- A memoir of community-based and collaborative medicine, from bootstrap measures to cross-cultural adaptations in Northern Ontario
- Author has been an physician in Ontario's remote north since 1978, serving a diverse mix of communities in trying settings
- Author's first book, A Doctor's Quest , about overseas medical missions in Africa, sold over 2,000 copies
|Product dimensions:||6.00(w) x 9.00(h) x 0.60(d)|
About the Author
Gretchen Roedde, assistant professor at the Northern Ontario School of Medicine, has been a physician since 1978. Working with Indigenous communities, she practises near Lake Temiskaming. She has also worked as a public health doctor in the developing world, specializing in mother and child health and HIV/AIDS. Gretchen lives in Haileybury, Ontario.
Read an Excerpt
BAPTISM, GIVEN: SEGAHUNDAH-GAWIN
BAPTISM, RECEIVED: SEGAHUN-DAHGOOWIN
BAPTIZED, HE IS B.: SEGAHUN-DAHSO
"Abinoojii." "To be lifted up" is a better explanation than "child," which is another translation. An Anishinaabe phrase from Wikwemikong, a community that is home to three languages, Bea Shawanda spoke it firmly. She was directing me, as a child, to find my own inner strength for what was ahead. This simple but powerful expression said to her lovingly by the family, Sophie and Eli, who raised her was now said by Bea to me, "Child. You will be lifted up." She was trying to prepare me to go up north.
But Bea still had questions.
"Why do you think we should let you help us? What gifts are you bringing to us? I am the bridge between the people and you coming to us to help. I need to explain you to the Chiefs. If we bring in non- Native resources, like you in health and social services, we have to help you bridge." She spoke angrily.
I felt threatened. I had never been up north, in isolated First Nations' communities. I knew nothing about these communities. I had met Bea when I was volunteering with her group in Toronto, working with homeless Indigenous people. She had asked me to help with Grand Council Treaty No. 9, a new Indigenous organization representing the northern half of the province of Ontario, in Canada. Its goal was to set up a First Nations paramedic training program for a group of OjiCree communities in the Windigo Tribal Council, north of Sioux Lookout, in northwestern Ontario, and to set up alternatives to jail for addicted youth. She had invited me to this Chiefs' Conference in Thunder Bay to start meeting the people I would be working with. It was true. What gifts did I bring?
We were in our hotel room. I was rocking one of Bea's kids, Maheengun, in my arms, swaying rhythmically and pretending not to feel worried about my inexperience. I kept my face neutral and left the hotel room, still rocking Maheengun. Pint-size dynamo (maybe five feet?) Bea still argued forcefully beside me, asking me about my commitment as we took the elevator to the large conference room on the ground floor.
I looked across the room and shook my head, tossing my dark blond hair loosely over my shoulders. There was one other non-Indigenous person there, a good-looking, dark-haired guy with a moustache. I couldn't help but notice him. He wore a green plaid Viyella shirt with brown corduroy pants and closed-toe wooden clogs. He nodded at me, unsmiling, from the other side of the large, smoke-filled room, as a confusion of voices — Cree, OjiCree, English — hummed through the haze. He seemed totally unfazed by the chaos. I had no idea I was staring at my future husband.
* * *
I had started off as a physical anthropology student at the University of Toronto planning to study primates in Gibraltar in the summer. Instead, I switched to social anthropology and had sessions that looked at various ethnic minority cultures around the world. One day, a guest lecturer, a Cree leader, spoke of the symptoms of the pain of his people, violent and accidental deaths, drinking, and drugs, babies born with fetal alcohol syndrome. I went up to him after the lecture. "Is there anything I can do to help?" He looked down at me, grinning broadly. "We actually don't need your kind of help. But if you're serious, call Bea Shawanda. She lives in Toronto. She is the new head of the Treaty No. 9 health program. But I am pretty sure we don't need more anthropologists. Ever thought of becoming a doctor? That would be more helpful to us. Till we train more of our own."
