Proceedings of the Standing Senate Committee on
Aboriginal Peoples
Issue 2 - Evidence of November 26, 2002
OTTAWA, Tuesday, November 26, 2002
The Standing Senate Committee on Aboriginal Peoples met this day at 9:02 a.m. to study issues affecting urban Aboriginal youth in Canada and, in particular, to examine access, provision and delivery of services; policy and jurisdictional issues; employment and education; access to economic opportunities; youth participation and empowerment; and other related matters.
Senator Terry Stratton (Acting Deputy Chairman) in the Chair.
[English]
The Acting Deputy Chairman: Good morning, ladies and gentlemen. Our witnesses today are Ms. Allison Fisher from the Wabano Centre for Aboriginal Health; Mr. Richard Jock from the National Aboriginal Health Organization; Mr. Jerry Lanouette from the Odawa Friendship Centre; and Mr. Michael Tjepkema from Statistics Canada.
Mr. Tjepkema, please proceed.
Mr. Michael Tjepkema, Statistics Canada: Honourable senators, I was asked here today to present my paper, which was released last year, on the health of the off-reserve Aboriginal population. Copies have been distributed to you this morning for your information. I will give you a quick summary of what we know from the literature.
We know that Aboriginal people are generally in poorer health. They have a shorter life expectancy, a higher infant mortality rate and higher rates of chronic diseases, such as diabetes. We also know that they are generally younger and that the general population experiences more poverty, has higher rates of unemployment and lower levels of education.
However, much of the research has focused on the on-reserve population and usually excludes the people living off- reserve who make up about 70 per cent of the total Aboriginal population. Generally, this population lives in Ontario, in the Western provinces and in the North. The objective of my paper was to, first, look at the health status of this Aboriginal population and, second, to make comparisons to try to understand why there is a gap in health status.
Before I begin the presentation, I would like to comment that the data in the presentation represents the total Aboriginal population who live off-reserve and who are aged 15 years and older. As well, the data has been age- standardized to allow fair comparison. I will examine the three groups in combination: North American Indian, Metis and Inuit. I will not provide a breakdown of the kind of Aboriginal.
Chart 1 shows a measure called ``self-perceived health,'' which is a commonly used and reliable indicator to measure a person's overall health status. Research has also shown that self-perceived health is predictive of premature mortality, even after other health status measures have been taken into account. Respondents were asked to rate their health as either excellent, very good, good, fair or poor. This table clearly shows that the Aboriginal population, aged 15 years and older and age-standardized, perceived their level of health as poorer. For instance, 23 per cent of the Aboriginal population rated their health as fair to poor, compared to only 12 per cent of the general population.
Chart 1(b) shows data on urban Aboriginal youth. My paper does not look at that area specifically but for this purpose, I looked at urban youth aged 12 to 24 years, using the same measure of self-perceived health. It appears that Aboriginal youth were also more likely to perceive their health as poor.
Chart 2 shows three specific health status measures: chronic conditions, such as diabetes, arthritis, high blood pressure, et cetera; activity restrictions, where we asked respondents whether they have a long-term physical or mental condition that reduces the kind or extent of activity they are able to do at home or at school; and the likelihood of experiencing a major depressive episode. We determined the latter measure by a series of questions using a diagnostic tool that provided the probability of the respondents having experienced a depressive episode in the previous year. Once again, chart 2 shows that the Aboriginal population has more chronic conditions, more activity restrictions and more depression than the non-Aboriginal population.
Chart 2(b) focuses on the urban area Aboriginal youth, where it appears that the same story holds true, although the prevalence is lower, mainly because of their younger ages.
Chart 3 shows household income by Aboriginal status. Research has shown that income is highly correlated to health. Those on lower income generally experience more health problems. The chart shows that Aboriginal people are less well off in terms of household income. To give you an indication, the low-income group would be a family of four earning $20,000 or less per year; a middle-income group would be a family of four earning between $20,000 to $40,000 per year; and a high-income group would be the same family of four earning over $40,000 per year. This discrepancy, or gap, in income could be affecting Aboriginal people who report poorer health and who have more health problems. Chart 3(b) shows the same pattern for urban Aboriginal youth.
Chart 4 shows the same four health status measures, more specifically, fair or poor health by household income. The first set of bars shows the Aboriginal and non-Aboriginal population in the low household income group. Even though the percentage reporting fair or poorer health decreases as income rises, even within each household category, we can see that the Aboriginal population has a higher percentage reporting fair or poorer health, suggesting that it is not just income that is driving their poorer health.
Chart 5 looks at major depressive episodes, and the pattern is similar with the gap in each household income category. In the high-income category, the gap is narrowest, suggesting that it is the Aboriginal people who have the lowest income facing the highest amount of disparity in health.
Chart 6 looks at chronic conditions. The pattern is similar, with the high-income household group having the smallest gap in percentage.
Chart 7 looks at the long-term activity restriction. You will notice on this chart for the high-income group that both Aboriginal and non-Aboriginal people have the same percentage. Much of the disparity in health is focused on the low- and middle-income household groups, the poorer of the individuals.
Besides income, there are many other determinants of health. Table 1 looks at some of these determinants. The first set of variables called socio-economic status is generally measured using three types of variables: education, income and work status. Looking at the table, you can see that for each of those variables, the Aboriginal people who live off- reserve are more likely to be less well off than the non-Aboriginal. For instance, a greater percentage of Aboriginals have not completed high school. They are more likely to be in low-income households and less likely to have worked the entire year.
Other health determinants and health behaviours that were used in my analysis are the following: daily smoker, physical inactivity, obesity and heavy drinking. For all these variables, except for physical inactivity, the percentage was higher for the Aboriginal population. For physical inactivity, both Aboriginal and non-Aboriginal people had the same prevalence. Perhaps these differences could explain why Aboriginal people are reporting poorer health.
Table 1(b) looks at urban youth aged 12 to 24. Interestingly, the same pattern is generally true on this table. If we look at physical inactivity, Aboriginal people are less likely to be inactive. That is actually an encouraging sign.
Chart 8 shows a technique of modelling where we take a bunch of variables and even out the playing field. For instance, we factor out the disparity in income and education, and we can see if they are still more likely to report poorer health. Chart 8 looks at the outcome of fair or poor health. The first set of bar charts looks at age and sex, so we control for differences in age and sex. We want to see if they are still reporting poorer health. In this case, we can see that the odds ratio, which is what we call it, has a magnitude of 2.3. This is considered the baseline. If the health status were similar between the two groups, that odds ratio would be down to 1.0, so it gives an idea of the magnitude of the difference.
When we factor in socio-economic variables such as the income, education and work status, the odds ratio is reduced from 2.3 to 1.5, suggesting that some of the disparity in reporting fair or poor health is due to lower socio- economic status. However, it does not explain the entire disparity in health because the odds ratio is still over 1.0.
In the last set of bar charts, when we factor in the four health behaviours of smoking, physical inactivity, obesity and heavy drinking, the odds ratio is reduced from 1.5 to 1.3, suggesting that part of the disparity in health is partly explained by these variables; but, it is not the whole story. Other variables are driving their poorer health.
Chart 9 looks at the outcome of depression, and there is a similar pattern to chart 8.
Chart 10 looks at chronic conditions. You can see that the odds ratio is reduced as we add more variables into the model.
Chart 11 looks at long-term activity restriction, and the pattern is similar.
Just to summarize, we know from this analysis that the off-reserve Aboriginal population is in poorer health than the non-Aboriginal population. However, when we do control for differences in a socio-economic status, the inequalities are reduced. The magnitude is reduced, although the inequalities do not disappear. They are still less well off. Even if we levelled the playing field on income, there are other variables suggesting that their health is poorer. Some of these variables could be because the analysis was more of a summary. Other variables could be life events, stress, poor housing, and perhaps coping mechanisms. These are all variables that might explain why there is still a disparity in health.
