The 2002 National Training Session, Healing Hearts, began with an opening Honour Song, by the Waneskewin Singers and a prayer by Elder Shirley McNab of the Gordon First Nation. The following excerpts from the plenary session speakers laid the groundwork for the entire three-day training session.

Chief Lawrence Joseph welcomed the delegation to Saskatchewan on behalf of the Federation of Saskatchewan Indian Nations and spoke passionately about the critical front-line work being done by CHRs and the need for our communities to start talking about our realities and finding our own solutions to the issues that plague us.
Chief Lawrence Joseph

Keith Conn, Director of the First Nations and Inuit Health Branch, Health Canada, spoke about initiatives within the Federal Government to address these very issues. Finally, Dr. Aurore Coté and Ms. Judy Rourke gave introductory remarks on the issues of Sudden Infant Death Syndrome (SIDS) and Fetal Alcohol Syndrome/Fetal Alcohol Effects (FAS/E) that were the thrust of this year's training workshops.

"Talk About Your Realities"
Chief Lawrence Joseph is Vice-Chief of the Federation of Saskatchewan Indian Nations. He is a member of the Big River First Nation and former Councillor of the City of Prince Albert, Saskatchewan. Chief Joseph is also a well-known entertainer.

Chief Lawrence Joseph welcomed the National Training Session to Saskatoon on behalf of the 74 First Nations of the Federation of Saskatchewan Indian Nations.

He spoke passionately about his own experience with alcohol and his own healing. He also spoke about the critical work of front-line health workers like CHRs because they deal on a daily basis with those issues nobody likes to talk about. "What I'm talking about is the realities of First Nations," he said. He encouraged CHRs to talk about these issues that they face every day. "Talk about the addictions, talk about the molestations, the sexual abuse, the incest, the alcoholism, the drug abuse. All these things are factors and symptoms of lives gone by. I am encouraged that the mothers and the sisters of this Nation are gathered together as soldiers to fight these things, to bring them to light, to bring them to world attention."

Chief Joseph used Saskatchewan as an illustration: "There are a total of one million people in Saskatchewan. Treaty First Nations people number 10,000, or 11per cent of the province. But in the prisons, the federal penitentiary at last count, was 77per cent Aboriginal people. At any given time the Province of Saskatchewan has 80 per cent Aboriginal people incarcerated. The women's prison in Prince Albert is sometimes up to 90 per cent. But the most discouraging statistic is the youth facilities in the Province of Saskatchewan. Some of those are 100 per cent Aboriginal people."

Chief Joseph made the point that Aboriginal people are big business. As long as Aboriginal people remain oppressed they are creating employment for social workers, guards, police officers, and so on. He stated the importance of gatherings like this to talk about these realities, and say together that enough is enough.

Chief Joseph encouraged the participants to look holistically at health. For example, in Saskatchewan they have named addictions as a priority - not only alcohol, but drugs, and solvent abuse, tobacco and gambling. "We have to put them together as a big major enemy to do battle against." He went on to say that in Saskatchewan, they have also been able to say to other governments: "This is your mess, give us the resources to fix it."
Finally Chief Joseph reminded participants to take this opportunity to look for solutions to help that single mother or that child who has been diagnosed with FAS/FAE. He asked people to talk about it from their own reality, not from the traditional western civilization's agenda. "Sometimes you will be alone," he said," but collectively, when you are connected to the right people, and most definitely with the foundation of our Creator's help, how can we fail?"

FNIHB Supports Community Level Training

Mr. Keith Conn is the Director General of the First Nations and Inuit Health Branch, Health Canada. He is a Cree from James Bay. This is the second time Mr. Conn has addressed the CHRs in this capacity. On other occasions it was while he was Director of the Health Secretariat.
Mr. Keith Conn

Keith Conn, in his keynote address to the National Training Session, stressed that the First Nations and Inuit Health Branch of Health Canada (FNIHB) is aware of the enduring importance of community level training and is pleased to have been able to support NIICHRO in the development of these necessary "Train the Trainer" programs. These programs are designed to develop awareness and community strategies to address some of the critical health issues in Aboriginal communities.

The incidence of SIDS is highest in Aboriginal communities and among people with lower incomes, where it is up to three times higher than in the general population. "It will take all of us working collaboratively to unravel the riddle of SIDS - not only here in Canada, but around the world," said Mr. Conn. He went on to announce that the Canadian Foundation for the Study of Infant Death was successful in its bid to host the International SIDS Conference in Canada in 2004, whose theme will be "SIDS in Indigenous Communities." It is important that Aboriginal people play a critical and operative role in health initiatives that will benefit them, so I'm pleased that NIICHRO, along with other Aboriginal partners, will be working with the Foundation to organize this conference whose focus will be on finding long-term solutions to this medical mystery and on reducing the incidence of SIDS in Aboriginal communities around the world."

Mr. Conn also stated that the issue of Tobacco is a high priority for Health Canada. The smoking rate for the general Canadian population is about 23 per cent, while among First Nations it is 62 per cent and as high as 72 per cent for the Inuit. There is clearly a need to reduce the rate of tobacco use among First Nations and Inuit people in Canada. According to figures from the Canadian Paediatric Society (CPS), "Men and women on reserve have a 40 per cent higher rate of stroke and a 60 per cent higher rate of heart disease than other Canadians. Lung cancer is a major cause of death and Inuit women have one of the highest rates in the world."

