Indian Health Nursing

I recall my first day going out to Yellowquill First Nation. The other nurse, Karen, in the office was taking me around as part of my orientation. It was much needed, as working in Community Health was much different than the hospital work that I had been trained for. So, I wasn’t even sure what the heck I was going to do every day at work. I learned that we had monthly immunization clinics, drop-in visits on new moms and babes, follow-up with people with chronic illness, and school visits (although only Yellowquill had a nursery/kindergarten, the rest of the kids from Yellowquill and Kinistin all went to school in town). Most nurses had a CHR, Community Health Representative, to assist them. The CHR was a local person, with some basic training that Medical Services Branch (MSB) did on health topics. I did have a CHR at Kinistin, but not one at Yellowquill. Both Kinistin and Yellowquill First Nations were Saulteaux, and most people spoke their language. One of the roles of the CHR was to translate for people with the nurse. (I still kick myself that no one told me and I didn’t think myself to learn Saulteaux, in 4 years I could have learned a lot. At least more than how to say ‘hello’ – ‘aneen’ – but I don’t even know how to answer.) So, day 1, there was a language issue. I couldn’t understand the people, and they couldn’t understand me!

So, back to my first day at Yellowquill. Karen was showing me the way to the reserve. You know, there is little signage to most reserves, and terrible roads, so you need to know where you are going and have a good vehicle. As we neared the reserve, there was a man laying on the side of the road. We looked at each other, and asked, ‘Is he dead?’. We got out to check. No, he was just drunk, passed out on the side of the road. I asked someone about him later, and I was told that he had ‘enfranchised’ himself, that he no longer belonged to the reserve. I didn’t know what enfranchisement was. A First Nations person could enfranchise themselves, essentially stop being First Nations, and they would be ‘paid out’ by Indian Affairs. Some amount would be determined and given to that person. But, then they no longer had the same rights as other First Nations. I guess they would be non-status after that. In the early 1900s, there were a number of things that would lead to enfranchisement – getting too much education like a university degree, having a job, joining the military, etc. Of course, if a man enfranchised, his wife and kids would also be enfranchised. So, basically, this guy was passed out on the road because he didn’t belong to Yellowquill anymore and he no longer had a house on the reserve.

In 1977, Yellowquill consisted of 800 people with 80 houses, average of 10 people per house. Only one house had running water (the old Indian Agents house). The rest had outdoor biffies and a barrel in the house to fill with water. There were few cars on the reserve, with some people still using horse and buggy to get around. Most homes had wood stoves, I don’t recall any with basements or central heating with a furnace. I think all the homes had electricity, but many did not have a refrigerator. There would be meat laying in the porch, or on the counter in the kitchen.

I remember calling my mom after a few visits to the reserves, and telling her that I couldn’t believe the poverty of the people. I always thought that we were poor growing up, but living on the farm, we always had food, water from the well, and only 7 of us in our little house.

I had been impacted by colonization and didn’t know it. Twelve years of school and 2 more years of nursing school had for sure not affirmed any of my beliefs or values, and Eurocentric ways had been instilled into every fiber of my being! I ‘agreed’ when others made negative comments about First Nations people and their situation. I recall a local East Indian doctor saying, ‘in the villages in my country, the head man just tells people to pull up their socks and get to work, and the people do it, that’s what is needed in this country’.

I’ll finish with a short story of my work. I was informed by my bosses that a dentist (from Melville or Yorkton?) had a contract and was coming to Yellowquill to provide dental services to the school children. Well, he wasn’t exactly coming to Yellowquill. He would be in the hall in Rose Valley. So, it was my job to get consent from parents for their kids to have the dental work done.

Informed consent is difficult when you don’t speak the language. So, I would use sign language – pointing to my teeth, and then saying the name of their child/ren. Occasionally, a younger child would translate for me, and some of the people complained that they had a bad experience, that their child’s filling fell out or some other problem. But, many signed the consent form.

Then, I was to arrange appointments of the school kids throughout the day for the dentist. He brought his assistant, and they set up in the kitchen of the hall. Dutifully, I went to the school with my list of kids that I had consent for, and then got them to the hall. And then I would get the kids to send other kids when they returned to the school. I had a little portable TV, so I took that and set it up in the hall for the kids to have something to do.

The dentist would give kids 25 cents when they finished. I can’t recall anyone having a clear appointment where they didn’t have any work done. Everyone had at least one filling before they left. So, the kids were bored in the hall, with 25 cents burning a hole in their pocket. They were asking if they could go downtown and buy something. I said sure, so off they went. Some came back with gum, chewy candies, etc! No wonder their fillings fell out. The dentist did not do one bit of health teaching! He did the dental work, gave them 25 cents and they were done. I don’t know if he even used freezing on them, come to think of it.