There is definitely a need for more research using this new data source, which I forgot to mention was the Canadian Community Health Survey. It allows us to analyze this important population, and it was not available before.
That concludes my formal presentation, and I would be happy to entertain questions from committee members.
The Acting Deputy Chairman: The idea was that we would go through all four presentations simply to have some control and balance. If that is acceptable to the committee, we will proceed on that basis, or do honourable senators want to ask questions as we go?
Senator Pearson: I have one or two questions related to how the statistics are gathered.
Senator Hubley: Just a quick clarification on the makeup of the family. You had mentioned a family of four. Could you tell me the makeup of that family?
Mr. Tjepkema: We did not look at the actual makeup of the family. Previous research used in the 1996 census does show thatthe Aboriginal population is more likely to be composed of single-parent families. The analysis of a family of four was a way to provide a more reliable estimate of household income, using a combination of the income gathered by a household and looking at how many people live in that household. It was more of a measure of income. We did not actually look at the specific family makeup and whether there were two parents or how many kids there were.
Senator Pearson: I find it interesting that Statistics Canada has been able to do this kind of research. You talked about the Canadian Community Health Survey. When you are comparing the Aboriginal population to the non- Aboriginal, is that survey broken down into other components, such as the population of Haitians in Montreal or somewhere where one would find statistics similar to this?
Mr. Tjepkema: The sample size is not large enough to look at it by city. The paper that I have provided copies for does look at some urban and rural differences and the territories. However, it is essentially a comprehensive health survey that looks at a wide assortment of factors, which are essentially the tip of the iceberg of how this survey can be used.
Senator Pearson: Is someone else looking at the health status among immigrant populations?
Mr. Tjepkema: We released two papers on the immigrant population this past fall, which looked at their health status, physical conditions and mental conditions.
Senator Pearson: Are they available?
Mr. Tjepkema: We can certainly make them available to you.
Mr. Richard Jock, Executive Director, National Aboriginal Health Organization: Honourable senators, it is interesting to follow the presentation of my colleague, Mr. Tjepkema, in that the considerations of the determinants of health are important, some of which have been outlined clearly.
In terms of a snapshot, and I am sure you have heard lots of statistics thus far, but I want to emphasize a couple. One is that according to Statistics Canada census data, children and youth, birth to aged 19, represent 44 per cent of the Aboriginal population. As well, 52.1 per cent of Aboriginal people overall from age 0 to 14 live in poverty. That was clearly differentiated further in the Canadian Community Health Survey. Also, there are four times as many young Aboriginal parents under the age of 25 as compared to the general Canadian population.
In terms of a more detailed study, I would refer you to Sylvia Maracle, who has worked on a study called ``Tenuous Connections: Urban Aboriginal Youth, Sexual Health and Pregnancy.'' It found that 27 per cent of Aboriginal families were headed by single parents versus 12 per cent in the general population, and that 39 per cent of Aboriginal single mothers earn less than $12,000 a year versus a 22 per cent figure for the general population. That is a focused study and a good reference source.
Again, relating to the determinants of health, I would add two potential explanations for the differences that seem to be inexplicable, which have been highlighted in work done by Dr. Michael Chandler regarding the notion of cultural continuity. In his study, where all six of the factors that he identified were present with respect to cultural continuity, suicide rates were negligible or zero. Where none of those factors were in place, these rates were the astounding rates that you have seen reflected quite often in the media. Cultural continuity and the elements of self-determination are key ingredients in terms of that difference as they relate to cultural stress and the challenges of being an Aboriginal person in Canada.
The other statistic I would emphasize, although it is difficult to tie this one down scientifically, is the prevalence of fetal alcohol syndrome/fetal alcohol effects. A B.C. report entitled ``A Framework for First Nations: An Inuit Fetal Alcohol Syndrome Effects Initiative'' notes that the rates may be as high as one in five. Again, these are two elements that also need to be considered in looking for solutions.
Other contributing factors include increasing anecdotal evidence about the prevalence of HIV/AIDS; sexually transmitted diseases, or STDs; teen pregnancies; smoking, alcohol and drug abuse rates; a rising concern over improper nutrition; and the lack of fitness. In fact, there is a worry that obesity may be a real rising concern in Aboriginal communities. Other contributing factors are the impact of mental, physical, verbal and sexual abuse. As well, a considerable amount of work is being done in the area of residential school abuse. I would say that the Aboriginal Healing Foundation would be pleased to provide this information to the committee or perhaps it could be scheduled to appear as a witness before the committee.
I also want to relate some of the preliminary poll results for First Nations and Metis with respect to the need for culturally relevant, culturally competent care. Over 80 per cent of those surveyed believe that health care programs that better reflect Aboriginal culture could help improve Aboriginal health. Further, 67 per cent believe that a return to the principles of Aboriginal medicine and healing practices can also help improve health. The group being interviewed did not wholly correspond to the group that you are interested in today, but 30 per cent of our respondents were in that age group.
I have some quick highlights to give you about measures that seem to be effective, particularly in the pre-youth age group. Aboriginal Head Start appears to be one program that is setting up the context for improved beginnings. The only problem with that is that, by estimates, as much as 85 per cent of Aboriginal people are not able to access this program.
Other programs that show promise, and I say ``promise'' because there is still a need to evaluate these programs in the long term, include our nutritional counselling programs, support and encouragement for safe sexual practices, parenting programs, and youth emotional support and counselling programs. In addition, it is worth noting that one- fifth of Aboriginal children and youth require greater than normal staff time due to special needs such as speech delays, fetal alcohol syndrome and its effects, emotional or behavioural problems, and hearing and visual impairments. To not focus on the needs of that particular group puts it at heightened risk of significant societal problems later in life. As well, 38 per cent report poor economic conditions. This information comes from the study that was done by Aboriginal Head Start, which reinforces the point that was made earlier.
Additional initiatives that are showing promise, particularly with Metis youth, are the national Metis youth role model program, early intervention program. There is also the Metis National Youth Advisory Council and there are the Metis youth talking circles on HIV/AIDS. I am just highlighting examples. I do not speak for the Metis organizations, but I would point out that those youth face additional barriers due to jurisdictional disputes and lack of clear availability of funding, to a certain degree discrimination and lack of understanding from mainstream services, and a fair disparity between Metis people and federally registered First Nations and Inuit people. As well, in general, a lack of core-trained workers is of critical interest for the future.
I would like to highlight the urban Aboriginal health centres in general. My colleague here is certainly an expert on delivery in that regard. I would also like to highlight that we have provided a report to you that summarizes some areas of interest. I would also like to point out that these Aboriginally controlled health centres are rare in Canada. There are only in British Columbia, and I believe that number may be diminished because of cuts in the health care system. There are 11 such centres in Ontario, which are provincially funded, and there is one in Winnipeg. If you look at the whole picture across the country, you will see a poor and inconsistent focus on Aboriginal health in the cities.
The centres in place are successful and provide a culturally appropriate regime of primary care, which is generally delivered in a multi-disciplinary team approach. We will examine this in the next presentation.
I would emphasize that in other areas of interest there is an ongoing need for evaluation, in a formative way rather than in a punitive way, of how programs perform, their effectiveness, and how broad-based initiatives, such as community development, land claims and other general government policies, have an effect on Aboriginal communities. The document entitled ``Integrated Health Policy for Canadian Youth'' has been provided to members of the committee.
It would be important to provide sustainable funding to Aboriginal health centres that would focus on the particular needs of Aboriginal youth. The funding would also provide for a systematic hiring of Aboriginal youth advocates, elders and social workers who could focus on the particular needs of youth. It would be important to support Aboriginal health centres and their interest in incorporating traditional healers as an important part of the health care choices for Aboriginal youth.
