C1071RAPatents granted and pending.

This guide is not intended to be all things to allpeople. Rather, it was developed in responseto requests from service providers as a start‐ ing point in the development of culturallycompetent systems of care. The focus is toaddress the unique needs of First Nations,Métis & Inuit (FNMI) within the Simcoe, Yorkand Muskoka region in the following areas: 1) Cultural awareness ‐ an acknowledgement

of cultural differences;2) Cultural sensitivity ‐ understanding the con‐

sequences of European contact and theinter‐generational impact on the emotional,physical, mental and spiritual well‐being;

3) Cultural safety ‐ focuses on a serviceprovider’s ability to recognize their own cul‐tural bias and assist a client in the develop‐ment of a plan of care that promotes indi‐vidual well‐being and does not compromiseculture;

4) Cultural competence ‐ knowing your limita‐tions, local resources and when to draw onthe cultural knowledge within the FNMIcommunity. This also involves clearlydefined policies, programs and interven‐tions that fit the cultural context of the individual, family or community and know‐ing when and how to refer;

5) Evaluation and assessment ‐ importantmeasurements best conducted on a regular basis. This review assists with the develop‐ment of culturally sensitive systems that impact wellness outcomes and promisingpractices based on feedback from con‐sumers, staff and community. (Adapted fromBritish Columbia’s First Nations Health Council, 2009.)

Specific orientation or training can be providedby a trained facilitator from the First Nation,Métis or Inuit community. Contact the BarrieArea Native Advisory Circle (BANAC) for moreinformation at ed@banac.on.ca.

Please note that FNMI is used for FirstNation, Métis and Inuit for consistency andin the interest of space only.

The relationship between FNMI and Canadahas evolved over hundreds of years.Terminology has evolved as well. In this sec‐tion, the term “Indian” is used in reference tospecific legislation.

First Nations practiced Treaty making prior tothe arrival of Europeans. First Nations sharedknowledge of the land and resources withEuropeans upon their arrival, and establishedPeace and Friendship Treaties in order to cre‐ate respectful and mutually beneficial trade.These early treaties were often recorded inFirst Nations languages and adhered to FirstNations forms of governance. The RoyalProclamation of 1763 recognized theseNation to Nation relationships.

Approximately 100 years later,the British North America Actchanged the Nation to Nationrelationship to wards of theCrown and gateway to forcedassimilation. During this period, anumber of Acts were introducedto support this such as: GradualCivilization Act; GradualEnfranchisement Act; and theIndian Act with numerous patern‐alistic amendments.

Enfranchisement was a process by whichIndians lost their status voluntarily or involun‐tarily and became non‐status Indians. Someexamples included marriage of a First Nationwoman to a non‐Indian man; when a maleturned 21 and could speak and write Englishand absence from the community for extend‐ed periods of time.

The Indian Agent was introduced as a way forthe Crown to hold control of land and assumepower to dispose of lands reserved forIndians that included land transfer to TransCanada Highway, CNR, CPR, hydro, etc. Inmany instances, a source of litigation today.

The Indian Act legislation was created in1876 for the purpose of governing thelives of Indians. It established criteria forstatus, non‐status and First Nation bandmembership. During this time, if youwanted to leave the reserve you neededpermission from the Indian Agent orface incarceration. Lawyers were barredfrom acting on behalf of Indians or risklosing their licence. Indians were notgiven the right to vote until the 1960’s.Over time, many amendments to theAct further restricted the rights andfreedoms of First Nation people. One ofthe more significant changes was the1985 amendment, Bill C‐31, whichallowed women who previously losttheir status through marriage, or enfran‐chisement to apply to have their statusreinstated. The latest amendment, BillC3, allows grandchildren of those men‐tioned above to register their status aswell, creating confusion about rights,benefits and identity.

FNMI continue to act as strong advo‐cates in the promotion of autonomy aswe work together to rebuild a nation tonation relationship.

Historic Sources ofDistrustIt is important to understand that historicdistrust continues to impact modern dayinteraction. As a result, the importance ofestablishing relationships and rebuilding trustcannot be over‐stated. Many First Nationcommunities were devastated as a result ofcontact and the introduction of infectious dis‐eases. Similarly, many treaties made by thegovernment were broken with negotiationsand/or court cases still ongoing.