The dentist was mad because I didn’t have enough kids for him each day. I think he was there for 3-4 days, and he wanted 12-15 kids per day. I usually had 10 or a bit less. I think I even arranged for the school bus to drive kids over that attended school in Kelvington. Anyway, it was a lot of work for me, and questionable work on the kids.

So, I told head office that I wouldn’t allow him back. The province had started a dental program in the schools. They had dental nurses, dental assistants, etc, and they went to the classrooms, teaching kids about how to look after their teeth, brushing and flossing, and eating the right foods. They could do some of the simple treatments and had access to a dentist for more complex cases. I signed up as many kids as I could from Yellowquill and Kinistin. MSB didn’t like it because the province charged them per First Nations child enrolled, and it was expensive.

And, come to think of it, what non-Indigenous family would have allowed their child to see the dentist without knowing what they might do, and an explanation of the status of their child’s teeth? And in the care of a nurse that they didn’t really know? The dentist didn’t even explain to me what they were doing. The kid disappeared into the kitchen and I would ask them what they had done when they emerged!

Dental care is covered under Non-Insured Health Benefits (services provided specifically to First Nations, not covered by the province or other programs). During my time, utilization of this benefit was around 40%. It was common to see people missing teeth or having toothaches. Many people didn’t have the money to pay up front, and some dentists either didn’t take First Nations clients or would not bill the government directly. To compound this, I think that some First Nations didn’t like going to the dentist. Maybe from early experiences?

When I had children later, my husband and I took them to a children’s dentist in Regina, and they explained clearly to us what they had to do. They made it as pleasant experience as possible. And it was paid for by Non-Insured Health Benefits through MSB. I have a lot of regret for what happened to those children back in the day.

Many people in the communities where I worked were ‘transient’, likely due to lack of housing and other physical and social factors. So, it was common to be looking for people or children and finding that they had moved to a town or city. In Wadena, the other nurse and I met regularly with the provincial public health nurses and shared information, because sometimes our clients would have moved into town and be under the jurisdiction of the province. Of course, in those days, all we had was paper records, so such thing as technology or electronic files. This caused problems, as we had forms to request records which took some time. This was especially true for babies, as we were starting their primary series in immunization. If they moved in the meantime, they maybe would get immunization elsewhere that we didn’t know about, and we would end up immunizing children over and over. When I first started, the practice was to re-start the primary series if there was too long an interval between doses. Some kids had remarkable health records with massive amounts of immunization!! I’m not sure that the system is any better today; I don’t think the First Nations and Inuit Health Branch (formerly MSB) and the province have a system to share health records.

That’s the life of Indigenous people. Governments trying to cut corners to save some money in the budget, instead of fixing the whole problem. Spend first and properly, and save money in the long term, was rarely done by government. We often talked about the ‘bandaid’ approach used by government. If there was a gushing wound, they would apply a bandaid, and hope that it worked. Some 40+ years later, this is still the approach.

There was not much understanding of the history of Indigenous peoples in Saskatchewan or Canada; I sure didn’t learn anything in school. A lot of ‘blame the victim’ occurred - all they need to do is get a job, why do they live on the reserve, they should move out and go to school, so they can get a job. They need to learn English and never mind their language. They should learn to manage their money, so they’re not so poor. On and on… we’ve likely heard all this and more, some even repeated in the media or people that live in the nearby towns.

I remember that Karen and I were assigned to teach a module on the elderly to the CHRs. I didn’t know anything about teaching, so basically Karen took over, and did it all. I was unhappy. I didn’t need to be ‘rescued’; I needed to be given some work to do to contribute. And then, at the end, we were thanked for the module that we did. I didn’t feel good, as I knew that I hadn’t contributed much, and the praise was not deserved for me anyway.

We used to have a Zone meeting usually once a month in Fort Qu’Appelle. The Zone Office was next to the Fort Qu’Appelle Indian Hospital. It was the old nurse’s residence, and the main floor and basement had been converted to offices. There was a meeting room in the basement, with a square of tables set out. And along the outside walls were comfy chairs and couches. The nurses would all sit at the table and the CHRs would sit along the walls. There was a significant divide. With one exception, Leonard O’Soup was the CHR from one of the reserves around Kamsack, and he would sit next to his nurse, Olga. Leonard had a hearing aid, and it would start a high-pitch whistle, until he would take it out and lay it on the table. I remember one meeting, the Zone Nursing Officer was mad, and she slammed a yard stick down on the table in front of her. The CHRs were having a meeting elsewhere, and she said that she had heard that they were complaining about the nurses, and she didn’t want any more of that! On the way out to their space, Big Bill McNab (my husband’s cousin) told them loudly that there would be ‘no bit-sing allowed’. (Cree speakers don’t say ch or sh sound). This was the only way that we could fight the system, underhanded stage whispers!