I would like to highlight the Canadian Community Health Survey, which has been referred to by the National Aboriginal Health Organization, NAHO, and the First Nations and Inuit Regional Longitudinal Health Survey, which was first done in 1997 and is expected to be completed by February 2003. In that survey of 27,000 people at the reserve level, there are child surveys and adolescent surveys. This survey will be an important part of any future data interests, and we would welcome relevant and appropriate partnerships in respect of its use. This would have to be done in the context of First Nations governance. It is significant that there is no similar opportunity for data collection for Metis people. I am sure you will see from the data you have received that there is a clear gap in the information on Metis people and in the collection of such data. It would be important to address this gap, which would be a Metis governed process, and fill in these important gaps in data and knowledge.
I would emphasize that it will be important, particularly for youth, that Aboriginal people fully participate in developments such as the health info-structure, broadband and other technologically driven initiatives in Canada, if we are to have full access and enjoy the full potential that other geographic and cultural areas of Canada experience.
You have copies of the overall report, so I will not extend my presentation any further.
The Acting Deputy Chairman: Mr. Jock, it was good to hear about those areas of success. It is critical that we have information on successful efforts as well as on areas that present problems. You will want to put beacons on these successful areas because from that good start, you can grow success across the country.
I would appreciate it if Ms. Fisher and Mr. Lanouette could also tell us success stories because it is important for us to know about them. I will now vacate the chair and ask that Senator Pearson take over as the acting chairman for the remainder of today's meeting.
Mr. Jock: If I may, I am interested in your comment. Unfortunately, some of those successes have either short-term or expired funding, and so they are at risk of not continuing. It would be important to support those kinds of successes in a sustainable fashion.
Senator Landon Pearson (Acting Chairman) in the Chair.
The Acting Chairman: Ms. Fisher, please proceed.
Ms. Allison Fisher, Executive Director, Wabano Centre for Aboriginal Health: It is a pleasure to be here, honourable senators. Mr. Jock touched on some of what I will speak to. It is unfortunate that Senator Stratton had to leave because we feel our model of care in Ottawa is one of those success stories.
The Wabano Centre for Aboriginal Health, the WCAH, a community-based, Aboriginal-driven, primary care health facility that offers culturally based services for urban Inuit, Metis and First Nations people, is funded by the provincial government. At Wabano, we operate an integrated, holistic approach to health, encompassing the physical, emotional, mental and spiritual aspects of well-being. Traditional teachings and healing practices, as well as cultural and community programming, complement our contemporary medical model. That means that at Wabano we use traditional healing practices from the Inuit, Metis and First Nations peoples. We have a contemporary model of high- quality primary care. We focus on the individual in the context of family and community life. We believe in the wisdom of our elders and traditional healers, and we believe in the benefits of ceremony and the celebration of our survival.
At the close of Wabano's fourth year of operation, our caseload for primary care services has grown to 2,400 people. We also service more than 2,000 clients in our other cultural and health promotion services. Approximately 46 per cent of our clients are under the age of 25, giving us a key role in the future of Ottawa's urban Aboriginal population. At the Wabano Centre, we pride ourselves on providing holistic programs within a supportive, inclusive, accessible and safe environment that welcomes all Aboriginal people — Inuit, Metis and First Nations. In this place, services are provided regardless of status. It is a place of belonging, of trust and of community.
Wabano uses an integrated service model based on a multi-disciplinary, cross-sectoral model of collaboration. In all programs, we strive for the following: that all our programs must incorporate and model the beliefs, principles and traditions that are part of Aboriginal culture. We start by building on the strengths of the people in our community. Our Aboriginal community members are fully involved in the design, delivery and evaluation of programs and services that are meant to benefit them. We actively promote community development and capacity building through interagency direct service links and partnerships in education and in training.
We have a series of statistics, and I have many more that I will not speak to today. However, I will touch on a couple of them that have not yet been mentioned. Our centre would see the following statistics first hand: the high rates of suicide, HIV/AIDS and the alarming increase in type II diabetes in our young.
We have talked about poverty today. The people who come to the centre are poor, female, young and struggling to provide food for their children.
Aboriginal teen pregnancies in the provinces are four times that of the general population. For girls under 15, the rates are estimated to be as much as 18 times higher than the general teen population in Canada. We see those problems at the Wabano Centre.
There was a study done by Sylvia Maracle and the Ontario Federation of Indian Friendship Centres in 2002. I believe that report may have been tabled with the committee. I bring it to your attention because it is part of what we see here.
The report points out that 57 per cent of males and almost 78 per cent of females had conceived a child by the age of 20. The study further found that 28 per cent of sexually active respondents began intercourse at the age of 13 or less, and 66 per cent had engaged in intercourse by the age of 16.
Solvent abuse and addictions in Aboriginal communities is a serious problem, especially among youth where poverty, prejudice and lack of opportunity are conditions of life. When viewed together with the statistics of early pregnancy, this has an enormous implication for escalating the already high rate of fetal alcohol syndrome and fetal alcohol effects. The Aboriginal population with FAS/FAE is 10 times higher than the national average.
These trends are deeply disturbing. They will have profound impacts on educational attainment and, consequently, the socio-economic potential of Aboriginal youth. The data also suggests an alarming degree of exposure to sexually transmitted diseases, and yet another generation will have to battle the problems of ill-health and the poverty cycle.
What are the critical issues that our staff are identifying when our youth come to our centre? They are seeing the high rates of poverty. Family violence levels are unabated. These kids are exposed to tremendous amounts of family violence; the ghettoization of Aboriginal families into poorer areas of the city where crime and other negative influences on youth are rampant; a lack of cultural support and positive cultural experiences in family life, especially urban Inuit who are far from their extend families in the North; a lack of parental support and supervision; and a lack of fun and supervised stimulating community activities.
What are the outcomes of what we see? They are a high dropout rate at school, poor attainment, sporadic attendance, high unemployment, excessive drug and alcohol abuse, health problems that are often persistent and will be persistent throughout the life cycle, and early sex. Teenage pregnancy levels are high. As well, you are all well aware of the statistics relating to the incarceration of Aboriginal youth.
We have invested significant time and creativity into addressing the problems of Aboriginal youth, and we have seen success in this regard. I will go into some of those success stories.
In order to bridge the gap between seniors and youth so that youth may benefit from the wisdom of culture, we have created an intergenerational program where seniors and youth meet once a week to share their stories and teachings. When seniors are able to link youth to the past and youth are able to link seniors to the future, the bonds of trust between two formally dissimilar groups are strengthened and each gains a new and fresh perspective on the other.
Our cyber café program encourages youth to stay in school by promoting two opportunities each week to improve or maintain good grades. Volunteer tutors help them with their homework and computer skills and act as positive role models. I would like to take a few minutes to describe this program in more detail. I will present honourable senators with a case study.
The average age of the kids in this group is between 14 and 15, and they are in Grades 9 and 10. They are living those poverty statistics I quoted to you earlier and most come from single-parent homes where they are left alone regularly. According to one of our volunteers, the boys come to the cyber cafe for the big-boy relationship with the mentors. They like the environment and like to be among the older males who take interest in them. The girls come in for help in math and French. They like the environment because it is safe and they are respected. ``All the kids can be proud that they are Indians here.'' That is a direct quote from them.
One young Aboriginal youth who is a volunteer mentor said, ``You are a product of who you hang out with. These kids hang out with some bad dudes. We get some hard-to-handle kids, and we become parents for them. We need to help parents learn to parent these kids.''
The spirit of youthful energy they bring to this program is tangible and real. We witness their self-confidence and self-esteem growing as their peer and mentor friendships strengthen. They support each other in practical and non- judgemental ways while spinning ideas and plans off each other for how to help other kids.
In the time they have spent in this group, they have actually written a proposal to the United Way to do a video. They hope this video will help other kids. These are 13- and 14-year-old kids. They are hoping that other kids can avoid the same problems that they have. This is a quote from one of the kids: ``We want the opportunity for other kids to make good choices to too. These are our problems and we can't run away from them.'' This is capacity building and sustainable change in action, and it is most profound and hopeful.