I left, making room for the throng of mostly female students crowding around him, being charmed by his smiles and tanned coppery-skinned good looks.
I took his advice. I did look up Bea Shawanda and worked with her for several months. I met her kids, Byron, Elizabeth, and the baby Maheengun. Bea invited me to prepare to go farther north. And I applied to medical school. So I was there, in Thunder Bay, at the Treaty No. 9 Chiefs' Conference, at her invitation from a few weeks earlier. At the conference for the Chiefs the sessions moved slowly, with translation back and forth between Cree, OjiCree, and English. About ten of the one hundred people in the smoky room were women. The men were all clean-shaven, except for that white guy with the moustache. A few wore beaded deerskin jackets. I was trying to take in every detail. I kept Maheengun in my arms, as Bea was busy building relationships and camaraderie, laughing with the Chiefs, engaging them with her ideas for social programs, drug and alcohol worker training, and a paramedic program. Abinoojii. Did I have the skills to rise to this challenge?
I survived that first difficult week. Back in Toronto, Bea and I met at her home. Bea explained: you need to be confident that you have skills to share with us. You need to know that people may be angry with you as a non-Native person helping us. "I needed to see how you would react. What you'd do if people in the communities say challenging things to you. You will not be working for the white world. You will not be staying with the teachers or at the nursing station. You'll be living and travelling with our people. Our people have a lot of anger with the white world. I, myself, had bad experiences in the residential schools. I went to school when I was four and a half. These schools were used as orphanages. It was there I first experienced violence. My mom had died when I was two, and I was adopted within my family. I worked through those difficult years by becoming an activist. That was part of the healing process for me."
Bea looked up at me, a novel experience as I am only 5 feet 4 inches tall myself. She had had tuberculosis in her spine as a kid. She spent months in the TB sanatorium. She remembers feeling frightened of the janitors. She couldn't walk for a while and was told she could never have kids. She proved the doctors wrong and had borne the children she was raising. She sure was raising me in a new world, too.
"I think you'll be okay because you are working for us. I was taught that in the first five years, a child receives what they need, including courage of heart. Abinoojii. I hope it is the same in your culture. You should have the strength you will need."
I "passed." Bea and the chiefs had agreed I could travel and work as a volunteer for Treaty No. 9. My travel expenses were paid and were extensive as most of the communities are fly-in.
In the summer of 1974, I lived with Bea, her sons, and her daughter, Elizabeth, in Timmins. I had finished my B.A. in anthropology; in the fall I was going to medical school. Bea already felt like family. After working in the head office in Timmins to prepare, this feisty woman and I travelled with her kids to spend a week at Bea's home community, Wikwemikong. She was Odawa, one of the three Nations that comprise the Wikwemikong community (with Ojibwe and Pottawotomie) on Manitoulin Island (Mnidoo Mnis).
Wikwemikong is the largest community — the "fourth stopping place" — on Mnidoo Mnis. According to history recorded both orally and on birchbark scrolls, the Anishinaabe people had been led by spiritual clan leaders, miigis, to migrate west along the St. Lawrence. The first stopping place was small Turtle Island, now Montreal, followed by Niagara Falls, then Detroit, and then Manitoulin. The entire North American continent is seen as a large Turtle Island in Anishinaabe mythology.
Bea was related to most of the people we met. "Ahnii!" shouted various relatives, greeting us in Odawa. Her kids were cheerfully meeting cousins, and outfits were finalized for dancing at the powwow, full skirts overlaid with small bells, elaborately braided hair, deerskin shirts and leggings. I struggled to learn a few simple steps of a round dance and joined in the powwow. Wikwemikong is large, with three thousand people on reserve and more who live off reserve. In between dance practices and meals of fried baloney, corn on the cob, and fry bread, we visited the local seniors' home, where everyone, staff and residents alike, was First Nations. In the health centre, a mix of Western and traditional medicine was in use. We met with health workers and community members at the general medical clinic who were upset about the recent spate of teenage suicide attempts, many of which had been "completed."
