Context
When conducting health research in the NWT, researchers should take the time to understand that history in a context that promotes improvement of the survival, dignity and well-being of Indigenous peoples.
The NWT is more than one million square kilometers, with a population of 45,000 people spread among 33 mostly remote communities, many without all-season road access. Indigenous people (First Nations Dene, Métis and Inuvialuit) are 50% of the NWT population, with nine recognized Indigenous official languages alongside English and French.
Colonization throughout the 1800s and 1900s brought about a transition from nomadic land-based cultures to permanent settlement and the introduction of the fur trade in the NWT. It also introduced disease epidemics, residential schools, forced dislocation, and disrupted cultural and family practices. Colonization has had profound and ongoing traumatic impacts on psychological, environmental, social, and family health. Since the 1970’s, the political landscape of the NWT has been transformed by the negotiation of Indigenous land and self-government agreements with the federal and territorial governments, which recognize Indigenous authority over lands, resources, and social programs, including health and well-being.
Health Impacts
The history and ongoing effects of colonization have led to sharp differences in social determinants of health outcomes between Indigenous and non-Indigenous residents of the NWT. Without cultural understanding and trauma-informed approaches, the health system has failed to connect with many Indigenous residents. In recent years this has become an area of focus for the GNWT, and in 2019, a Cultural Safety in the NWT Health and Social Services System plan was developed, marking a start toward normalizing culturally safe health care provision in the NWT.
Effective and culturally safe health research is critical to improving the NWT health system, however there are many research gaps (Young, 2003). Communities tend to have low trust in the health system and in research, due to a colonial legacy of vulnerable Indigenous adults and children being subjected to degrading health research and treatment (Mosby, 2013; Drees, 2013). While some negative experiences occurred years ago, there continue to be recent examples of culturally unsafe care, including in the NWT, that support this distrust (Smylie, 2015; Hildebrandt, 2015).
United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP)
UNDRIP was adopted by the UN General Assembly in 2007 and has been fully supported by Canada since 2016. Both the Truth and Reconciliation Commission of Canada (2015) and the final report of the Missing and Murdered Indigenous Women and Girls Inquiry (2019) have called for implementing UNDRIP as a basis for institutionalizing practices in Canada that promote cultural safety and ensure legal and human rights of Indigenous peoples are respected. In 2019, the GNWT identified implementing UNDRIP as one of its top priorities. Researchers and others who wish to work in the NWT, particularly with Indigenous communities, must be familiar with these areas to work ethically and effectively.
Working in the NWT
Indigenous communities and governments in the NWT have expressed the need to ground health and wellness programs in community priorities, Indigenous culture, and land-based traditions. Incorporating this wisdom into the design and delivery of health research and programming is vital. In particular, land and land-based approaches play an active role in health and well-being in Indigenous communities in the NWT. Hotıì ts’eeda requires that research work it supports use community-based approaches and be led by or conducted in partnership with Indigenous communities and governments. Hotıì ts’eeda's also focuses on building cultural competence among NWT health and social services professionals, working towards a culturally safer environment for Indigenous patients and clients.
When conducting health research in the NWT, it is critical that researchers build projects based on community health and wellness priorities. Research priorities in the NWT come from communities, organizations, Indigenous governments, and the Government of the Northwest Territories. Specific research priorities can be found on the web pages of those organizations. Indigenous and community governments also have wellness plans that indicate priorities. Hotıì ts’eeda recommends that researchers undertake cultural competency training and be prepared to learn about, and adapt their research plans to fit, local Indigenous priorities.