From the 1800’s through the 1990’s, residen‐tial schools were used to assimilate FNMI.Children were forcibly removed from theirfamilies to attend schools far from homewhere they were punished for speaking theirlanguage or practicing spiritual ways. In his

formal apology, Prime MinisterStephen Harper acknowledgedthe intent of the residential schoolera was “to kill the Indian in thechild.” Forced to attend, half ofthe estimated 150,000 FNMI chil‐dren died in care. Many survivorsexperienced spiritual, physical,mental and sexual abuse. Therewere approximately 130 schools

across Canada with 23 in Ontario. The lastschool closed in 1996. Residential school sur‐vivors were taught that their traditional cul‐tures were inferior or shameful, which stillaffects many FNMI communities today. Thecurrent Truth and Reconciliation Commissionis a process where survivors can share theirstories and begin the healing journey.

The 2011 Children’s First Report refers to the60’s scoop with over 11,000 status FirstNations children adopted, 70% into non‐FNMIhomes according to statistics from AboriginalAffairs and Northern Development Canada.Conditions that continue to contribute to cul‐tural identity confusion are referred to as the“Millennium Scoop” syndrome.

The defeat of the Meech Lake Accord in 1990by Elijah Harper was based on the concept oftwo founding nations with the proposedaccord omitting Aboriginal people. In 1991,the Royal Commission on Aboriginal Peoples(RCAP) was a response to the OKA crisis andMeech Lake Accord. This resulted in approxi‐mately 400 recommendations including acall for the recognition of Aboriginal nation‐hood, better economic and educationalopportunities and improved social condi‐tions to name a few.

Regional and Cultural DifferencesThe FNMI community represents adiverse range of cultures, languages, tra‐ditions, beliefs, history, political affilia‐tion, experiences and perspectives.According to 2006 Census data,

1,172,790 people reported as beingAboriginal: 698,025 (North AmericanIndian); 389,780 (Métis); and 50,480(Inuit). One‐fifth (242,490) resided inOntario with 150,075 living in urbanareas. In the Simcoe, York and Muskokaregion there are 18,045 FNMI with13,035 in Simcoe, 3,595 in York and1,415 in Muskoka. This demographicincludes: 9,465 First Nation; 7,900 Métisand 680 Inuit. According to census datafor York, Simcoe and Muskoka region,approximately 54% are under the age of29 years with FNMI youth representingthe fastest growing demographic inCanada. The Assembly of First Nations (AFN) indi‐

cates there are 633 First Nation reservesin Canada, which represents 52 distinctnations or cultural groups and more than50 languages. According to the MétisNation of Ontario (MNO), there are15,000 Métis citizens and 30 charteredcommunity councils. The Inuit TapiriitKanatami (ITK) represents 55,000 Inuit in53 communities representing four Inuitregions in Labrador, northern Quebec,Nunavut, and the Northwest Territories.Demographics vary from region toregion and it is important to know theFNMI demographics in your area. A sense of community can be enhanced

through social interaction and culturebased programs, services and activitiesfound at Friendship Centres, MétisCouncils, Native Women’s groups, andHealing Lodges, for example. The FirstNations and Métis have a historic con‐nection to the Simcoe, York and Muskokaregion and now consists of a number ofFNMI from across Turtle Island (NorthAmerica).In 2011, 1,400,685 people reported asbeing Aboriginal or 4.3% of the Canadianpopulation. Source: 2011 NationalHousehold Survey

Strengths in FNMI CommunitiesUnderstanding the historical impacts felt byfamilies and individuals with a focus on solu‐tions is vital to bridge building and culturallycompetent service delivery. Recognizing strengths and contributions of

the FNMI community form a strong basis forpartnership and relationship building. Each FNMI community is unique with a

range of culturally sensitive services and ini‐tiatives in response to growing interest anddesire to learn from FNMI people. Thesefocus on the physical, emotional, spiritual andmental well‐being for the next 7 generationsthat include: • 7 Grandfather Gifts/Teachings;• Empowering families and communities;• Providing safe environments;• Development and delivery of culturally sen

sitive/appropriate programs and services;• History of collaborative efforts; • Maximizing resources and bridge building

among existing services.

Cultural Identity It is important to understand that culturalidentity can be a source of confusion as aresult of legislated oppression with past, pre‐sent and intergenerational impacts.

The celebration of cultural identity and re‐connection to the culture is individual withparticipation in cultural practices, family andcommunity influences strong factors in thislife‐long journey.