Our approach to HIV/AIDS prevention and education is one of the most innovative in Canada, using street theatre and traditional storytelling to help shield our youth from infection. We promote responsible decision-making and reduce risk-taking behaviours through the use of storytelling, video-making, puppetry and street theatre.
We have so many other innovative projects. We have a child and art project. We have FAS prevention programming. We have a special partnership with the Ottawa police for our early intervention project for ages 6 to 12. These are described more fully in our written brief and the evaluation reports published by our centre.
What obstacles do we face in building our service delivery model at the centre? We find that it is difficult to sustain program funding, as budgets are subject to yearly review and programs are viewed as experimental or pilot projects. I know that was mentioned before.
The scarcity of resources forces us to focus our energies on crisis management rather than capacity building or long- term planning. Programs frequently operate without a proper infrastructure for personnel, program policies and procedures. Funding is usually not available for infrastructure development. It is difficult to train and retain staff due to the uncertainty caused by a lack of multi-year funding. That is a critical piece of information. It even lends to the issue of trying to keep a doctor. It goes all the way down. If doctors do not know that this health centre will be here in a year and a half, why would a doctor want to stay at our clinic or why would a nurse practitioner want to continue doing her work?
There are no resources for community level research and development that would allow us to collect data and compile information as a guide to service delivery improvements. Without that, we cannot continue to come before you and say that we have results to give you.
I have many recommendations, but I will just highlight a couple of them.
Parenting skills and family bonding are one of the most urgent issues facing Aboriginal youth today. A nationwide initiative should be undertaken to educate our youth on responsible sexuality, risks associated with FAS/FAE, and the joys of delayed parenthood and family life. The school systems need to develop culturally supportive programs for Aboriginal youth that create a place of belonging by positively reflecting and drawing from the wisdom of their culture and teachings.
The standard health curriculum needs to include education, at a very young age, of the risks of FAS/FAE. Otherwise, we will not get at the problems if we do not start to educate. I was talking to a specialist from the United States who told me that they start at Grade 4, and it is built into their curriculum every single year. It is not good enough to give a little course and think that five years later the problem will be solved.
We need more single-mom support programs and programs that teach healthy and responsible sexuality. Additionally, there needs to be an expansion of day care programming centred around schools so that young mothers can continue their education and the reality of their parenting.
Urban Aboriginal youth urgently need a program that promotes a strong sense of cultural pride and identity. We have given you examples of programs, but, again, they are subject to yearly funding and may very well end.
Remember, also, that many of our children's initiatives suffer from federal-provincial policy that limits access to federal dollars to First Nations persons on reserves to the detriment of urban Aboriginal populations.
In spite of statistics indicating that Aboriginal people suffer from stress and psychosocial disorders at a greater rate than the non-Aboriginal population, there are few mental health resources. One of the four top problems that we see in our centres is depression. It is young people who are suffering from depression.
We urgently need an FAS/FAE prevention program that specifically targets youth who are FAS/FAE impacted and who are at risk of perpetuating the cycle in their own pregnancies. The rates of family trauma, addictions and suicide will continue to spiral until this is effectively addressed.
At Wabano we have learned that healing and restoring health is a living process that must be woven into the fabric of daily life in our families, communities and nations. To this end, the emphasis of our centre is on restoring Aboriginal health, building Aboriginal capacity and strengthening the bonds within Aboriginal family and community life. I believe we have succeeded.
We are painfully aware now that turning the present situation around means reducing the rates of violence, addiction and incarceration, which in turn is irrevocably tied to improving the quality of life for our young people. This will require more ad hoc and piecemeal initiatives, however well-intentioned, however creative and however successful at the local levels. We have proven that we have the commitment and the capacity to work effectively at this level. What we need from you is the following: a comprehensive health policy by and for Aboriginal people that addresses the health of urban as well as reserve and rural populations, and an accountable economic, social and environmental policy that demonstrably improves Aboriginal people's quality of life and environmental conditions. We need you to practise good governance by creating a political framework that eliminates jurisdictional and systemic barriers and permits different levels of government and their departments to work in a coordinated and collaborative way on solutions. Finally, we are asking you to demonstrate your commitment to restoring health and hope to Aboriginal young Canadians by ensuring that our success stories at the Wabano Centre become the standard rather than the exception.
Mr. Jerry Lanouette, President, Odawa Friendship Centre: Honourable senators, on behalf of the membership of the Odawa Native Friendship Centre, it is an honour and a privilege to be here. I am pleased to address the Standing Senate Committee on Aboriginal Peoples as it examines issues that affect urban Aboriginal youth. I will try to do justice and honour to this gift.
I have been involved in Ottawa's Aboriginal community since 1979 in many areas. I presently sit on the Board of Directors as President of the Odawa Native Friendship Centre. I am an urban First Nations community member here in the Ottawa area, and I am originally from a community called Algonquin Barrier Lake, which is also known as Mitchikanibikok Inik, which is about three hours north of here on the Quebec side. Many of our community members presently reside here in the Ottawa area, and are originally from Kitigan Zibi, which is Maniwaki, not that far from here.
I am a self-employed Aboriginal businessman in the Ottawa area, and I have been in the high-tech industry for about five and one-half years. I have previously sat on the National Aboriginal Head Start Council as a community representative representing Ontario. This, again, was a volunteer position.
Since 1979, all the work I have done for the Ottawa Aboriginal community has been as a volunteer, other than my computer business. Therefore, I can speak best as a community representative involved as a volunteer.
I have with me a sacred eagle feather that belonged to my departed sister, Roxanne, who took her own life about six years ago. She committed suicide. Many of the issues that Ms. Fisher raised in her presentation affected my sister. She suffered from depression and she was not able to cope. She was a social worker who brought her work home with her. It affected her so much that she eventually took her own life. She was unable to deal with those problems.
She was also a victim of sexual abuse from the priests in our community when she was a young child. The members of our family are products of the residential school system. Both of my parents were in residential schools. We were raised by our grandparents — my brother and I, more specifically, until we were into our early teens — for which I am fortunate. They gave us a good grounding, good sound values and good strong family values.
This feather symbolizes the good work my sister did in her lifetime in regard to Aboriginal youth, and it helps me concentrate on my day-to-day efforts. It helped me change my lifestyle by helping to promote our culture in Aboriginal youth promote and by studying the teachings of our seven generations. These were taught to me by my grandfather.
This eagle feather is also significant to all Aboriginal people across Canada and North America as a way of asking and delivering messages to the creator and to those who need to hear this message. In telling you this, it is my hope today that the message to this committee is heard and that our recommendations will come out in our presentations today.
We recognize that our youth are gifts from the creator and they are our nation's most valuable resource. The youth are looking for guidance and help in bridging the gaps created by our generation and those before us. Many of the problems that exist at present are issues that were not addressed by our generation or previous generations and were either ignored or shoved away.
With that, I would like to point out what the Odawa Native Friendship Centre tries to do for our community members. The role of our centre has come to reflect a traditional one and focuses on the functions of the extended family that are so important in Aboriginal societies. This role have been defined in Aboriginal society in terms of providing support to all members in times of need and crisis. Just as important has been the role of the extended family in providing acceptance and structure within the community. The Odawa Native Friendship Centre has defined its role to the community as providing continuous care from infancy to elder.
Our mission is to enhance the quality of life for Aboriginal people in the National Capital Region by maintaining the traditions of community, ethics, self-help and development, as well as by providing traditional teachings from our elders. These traditions are important because, as Ms. Fisher mentioned, one of our successful intergenerational programs is one where the youth and elders sit together and share their stories and their teachings. It is good that both are learning from each other. We try to promote that as well.
We reinforce the traditions by continuing to promote Aboriginal culture and development and a greater awareness of other cultures and interaction with them. This includes our annual Odawa summer powwow, which is a celebration of Aboriginal culture and is enjoyed by over 20,000 visitors to the Aboriginal community in Ottawa. They include Aboriginals and non-Aboriginals from across Canada, and many come from overseas. Many people from Japan, Germany and Denmark make it a point to visit us every year.
