – physical, mental,emotional and spiritual – of ourselvesand to maintain balance in our lives.

The women who participated in theresearch have rich spiritual lives. Theypray, smudge, do ceremonies, followMedicine Wheel teachings, meditate anduse breathing techniques. Most of thewomen express their spirituality in dailypractices. In her prayers each night, onewoman thinks of “ten things that I’mthankful for that day.” Another womanalways carries sage and sweetgrass withher. Having them on hand, even whenshe doesn’t have the time or place to usethem, gives her a sense of well-being.Another woman spoke of her

relationship with the spirits around her.She talks to them, thanks them and asksthem for guidance or watches for a littlesign from them when she is unsure ofthings. This consciousness, she said, hasreally helped her with recent deaths thathave occurred in her family. She knowsthat these people are in a better place,because they visit her, and sheunderstands that their deaths are not areason for sorrow. Daily communionwith the Creator brings strength toanother woman, something she shareseasily with others: “I really think thatthat’s made a significant difference inmy life and my own well-being and howI relate to others. And the kind of energyI think I have in terms of myrelationships, not only in my home, butoutside of my home. In the community,too. And I feel good about that.”

One participant related that when shewakes up every morning, she feelsthankful that her heart is open and shecan move around, and simply feelsgrateful to be alive. Many of the womenfind that their spiritual practices enablethem to start (or restart) their day, adifficult situation, or a simple moment,“with a clear head”:

I need to, in the morning, greet the day, inmy house – I don’t always have to gooutside to do that. I can do that when I getup in the morning, too, look outside and seewhat it’s like. So those things help me startmy day and move through my day.

I do a breathing technique where I can justlie down and breathe for an hour andwhatever it is will change shape somehow.Either there’ll be more clarity or a newquestion or an answer. It will change shapecompletely and I’ll know more what really ishappening.


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[I meditate], not necessarily on a dailybasis, but maybe on a moment-to-momentbasis, because sometimes when I stop at ared light, I will close my eyes, for even 30seconds. And I’ll take a breath, I’ll breathe,I’ll reconnect with my essence.

Taking the time to feel their spiritualconnection enables the women torefocus, gather confidence, anchorthemselves, and recollect their identities:“I’m reminded of the earth. I’mreminded of who I’m supposed to be andwho I am. I’m reminded of the relativesand my relations. All of those things.”

The women talked extensively abouttheir relationships with others. To takecare of herself, one woman stated, “I getreconnected with the people [who] I loveand care for.” All the women spoke ofthe importance of finding and preservingtime to spend with their immediatefamilies and maintaining close contactwith their extended families. Onewoman’s desk at work is partiallycovered with rocks. Her children collectrocks, carry them in their pockets, andsometimes give them to her. She feelsthat there’s a reason for this and keepsthe rocks with her. Family and friendsprovide and invaluable circle of supportto most of the women, and theyacknowledge the importance ofreciprocating that support:

I’m very glad that I have a roof over myhead and nice food and my family takescare of themselves, and my children havefamilies of their own. I look after mymother. But if there’s something wrong inthe family, if anyone is ill, then that has aripple effect too. That affects me. Someonehas to be there to take the little girl toschool or – that’s how it is. There’s the selfand then there’s the extended parts of methat are with the people that I love.

Repeatedly, the women referred to theimportance of being emotionallygenerous and responsible in theirrelationships with others. Thisgenerosity can be expressed in thesimplest of exchanges: “You smile atsomeone and they tend to smile atsomeone else. Something as small as asmile spreads around and makes peoplefeel good.” Many of the womenvolunteer in their communities. As onewoman explained, it’s easier for most ofus to give time rather than money, andthe payoff for this generosity is good.Several of the women’s commentsrevealed a shared commitment to extendhonour and respect to others – to treatothers the way we would all like to betreated: “[I] remind myself of who theyare so that I can work with them better.Not them changing, but I can work withthem better.” One woman spoke ofextending this generosity with theexpectation that sometimes, at least, shewill get something in return:

The difficult people, some of them I like,even though I know they’re difficult, theycould be difficult, but I try to be aroundthem at times when they’re not having sucha hard time. They must be trying to teachme something, I think (laughs). Ourteachers come in many forms.

Most of the women also spoke of theimportance extending a similargenerosity, honour and respect tothemselves. For example, almost all thewomen described being deeply satisfiedby their work. Most of the women havefound jobs they love working, in somesense, in the service of theircommunities. Regarding themselveswith generosity, honour and respect


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leads the women to make healthychoices in their lives:

I really make conscious decisions these daysabout who I want to be around and who Idon’t want to be around, in terms of thekind of energy that I want to be with.

You choose who you want to be with. Iguess that comes with experience andwellness in your life, because you tend tomake a decision based on choosing life,rather than death or destruction. And Icertainly do that now, because it’s part ofmy life source. It’s my survival.

I do feel that I have to decide how much Ican do, because if I try and do too much, itdoesn’t work out for me, or for that otherperson. That’s the thing about lying tomyself, thinking that I was a caregiver in thepast, and what I thought I should do, basedon my internalized job description of what acaregiver was.