It is important to respect where individualsare in their cultural identity and traditionalpractices with “culture” meaning differentthings to different people.

FNMI may identify their community of origin,spirit name and clan if they know it. This isanother important aspect of identity and away to make connections to new people.

Critical to this understanding of cultural iden‐tity, confusion and/or disconnect, is theimpact of historic trau‐ma such as: residentialschools; the 60’s scoop;adoption outside thecommunity; boardingschools and outlawedpractices that viewedtraditional ways astaboo. These factors caused older genera‐tions to feel shame, fear and guilt about whothey were and their original way of life.However, the 70’s marked a critical time ofresurgence and resistance to cultural oppres‐sion. Leadership and Elders often identify lan‐guage as a vital link to this reconnection.

This resurgence also marked greater aware‐ness by Canadian society and a desire tolearn about the significant contributionsmade by FNMI people in medicine, science,transportation, ecology, wholistic practicesand FNMI role models to name a few.

Elders/Senators are the wisdom carriersand transfer knowledge from one gener‐ation to the next. They are typically rec‐ognized by their community for wisdomgained throughout their lifetime. Eldersare looked to for historic and traditionalknowledge valuable for local contextand decision‐making processes.

Elders are typically offered tobacco and agift for this work.

It is customary in many communities toshow respect by inviting Elders/Senatorsto speak first, not interrupt and allowtime for opinions and thoughts to beexpressed.

In group settings, Elders and MétisSenators are often asked to open andclose a meeting, to help people to be ofgood minds.

Role ofElders/Senators

SourcesThis guide was inspired by the Culture Card devel‐oped by the Substance Abuse and Mental HealthServices Administration (SAMSHA) in partnershipwith American Indian & Alaska Native (AI/AN) ad‐hoc group. The authors wish to thank AI/AN,SAMSHA, First Nation, Métis and Inuit communitymembers and mainstream organizations in thisregion who took part in the Barrie Area NativeAdvisory Circle consultation and planning meet‐ings. Although this resource was developed to fill anidentified need, it is not intended to provideexhaustive information about all matters pertain‐ing to First Nation, Métis and Inuit. For more infor‐mation, contact your local First Nation, Métis

Council, Friendship Centre, NativeWomen’s group, Healing Lodge, TribalCouncil, Inuit Tapiriit Kanatami, MétisNation of Ontario, Ministry of AboriginalAffairs...

Information Resources: This resourcewas locally developed based on FNMI andmainstream service provider feedback inthe Simcoe, Muskoka and York Region.Community consultation documentsserved as an important foundation.Additional resources include: AboriginalAffairs and Northern DevelopmentCanada; Assembly of First Nations; CensusCanada 2006; Inuit Tapiriit Kanatami;Métis Nation of Ontario and RoyalCommission on Aboriginal Peoples. *Joseph, R. and Joseph, C. (2007).(Working Effectively with AboriginalPeoples™), p. 127. Indigenous Corporate

Training Inc, Vancouver, BC.

If you have suggestions in the development ofadditional resources to complement this guide,please contact ed@banac.on.ca.

About this GuideNation to NationRelationship

Cultural Customs/Traditional Territories

Elders often offer teachings or advice in ways that are indirect, such as storytelling to help guide and advise us in our work.

In a social setting where food is served,Elders are generally served first. It is dis‐respectful to interrupt, openly argue, or

disagree with an Elder.

Elders and Métis Senators are held in highesteem and have earned the respect of thecommunity.

As we carry out business in this region, it isimportant to acknowledge traditional terri‐tories. Some ways to acknowledge this mayinclude inviting an FNMI delegate, leadership,Elder or Métis Senator to offer openingremarks, prayer and/or a brief historical back‐ground as appropriate.

Many FNMI experience a cultural divide andmust adjust to contemporary society whilemaintaining cultural identity. Cultural compe‐tency of service providers is an importantpart of this transition. Questions are encour‐aged for the purpose of improving the serviceproviders understanding, developing relation‐ships, cultural competency and awareness. Itis important to acknowledge and follow theprotocols and practices of specific geograph‐ic areas. For example, there are Anishinabeand Mohawk communities/families withinthe region that have similar and different cul‐tural practices.