We promote positive Aboriginal images, self-respect and expression through a variety of cultural programs and activities by facilitating the development of skills, knowledge and leadership in Aboriginal youth that will allow them to successfully participate in surrounding communities. We continue to offer a range of services that meet the special needs of Aboriginal people who require assistance in an urban environment.
One goal of the Odawa Native Friendship Centre is to engage our urban Aboriginal youth in activities designed to share values that will lead to the development of strong personal character, a healthy attitude, positive interpersonal relationships, a sense of accomplishment, responsibility and self-respect, with an appreciation of Aboriginal cultural values and practices. This develops leadership, positive family values and an understanding that the strength of a community is derived from the strength of its individuals. This is done in various ways, but mainly through the delivery of programs. One of our programs is called Aboriginal Head Start, which I am sure many of your have heard about. It is one of the government's most successful early intervention programs to help our Aboriginal youth develop at their early stages. There are more than 114 Aboriginal Head Start sites across the country in urban Aboriginal settings. It is a comprehensive program that provides early intervention to First Nations, Metis and Inuit children. It includes six components: protection and promotion of Aboriginal culture and languages, education, health, nutrition, counselling and parental involvement. This program has become such a measurable success with urban communities that is has been mirrored within the First Nations reserve communities.
There are serious issues connected with this program as identified by urban Aboriginal community members and by myself as a former Aboriginal Head Start Council member. I resigned in the spring to protest a lack of action regarding some of these issues.
In the Speech from the Throne on January 31, 2001, and again in the September 30, 2002, Speech from the Throne, it was announced that there was to be an increase in funding. There has been no increase in funding as of yet. It has not been accessible. There is concern that upwards of 75 per cent of any funding will go to on-reserve Head Start programs as opposed to urban centres where, of course, we also require some help.
Aboriginal Head Start was created and designed to be community driven and controlled. It was to be structured to ensure the development of locally controlled projects. There have been instances where disputes have arisen between the funding source, Health Canada's regional offices, and the sponsors, usually Friendship Centres, as evidenced in our case recently at Odawa, for sites that are not self-sponsored. There is no a national dispute resolution mechanism in place. There is no dispute mechanism available to the Aboriginal Head Start sites. A grievance procedure to help address community issues is missing. These groups must pursue costly and ineffective court procedures to address any protest or grievances that they have with Health Canada's regional offices. The delivery mechanism has become autocratically driven, bureaucrat and without due process for the communities.
There are presently no government support or development programs directly aimed at Aboriginal youth ages 6 to 12 delivered by the Odawa Native Friendship Centre, which creates a huge gap in continuing the excellent and healthy foundation built by the Aboriginal Head Start project. While the federal government recognizes that Aboriginal children must be a funding and policy priority, there has been little activity in this area.
One program that helped address our needs within the Friendship Centre was called Little Beavers, but the leader of the Ontario government cancelled it a few years ago. Many youth in this age group often seek to participate in programming for other age groups in order to meet their own needs.
The Ontario Federation of Indian Friendship Centres, the OFIFC presentation, reported the Urban Multipurpose Aboriginal Youth Centres Initiative. On April 20, 2002, they submitted a presentation to the standing committee here. It is a five-year initiative funded by the Department of Canadian Heritage until 2003, I believe.
This initiative was designed to promote the goals of status and non-status First Nations, Metis and Inuit youth by developing projects and activities that are culturally relevant and based in urban Aboriginal communities with a population base of 1,000 or more. The primary objectives are to support and assist Aboriginal youth in enhancing their economic, social and personal prospects. While the initiative is designed to serve urban Aboriginal youth between the ages of 15 to 24, most project participants are between 13 and 21. However, children as young as 10 have participated in projects because of the lack of appropriate programming for their own age group.
Employment and training are other issues. According to information gathered through the OFIFC-Great Initiative, O-GI, which is a province-wide labour market study, there are significant issues and concerns regarding employment and training opportunities for youth in our communities. Results from the same labour market study lead us to believe that clients in the youngest age categories experience the highest unemployment rates. This was presented to you by OFIFC back in the spring, on April 20.
Our Friendship Centre is aware of these issues, and whenever possible, we have begun to offer initial solutions through such programming as that provided by the Urban Multipurpose Aboriginal Youth Centres Initiative and other youth services, such as job readiness or retraining programs.
Another issue is education. Barriers that Aboriginal youth face in completing an education may be the most difficult challenges they face. Success in education will determine their future employment levels, housing conditions, social conditions and other quality of life measures in years to come. There are many reasons our youth leave school prior to completion, including systematic and institutional racism, lack of appropriate cultural programming, a streaming of Aboriginal students to less challenging, non-academic high school programs, school systems not adequately prepared for Aboriginal students, preparing Aboriginal students for high school or college and, in many cases, general lack of hope.
OFIFC has been helping us address this issue with the creation of three native alternative schools. We recently submitted a proposal to one of the schools. These schools are presently located in London, Sudbury and Fort Erie. The schools attempt to address issues that urban Aboriginal youth have in completing school. The schools are in partnership with local school boards and are located at Friendship Centres. The school boards provide teachers and education resources, and the Friendship Centres provide counsellors, Aboriginal-specific curriculum resources, a safe environment and services to help youth succeed. The project was reviewed recently by the Ontario Ministry of Education and Training and was found to be successful. While this is encouraging, more funds are needed in this area.
With respect to economic development, we have already addressed the grinding reality of poverty faced by urban Aboriginal youth, as well as their lack of participation in the labour market and of success in completing their education. Given these three factors, it seems almost impossible that we can encourage our young to become meaningful participants in economic development.
However, the Odawa Native Friendship Centre and OFIFC believe that community-based economic development programs and initiatives are key in encouraging participation of urban Aboriginal youth in the economy. Economic experts have long identified a supportive business development climate, economic development funding, access to capital, access to markets, and support for individual, community and institution capacity-building tailored to the cultural, regional and actual job market as being the essential building blocks of economic participation.
We at the Odawa Native Friendship Centre do not have a surplus of funding; we have a lack of it, and we draw from studies that have already been developed. The statistics are there. There are proven reports, proven statistics, and we tend to draw on the Ontario Federation of Indian Friendship Centres for many of our reports and studies. They are there to help us. We make no excuses. We use their resources on many occasions. We also use the resources of the National Association of Friendship Centres.
Our experience tells us that commonly held stereotypes of Aboriginal youth being lazy or not wanting to better themselves is not true. Our youth would rather have the economic ability to spend money the same way most middle- class Canadians do, to enjoy the ability to live in safe neighbourhoods and to plan and save for the future. However, many of our urban Aboriginal youth believe these goals require a level of financial attainment that they simply have no hope of achieving.
Over the past few years, the federal government has focused Aboriginal economic development initiatives on reserves. This means that very little economic development is encouraged in urban communities, which translates to even less institutional capacity in Friendship Centres to address the economic development requirements of Aboriginal youth.
In speaking with our community members and youth, I have some recommendations to address the gaps in service delivery. I will speak to just a few of those recommendations. As community members, it is our collective responsibility to view the struggles of Aboriginal youth within that context. I would like the Standing Senate Committee on Aboriginal Peoples to adopt the following recommendations.
First, in respect of Aboriginal Head Start we recommend that an equitable split in new funding dollars be allocated to both on-reserve and off-reserve, being Urban Head Start; that a review commence with the objective of having communities look at the overall governance of the program; and that more authority be delegated to the project sites in governing their programs in consultation with other regional Aboriginal Head Start sites.
Second, we recommend that the federal government support and develop programs aimed at urban Aboriginal youth aged six to 12; and that the federal government ensure that Aboriginal children become a funding and policy priority, which is clearly communicated and supported in its interactions with provincial governments.