After training in the United States, Bea had become the first Indigenous leader to in eastern Canada to set up drug and alcohol programs. She wanted to expand both treatment and prevention options. Bea left her kids with her Treaty 9 family in Timmins. We were freer now to travel and drove south from Timmins for several hours, looking at alternatives to incarceration for Treaty 9 area youth with drug and alcohol offences. We stopped in for a couple of hours at Project Dare, which was modelled on Outward Bound. The goal of this centre was to give troubled young teens a chance to learn about themselves as individuals and to rely on their team to exceed their limits. A centre like this could help to prevent substance abuse.
We drove onto the grounds late one afternoon in early summer. A mixed stand of maples and pines swayed gently in a light breeze above our heads. We scrambled down a winding path to look across at a rocky slope farther along the escarpment. Six young people were learning to rappel against the cliff, swinging on complicated ropes and harnesses. Their feet scrambled for footholds as they descended. Two others were trying to climb up the rocks, laughing with each other. At the base of the cliff on the shore, another group of three were getting a canoe ready for a voyage.
The director came out of a one-storey building to meet us. After we introduced ourselves, he explained the theory of the program. "These kids have had a lot of tough experiences, and the adults around them were often not trustworthy because of drinking and other problems. So it's a huge transformation for these young adults to learn how to rely on each other."
Bea explained what Treaty 9 was doing. "I'm the director of Health and Social Programs. We are training workers for the National Native Alcohol and Drug Abuse Program. That is one step for First Nations people to have someone of our own culture to help stop addiction. But the cycle is hard to break. Young people whose parents are drinking learn this early as a coping strategy. We're trying to find safe places where our young people can learn to be self-confident, to live in the bush, and to help each other in positive ways."
I could not imagine communities where no one had running water, all lived in poor housing, and alcohol abuse and gas sniffing were common. How could this be happening in the wealthy province of Ontario, in the rich country of Canada? In 1974, the reality facing First Nations had been largely neglected in the media. I was glad to be travelling with Bea and her kids, who were cheerful and optimistic as I became painfully aware of truths they had always known.
After another hour of touring the facility and asking how Treaty 9 youth could access services like Project Dare, we drove to our next stop, Cecil Facer, a minimum-security institution for youth. It was an early evening in late June when we arrived at the main buildings. I was a bit scared. Although minimum-security, this was still basically a prison. How angry might these kids be toward white people like me?
The sun was just setting as we arrived. The sky was turning a deep blue violet. The dark red sun slipped below the horizon. The officer in charge smiled uncertainly and led us into a large informal room. About twelve people were there, a mix of staff and inmates who had just finished their supper. The youth workers were a bit hip, casually dressed. The Indigenous kids seemed shy and avoided eye contact. The white kids were equally hesitant to speak.
Bea took the lead, explaining why we were here. "We have a lot of kids raised by families who had little parenting skills. Their parents suffered through the residential schools, where they were beaten if they spoke their own language. They were cut off from their own traditions. Some of them spent years in TB hospitals. It is not surprising that they had a hard time being good parents. So their kids get drunk, take drugs, and break the law. Now some end up in jail south of Timmins. We want to try to set up a place where they won't get into trouble, where both they and their communities are safe. Where they can still go to school. An alternative to jail."
Two of the white kids started to laugh quietly, off to one side. They were both heavily tattooed.
"This is no jail. It's easy to break out of here. We skip out for the night or a few days. These 'guards' are no match for us."
"Hey, settle down you guys! Don't tell these strangers all your secrets!" joked one of the youth workers, who was dressed in jeans, his name badge on a string around his neck. Bea and I took careful notes: what it would take to create a combination educational boarding facility, with traditional skills building (trapping, canoeing) to help troubled Indigenous teens. We weren't worried about kids getting away. We just wanted them to have a place to go that wasn't prison, somewhere safe for them to sort themselves out.