VeteransHistorically, FNMIhad high rates ofenlistment in themilitary service (1in 3) long beforegiven the right tovote in the 1960’s.Upon return fromservice, many FirstNation (status) vet‐erans experiencedhardship based ontheir status andinability to accessbenefits unlessthey gave up theirstatus. There arelong standing tradi‐tions that honourveterans at cere‐monies and powwows with special songsand dances to acknowledge their manycontributions and sacrifices.

ConsultationThe “Duty to Consult” flows from theSupreme Court of Canada decision(Delgamuukw Case) and reaffirmed in theRoyal Commission on Aboriginal Peoples(RCAP). It is important to build relationshipswith FNMI partners and cultural advisors inthe region in the development of culturallyappropriate policies, programs, services andinitiatives.

Meaningful consultation protocols areemerging to ensure FNMI are consulted atthe beginning of projects and informed onmatters that affect their traditional territoryand peoples.

First Nation and Inuit governments have theright to hold elections and determine theirown citizenship (enrolment), but are still con‐fined by Indian Act restrictions. The MétisNation developed their citizenship code andmembership rights as supported by thePowley decision of 1992.

Although the constitution protects “Aboriginalrights” as collective/community rights, legisla‐

tion has played a rolein creating complexissues and challengesas FNMI attempt toexercise those rights asindividuals.

RecommendedReadings:

• Ontario Human Rights Code• Ilaquiinniq

• Aboriginal Justice Inquiry• Jordan’s Principle• Ipperwash Inquiry

• Touchstones of Hope• Split-Feather Syndrome

• Three Day Road• Gladue Case• Powley Case

• Mishoomis Book

A Guide to BuildCultural Awareness

Culture Card

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Funding to support this printing was providedby: Aboriginal Health Circle, Barrie Native

Friendship Centre, B'saanibamaadsiwin MentalHealth, Chigamik CHC, County of Simcoe BestStart Network, D’naagdawenmag BinnoojiiyagChild & Family Services, Durham District SchoolBoard, Elizabeth Fry, Enaahtig Healing Lodge &

Learning Centre, Family & Child Services ofGuelph & Niagara, Georgian Bay Native Women's

Association, Good Shepherd, Kawartha PineRidge District School Board, Kinark,Niagara Chapter of Native Women,

Ontario Federation of Indian Friendship Centres,Ontario Native Women's Association, Peel CAS,

Simcoe CAS,Simcoe County District School Board,

Simcoe Muskoka Catholic District School Board,Simcoe Muskoka District Health Unit.

www.banac.on.ca

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Spirituality Myths & Facts Communication StylesRelationship BuildingThe following suggested steps are based oncommunity consultation feedback with theunderstanding that each community will havetheir own preferences and protocols. Step 1 –Examine your own bias’ and beliefs

about FNMI people related to issues such as:history, impact of colonization, racism, oppres‐sion, poverty, addictions, age and gender,health issues, suicide, mental health stigma,treaty rights, land claims, hunting, fishing, taxexemption, etc. Some questions to considerinclude: Are you comfortable working withFNMI people and issues? Do you understandthem? Do you accept that Aboriginal peoplehave special rights? Are you willing to learnmore to develop your own cultural competen‐cy? * (Adapted from Working Effectively withAboriginal People)Step 2 – Acquire knowledge about the com‐

munity you are working with such as proto‐cols, previous studies, available data, existingservices, contact people, leadership, geo‐graphic representation/catchment area, trans‐portation/access (ie: ferry schedule), past andpresent relationship, services and communitywebsites. Step 3 – Organizational Scan (Assess the 4 P’s

– People, Place, Policy, Process)a. People – Who are the FNMI in your catch‐ment area? Do you employ any FNMI staff? Do you have a method of tracking or collectingdata in relation to FNMI clientele? Do youhave any FNMI programs or services? Haveyou had any cross cultural awareness sessionsin your organization? Do you have a personresponsible for FNMI programs and sensitivitywho can act as a service navigator within theorganization? Are staff knowledgeable aboutFNMI specific services available amongstakeholders/partners?b. Place – Do you have a warm and welcom‐ing environment to reflect the FNMI community such as appropriate literature,books, pictures, etc. c. Policy – Do you have policies in place thatsupport inclusive and equitable services forFNMI clients and staff such as voluntary selfID, hiring practices, designated FNMI repre‐sentation at Board level, involvement of FNMIin planning as per duty to consult, etc. Theseneed to be reviewed and revised regularly tomeet changing environment and needs. d. Process – Regular meetings, terms of refer‐ence, evaluation, means of communications,conflict resolution, circles, access to traditionalmedicines and ability to smudge. All of thesecontribute to shared service delivery, relation‐ship building, better understanding and cultur‐al competency.Step 4 – Moving Forward & Building Capacity

is based on the organizational scan and docu‐mented FNMI needs. Moving forward couldinvolve visioning sessions, cross culturalawareness training, identified outcomes withtimelines and funding requirements thatinclude a financial commitment for FNMIcapacity building.