Third, in respect of the Urban Multipurpose Aboriginal Youth Initiative, we recommend that the federal government ensure that the initiative be renewed and enhanced for an additional five years.
Fourth, in respect of employment, we recommend that the federal government ensure that Human Resources Development Canada works with its regional offices and with urban Aboriginal organizations, particularly the Odawa Native Friendship Centre and the Ontario Federation of Friendship Centres, to direct significant resources toward the development of a comprehensive urban Aboriginal youth employment and training strategy.
Fifth, concerning education, we recommend that the federal government work with urban Aboriginal organizations, such as the National Association of Friendship Centres to ensure a comprehensive and fully resourced strategy that addresses the high secondary school dropout of urban Aboriginal youth.
Sixth, concerning economic development, we recommend that the federal government adopt an interdepartmental approach to developing a comprehensive economic development strategy to ensure that urban Aboriginal youth have equitable access to economic development programs.
Seventh, we recommend that the federal government ensure that urban Aboriginal organizations, particularly the Friendship Centres, are partners in the National Aboriginal Youth Strategy so that the voice of urban Aboriginal youth is represented at the national table.
Eighth, in respect of the inclusion of Friendship Centres, we recommend that the Odawa Native Friendship Centre be included as a full and active partner in its dealings with the Ontario Federation of Indian Friendship Centres, the National Association of Friendship Centres and the Standing Senate Committee on Aboriginal Peoples, with special consideration given to youth-related issues.
Most recently, regarding economic development, we have started an initiative in Ottawa with the Aboriginal Human Resources Development Council. Donna Cona Inc. is another Aboriginal business in Ottawa that has grown to the national level. The business is lead by John Bernard, Willis Business College — Canada's oldest — and the Odawa Native Friendship Centre. The initiative is called ``Technowave.'' We are aiming to bring in 2,000 youth annually to train them in the IT field and to teach them life skills and what it is like to be out in the employment field today.
Senator Hubley: Many questions come to mind, but I would like to speak to the centres. What percentage of Aboriginal people in Ottawa would be familiar with your centres and would make use them?
Ms. Fisher: I would say that at one half of Aboriginals in Ottawa would be familiar with all of our services.
Senator Hubley: Is the model used for your centre in Ottawa the same as the model for other parts of Canada? Would they be the same, including their programming? Are there similarities between the youth centres across the country?
Ms. Fisher: I can only speak for my colleagues across Ontario because this service delivery model is that concept. The 11 centres located throughout the province would have similar programs. Their focus may be different, depending on where they are located. We are fortunate to have physicians in our centre, whereas some centres in the North do not have that luxury. However, they would provide similar programming around the youth. In Ottawa, we are fortunate to have strong partnerships with the City of Ottawa that enable us to deliver different kinds of projects that other locations may not be able to provide.
Senator Hubley: Are you able to identify, within the Aboriginal youth that come to your centre, the leaders of tomorrow? Do you have a peer education program or a peer support program? Is that part of the work at your centre?
Ms. Fisher: I talked about the cyber café, which is a homework club. The name encourages youth to come into the centre. There are 15 kids in the program each night. It is costly, so we can only afford to run the program two nights per week. In the program, youth are able to experience the benefits of mentoring because we have young, university- level Aboriginal tutors to assist these kids. We serve a hot dinner and we provide health education. Many cultural components are attached to the program so there is a holistic approach. We also have a unique HIV/AIDS program called ``Keep the Circle Strong.''
The question was how to deliver the message to young people. We placed a call to the city and asked if anyone wanted to come to the centre to make masks — an art project. All kinds of people came to the centre to make masks of animals. By using traditional images, such as a bear or a mouse, we were able to teach about HIV/AIDS through the masks. A facilitator would wear a mask and talk to the children through the mask. Depending on the age levels, that was probably the most effective way of educating that I have ever seen. We also taught the youth to use the masks, so it became a peer education program.
All of our programming, particularly around our youth, is peer-oriented, in that we try to get the youth to be the teachers.
Senator Christensen: The Wabano centre is a provincial organization, and you mentioned that there are 11 in the province of Ontario. Is the centre provincially funded?
Ms. Fisher: Yes, it is.
Senator Christensen: Does the funding for your programs come from different sources — federal, provincial and municipal?
Ms. Fisher: Yes.
Senator Christensen: We hear about the problem of core funding for long-range planning. Do you have any suggestions for that to take place? All levels of government have difficulty establishing core funding. Do any of you have suggestions as to how this can take place? There are good programs, such as Aboriginal Head Start. We hear, over and over again, that there is uncertainty about how far the program can go because of the funding issue. It may be that when the program really begins to percolate and becomes a useful tool, the funding may suddenly end, taking with it all of the expertise, the momentum and the initiatives used to work with children funding ended. Do you have any thoughts on how we can structure the funding of these programs so that it can be ongoing and provide more certainty?
Ms. Fisher: Funders are tentative when they are developing an idea around what they will do and for how long they will do it. Any pilot project must be for a period of at least five years. For the first two years, you are working through it and working at it. Some projects are one year and others are two years. The strategy renewal is five years in Ontario. For my core, primary health care piece, I only go for renewal every five years. The burden is not so great on us to do our evaluations and so forth. Any substantial program should be at least five years in length. I am sure my colleagues will have further comments on that.
Mr. Jock: I will provide a comment on a general level. Much of the information is contained in the report on Aboriginal health systems that I provided to you. There are two important elements to consider. One is that, in general, the data shows that First Nations people use the hospital system at least two times as much as the average person in Canada. We think it would be similarly true for all Aboriginal peoples.
Similarly, Aboriginal people use physicians approximately two times as often. One way to provide an incentive for people to work together would be to look at a special fund that could be accessed only by federal, provincial and Aboriginal agreement. It would, in a sense, offset some of the increased costs associated with the health care system. Essentially, this could provide an incentive for people to deal with a very real issue and would provide much better access in an appropriate fashion. A good example is Wabano.
As well, if this fund were federally established, it would provide for more sustainability against the changes that happen from province to province. An example I would use would be British Columbia. A good was start made with the Aboriginal health systems. There was a lot of involvement with the regional health districts. With massive cuts to the health system, all of that is really in jeopardy. Looking at a sustainable base and providing incentives based on real agreement with the players, including Aboriginal people, would be a way to construct a logical model to improve access to health care. I throw that out for consideration because I believe any system has to work with incentives. It works best with incentives. I believe that is an example of what might create incentives for sustainable Aboriginal health systems.
Senator Christensen: We appreciate the importance of elders who are available to work with the youth. Do you find in the urban settings that this is a difficult situation to set up? Statistics suggest that it is usually the young people who migrate from the reserves into the urban centres. Are elders available in the urban centres to provide counselling to the younger people who have come from the reserves?
Mr. Lanouette: We presently have a life-long care program in place. I am aware that Wabano delivers a similar program for their elders. It is amazing. We have excellent participation from our elders. You only have to mention that you need a hand or it might be a good idea that they be involved in youth activities, and they are the first ones to volunteer their time. They are there.
Senator Christensen: Have they been in the urban setting for a long time, or have they also come from the rural areas?
Mr. Lanouette: We have a mixture of both. Some of them migrated to the urban centre 20, 30 or 40 years ago. There are also elders who, as they get more elderly, come to an urban centre because health care is more available to them, resources are closer, the shopping centres are closer and so on. They do not have to travel. It is not such a burden to do things for themselves. I am sure Ms. Fisher could expand on this as well.
Ms. Fisher: The fact that you have an environment where people come for all types of care, you will get all ages of elders covering the entire lifespan there.
At Wabano, a large portion of our primary care is for the elderly. Odawa provides service to them through home visits. We provide service to them by picking them up and bringing them to the doctor's office or to a referral. They, in turn, spend a lot of time in our other programming. We have community kitchens. We deal with issues around abuse of the elderly. We have special programming for nutrition issues, such as a dietician for diabetes. A large percentage of the elderly suffer from diabetes. In turn, they are there and they feel that they give something back to their community. That is how we get them involved in our programming. There are a lot of elders around. They have their own special issues related to having to live in the city.