There’s a number of ways that I’ve had toback off from doing too much. That’s beenone of the longest running lessons of mylife, when to just get back to balance againand grant that other person their own spaceto fuck up entirely if that’s what they’regoing to do, to manage in whatever waythey’re going to manage. That still comesback to me every once in a while, and then Iknow, by the situations that I’m in or thepeople that I come in contact with, becausethe parts that are unhealed in me, I will findmyself in those situations again and again,and I still recognize that. I can recognize iton a conscious level now and I’m verygrateful for that.

As part of taking care of their well-being, many of the women write, or findother ways to express themselves. Onewoman proudly stated that, “When Ineed to cry, I cry.” Another remarkedthat, “I’m not scared of owning stuff andputting it on the table, but I think thatwell-being is also about expressing

anger and expressing those emotions thatyou just feel.” Being able to express howyou feel is particularly important indifficult times. One woman commentedthat, “When I’m under a lot of stress, Italk with somebody. It’s too hard to keepit to yourself. Find someone you trustwith your problem.”

The women participating in the researchhave found many ways (some of whichare presented above) to take care of theirphysical, mental, emotional and spiritualwellness. For many of the women, thecombination of practical and carefulattention to all aspects of their being andwellness seems to have made themunusually able to face challenges andtake risks in their lives. Rather thanavoiding stressful situations, the womenhave learned to deal with them as theyarise and try to face what’s reallyhappening with courage and faith:

I’m a believer that the creator chooses thespace for us to be in at a certain time, sothere must be a lesson there for me to learnabout the situation that I find myself in --teaching me a different way of coping,maybe, or a different way of relating. So Itake those as lessons, if I experience somedifficulty, to replenish myself or I looktowards the creator.

A significant proportion of theparticipants had, in their mid-lives,returned to school or college, changedcareer direction, and/or began to workoutside of the home for the first time.Some women shared stories of times ofsignificant transformation in their lives:

I was carrying a lot of stuff from the past. Iwas hanging on to them and had to dealwith them and let them go. I have a positiveway now of dealing with things. I didn’tknow I was carrying those negative things. Istumbled upon them. I was taking this


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counseling course, so these things startedcoming up for me. I didn’t know, I wasn’taware of stuff that could affect you laterfrom childhood… Back then, I used to copewith these things, I’d get upset or hurt andthink, I’m going to go drink. It was my onlyway of coping, I think. Then after I wentthrough all this therapy, I don’t feel thatway anymore. I think that was the biggestarea, that emotional part, if you’re notaware that you’re carrying.Another woman had lived on her homereserve all her life. She raised her ownchildren there and had never workedoutside her home. When her youngestchild moved out, she began to attend acommunity college in a nearby town.Upon graduation, she and her husbandmoved to the small city where they nowlive and work. In the face of change, shesaid, she and her husband, “sort of foundeach other growing. We’re more open.We’re closer now than we were 30 yearsago. It was sort of a brand new start forme and my husband. We’re settled andwe’re happier now than we were a fewyears ago. And I love what I’m doing,going to work. I don’t find it a chore. Ienjoy it.” This woman’s story affirmsanother participant’s assertion that,“Practicing well-being has a ripple effectfor everyone that we’re in contact with,including family, extended family,community and nation.”

Contributing to CommunityWellness

I really feel and see the need for ourcommunity to be well, and I think that reallybegins with each of us. I try to practice thatin my own daily life, and I try to emphasizethat in the community too, especiallythrough my work. If I’m able to be with agroup of people where I can carry amessage, to encourage them to be well and

to take care of each other in the workplaceand encourage them to do that at home – Ido that. I take advantage of each of thoseopportunities. And I share that with people.

The participants were asked to describesome of the ways that they take care ofthe wellness or healing of theircommunities. For many of the women,responsibility for the well-being of thecommunity starts in their home, in theirrelationships with family and friends.Several women felt that one of theirmost significant contributions to thewellness of their community will be toraise their children to be whole andhealthy people, to be “independentpeople who do not rely on others,” “tobecome strong people, to understand thepower of being themselves, to dowhatever they want to do, and to knowthat they don’t have to stay inrelationships that are unhealthy.” Someof the women are also very activelyinvolved with their grandchildren, andtake their responsibilities to them veryseriously. A woman who is teaching hergrandchildren traditional cultural ways,the Saulteaux and Cree languages andeven how to make bannock, said,“That’s my main goal, to teach whateverI’ve got to the little ones and see themgrow up to be proud of where they comefrom.” One woman described how, as asingle mother, she also provided housingto people who are mentally-handicapped. In this way, she was ableto stay at home raising her children,bring in an income without using orfighting the system, and provide a much-needed community service. Anotherwoman talked about how she has alwaystried to make her home available as akind of community drop-centre.Referring to the “kitchen table concept,”she stated that, “There are more


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decisions made around the kitchen tablethan there is in the government office orat the legislature.” As well as providinga place where community members cangather and talk, she has recognized howimportant it is to listen, in particular toyoung parents, because our communitiesand families are now organized so thatyoung parents, mothers andgrandmothers no longer live closelytogether. “When parents are left on theirown,” she commented, “it’s reallydifficult.”