The First Nations and Inuit Tobacco Control Strategy (FNITCS) is part of the Federal Tobacco Control Strategy, announced by the Government in 2001. Populations targeted by FNITCS are potential and actual non-traditional tobacco users, and those exposing others to second-hand smoke. The Strategy will place special emphasis on reaching pregnant women and youth, and on reducing exposure to second-hand smoke.

The program is designed to build the capacity within First Nations and Inuit communities to develop and deliver comprehensive, culturally sensitive and effective tobacco control programs at a pace acceptable to those communities. Developed by FNIHB with the help of a National Advisory Circle made up of First Nations and Inuit representative organizations, including NIICHRO, the strategy will be delivered through partnerships between health advocates and service personnel within the communities.
Finally, Mr. Conn spoke about the impacts of FAS/E. The National Awareness Campaign that FNIHB released in May stresses the importance of not drinking alcohol while pregnant. Avoiding alcohol before becoming pregnant is equally important for having healthy babies.

FAS/E is 100 per cent preventable. However, Mr. Conn stressed that we also need to examine the reasons why First Nations and Inuit have a much higher incidence of this health disorder. "Before finding solutions, we need to acknowledge the history of poverty, unemployment, overcrowded housing, and so on, and how this directly affects the rate of addictions and alcoholism in First Nations and Inuit communities."

Another key area in an FAS/E strategy is that of diagnosis. As much as it is a sensitive issue, it is the foundation on which programs that best address FAS/E in the communities can be designed and delivered. Mr. Conn noted how critical it is for diagnostic tools to be carefully developed to ensure accuracy, and that there be community-level supports in place for proper follow-up.

Health Canada is working in partnership with Correctional Services Canada, the RCMP, Indian and Northern Affairs, the Department of Justice, the Homelessness Secretariat, and Human Resources Development Canada so that a full range of accessible information and services may be put in place that address the needs of at-risk youth, expecting mothers, families, incarcerated individuals, and communities.

Sudden Infant Death Syndrome Still a Mystery

Plenary speaker Dr. Aurore Coté is a world-renowned SIDS researcher who has published in many respected journals and presented her research around the world. She is a pediatric respirologist at the Montreal Children's Hospital and an Associate Professor at McGill University. She is known for her work in SIDS public education and for her compassion in assisting bereaved families. Dr. Coté is a member of the Research Advisory Committee of the SIDS Foundation and the Scientific Co-Chair of the SIDS 2004 Conference in Edmonton titled "SIDS and Indigenous Communities." She is the mother of one son.
Dr. Aurore Coté

Dr. Coté shared some of the most recent data on SIDS to the plenary session. She reminded the delegation that SIDS is really a lack of understanding. It has a name, however: "Scientists, when we want to hide our ignorance, we give it a name. And usually when the name is made of letters, it's probably because we're just more ignorant. And when the name is finished by the word syndrome, I think it is the highest sign of ignorance because it means that it is an association of many things for which we cannot find a cause," she said.

She reminded the delegation that we don't know the cause of SIDS. Quebec has the lowest rate of SIDS in the world. Though we don't know the cause of SIDS, we know the common risk factors for all deaths of infants in the first year of life. We also know that when health in general is good and easy, postnatal mortality is low and SIDS is low. If there is a way to increase the health of babies in the post-natal period, it will decrease SIDS. Therefore increasing the health of babies 0-1 year of age will decrease SIDS.
Dr. Coté said that in her work she has learned that people are really similar in a sense, and this becomes even truer when you see parents who have lost a baby. They share the same pain, the same fear and the same lack of understanding as to why they have lost their baby.

"In Quebec, mortality rates dropped 50 per cent by placing children on their back to sleep," she said. "There has been a big decease in infant mortality in First Nations and Inuit communities too. This should be seen as a sign of hope."

Respect: The Foundation for Dealing with FAS and FAE

Judy Rourke has a Master's degree in Education and is a Certified School Psychologist. She is qualified and experienced in performing individual assessment evaluations on learning and behaviour. Her 25 years of vast experience with fetal alcohol syndrome includes more than 100 training workshops in First Nations communities in British Columbia.
Judy Rourke

It takes a community to raise a child. Fortunately, traditional Aboriginal communities support that belief and prevention of Fetal Alcohol Syndrome is everyone's responsibility. FAS is a sensitive issue and must be grounded in the principles of respect. Respect comes from understanding:

• The traditional Aboriginal teachings;
• The history of your community;
• Family histories;
• Mother's stories;
• The fact that the individual affected with FAS/E is a spiritual being; and
• The fact that a person with FAS/E is a person with a disability.

We need to recognize the root causes of FAS/E. This includes the loss of land, loss of culture and loss of resources that Aboriginal people have experienced through colonization. Harm prevention strategies when dealing with FAS/E include:

The CHR's role is to take away the shame that the mother sometimes feels. "I want to remind you," she said, "that there is no mother in this world who sets out to do any harm to her baby. We have to help that mother work around those issues. Our attitudes in our communities must be grounded in hope." Community action is needed for prevention - and includes:

Public education in our communities;
On-going training. That's why we have training opportunities like this National Training Session, to begin to learn and collect information and resources to take back to our communities;
Community Action. To provide services in our community - we want advocacy help for that young mom. We need linkages among services. We need safe affordable housing. We need daycare. We need parent involvement. And we need long-term support for high-risk women.