Senator Christensen: Would they be part of a larger extended family unit in the urban area, or would they often be on their own?
Ms. Fisher: We get a mix. We have many Aboriginal elders who are alone, and some have bits of extended family.
We encourage that the participants in our programs make up their extended family, that they make up their aunties, uncles, grandmas and grandpas. People go into these boys and girls clubs and they are mentors, but here the elders become an aunty or an uncle so that they get to participate and develop their own extended family. That is the holistic principle of the centre.
Senator Christensen: Do you find that there is a large uptake from the Inuit in these centres? Certainly, First Nations and often the Inuit prefer to have their own centres.
Ms. Fisher: Wabano does not have that problem because we provide primary care. Half the Inuit population in this city comes to Wabano anyway. Because of that, they begin to get involved in our other programming. We are conscious of the cultural differences, of course. We try to blend the cultures together. They are involved in our community kitchens, our perinatal programs and our elders program.
There are not many Inuit elders in the South. When we have to do an activity that is special to the Inuit, we have to bring an elder down from the North. That area is unique in relation to the lack of elders; it would be in the Inuit community.
Senator Léger: I am fortunate to be a witness of the witnesses. It is unbelievable what I hear in this committee every week.
Mr. Lanouette, I feel that you are a living example of what you are all trying to do, both by volunteering and by living. You have a little enterprise, and therefore you can give of your time.
Beyond statistics, with all that is lacking in the statistics, when someone is poor — white, red, any colour — it brings on depression. Does all depression relate to being poor? I do not know.
Cultural continuity is so evident. I know that the accent must be put on finding solutions. Congratulations, I would have a hard time going through what you and your sister are going through. The way in which you understand her is wonderful. We do not often get a chance to hear such stories.
Elders working with youth is a positive development. What in the whole wide world did we do between today's youth and the elders? We know. You said a few things, Mr. Lanouette, and we are carrying the consequences. Hopefully, we can mend the gap, and that is what you are doing.
Who will be the elders of tomorrow? Perhaps elders can start being elders at a younger age in the sense of wisdom and helping. It is clear that you have youth who are very promising. Everything is relative. You have the elders. Good lord, what happened there?
While you were talking, Mr. Lanouette, I was writing, ``My, my, my.'' Your grandmother and grandfather raised you. That helped, but it is what we did in between.
Mr. Lanouette: We are tomorrow's elders. We must provide positive role models to our youth and show them a good path to follow because there are many paths out there, paths that are easy to follow to crime, violence and drugs. We do not want them to follow those paths. We try to portray a healthy past.
There are struggles along the way. There is a lack of time, resources and people to help, but one must persist. The underbrush gets cut away, and you can make the path wider for someone else to follow.
[Translation]
Senator Gill: In my opinion, I think you described the situations in a fairly realistic way, I come from Northern Québec, and I believe it is the same inside communities and outside communities.
It is obvious that outside communities are the products of the communities. This gives us an idea of the picture and the situations that exist practically everywhere, on reserves, and obviously off reserves.
In fact, I congratulate you for your realism; you mentioned several times that youth lacked hope, were in fact often on the verge of despair and of committing a fatal act, which is suicide, or other things that happen in society.
You mentionned, a few times, that there have been accomplishments. You have had help regarding these accomplishments; whether from the Department of Indian Affairs, the Secretary of State, or the Department of Human Resoures. These projects were often relatively sucessful, and then budgets were cut. Did this happen often? I would imagine.
I know you were prepared and that you collected statistics on the situations of your organization. What are your expectations as you appear before our Committee? I would imagine you have expectations when appearing before the Commons committees. When appearing before the Senate Committee, what are your general expectations as regards the situations you describe and the solutions you would like to see?
Mr. Lanouette: You heard our recommendations: that we be included in the development of new improvement programs for Aboriginals; and, that we be considered in program progression and that we reach an agreement.
[English]
Ms. Fisher: Today we have given you some examples of how community-based programs actually work in a city. It is my hope that we deliver service to our communities in the urban centres based on our culture and our strengths. I want the committee to understand that we are able to do that, and we have proven that we have been able to do that. However, we need support in maintaining resources. I deal with this day in and day out.
Youth comprise 27 per cent of the homeless Aboriginal population in the city of Ottawa. HRDC funnelled money through the City of Ottawa, and we had a two-year program. We were frequently asked how we would sustain the project. I know that I will not be able to sustain the project. I am giving service to a group of people that will never get service unless I give it to them and unless others think about these people.
What will I do in April? I have set up programs and partnerships. I have tried to find ways that our youth will at least have a place to live in times of emergency. We provide food in a partnership with non-Aboriginal community health centres. That will end.
We are in a difficult situation, and this is the message. If we do not get support and sustainable funding, we will be lost. We will solve the problems, but we cannot do it without those resources.
Mr. Jock: In terms of improving health, there is interest from two ends. One is the need to improve Aboriginal health systems. Some examples were referenced today of systems designed and governed by Aboriginals in our organization. We think that is the way to proceed. Such a system should systematically be put in place across the country so that we have these best practices across the country.
We must recognize that the determinants of health are also important. Part of the plan is to determine how to deal with those determinants of which we have spoken. We need to focus on education, employment and future interests, one of which is self-determination, as ways of fundamentally changing that relationship. We promote those things as an organization, and we support you to do the same as you develop your recommendations.
Health is a key issue. It may be a way to get people organized and committed. It is fundamental to all the people living in this country.
The Acting Chairman: I was struck by your comment about Aboriginal Head Start. I have heard from a number of sources about some of these issues around governance and inequities, particularly regarding the development of a focus to on-reserve rather than off-reserve, which does not make much sense to me. We will look at it carefully.
You made practical comments about the need for grievance mechanisms and dispute resolution. These issues arise when a program has been around for a while. You begin to find out some of the issues around controlling it. I appreciate those comments, and you might elaborate more on that in a minute.
You commented about school retention and the issues related to education and so on. Those are big issues for young people. I have spent much time with the Ottawa School Board, and I am struck by your comments on vocational training. They are telling us that vocational schools are not attracting young people. They are providing a lot of education in highly remunerated professions. The average age of bricklayers now is 56 years. There is a entire stream of trade opportunities that are not being pursued, not only for Aboriginals but for the entire population. Somewhere along the line we have gone astray as a society in devaluing the work that these people do. Immigrants are doing much of this work.
Ms. Fisher, pregnancy, sexuality and early childhood development are fundamental to finding long-term solutions. The conditions in which young people become pregnant affects the building of families. I would like you to comment on the importance of family bonding, going beyond the usual good parenting to include family bonding, which is important because it gives children models. Children need an entire set of aunts, uncles and grandparents.
I am encouraged by some of the research. There was the first apparently big international discussion about the role of grandmothers. No discipline has ever looked at that role. I would be interested, Mr. Lanouette, if you could tell me whether you were speaking about your maternal or paternal grandmother.
Mr. Lanouette: My maternal grandparents.
The Acting Chairman: It is the maternal grandmother that has a big influence on the well-being of children.
This entire question of the sensitivity of a girl when she is pregnant is important. I am assuming you are giving care to pregnant girls to some extent. It is a time when girls are sensitive to making changes.
When one is pregnant, there is a kind of openness to change that one may not have later in life with changes in lifestyle. I would be interested in your programming around these girls and young women. This is a concern when it is tied to FAS and other drug use. I learned yesterday about a centre in Montreal that deals with babies addicted to methadone. A girl who had methadone was told she had to continue taking methadone while she was pregnant. If she quit methadone, the baby might have suffered a heart attack because the baby was addicted in the womb. There are some odd messages out there. I would be interested if you could inform us about the programming for these young people who might be suffering from drug addiction. What helpful suggestions do you have for us?