Be an ally!

When working with FNMI families, it isimportant to recognize our own bias andmisconceptions as these can be interpretedas discrimination or racism by the FNMIclients, individuals and families. The following Aboriginal Capacity Building

Circle (ACBC) guiding principles are based onthe community feedback from the VisioningDay held in April 2009 and further defined atthe Gathering of the Clans in June 2010.These principles are an encouraging exampleof consultation when FNMI and mainstreamservice providers work together to meet iden‐tified needs in a meaningful way.

Find out about community protocols andwho to contact.

Ensure families are given ALL availableoptions.

Be honest and clear about your role, expec‐tations, and provide appropriate notice formeetings. Send out meeting materials andagenda prior to meeting and allow time forfollow up.

Allow others to finish speaking beforeyou speak. If in a circle, wait your turnand respect confidentiality protocol.

Use language people can understand. Avoidjargon and acronyms.

Provide food and refreshments if you arehosting a meeting.

Be aware of differences in communicationstyles.

Model and encourage respectful communi‐cation.

Explain what you are writing when you arecharting or making clinical documentationduring a session with client(s).

Prior to European contact, spirituality was away of life, source of strength and unity. Since contact, and as a result of historical

oppression, spirituality can be a source ofconflict and confusion. It is important tonote that many cultural and spiritual prac‐tices that united communities were out‐lawed in the mid‐1800’s. This contributed toa cultural disconnect and divide with manyimpacted and now seeking to learn moreabout the original way of life. Spirituality is a wholistic source of strength

that includes caring for self, family and com‐munity in the promotion of physical, mental,emotional and spiritual well‐being. Themajority of FNMI communities have tradition‐al and various religious practices.

There is a resurgence of traditional prac‐tices previously outlawed such as: potlatch,powwows, naming ceremonies, sweat lodge,fasting and traditional gatherings. Social andhealth challenges and their solutions areoften viewed from a wholistic perspective.This is an important approach in maintainingbalance and wellness. In many First Nation communities and urban

organizations, opening with a smudge andprayer by an Elder/Métis Senator arebecoming more common place. Generally,tobacco and a gift are given as a sign ofrespect for this work. Spirituality, world views and the meaning of

life can represent diverse concepts that arevast and practised to varying degrees in dayto day living. All Creations stories are viewedas true and equal, thereby highly respected.

Myth: Aboriginal people are ALL the same.Facts: The term Aboriginal is used in theConstitution to describe 3 distinct groups:First Nation (status & non‐status), Métis andInuit. Each has a unique history, culture, lan‐guage, perspective and spiritual beliefs. Avariety of terms have evolved such as Indian,Native, First Nation and Indigenous. Whilepreferences vary, it is important to take direc‐tion from individuals or community as appro‐priate. A growing trend is the use of specificNations such as: Anishinabe, Métis,Haudenosaunee, Cree, Algonquin, etc.

Myth: Aboriginal people get everything forfree. Facts: FNMI are entitled to the samebenefits as ALL Canadians including Child TaxBenefit, Old Age Security, OHIP, &Employment Insurance. Where treaty rightsexist and entitlement is rights based, they are

still subject to regula‐tion and/or fundingsuch as hunting, fish‐ing, housing, educa‐tion and health.Comprehensive landclaim settlements

include reserve land & payment of annuitiesdepending on the terms and conditions oftheir Treaty agreement. It is important tonote that new government legislation such asBill C31 and C3 continue to impact rightsbased eligibility and access to services.

Myth: Aboriginal people receive free housingand post‐secondary education. Facts: Underthe Indian Act, the Federal government pro‐vides a level of housing and post‐secondaryassistance to First Nations and Inuit to achievethe same standard of living as otherCanadians. However, funding has beencapped and only increased 2 – 3% in the last25 years. It does not meet the high demandswith waiting lists compromising student edu‐cation, career and life goals. Métis studentscan now access subsidies through the MétisNation of Ontario. Housing & education subsi‐dies are provided in a manner similar to thoseprovided to all Canadians.