The women expressed a real awarenessof the impact of their own behaviour onthe well-being of their community. Asone woman said, “If we’re not wellourselves, how can we help others? Bystarting with each of us, I think that’show we can help each other and otherpeople.” In many ways, the women tryto provide positive role models to theircommunity members, whether bygraduating from high school, beingphysical active, having the confidence tocompete in a pageant, eating well,offering leadership, peacemaking,sharing their spirituality, or simply by“showing people a better way, leadingthem to a better place – that’s thegreatest joy!” Another woman describedthe importance of her return to thecommunity after completing her post-secondary education:

If our people, our kids, leave here and goout for education and stay there, you don’tget too much back, unless we come backand do something for our community. Andthen go out after you’ve done your time.Then go if you want to go, but come backand give back. That’s what I believe.

The women care for the well-being oftheir communities in actions as humbleas picking up garbage in the

neighbourhood, as generous as makingthe time to visit and keeping strongconnections with older people in thecommunity, as visionary as advocatingfor activities and services for youth, oras conscientious as trying “to find or toknow resources in the community, too,so I can help people if they feel theyneed to talk to someone or need to gosomewhere. Or somebody who can bringa good message to them, nurture themand take care of them. I try to identifythose good people for them, so they cango into their circle to help.” The womenalso engage in a wide range of volunteeractivities, including participation inboards of community organizations,public outreach events for health careorganizations, youth groups, andcoaching activities. A woman whomanages a hockey club gave animpassioned description of what herinvolvement means to her and hercommunity:

They have this vision and this dream andthe bottom line with this vision and thedream is their identity. Who they are, whowe are, what are we capable of. And thehurdles that are there always. And they’rethere, you know. And the bars that keepgetting higher and higher. Every tournamentwe have to jump another hurdle, but it’s notthe same hurdle for mainstream society …but we jump it anyway, because that’s theway that you can go ahead. And so now, Ijust see myself as the person who iscarrying the torch of the people that havealready gone, because they passed away,the ones that had this dream of having acommunity hockey team. And it’s preservedwith Aboriginal backing… We can rise above– we can take every obstacle and turn it intoa challenge. And we’ve had to and beensuccessful.

The participants show a similarly highlevel of commitment to their


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community’s well-being in theirprofessional lives. All work in directservice to their communities, either atcommunity or health care organizations,or in education. Women working ineducation spoke of the gratitudeexpressed by students on a daily basisfor the time and patience given them, theshear pleasure of passing on the skillsand knowledge they have, seeing thevulnerability and excitement in students’eyes when they learn something, andtheir own efforts to ensure that theirschool and system do nothing but benefitthe community’s children. Womenworking for a health care organizationtalked about their ambitious efforts tofind “more positive ways, more positivethings to do.” The list was long. Theyarrange drop-in social events to bringcommunity members into their facility,offer public education, try to break downbarriers to and bridge gaps in services toAboriginal people, and enhance theservices their organization currentlyoffers. One woman works on fundingdevelopment at an Aboriginalcommunity organization and plans tocontinue such work for other reservesand communities, to “show them whatmoney is out there, available to establishprograms for their communities.”Another works hard to ensure that ratherthan doing things for the people withwhom she works, she teaches them, sothat they “leave with knowledge that willhelp them to better develop themselvesor their community.”

Strengthening AboriginalWomen in theirCommunities

This one traditional person told me in thisworkshop, … childbirth … was one of thesacred ceremonies. Women have so muchto offer. The way he put it, “When awoman’s in the room, you feel the warmth.”You bring the warmth in that room. I findthat so true. Like, when you’re not there,the kids say, “Where’s Momma?” That’susually their best word, “Mom,” wheneveryou’re looking for something. You know?

Participants felt that to strengthenAboriginal women, we must (asindividuals and communities) reclaimthe acknowledged importance of womenin our traditional cultures. Theyunderstood that, before the introductionof European values, missionaryinfluences and patriarchal systems, therewas no question about whether men andwomen were equal. Following Europeancontact, women lost a lot of respect andstatus:

Our traditional roles have been given awayor taken – doesn’t matter how it happened,but we’re not as strong in our communitiesanymore. Once we were both the life-giversand decision-makers in our communities –culturally, traditionally, we have to take backthat role.

One participant stated that, “IfAboriginal women are going to make animpact or be empowered by theircommunities, we have to go back to ourroots, the basis of our cultures. That willlead us to respect and honour women …When honour and respect flow in ourcommunity, we won’t have problems – itwill empower everyone.”


