Culture, literacy and health: Issues
for Innu people
by Renee Bowers with Lyla Andrew,
Michelle Snow, Liz Michelin and
Mary Mae Osmond
In August 2004, Renee Bowers of the
Sheshatshiu Innu Health Commission
facilitated a discussion about
health, literacy, culture and language
with a group of educators and health
care workers. Sheshatshiu is one
of only two Innu settlements in
Labrador—the other is Natuashish.
The Innu Nation (www.innu.ca) represents these communities.
Innu Eimun, an oral language,
is the first language for most people in Sheshatshiu. Innu Eimun “been passed on through speaking.
It was only when the priests started to work with the Innu that the
concept of writing the language began to develop” (see below).
Currently, work continues on developing
a written version of this language.
Health care workers and educators in Sheshatshiu have the complex task of
working across cultures and linguistic traditions when trying
to bring information from the mainstream health care system to the people of
Both Innu and non-Innu workers participated
and the discussion was quite lively.
Mary Mae is from the community
and has worked in counselling
for a long time and Michelle
is from the community but relatively
new to the health field. Lyla
has been in Sheshatshiu for
about twenty-five years and is married to an Innu man.
Here are the notes from that discussion:
Is there a system of traditional
health care that the people of Sheshatshiu use?
People still utilize many aspects
of the traditional health care system. They still use a sweat lodge—however
the purpose has changed slightly. Initially it was used to solve physical
ailments, for example sore joints, arthritis. Today it is used more
for spiritual healing and mental health. The sweat lodge is meant
to represent a mother’s womb in which a baby feels safe and
people feel a sense of trust, respect, safety and comfort.
Other traditional medicines are still
used as well but are hard to define, for example the use of spruce
gum to heal wounds, and juniper, birch bark and cherry tree.
When do people use the mainstream
health care system and when do they use the traditional system? And
is the traditional system conducted completely orally?
People tend to use the mainstream
system more in the community and traditional system more in the country,
with the exception of the elders. This is mostly due to the availability
of materials in the country instead of in the community. The knowledge
is passed on orally as the elders are the teachers of traditional
medicine and teach through oral methods and by demonstration.
What does being healthy or being
well mean to people in Sheshatshiu?
There has been confusion regarding
the terms wellness or being healthy in Sheshatshiu. Initially, after
settlement of the community, because of the high rates of alcohol
abuse, being healthy simply meant to attain sobriety. However, the
community’s knowledge of health has since changed and the importance
of addressing all aspects of health, and the relationships between
these aspects, are becoming more evident.
The definition of health also varies
among different generations in Sheshatshiu. The elders would consider
being healthy as someone who is active and free and living in a traditional
manner. This perception of health is not passed on to many in the
younger generation and they cannot experience the elders’ version
of being healthy. This is in part due to changes in the community.
The rapid amount of change in the
community has brought with it the effect of negative coping practices—in
part because of the way the change has occurred. Many people feel,
not as if their culture is changing with the times, but rather as
if the changes are being made to their culture and way of life. In
essence, the feeling of loss of control has resulted in the problems
we see today from a mental health and physical health perspective.
What does being literate mean to
people in Sheshatshiu?
As a group, we understand the definition
of being literate as the ability to read and write. Innu Eimun is
an oral language and has been passed on through speaking. It was only
when the priests started to work with the Innu that the concept of
writing the language began to develop. As the Innu strive for self-governance
and autonomy over their services, the issue of literacy in English
becomes quite evident as a barrier and is having more of an impact
on the community. It becomes an issue when trying to educate the youth
to continue on in school outside Sheshatshiu and come back to deliver
services, when working with contracts and agreements and their implications
and when dealing with outside agencies such as funding sources and
various government departments. Also, recently in Sheshatshiu, the
Innu have become involved in many economic development projects and
political issues such as land claims agreements. All of these activities
require a degree of literacy and have proven the relationship between
literacy and power as supported by many adult education theories.
What are the barriers to health/wellness
as defined by the people of Sheshatshiu?
Again, the biggest barrier to health
and wellness in Sheshatshiu is the definition of health and wellness
itself. The experience of being healthy from an Innu perspective is
not being passed on to the youth in the community. Today’s generation
is the first generation that has grown up in one community and they
have to figure out what it means to be healthy in this new environment.
Is being sober enough to be healthy? Is a clean house a good sign
of hygiene? There are questions about whether newer medicines and
treatments are better and if they really improve the health of the
There are questions regarding mental
health -- whether the connection between the ill physical health the
Innu are now experiencing is directly related to the emotional stress
experienced by people in the community. For example, we need to examine
the relationship between wellness and the importance of close relationships
in the community. Before settlement, social relationships were very
important and were maintained, in part, by the living arrangements
such as tents. When the people began living here year-round in the
1950s, the social structure changed as people were separated into
their respective houses and there are questions about the effect of
this move on the social health of people living in the community.
