COLONIZATION EMBODIED: DIABETES IN SHESHATSHIU By Zoe Nudell A Thesis Submitted to Saint Mary’s University, Halifax, Nova Scotia in Partial Fulfillment of the Requirements for the Degree of Master of Arts in Atlantic Canada Studies. June 2006, Halifax, Nova Scotia Copyright Zoe Nudell, 2006 Approved: Dr. Peter L. Twohig Supervisor Dr. Trudy Sable Reader Dr. Ausra Bums External Examiner Date: June 26, 2006 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Library and Bibliotheque et Archives Canada Archives Canada Published Heritage Direction du Branch Patrimoine de I'edition 395 Wellington Street 395, rue Wellington Ottawa ON K1A 0N4 Ottawa ON K1A 0N4 Canada Canada Your file Votre reference ISBN: 978-0-494-23856-1 Our file Notre reference ISBN: 978-0-494-23856-1 NOTICE: AVIS: The author has granted a non­ L'auteur a accorde une licence non exclusive exclusive license allowing Library permettant a la Bibliotheque et Archives and Archives Canada to reproduce,Canada de reproduire, publier, archiver, publish, archive, preserve, conserve,sauvegarder, conserver, transmettre au public communicate to the public by par telecommunication ou par I'lnternet, preter, telecommunication or on the Internet,distribuer et vendre des theses partout dans loan, distribute and sell theses le monde, a des fins commerciales ou autres, worldwide, for commercial or non­ sur support microforme, papier, electronique commercial purposes, in microform,et/ou autres formats. paper, electronic and/or any other formats. The author retains copyright L'auteur conserve la propriete du droit d'auteur ownership and moral rights in et des droits moraux qui protege cette these. this thesis. Neither the thesis Ni la these ni des extraits substantiels de nor substantial extracts from it celle-ci ne doivent etre imprimes ou autrement may be printed or otherwise reproduits sans son autorisation. reproduced without the author's permission. In compliance with the Canadian Conformement a la loi canadienne Privacy Act some supporting sur la protection de la vie privee, forms may have been removed quelques formulaires secondaires from this thesis. ont ete enleves de cette these. While these forms may be includedBien que ces formulaires in the document page count, aient inclus dans la pagination, their removal does not represent il n'y aura aucun contenu manquant. any loss of content from the thesis. i * i Canada Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. To m.y Mother, who ta u g h t wie how to Listen 5 Thawte-you to alt of the people lw sheshatshlu. who participated lw this research, awd to Peter, Tmdupjactele, B>ew, pavld, Molly awd all of the other frlewds whose support and Interest teept this project fresh awd excltlwg. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Colonization Embodied: Diabetes in Sheshatshiu By Zoe Nudell Abstract This research explores the Innu experience of Type II diabetes in Sheshatshiu, Labrador. The unique political history and social structure of the Sheshatshiu Innu is linked to the historic and current provision of health care and the health status of Innu people in Sheshatshiu. An examination of the lifestyle and culturally relevant approaches to Type II diabetes indicates the trend towards individualism in public health, and the perseverance of colonial attitudes to native health. Innu conceptions and experiences of Type II diabetes emerged from an analysis of community-based, qualitative interviews conducted with Innu community members. The insights offered by the Innu illuminate the disease experience in Sheshatshiu, and are also relevant to native and non-native people across Canada. The interviews revealed that the Innu understand Type II diabetes to be a disease of colonization. The Innu argue that the broader political, legal and economic context must be considered in order to achieve health in Sheshatshiu. June 26, 2006 ii Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Table of Contents A bstract ..............................................................................................................................ii Glossary of Innu Terms............................................... v Introduction..................................................................................... 1 Background and Research Questions........................................................................8 M ethods.................................................................................................................... ..13 Literature Review.....................................................................................................13 Secondary Analysis: Materials and Purpose.........................................................14 Community-based research: Conducting the New Interviews.............................15 I) Getting Started II) Recruitment of Participants and Development of the Interview Questions III) Interview Approach IV) Description of Interview Participants and Interview Locations V) Transcription, Coding and Analysis of the New Interviews VI) Structure of the Thesis Chapter 1 ............................................................................................................................22 The In n u...................................................................................................................... 22 Native Rights in Newfoundland and Labrador: Jurisdictional Ambiguity and Denial of Sovereignty and Recognition ............................................. 23 Settlement of the Innu: A modern colonial project..................................................... 29 The Land is Health: Settlement and the severance of the Innu from the land 34 The struggle for recognition: Protests, Land-Claims, and Self-Determination 38 National, Regional and Provincial Health Care: Jurisdictional Ambiguity, Inconsistent Service-provision, and the Erasure of the Innu from the Federal View .......................................................................................................... 44 Who Provided What When?: History of Health Care Provision and Financial Agreements ............................................................................................................. 47 The Innu Are Invisible: Jurisdictional Ambiguity and Documentation..................... 54 Chapter 2 ............................................................................................................................62 Sheshatshiu: The research setting.............................................................................62 A better life: The Liberal Promise.........................................................................64 Housing, Infrastructure, Employment (or Unemployment)................................65 Schooling.............................................................. 68 Registration for the Innu of Labrador .................................................................. 70 Health Care..............................................................................................................73 Alcohol and Individual and Community Health .................................................. 78 Politics in Sheshatshiu: Band Council Government and Alcohol are Introduced Ills...................................................................................................... 85 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Chapter 3 ............................................................................................................................90 Secondary Analysis of the Extant Data Series Purpose of Secondary Analysis.............................................................................90 Data Analysis: The whole picture - an integrated conception o f food, health, culture and lifestyle change, and diabetes ...........................................................91 Inseparability o f medicine, spirituality and culture (vs purely pharmacological approach)............................................................................... 99 Chapter 4 ...........................................................................................................................107 Diabetes: The evolution of the individualistic “lifestyle” approach and the native-specific “culturally relevant” approach.................................................107 Diabetes in the North American Aboriginal Population........................................... 108 Diabetes in Sheshatshiu ............................................................................................ 108 The Lifestyle approach to diabetes ............................................................................ I l l Diabetes among Native people: the culturally relevant approach in Canada ..........117 Critiquing the Culturally Relevant Approach to Native Diabetes Care....................131 Diabetes Management and Prevention in Sheshatshiu ..............................................140 Cultural Validation: An Alternative to the Culturally Relevant Approach ............... 144 Chapter 5 ...........................................................................................................................147 Analysis of Interviews Conducted in 2005: The Innu Conceptualization of Diabetes ..................................................................................................................147