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Participants called for women to takeresponsibility for creating some of thismuch-needed and deserved honour andrespect by actively supporting eachother. As one woman pointed out,women “are still the backbones of ourcommunities -- just not as recognized aswe once were,” or, as another remarked,“Aboriginal women are alreadyempowered – we just need to startshowing it to others.” Participants calledfor greater representation of women inmanagement and leadership positions.One woman spoke with frustration ofhow, although effectively her wholecommunity is run by women -- withwomen filling the majority of staffpositions, from worker to departmenthead -- the top jobs in the community aretaken by men.31 She feels that theprimary reason her community does nothave a female leader is that “womenaren’t willing to elect women into thosepositions,” and concludes that “weshould just look at the value of what wecan give each other and do for oneanother and not think, ‘oh well – she’sdoing better than me, so I’m not going tovote for her.’ ” A woman in anothergroup seconded her ideas:

I think we have to just start using our voicesin our community. And acknowledging,starting with our mothers and ourgrandmothers, giving them their power back 31 This reflects general trends in the Aboriginalcommunities of Canada. Aboriginal women aremore likely to have a university degree or post-secondary school experience than are Aboriginalmen, and have higher employment rates than doAboriginal men. In spite of this, the vast majorityof Aboriginal women are employed in sales,service, clerical and administrative positions(Madeleine Dion Stout, Gregory D. Kipling andRoberta Stout. Aboriginal Women’s HealthResearch Synthesis Project: Final Report.Winnipeg: Centres of Excellence for Women’sHealth, May 2001).

– and taking ours. Exercising ours. Andencouraging our children, our daughters andother women in the community. That’s theway it’s going to happen.

Participants also spoke extensively aboutthe “career-or-family divide” thatwomen face. Several women remindedthe groups that women should besupported in whatever decision theymake, whether, for example, they chooseto work, to stay at home, or to stay athome and pursue an education at thesame time. As the women pointed out,with the breakdown of traditional socialstructure, women generally don’t havethe strong support systems that theirmothers, grandmothers and family onceprovided. Support systems to enablethese choices, they felt, should beprovided federally, provincially, bycommunities, and within families.

Honoring women should include valuingthem as life-givers. As parents, we havethe opportunity and responsibility toraise children who will value and respectwomen. One woman related that:

I heard an elder say, “The way you takecare of your plant or your tree as it’sgrowing, that’s how it’s going to turn out!” Ithink that’s always so true. Bringing upchildren, it’s how you take care of children,how straight they grow or how lop-sidedthey are. I think we need to work with theyouth, the children too, with that need forwellness.

A number of women suggested thatAboriginal women will be strengthenedwhen our communities take moreresponsibility for our children, connectwith who they are now, and show moreconcern for who they will become. Theyasked that communities begin to listenmore to children, look for ways to


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mentor them, provide activities that theycan enjoy and succeed in, protect themand raise their expectations of the schoolsystem. Education, one woman pointedout, can bring us “a sense of belongingand adding to everything, a contributionto the community you live in throughyour education.” Traditional values willbe reclaimed, in part, women felt, whenwe ensure that history – that is, “whatreally happened” – traditional teachingsand Aboriginal languages are presentedin community schools. As one womanexplained, “If you know your language,you will know your culture. You willknow about the family system, the oldtraditional value, and it will help you.”School is a place where children can betaught “about the importance of womenand their roles, and also about theimportance of men,” a lessonparticularly valuable to those childrenwho are unlikely to learn it at home.

Participants also suggested that womenwill be strengthened when communitiesprovide our elders and men with some ofthe supports they need. “There are a lotof support groups for women, but whatabout men?” one woman asked. Otherwomen commented that while womenare getting stronger, men seem to “feelthreatened,” that they are “on thesidelines … not participating,” and thatthey “don’t know what’s appropriate orwhat’s not nowadays,” or “what’sexpected of them anymore.” The womencalled for support for men, both to helpthem change their attitudes about womenand to enable them to recover a sense oftheir own strength and value.Participants were also bothered bychanges in our attitudes to elders: “Wedon’t look to our elders anymore.Instead, we put them away in a home.

They’re our best resource.” Asindividuals and as communities, onewoman stated, we can be strengthenedby “the bits and pieces of wisdom andknowledge that elders can offer and thatwe can offer each other.”

The women’s greatest concern, whenconsidering how their wellness might bestrengthened, was the need forcommunities to take ownership andcontrol of their own cultures. A womandeclared that:

We’re guilty of lateral violence. We’re nothappy for someone’s success – we’rejealous! That stems from our historicaltreatment – now we’re doing it to eachother, as Aboriginal people. The Metisagainst First Nations, First Nations againsteach other, family against family. Lateralviolence is like a disease among our people.We treat each other so badly, yet we shouldbe grateful for their successes becausethey’re making pathways for us.

Another woman shared the story of herreturn to school, only to hear that peoplein her community were saying, “Why isshe going back to school? She’s alwaysgoing to school. What’s the matter withher? Why can’t she learn?” Women feltit urgent that we address the jealousy inour communities and challenge eachother when it appears:

People return to the community and havethat attitude on them all the time. It burnsthem out very quickly. In our community,some really good people have come backand tried so hard, and before long, a coupleof years, they’re the enemy … They becomeapathetic as well.

