Right to Health Introduction: Connecting Health and Safety

CHAPTER 6 Confronting Oppression – Right to Health Introduction: Connecting Health and Safety In Chapter 5, we explored how the destructive impact of colonial policies on culture, family, and community constitutes a form of cultural violence, which many people who shared their truths with the National Inquiry recognize as the starting point for other forms of violence that they or their missing and murdered loved ones have experienced in the past and continue to experience today. In this chapter, we build on this foundation, as told to us by families and survivors, to consider how colonial violence directed toward traditional cultural practice, family, and community creates conditions that increase the likelihood of other forms of violence, including, in particular, interpersonal violence, through its distinct impacts on the mental, emotional, and spiritual health of Indigenous Peoples. In sharing stories about the health issues they or their missing or murdered loved ones faced, the experiences they had in seeking health services, and the consequences of encounters that more often than not further diminished rather than promoted health and wellness, witnesses illustrated how addressing violence against Indigenous women, girls, and 2SLGBTQQIA people must also address their right to health. This chapter begins by defining “health” as a human right according to international human rights standards, in order to explain how the right to health is directly connected with positive outcomes, both individually and in communities, for women, girls, and 2SLGBTQQIA people. In addition, we explore health as understood through distinctive First Nations, Inuit and Métis perspectives, to understand how Indigenous ways of being well are directly connected to main- taining safety. We then look more closely at the testimonies witnesses shared about physical, mental, emotional, and spiritual health, and the connections between health and violence, in the context of the four pathways that maintain colonial violence. Then, we share testimony that explains and demonstrates how the impact of colonial violence on traditional culture, family, and community, as well as the ongoing disruption to cultural continuity through present-day iterations of colonial policies such as child welfare apprehensions, 413 Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls environmental destruction, or gender-based discrimination within the Indian Act, carries significant health consequences for Indigenous people, often in the form of multigenerational and intergenerational trauma. Next, we consider how the socio-economic marginalization of Indige- nous people and their communities further compromises their physical, mental, emotional and spiritual health, particularly by creating conditions that facilitate violence and that exacerbate trauma. We consider how, despite widespread recognition of the significant health problems faced by Indigenous Peoples – and widespread recognition of the significant health consequences all forms of interpersonal violence hold for Indigenous women, girls, and 2SLGBTQQIA people in particular – the systems and institutions that Indigenous people reach out to for health care- related support often fail to provide the support needed and, in doing so, often deepen these health concerns. We demonstrate how these failings within the health care systems to repair harm and restore health seem to demonstrate a willful ignorance of many alternative Indigenous health care and healing models that, through centring culture and cultural continuity at the same time, address and improve physical, mental, emotional, and spiritual health. As an example, we end by discussing how respecting the knowledge and agency Indigenous Peoples hold in terms of their own needs in the areas of physical, mental, emotional and spiritual health, and the steps that must be taken to create the conditions with which they can meet these needs, is an important part of addressing all forms of violence against Indigenous women, girls, and 2SLGBTQQIA people. Ultimately, what we heard is this: when the right to health is in jeopardy, so is safety. Improving health services and delivery mechanisms can contribute in concrete ways to promoting community and individual health, safety, and healing, especially when it involves embracing effective and self-determined solutions that challenge racist, sexist, homophobic, and transphobic assump- tions that all too often continue to shape how the health of Indigenous Peoples, and especially Indigenous women, girls, and 2SLGBTQQIA people, is valued. Defining “Health” In 1948, the World Health Organization (WHO), an agency within the United Nations system, defined “health” as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”1 Although the definition itself has not been amended since 1948, the United Nations and other international health organizations have since the 1990s acknowledged the particular importance of understanding health in a holistic context and in a way that includes Indigenous world views. As health researcher Odette Mazel argues, this recognition opened up new opportunities for viewing health as a legal entitlement and for recognizing it as a social justice issue with societal causes.2 Today, the WHO recognizes that “this definition extends beyond the traditional Western biomed- ical paradigm which treats body, mind and society as separate entities and reflects a more holistic understanding of health.” This includes the idea that “well-being is about the harmony that exists between individuals, communities and the universe.”3 Traditional health systems, as the Pan 414 Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls American Health Organization/WHO has defined them, “include the entire body of ideas, con- cepts, beliefs, myths, procedures and rituals (whether explainable or not) connected with the maintenance of health or health restoration through the treatment of physical and mental illness or social imbalances in a particular individual, community or people.”4 Simply put, the context in which a person lives directly contributes to their health and well-being or takes away from it, and it is the interaction of all of these factors, which includes many of the themes reflected in our testimonies, that can be determinative of good or poor health. FIRST NATIONS HEALTH AUTHORITY (BC): FIRST NATIONS’ RIGHT TO HEALTH The First Nations Perspective on Health and Wellness visualization below is intended to serve as a starting point for discussion by First Nations communities on what they conceptualize as a vision of wellness for them- selves and the First Nation Health Authority in British Columbia. The Centre Circle represents individual human beings. Wellness starts with individuals taking responsibility for our own health and wellness (whether we are First Nations or not). The Second Circle illustrates the importance of Mental, Emotional, Spiritual and Physical facets of a healthy, well, and balanced life. It is critically important that there is balance between these aspects of wellness and that they are all nurtured together to create a holistic level of well-being in which all four areas are strong and healthy. The Third Circle represents the overarching values that support and uphold wellness: Respect, Wisdom, Responsibility, and Relationships. The Fourth Circle depicts the people that surround us and the places from which we come: Nations, Family, Community, and Land are all critical compo- nents of our healthy experience as human beings. The Fifth Circle depicts the Social, Cultural, Economic and Environmental determinants of our health and well-being. The people who make up the Outer Circle represent the First Nations Health Authority's vision of strong children, families, elders, and people in communities. The people are holding hands to demonstrate togetherness, respect and relationships, which in the words of a respected BC elder can be stated as “one heart, one mind.” Children are included in the drawing because they are the heart of our communities and they connect us to who we are and to our health. Source: Adapted from First Nations Health Authority Perspective on Health and Wellness, www.fnha.ca/wellness/wellness-and-the-first-nations-health- authority/first-nations-perspective-on-wellness. 415 Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls In this chapter, we define “health” as a holistic INUIT TAPIRIIT KANATAMI (ITK): SOCIAL state of well-being, which includes physical, DETERMINANTS OF INUIT HEALTH mental, emotional, spiritual, and social safety and does not simply mean an absence of illness. The right to health is also a right to wellness,5 and is ENVIRONMENT linked to other fundamental human rights such as FOOD SECURITY QUALITY OF access to clean water or adequate infrastructure in EARLY CHILD HOUSING Indigenous communities, as well as the right to DEVELOPMENT shelter and food security, which impact all CULTURE MENTAL Indigenous communities but have particular AND LANGUAGE WELLNESS INUIT import in the North. These basic services, which HEALTH AVAILABILITY also include access to medical care without the LIVELIHOODS OF HEALTH need to travel long distances, are key to the SERVICES SAFETY security and safety of Indigenous

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