Mr. Lanouette: Aboriginal Head Start was announced in the Speech from the Throne in 1995. Proposals were being accepted in 1996. It is somewhat of a new program, but it is not a new program.
I have done work at the national level on dispute resolution mechanisms, but I do not know how the discussions have progressed.
There are some issues in the national office about who owns the program. Is it the community or is it Health Canada? I believe the community owns the program.
When someone brings in a new program, they develop a sense of ownership. That is human nature. However, you must be able to let that go. Some people at Health Canada are not letting go. They have to let someone else manage the program.
Your mind is set at a young age on staying in school. I have two young children. It surprises some people. I have an eight-year-old son and a five-year-old daughter. We waited a long time before having children.
The educational mindset begins at a very young age. My son participated in the Aboriginal Head Start program for three years. He then went to Grade 1. His reading, language and math skills were that of a child in Grade 2. My daughter participated in Head Start for one year. She is in senior kindergarten now in a school that teaches in both French and English. We wanted them to be raised as bilingual students. It will certainly give them advantages over other students as they get older.
I speak three languages. I speak Algonquin, French and English. It has certainly helped me.
We must help youth to understand that they will get nowhere without an education. I dropped out of high school in Grade 10. I was taking Grade 12 physics, chemistry and computer courses. I got bored and quit.
I became involved with some pretty bad dudes when I was young. I decided to change my life around. I joined the Canadian Armed Forces. I spent a number of years in the forces. I got my high school equivalency diploma. When I left the Armed Forces, I took a job driving taxi in Ottawa in 1979. I went to Carleton University and studied political science and Aboriginal history.
What I picked up on the streets is that everyone needs an education. You need to further your own education and your own mindset. That helped me. I do not have the solutions about how we keep kids in school. I can certainly share experiences with them and tell them why they need it, but every individual is different. What will motivate them to stay in school to learn is different. Everyone has different motivation. Some people are motivated by praise; others by money. Everyone is different.
As for school retention, studies have been done by the Ontario Federation of Indian Friendship Centres and other centres. There is a youth council within the National Association of Friendship Centres, and it is looking at this area. I would be happy to encourage them to share their findings with you.
Much of what is instilled in a person is brought to them by the maternal grandmother. In my case, she was a school teacher on our reserve and was one of my teachers when I was a kid.
The Acting Chairman: You are a good role model.
Ms. Fisher: There are not a lot of resources around for young moms. In our centre, we use all of our programming to help new individuals coming into the centre. We call that a circle of care. Initially, the mom or the young woman coming in for a discussion with the nurse practitioner on sexuality — and it gets to that eventually, although she may have been there to get treatment for a sore throat — is given the tools to access the resources around her. She would be immediately referred to a grandmother because we know that it is important that there be someone older in her life to talk to. That does not mean a doctor or a nurse practitioner. They are part of that circle of care, but she would link up immediately with a grandmother who would be willing to be her grandmother or aunt. That is the critical element. We do that in all our programs, such as our prenatal program. If these individuals do not have an extended family, we immediately have someone there for them. An elder is as important as the health care provider at the beginning stage.
Also, we recognize that culture is an important element. Many people are searching for that element. Through the teachings of respect, we hope that young single moms will begin to recognize and to search out those things for themselves. They have access to sweat lodge ceremonies and then basic things such as community kitchens. In community kitchens, they are able to socialize with other moms, where other moms teach moms.
If we had a lot of money, or a set program, we could start to do other things related to addictions. There is nothing in our centre that enables us to work on addictions at the present time, except through our doctors and nurse practitioners. For addictions, they would be referred most likely.
We encourage mothers and young people to be involved in activities such as community kitchens, ceremonies and celebrations. That is the best we can do.
The Acting Chairman: It is a very good start. The addiction issue is connected but separate. We all know there are not enough resources for young people with addictions.
Ms. Fisher: The real key with our clients is the cyber café program for 13 and 14 year-olds. That is where they pick up the need for education. That is where we can make a difference. We struggled to get the money for that cyber café. There is no money out there that says that we can have that wonderful program. However, that program has most impact by far. They get to talk about sexuality or anything they want to talk about. We can direct that talk. The environment is safe and accessible for them. We can start to talk about parenting and what that means. What is a parent? Those chats enable them to talk to their own parents.
We have a program at the centre called the child and art therapy session. We have a full time art therapist. We use art therapy as a form of allowing kids and their parents to communicate. We refer to that program to allow a young woman to start to learn about communication. There are all these elements, but multiple programs must wrap around that individual.
Senator Sibbeston: I come from a rural setting in the Northwest Territories. People live in small communities and native peoples eventually migrate to larger centres like Yellowknife. The plight of the Aboriginal people in the North is not bad, in part because they are numerous enough that they are not overwhelmed by the non-native population. I see elements in our northern society that make it possible for native people to succeed and do reasonably well and feel comfortable about themselves.
You are talking about the plight of Aboriginal people in the cities, which is difficult and challenging. I do not know a great deal about it because I have not lived a lot of my life in the urban centres. However, when I think about the northern and the rural settings, they are mostly inhabited by Aboriginal people. In terms of hunting and trapping, Aboriginal people were on the land. That is where all Aboriginal peoples came from and, to varying degrees, have moved away from.
In the North, I feel fortunate because you can still go hunting, speak your language and be among your own people. We are creating a society where native people can still do well. You can be educated and have a role in government. We have Aboriginal people heading our government as ministers. We are also creating an economy where native people are involved in the economy. We have diamond mines in Yellowknife. I was up to a mine about three weeks ago, and Aboriginal people are involved in that mine. The trucks, the catering and the accommodation are owned in part by Aboriginal people. In this way, native people are involved.
I imagine the difficulty with native people in urban settings is that the circumstances are not like that. They are overwhelmed by numbers. They are a minority in a big society. As native people live in a city, it becomes more and more difficult for them to relate and understand who they are because there is not that encouragement. There is not that foundation of language and culture. Somehow or another you must keep that alive and grasp at the things make you unique, apart from your colour. I can appreciate that challenge.
On the other hand, my wife is not native. She has always encouraged me. She has told me, ``There are many good things about you, and Canadian society can learn and benefit from you.'' Any approach you take, such as your holistic approach to medicine, can be a contribution to Canadian society. The things that you do culturally, and so on, can be an inspiration. They are unique and can certainly add to the mosaic and colour of Canada. It is a real struggle.
I must admit that the information you have given is overwhelming. How can we digest it? We cannot say much today because there is a lot of information to read. Then we can decide what we can do.
Our challenge is to find a way to improve the lives of Aboriginal people, particularly the young people in urban centres. We have a difficult task. We must delve into the story of the migration of Aboriginal people to cities and their struggle to somehow recreate their lives. With migration comes poverty and the difficulties of dealing with mass society.
I understand the difficulties. When our report is done, I hope that we can, in a small way, make recommendations or say things that can contribute. That will be the challenge because what we say or do must be relevant. It must be strong. It must be clear enough that governments can take it and determine that if they do certain things, there will be a definite improvement in people's lives. That is the task we have.
I appreciate what you have contributed to us today. Through time, we will be able to sift through it and take what we can out of it.
Ms. Fisher: If you have the time, senators, I suggest that you visit the centre. If we could walk you through the entire process, you would have a good sense of how this service is delivered in a holistic way. We are located at 299 Montreal Road.
Mr. Lanouette: Every Thursday we have a traditional meal at the Friendship Centre, and it is open to the public. You are more than welcome.
Mr. Jock: We did not touch on health careers among Aboriginal people. As we do have a very young population, perhaps we should be seen more strategically as the folks who can take care of the rest of the population as it ages. A real investment in health and social development, as per the recommendation of the royal commission, might be an interesting focus for our youth.
The Acting Chairman: Thank you to everyone on the panel. It has been an interesting morning.
Honourable senators, we have business to discuss on the budget. We will continue our public meeting, without transcription.
The committee continued in public.