Instead of tearing each other down, aparticipant commented, “we all need toempower each other.” One womandescribed her community, the site of a


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casino, as “shiny economically on theoutside, but socially, inside, it’s rotten.That’s a strong word – maybe we’rerecovering.” Another participantremarked that the casino wascontributing to a total breakdown offamily structure: “There’s more moneybeing generated within the community,but what is that doing to children?... Wedon’t need another addiction in ourcommunities.”

Solutions to the community problemsdescribed above require visionaryleadership. A participant in one groupwas asked to dream a future for hercommunity. Her answer revealed thecourageous imagination, committedconcern, common sense and greatexpectations that we need ourcommunity leaders to possess:

Well, one of the biggest areas is housing onreserves. There’d be no overcrowding.They’d all have one house each (laughter).The way that the women work today, likethey cap programming, the education andhealth and stuff like that. There’d be nocaps on what you need, like the schools.High school would be high quality education.They’d have a hospital within thecommunity. Doctors, therapists, maybe even

a traditional healing program right in thecommunity. Clean water. Proper, modernsewer systems. Those infrastructures wouldbe all there, so they wouldn’t have to begetting sick all the time from overcrowdingor poor quality water. Junk food would bebanned … We’d have to grow our owngardens … The roads would be paved, notmuddy or dusty. You can’t even go outsideto hang your clothes in most communities.What else? There’d be a lot of traditionalteaching, because living in harmony – liketoday they’re all fighting with each other.Using the elders and the youth also. Youthprogramming. Giving your staff, praisingthem and stuff like that, retreats, thankingthem for their services. What else? Help tobring the women’s, female youth programs,stuff like that. Native language also is a bigarea that needs to be addressed. Sustainingour language. Being a part of tradition,teaching my youth, my children, that there’smore than just living in the community, like,hunting, fishing – sustaining all thosetraditional ways, either be taught in theschool or go out to family camps. Even theTV that we watch … maybe we have it torelax. Satellite systems, what they see onTV, the violence. Banning the violentprogramming. I don’t know abouttransportation. When you get access to abigger community, it just brings biggerproblems (laughs). I don’t know if I’d wantjust isolated, or access, or semi -- maybe abig airport (laughs at self).


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A Vision of Aboriginal Women’s Wellness32

32 This figure is based on an image developed by Fyre Jean Graveline and Maryann Whitefish in responseto a draft version of this report.


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5.0 CONCLUSIONThe Aboriginal women who participatedin this research project take care of theirhealth and wellness by attending to andmaintaining balance between all aspects– physical, mental, emotional andspiritual – of their being. The women’sidentities are inseparable from theirfamily, history, community, place andspirituality, and understood in thecontext of their whole lives. Their senseof community identity is strong, rootedin their families, embracing friends,neighbours, peers, colleagues and peoplewith shared experiences and interests,and extending to the First Nations theyare a part of. The women emphasized theimportance of spirituality, manifested indaily practices such as prayer, smudgingor simply an ongoing commitment toextend honour and respect to others.They are conscious of the importance oftheir roles as life-givers, care-givers anddecision-makers in their immediatefamilies, extended families, communitiesand Nations. Their responsibilities inthese roles start in their homes and aremanifested in their relationships withfamily and friends. The womenunderstand the importance of being wellthemselves so that they can raise theirchildren, help their grandchildren andassist community members to becomewhole and healthy people. The womencontinue to take these responsibilities on,even while, with the breakdown oftraditional social structures, they havelost many of the strong support systemsonce provided by mothers,grandmothers, families andcommunities. The women’s attention to

all aspects of their being and wellnesshas made them unusually able to facechallenges and take risks in their lives.

The women expressed a tremendouswillingness to take responsibility fortheir own well-being and that of theircommunities, as well as the hope andexpectation that others be willing to dothe same.33 The women emphasized theimportance of reclaiming tradition andreturning honour and respect to womenfor the roles they perform in our familiesand communities. They spoke of theneed to encourage women to activelysupport each other. They also recognizedthe need to create more supports formen, many of whom now are strugglingto maintain or recover a sense of theirown strength and value; for children,who, as always, need and deserve ourcare, protection and guidance; and forelders, who offer us wisdom andknowledge derived from their lengthylife experience. With an appreciationthat their own well-being is closelylinked to that of their communities, thewomen understand that as theircommunities assume more control andownership of their own cultures, bothcommunities and women becomestronger and healthier.

The relationship between the identity ofAboriginal women in Manitoba and their 33 These values were evident in the interactionsbetween focus group participants. At eachmeeting, the women quickly created community,easily exchanging humour and empathy,affirming and supporting each other’sunderstandings and experiences.


