Hotıì ts’eeda – Working together for good health
Dr. Stephanie Irlbacher-Fox
This special issue of Northern Public Affairs on Working Together for Good Health is published in partnership with Hotıì ts’eeda.
Hotıì ts’eeda is funded by the Canadian Institutes of Health Research Strategy for Patient Oriented Research (SPOR), and is one of 11 such health research support units in each province and the NWT (with Yukon and Nunavut units in planning stages). SPOR SUPPORT (Support for People and Patient-Oriented Research and Trials) units are meant to promote and establish best practices and their uptake, by involving patients in all stages of health research, and ensuring that health research results make it into the hands of health policy makers.
In the provinces, SPOR SUPPORT Units look and function differently from Hotıì ts’eeda: Those units focus mainly on health research being done in hospitals or by scientists, health sciences researchers and medical practitioners, and in the context of larger scientific and Western medical initiatives. The provinces have significant physical infrastrucutre (hosptials, univerisites) and health researchers and professionals, as well as university students involved in unit activities. In the NWT, only four communities have hospitals, and there is no university. The context for doing research, and doing research in a good way, is completely different.
Hotıì ts’eeda is the only SPOR SUPPORT Unit in Canada that is hosted by a self-governing Indigenous government, the Tłı̨chǫ Government. It is the only one with a governing council made up of a majority of Indigenous governments working together toward a vision that sees building health research approaches and health research capacity with a focus that incorporates Indigenous knowledges and ways of knowing. The Governing Council of Hotıì ts’eeda includes representatives of the Inuvialuit Regional Corporation, the Gwich’in Tribal Council, the Délı̨nę Got’ı̨nę Government, the Government of the Northwest Territories Department of Health and Social Services, and the University of Alberta Department of Medicine’s Global and Indigenous Health Research Group.
“Hotıì ts’eeda” (pronounced Ho-tee’ t’say-dah) in the Tłı̨chǫ language roughly translates into: working together for good health, in a way that we leave each other in a state of grace.
In the NWT, Indigenous Peoples have suffered a long history of overcoming colonization and its impacts. As an organization, Hotıì ts’eeda involves patients in health research primarily by building health research capacity with a focus on Indigenous Peoples and communities, in ways that build on Indigenous strengths.
Themes explored in this issue include how to build trust between Indigenous communities and the health system. Building trust requires working in a way that supports Indigenous reclamation of Indigenous governance and control of health research, acknowledging and valuing Indigenous knowledge and methods, and changing commonplace and harmful approaches to conceptualizing, interpreting, and deploying research in ways that are harmful to Indigenous Peoples and communities. It means transforming research paradigms grounded in non-Indigenous perspectives, values, and priorities that emphasize deficits, and instead supporting research that builds on Indigenous cultures and realities, recognizing them as strengths.
Too often the stories we hear about Indigenous health and Indigenous Peoples highlight deficits. Programs and services often require Indigenous Peoples to change to fit into what is being offered. Hotıì ts’eeda’s partners and Governing Council have been clear: this organization is one that must meet Indigenous people where they are at, and it must recognize and build on the strengths in Indigenous communities. This is an orientation of respect, and it is in contrast to approaches that marginalize Indigenous Peoples.
The name of our organization is also our mission: To establish norms in health research where the work undertaken and accomplished is done in a way that researchers and their partners, communities and policymakers, organizations and funders leave each other in a state of grace. That is the foundation of any good relationship: Respectful collaboration that lays the ground work for a context of trust and ongoing relationship. Colonization and colonial approaches to research leave no one in a state of grace. Dominant-subordinate power relations, in whatever context they are found, leave no one in a state of grace. Working respectfully, in partnership, and in ways that create spaces for Indigenous control and decision making, is central to Hotıì ts’eeda’s mandate.
Some of the contributions in this volume are drawn from keynote addresses to partners attending Hotıì ts’eeda’s annual Ełèts’ehdèe which was held on Chief Drygeese traditional territory of the Yellowknives Dene in May 2019. The Ełèts’ehdèe (Tłı̨chǫ for “Gathering,” and pronounced Eh-chhlet’s -ay-day) is a central part of Hotıì ts’eeda’s governance, modeled on annual gathering of NWT Indigenous peoples as a way to provide in-person accountability in a context of reciprocity and relationship. At the Ełèts’ehdèe, researchers, cultural knowledge holders, Elders, and Indigenous experts gather to share their stories and best practices, receive Hotıì ts’eeda’s oral annual report, and provide direction on priorities for the upcoming year. The contributors in this volume embody approaches to Indigenous health that are based on honouring the resurgence of Indigenous culture and Indigenous strengths. The work they do is a testament to the potential of Indigenous Peoples to redefine their present and futures, in the face of both historical and ongoing colonization and its impacts.
This special issue highlights examples of excellence and innovation, where communities are leading the way on their health priorities and partnerships are being created that embody the meaning of working together for good health. Some examples describe areas where more needs to be done, and others highlight where momentum is growing across the NWT. The intention of this volume is to provide readers with a deeper understanding and appreciation for the importance of Indigenous cultural resurgence as a basis for good health. And an appreciation of the importance of working together in ways that support wellness for all individuals and communities in the Northwest Territories. ◉
Stephanie Irlbacher-Fox is the founding Scientific Director of Hotıì ts’eeda. Stephanie grew up in Inuvik, NT, graduating from Samuel Hearne Secondary School. She went on to earn a BA and MA in Political Science at the University of Alberta, and received a PhD from Cambridge University during 2005, where she was a Major Scholar at Magdalene College during her studies. She is the author of numerous academic books and articles, including Finding Dahshaa: Self Government, Social Suffering and Aboriginal Policy in Canada (UBC Press, 2009), a standard text in Indigenous Studies programs at many Canadian universities. For the past two decades Stephanie has worked for Indigenous Peoples’ organizations across the NWT on treaty negotiations and treaty implementation. She has a long-standing interest in the effects of government policy choices for social determinants of health. She is an Adjunct Professor at Carleton University’s School of Public Policy and Administration.