Another barrier is the appearance
of new diseases brought about by settlement and changes in the culture.
Many traditional medicines are not able to cope with newer diseases
such as diabetes and alcoholism. The tools were not in their kit as
they didn’t need these tools when they lived in the country.
In essence, the Innu have had to develop a new tool kit to deal with
There continues to be a struggle
with non-Innu health providers not understanding Innu culture and
health practices and this can act as a barrier to health for Innu
people. The lack of understanding and lack of acceptance of the Innu
has resulted in the Innu feeling some shame about their culture. A
cycle has developed in which the value judgments among the non-Innu
produce a sense of shame that perpetuates a lack of confidence. Traditional
knowledge is seen not to be respected and, as a result, is not passed
on to the younger generation. This in turn affects the ability of
the Innu to pass on the feeling of being healthy.
The health care delivery system does
not always reflect what is important to the Innu because of the lack
of understanding of Innu values. For example, the health system and
non-aboriginal culture places great importance on independence and
self-efficacy. Yet, in Innu culture it is the interdependence and
close relationships, not only with other Innu but also the environment,
that is seen to maintain a sense of balance and create a healthy person.
What are the barriers to literacy
as defined by the people of Sheshatshiu?
The greatest barrier to Innu literacy
is the fact of the oral nature of their language. This inherently
brings the challenge of reaching agreement amongst different groups
of Innu people who have resettled in various areas and have developed
different dialects of the same language. Due to the different dialects,
it is difficult to attain agreement regarding a standardized writing
system. While the Innu are worried about losing their language and
have been advised by linguists about the importance of developing
a standardized writing practice, the development of such a resource
requires materials that are not attainable at this time, but are goals
for the future generations of this community.
Also, some schools of thought suggest
the lack of a written version of the Innu Eimun means it cannot be
recognized as an official language and taught in a school setting.
Instead of looking at this fact as an important challenge that can
be met, it is looked upon as a barrier to supporting the language.
Finally, the words in Innu Eimun do not translate into English easily
at times as there are not any Innu words for English terminology.
Therefore, there is a pressure to conform to some aspects of non-Innu
terminology and spelling. For example, the name of the community of
Sheshashit has been changed to Sheshatshiu.
What is the role of the health care
system in eliminating these barriers?
The health care system is responsible
for bridging the non-traditional with the traditional Innu culture.
It is also responsible for trying to get health information to people
in Sheshatshiu in a manner that is respectful and effective.
In Sheshatshiu, we also have to rethink
what is included in the health system. The health system is not only
comprised of professionals working in the community. It is also the
Innu persons who may not have a great deal of professional knowledge
but have a local knowledge that must be respected as well. Health
care also has be to considered as more than curing the sick. People
sometimes perceive the health system as giving medicines which are
supposed to cure; they are not seeing the whole picture of preventing
illness or the need to take medicines on a regular basis to keep well
instead of providing a cure.
The link between literacy and health
care is vital on many levels and can lead to an improvement or deterioration
in service. The first level is improving health literacy to ensure
clients understand the information provided to them. The second is
improving the literacy of staff to ensure that they can orally explain
health to clients. And, of course, the third is linked to the education
system—the more literate and educated people from the community
become, the better able they are to become health practitioners and
deliver health services in the community.
What is the role of the education
system in eliminating these barriers?
While one would view the education
system as a strong advocate for eliminating many of the barriers associated
with literacy, the education system has been in part responsible for
creating barriers. This is mostly due to the fact that there is very
little recognition or valuing of the Innu language. There are classes
taught in Innu Eimun until grade four, and then classes are in English
only. Otherwise, Innu Eimun is predominantly learned at home through
dialogue with other family members, friends, etc. This produces a
sense of disconnection between Innu culture and the education system.
Also, some Innu children are taught in schools outside of Sheshatshiu
as it is perceived that children attain a better education if they
are taught in English only. The parents that are sending their children
to school elsewhere are usually more affluent, and the children tend
to lose their Innu language as they do not speak Innu Eimun with their
friends at school. Therefore, the division among people who can speak
Innu Eimun and those who cannot represents a social class division
to some degree.
Who else has a role in eliminating these barriers?
Every agency has a role in eliminating
these barriers—this effort requires a multi-pronged approach.
Various levels of government that deliver services in the community,
the health system, the education system and community members
should become more involved and give input into these processes.