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health and well-being has severalimplications for health care providers,policy makers and professionals. Thewomen participating in this researchproject envision their own identities andwellness in holistic terms. Theseunderstandings affirm the importance ofmoving beyond a scientific approach tohealth and healing to integrate holisticunderstandings of and approaches tohealth (including traditional medicine)into health care practices and policies.Health care practitioners, providers andpolicy makers should recognize, workwith and expand upon existing resourcesthat support the health of Aboriginalwomen and their communities. Forexample, as life-givers, care-givers anddecision-makers, Aboriginal women inmany ways are the health gatekeepers oftheir communities. Health care providersand policy makers should seek tostrengthen Aboriginal women byacknowledging the value of the familyand community roles and responsibilitiesthey have assumed, by creating andsupporting opportunities for them towork together, and by soliciting theirinput on service delivery and policydirection. Further research into theconnection between the well-being andidentity of Aboriginal women, forexample research that focuses on theidentity and well-being of Aboriginalwomen in remote communities, willenhance our understanding. The familyand community roles and responsibilitiesof Aboriginal women should also beacknowledged in education andrecruitment programs for Aboriginalhealth care professionals andadministrators. Programming andfunding should be designed toaccommodate the multipleresponsibilities of the women, rather

than forcing them to choose betweencareer and family. In particular,programming and funding should beavailable to women who return to orbegin a career after raising theirchildren.

The women’s shared holisticunderstanding of identity and well-beingalso illustrates the importance of acommunity health approach. The womendo not separate their own selves or well-being from the selves or well-being ofthe children, men, elders andcommunities with whom they share theirlives. Health care practitioners, providersand policy makers should assume asimilar approach. As the women pointedout, community issues, such as housingconditions or a decision to build acasino, can have a significant impact onthe health of Aboriginal women. Healthcare practitioners, providers and policymakers in Aboriginal communitiesshould be willing to support communityefforts to address such issues. Inpartnership with Aboriginal people andcommunities, they should work toidentify the particular strengths andneeds of all the community members(including women, men, children orelders) and communities they areserving, then design programming andservices that draw upon those strengthsand attend to those needs. Movingtoward community-directed healthprogramming and services addressessome of the need for community controland ownership identified by the womenin this project. The federal government’scurrent initiative to transfer jurisdictionof medical programs and services toFirst Nations communities, tribalcouncils and organizations reflects asimilar understanding of the need to


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return control of health care toAboriginal communities. Aboriginalcommunity ownership of health care,however, requires more than ajurisdictional transfer.34 Health carepractitioners, providers and policymakers, as well as federal and provincialgovernments, need to assist Aboriginalcommunities’ in the development of theinfrastructure, human resources andadministrative structures needed tocreate and control health care servicesthat are rooted in the cultural practicesand values of the Aboriginal people theyare serving.

34 Janet Smylie, SOGC Policy Statement: AGuide for Health Professionals Working withAboriginal Peoples. Rogers Media: Toronto,2001.


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6.0 POLICY RECOMMENDATIONS

The women who participated in theresearch presented identities that areinseparable from their family, history,community, place and spirituality, andunderstood in the context of their wholelives. They are conscious of theimportance of their roles as life-givers,care-givers and decision-makers in theirimmediate families, extended families,communities and Nation. They continueto take on the responsibilities these rolesentail even while, with the breakdown oftraditional social structures, they havelost many of the strong support systemsonce provided by mothers,grandmothers, partners, families, andcommunities. They spoke of theimportance of returning honour andrespect to women and of encouragingwomen to actively support each other.They also recognized the need to createmore supports for men, many of whomnow are struggling to maintain orrecover a sense of their own strength andvalue; for children, who, as always, needand deserve our care, protection andguidance; and for elders, who offer uswisdom and knowledge derived fromtheir lengthy life experience. With anappreciation that their own well-being isclosely linked to that of theircommunities, the women understand thatas their communities assume morecontrol and ownership of their owncultures, both communities and womenbecome stronger and healthier.

These research findings underscore theimportance of traditional culture to thehealth and wellness of Aboriginalwomen. Because of this, we recommendthat Aboriginal, federal, provincialand municipal governments recognize,value, and support traditional culturalpractices and understandings withrespect to health and wellness:

Traditional cultural teachings are acentral part of contemporaryAboriginal culture and provide apowerful place from which to teachand guide health and wellnesspractices. All levels of governmentshould provide funding and otherresources to initiatives that supporttraditional teachings relating to healthand wellness.35

All levels of government shouldsupport First Nations, Inuit andAboriginal communities to take

35 To some extent, this is already underway. Forexample, the federal government has recentlyapproved funding for the newly formed NorthernAboriginal Population Health and WellnessInstitute (NAPHWI). One of the goals of theInstitute, which is led by Manitoba KeewatinowiOkimakanak (a regional organizationrepresenting 30 First Nations communities inNorthern Manitoba) and the BurntwoodRegional Health Authority (mandated to planand deliver health care services across most ofNorthern Manitoba), is to integrate traditionalAboriginal healing methods and practices intoconventional Western medical programs andservices.


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ownership and control of their ownculture and traditional teachings inareas such as parenting, traditionalcounseling, traditional healing andmore. This is particularly important inthe context of the current transfer ofmanagement of some health servicesfrom the federal government to FirstNations and Inuit communities.Supporting communities to takeownership and control of health-related aspects of their culture andtraditional teachings will strengthentheir ability to develop health systemsthat make the most of communityresources. As part of this capacitybuilding, First Nations, Inuit andAboriginal people should be involvedin the planning and delivery ofhealth-related services and programsin their communities.