Myth: Aboriginal people are tax exempt.Facts: The origin of tax exemption for a statusperson is found under Section 87 and 90 ofthe Indian Act. Income earned by registeredIndians working on‐reserve is exempt fromincome tax. Generally, First Nation individualsmust pay income tax if they work off‐reserve.Depending on the Province, some registeredIndians do not pay provincial sales tax but inmany instances, there is uneven applicationof this right. Registered Indians do not have topay HST for goods delivered to a reserve.First Nations people living off‐reserve for themost part pay the same taxes as the rest ofCanadian society. Although on‐reserve mem‐bers don’t pay taxes, fee for service may becharged for basic services such as waterdelivery and garbage pick‐up for example.Foreign diplomats are also tax exempt.

Nonverbal Messages• Every culture expresses non‐verbal commu‐nication differently. This can include gestures,posture, eye‐contact, volume of speech, vocalnoises, protocols for cultural observances etc. ‐ For example, in some Aboriginal cultures,direct eye contact, stepping over a person orobject, or pointing at someone with a fingermay be a sign of disrespect ‐ Cultural awareness is necessary to avoidmisinterpretation of non‐verbal behavior. • A gentle handshake is often seen as a signof respect.

Humour • It is used as a means of teaching. Gentleteasing is intended to bring attention tobehaviour that needs to be changed and/orto show affection. Humour, teasing and laughter are often used

amongst people who are well known to eachother but not at the expense of someoneelse. It can be used to cover great pain anddifficult situations with smiles or jokes. It isimportant to listen closely to humour, as itmay be seen as invasive to ask for too muchdirect clarificat ion about sensitive topics. • It is a common concept that “laughter isgood medicine” and a way to cope.

Indirect Communication & Non‐Interference• There is an unspoken understanding torespect the code of non‐interference. Forexample, open criticism, disclosing personalinformation about another person, etc. maybe viewed as breaking this code. It is impor‐tant to understand that this code may beprevalent in FNMI communities.

Storytelling• It is the free will of the listener to determinewhat they will take away from the story withcertain stories often told in certain seasons. Itis the listener’s responsibility to hear themoral of the story, which is in contrast withdirect messages that mainstream society mayexpect.

• Getting messages across through telling astory (traditional teachings and personal sto‐ries) is very common and sometimes in con‐trast with “get to the point” expectations.

• It is important to understand that commu‐nication may be hampered by internalizedoppression and messages received over a life‐time of racism, discrimination, stereotypingand non‐acceptance. Relationship building iskey to overcoming these barriers.

Self Awareness &Etiquette Etiquette ­ Do’s

Health & WellnessChallenges

The United Nation’s Human DevelopmentIndex rates quality of life, life expectancyand access to basic services such as hous‐ing, education and income. Canada con‐sistently ranks at the top of the UN listwith FNMI conditions equal to ThirdWorld Countries. FNMI assert thataccess to services is an inherent right forall Canadians with Aboriginal & TreatyRights reflecting a constitutional relation‐ship with the Crown. Health services areintended to be comprehensive, accessi‐ble, portable and provided on an “asneeded” basis without regard for a per‐son’s financial status, residency or cost ofthe benefit. The First Nations InuitHealth Branch and non‐insured HealthBenefits (NIHB) program serves to helpclose the Aboriginal health gap.Although progress has been made in thisarea, chal‐lenges contin‐ue to exist.

The NIHBProgram is anational pro‐gram that provides coverage for benefitclaims to eligible status First Nation andInuit for specified prescriptions, dental,vision, medical supplies and equipment,short‐term crisis intervention, mentalhealth counselling and medical trans‐portation as per available funding.

However, ongoing cutbacks and changesto membership eligibility may impactaccess by an individual with jurisdictionalissues having the potential to furthercomplicate access.

Prevention and intervention effortsmust include supportive partners,enhanced community resources, part‐nership building and the development ofcultural competence.

Service providers must take great careduring intake and assessment practicesto consider cultural differences and pref‐erences in the development of a plan ofcare.