* * *
Thirty years later, in 2003, I was working as a general practitioner (GP) in the Northern Ontario community of Kirkland Lake. I had fulfilled my earlier goal: I had gone north to become a GP. I did locums in small towns, and I had worked in more remote communities in the far north with Indigenous Peoples and in poor countries overseas. This was a one-week assignment in Kirkland Lake, a mining town down on its luck, with at least one bar at every intersection and the occasional drunken fight on those same corners.
In the clinic where I was working, drug addicts would come in with a variety of tales to explain why they needed their narcotic prescription filled earlier than it was due. I had heard that the GP I was replacing had had his car trashed by local drug dealers because he had started to cut off the prescriptions for people who did not need OxyContin, Percocet, or morphine. He had succumbed to the scare tactics and begun reordering narcotics without asking questions.
In the midst of a busy day in the office, with five minutes allotted per patient and a waiting room overfilled with people, the next person brought into the examining room was a dark-haired, angular, brown-faced young man. His feet were shackled together. He did not meet my eyes. In my white world we expect eye contact. In Indigenous communities, eyes are often averted out of shyness, politeness, or respect. He wore a pastel-coloured jumpsuit. This sixteen-year-old Cree youth, from up the west coast of James Bay, was handcuffed to a police guard.
"Go on, Stan. Tell the doc what's wrong with you!" exclaimed the cop.
Stan said nothing, just looked down, so the cop replied on his behalf. "He keeps coughing. He was checked for TB before we brought him into custody. It's been over a week now. Maybe check him out for pneumonia?"
I listened to his breathing; there were reduced breath sounds in his lower left lung. I thought he did have pneumonia and gave him a prescription for antibiotics and a requisition for a chest X-ray.
* * *
There were still no good options for Indigenous kids who had drug and alcohol charges. The incarceration rate for Indigenous Peoples is ten times higher than for other Canadians. They make up less than 5 percent of the total population in the country but nearly one quarter of the jailed population. More than 20 percent of all federally incarcerated Indigenous offenders are twenty-five years of age or younger, as compared to just over 12 percent of non-Indigenous offenders. So these kids from up the coast of James Bay, the ones we had been trying to help in 1973–74, were still troubled and being jailed for minor offences.
Fort Albany, Attawapiskat, Fort Severn, Moose Factory — these are wild and free places, home to geese flying overhead and the northern lights cascading through the skies. But Stan had no freedom. This young man was beginning his adult life in prison. These young people had been charged with minor drug and alcohol offences yet began their adult lives as prisoners in poorly-equipped, white-dominated prisons. It didn't matter that the white people called the places "institutions." It didn't matter that most of the white people in my waiting room were requesting narcotics yet had managed to avoid drug and alcohol charges. It didn't matter that many Indigenous youth used substances to bury the pain of their earlier memories of sexual or physical abuse.
* * *
But in 1974, my dream was how all this was going to be changed.(Continues…)
Excerpted from "Deep Water Dream"
Copyright © 2018 Gretchen Roedde.
Excerpted by permission of Dundurn Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
SECTION ONE WABANONG / wah-buh-noong / Spirit Keeper of the East,
1 Baptism, 1973, 21,
2 East Is the Time of Spring and New Beginnings, 41,
3 True Home in the Spirit, 45,
4 Eagle Overhead, 71,
SECTION TWO SHAWANONG / shah-wuh-noong / Spirit Keeper of the South,
5 Blueberry Girl, 75,
6 Learning to Trust, 82,
7 Windigo Welcome, 89,
8 Porcupine Hiding, 102,
9 Coyote Trickster, 107,
10 Sage Lessons, 112,
SECTION THREE SHA'NGABI'HANONG / shahn-guh-bee-han-noong / Spirit Keeper of the West,
11 Makwa (Bear) Goes Within, 119,
12 A Grace-Filled Fall, 127,
13 Cedar Grounding, 131,
14 A Jubilant Birth, 141,
SECTION FOUR KEEWATINONG / key-weh-di-noong / Spirit Keeper of the North,
15 Moose on the Red Squirrel Road, 157,
16 Gift Giving, 170,
17 Sweetgrass, 177,
18 Winter Wisdom, 180,
Image Credits, 184,