Because every language, to someextent, preserves unique culturalknowledge, Aboriginal and provincialgovernments should support themaintenance of Aboriginal languages.Aboriginal people should be able tospeak and be understood in theirtraditional languages (especiallywhen they are communicating aboutthe personal and intimate subjects ofidentity, health and wellness).Supports may range from offeringclasses in local languages and dialectsto the provision of interpreter andtranslation services.

Health programs must incorporateAboriginal holistic understandings ofhealth and wellness into the workingdefinitions that guide planning,programming and daily practices.These understandings will enable us

to look beyond an isolated biomedicalmodel of health and wellness andrecognize that “well-being flows frombalance and harmony among allelements of personal and collectivelife.”36

It is also clear that Aboriginal womenare a valuable part of their families,communities, and larger Nations. Werecommend that Aboriginal, federal,provincial, and municipalgovernments respect, honour, support,and strengthen Aboriginal women’sroles in their families, communitiesand larger Nations:

Aboriginal women must berecognized as gatekeepers of familyand community health and wellness.This suggests, for example, thatAboriginal women should beconsulted on, included in, and givedirection to health assessments andother research projects.

Health care delivery mustincorporate an understanding ofAboriginal women’s roles andresponsibilities and of theirimportance as life-givers, care-givers,and decision-makers in theirimmediate families, extendedfamilies, communities and Nations.Programs and services shouldrecognize the connections betweenthe identities of Aboriginal womenand their family, history, community,place and spirituality.

36 Royal Commission on Aboriginal Peoples.Highlights from the Report of the RoyalCommission on Aboriginal Peoples. Ottawa:Ministry of Supply and Services. 1996.


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At a local level, support should beprovided to programs, services andpractices that acknowledge thecontributions Aboriginal womenmake to their families andcommunities and reclaim theirtraditional importance as life-giversand decision-makers.37 Aboriginalwomen should be encouraged to findways to actively support and celebrateeach other’s success and identities.

At an institutional level, health careproviders and other stakeholdersshould build capacity for Aboriginalwomen through aggressive andeffective human resource initiatives.Aboriginal women should beprovided with more opportunities toassume leadership and decision-making positions and their image asleaders should be enhanced through,for example, opportunities for role-modeling and mentoring.

The research findings clearly indicatethat the health and wellness of individualAboriginal women is inseparable fromthat of their families, extended families,communities and Nations. Werecommend that Aboriginal, federal,provincial, and municipalgovernments address the needs of

37 For example, the recently formed Mother ofRed Nations (MORN) provides voice,representation and advocacy to Aboriginalwomen in Manitoba, promotes, protects andsupports the well-being of Aboriginal womenand children, and is committed to supportwomen as they reclaim their traditional positionsas community leaders. The organization receivesmost of its funding through departments of thefederal government.

Aboriginal families and the largercommunities and Nations:

All levels of government and otherstakeholders should supportAboriginal women to achieve balancebetween their paid and volunteerwork, and family and communityresponsibilities. For example, women,families and community membersshould be able to procure adequatechildcare and home care, and supportshould be provided to caregivers.

Families and communities mustreceive adequate supports to care for,protect, and guide children.

At a community level, formal andinformal supports should be in placeto assist men to maintain or recover asense of their own strength and value.

At a community and institutionallevel, the wisdom and knowledge ofelders must be recognized andrespected.

The capacity of communities toaddress underlying issues that affecthealth (such as casinos, inadequatehousing, poverty, the legacy ofresidential schools, poor levels ofnutrition, and high levels of stress)must be supported and strengthened.This suggests that government andinstitutions must place more emphasison population health approaches.

All levels of government must buildbridges and encourage and enableorganizations to collaborate andcooperate in the delivery of programs


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and services that support health andwellness. It is especially importantthat all parties work to resolve themany jurisdictional issues that can getin the way of people and agenciesworking together.

The Living Well research projectaffirmed the important links betweenhealth and wellness and the culturalidentity of Aboriginal women. Furtherresearch in this area will improve ourunderstanding of how we can supportand facilitate the holistic practices ofwell-being used by Aboriginal women.Although the Living Well research teamvisited a number of communities inManitoba, Aboriginal women in theprovince are a diverse group,representing a wide range ofcommunities and cultures, each withtheir own health and wellness teachings,experiences, and practices. It may bealso useful to explore the issue of lateralviolence38 in Aboriginal communities(flagged by research participants) andwork with community members todevelop supports that will address it.

38 By lateral violence, we mean such things ascompetitiveness, gossip, or family feuds thatmay develop within First Nations, Inuit andAboriginal communities, separating and isolatingcommunity members. Lateral violence isassociated with multi-generational trauma and itsimpact on community wellness, resiliency, andculture must be addressed.


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ReferencesConnie Deiter and Linda Otway. Sharing our stories on promoting health and communityhealing: An Aboriginal women’s health project. Winnipeg: Prairie Women’s HealthCentre of Excellence, 2001, 33 pp.