A growing trend in hospitals and commu‐nity health centres is access to traditionalpractices with Elders and healers as ameans to bridge the cultural divide.However, health disparities still exist withlimited access to culturally appropriatehealth care. To fill the gap, FriendshipCentres, Métis Councils and NativeWomen’s groups provide additional ser‐vices to support overall well‐being asbudgets and staffing permit.

“Equity is the floor, not the ceiling.”Cindy Blackstock

Challenges Continued

ACBC Principles1. That children and youth will be groundedin their cultural identity, traditional beliefsand have their basic needs met;

2. That FNMI people have the right torespectful and culturally safe continuum ofprograms and services;

3. That programs & services for FNMI will beprovided by FNMI people and where appro‐priate, in partnership with others;

4. That the FNMI community will design,develop, implement, govern, administer andevaluate a continuum of programs and ser‐vices for children, youth and families in part‐nership with others;5. That FNMI Elders and youth are presentand will have a key role in planning anddelivery of initiatives;

6. That a fully resourced FNMI workforcestrategy is developed and implementedwherever FNMI people are employed;

7. That all partners have a mutual responsi‐bility to ensure a welcoming and inclusiveenvironment free from oppression andracism;

8. That all programs and services areinformed by the past, encouraged by thepresent and strengthened for the next SevenGenerations to come.

Seek guidance on appropriate behaviour,practices and protocol that would help ser‐vice providers demonstrate cultural respectwhile developing cultural competency.

Inform and obtain consent as applicablebefore inviting other agencies or staff to ameeting with individuals or families.

Include FNMI community on planningcommittees with an understanding thisdoes not constitute consultation.

Find out the process and protocol formeaningful consultation with FNMI.

Use a trusted FNMI facilitator when doingconsultations for/with FNMI communities.

Promote community events, socials, cere‐monies, etc. as deemed appropriate.

Find out about existing maintream andFNMI programs or services. Refer as applica‐ble and accompany as necessary as an advo‐cate.

Work in partnership with other stakeholdersto develop general guidelines to considerwhen offering services to FNMI families.

Etiquette ­ Don’ts

A Health Council of Canada report was one ofmany to highlight the significant overallhealth and economic disparities betweenthe FNMI community and Canadian popula‐tion that include:

• 3 to 5 times at risk of diabetes • Life expectancy 5 – 7 years less than thenon‐Aboriginal population• More likely to die in the first year of life • 1.5 times more likely to have heart disease,chronic conditions and/or infectious disease• Arthritis was the most prevalent chronic dis‐ease reported by Métis adults• Tuberculosis has been cited as 8 – 10x andup to 31 times the national average • 1 in 4 live in poverty, double the nationalaverage • More likely to go hungry, suffer from poornutrition with 41% obesity, live in over‐crowd‐ed and substandard housing, median income22,211 per year• Suicide rate for First Nation, Métis 5‐ 6times and Inuit 11 times the national average;• Rate of disabilities among FN childrenalmost double that for Canadian children• 1 in 4 children are also in CAS care• 33% of First Nations experienced sadnessand/or depression over extended periods

Don’t assume anything about FNMI individu‐als, families or communities.

Don’t force clients to make suggestions.

Don’t impose your own values and beliefs.

Don’t assume that all FNMI want servicesfrom FNMI agencies.

Don’t assume that all FNMI know their histo‐ry and culture.

Don’t put the onus on the FNMI client toinform you about their culture and history.

Don’t make stereotypical assumptions aboutFNMI.

Don’t interpretsilence as lack ofinterest or agree‐ment.

Don’t constantlylook at yourwatch during ses‐sions or meet‐ings.

Don’t use cultural symbols and items with‐out understanding their significance and cul‐tural protocol. (ie: sacred pipes, medicines,ceremonial masks, drums, etc.) When indoubt, ask an appropriate resource person.

Don’t assume there is one standardresponse when a person is in distress.

Don’t touch sacred items, such as medicinebags, hair, jewellery, other personal or cere‐monial and cultural items unless given per‐mission.

Don’t be afraid to ask someone from thecommunity if you aren’t sure about specificpractices and protocols. Gender roles mayvary among families and communities.Males and females have distinct social rolesin every day interactions as well as cere‐monies. It is always best to observe the localpractices and protocols.

Don’t take/use pictures or any other infor‐mation gained by working in the FNMI com‐munity for personal presentations, casestudies, research, and so on, without theexpressed written and prior consent of theparties involved.

Do not consider FNMI culture a privilege.

It is a right.