Centres of Excellence for Women’s Health. “Research as a Spiritual Contract: AnAboriginal Women’s Health Project”. Research Bulletin, 2(3), 2002, p. 14-15

Madeleine Dion Stout, Aboriginal Canada: Women and Health. Ottawa: Health Canada.1996.

Madeleine Dion Stout, Gregory D. Kipling and Roberta Stout. Aboriginal Women’sHealth Research Synthesis Project: Final Report. Winnipeg: Centres of Excellence forWomen’s Health, May 2001, 43 pp

Lissa Donner. Women, Income and Health in Manitoba: An overview and ideas foraction. Winnipeg: Women’s Health Clinic, 2000, 84pp.

Brenda Elias, Audrey Leader, Doreen Sanderson, and John O’Neil, Living in Balance:Gender, structural inequalities, and health promoting behaviours in Manitoba FirstNation Communities, Winnipeg: Northern Health Research Unit, 2000. 36pp.

Health Canada. The Health of Aboriginal Women. http://www.hc-sc.gc.ca/english/women/facts_issues/facts_aborig.htm

Manitoba First Nations Regional Health Survey: Final Report. Assembly of ManitobaChiefs, Manitoba Keewatinowi Okimakanak and the Northern Health Research Unit,September 1998.

Royal Commission on Aboriginal Peoples. Highlights from the Report of the RoyalCommission on Aboriginal Peoples. Ottawa: Ministry of Supply and Services. 1996

Janet Smylie, SOGC Policy Statement: A Guide for Health Professionals Working withAboriginal Peoples. Rogers Media: Toronto, 2001, 51 pp

Roxanne Struthers, “The artistry and ability of traditional women healers”, Health Carefor Women International, 24: 340-354. 2003.

Alex Wilson, and Janet Sarson. Focus Groups for Social Change: A user’s handbook.Duluth, MN: Praxis International, 2003 (in press).

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Appendix – Consent Form for Participants


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Aboriginal Women, Cultural Identity and Wellness ProjectConsent Form

Discussion GroupsYou are invited to be in a research study on the topic of Aboriginal women, cultural identity andwellness. The purpose of the research is to look into the ways that Aboriginal women haveretained and drawn upon cultural values, teachings, and knowledge as a way of healingthemselves, their families and their communities. We are trying to understand how Aboriginalwomen develop their cultural identities and how this contributes to their mental, physical,emotional, and spiritual wellness.

Please read this form and ask any questions you may have before agreeing to be in the study.The study is being conducted by myself, Alex Wilson (Opaskwayak Cree Nation) for the PrairieWomen’s Health Centre of Excellence.

Procedure:If you agree to participate in this research project you will have to do the following:1) Participate in 1 group discussion. The discussion group will take approximately 2hours and be run in a format similar to a talking circle.2) Agree to respect the confidentiality of other discussion group members.

These group discussion groups will be audiotaped to ensure accuracy.

Risks and Benefits of Being in the Study:The study has the following risks:First, since people will be talking about their life experiences, during the discussiongroup there is a possibility that sensitive issues may arise. There is a risk that you, orothers, may become upset or that the discussion may trigger painful memories.

Second, although every effort will be made to ensure confidentiality, there is a risk thatother participants might share information that they hear during the discussion group andthereby not honor the confidentiality.

A benefit from being in this study is that you will have the opportunity to tell your own story. Theresearch will lead to a better understanding of the topic of Aboriginal women, cultural identityand wellness, which in turn can help with policy and practices that affect Aboriginal women andcommunities. Ultimately this research will help Aboriginal women and our own nativecommunities return to a healthy balance.

Confidentiality:Every effort will be made to ensure that your identity will remain confidential.Pseudonyms will be used for names and places so that you will not be identifiable. Anyinformation that is gathered will be generalized. Audiotapes and notes will be kept in alocked file cabinet and once the research project is finished the records will bedestroyed.

The findings of this study will be presented in a document published by the PrairieWomen’s Health Centre of Excellence. A copy of the Report will be made available toyou, if you wish.


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Voluntary Nature of the Study:Your decision whether or not to participate will not affect your current or future relationswith the Prairie Women’s Health Centre of Excellence or with the researcher, AlexWilson. If you decide to participate, you are free to withdraw at any time without affectingthose relationships.

Contacts and QuestionsThe researcher conducting this study is:

Alex Wilson, Opaskwayak Cree Nation

You may ask any questions you have now.If you have questions later, you may contact the researcher at

(204) 479-1202 or toll-free 1-866-371-6848.

This research project was approved by the Prairie Women’s Health Centre ofExcellence. If you have any concerns about your rights or your treatment as aparticipant in this study please contact the Prairie Women’s Health Centre of Excellence,56 the Promenade, Winnipeg, Manitoba, R3B 3H9, phone 204-982-6630, [email protected].

Statement of Consent:

I have read and understood the information above and give my consent to participate inthis study. I agree to maintain the confidentiality of other group members. I havereceived a copy of this consent form.

Name (please print) ___________________________

Signature________________________ Date ___________

Signature of investigator/Researcher________________________ Date ___________

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