[SOLVED] Community-based pandemic preparedness

Question 1 (Reading) Community-based pandemic preparedness

1.a

Read the following article:

Kyoon-Achan, G. & Write, L. (2020). Community-based pandemic preparedness: COVID-19 procedures of a Manitoba First Nation community. Journal of Community Safety & Well-Being, 5(2), 45-50. https://doi.org/10.35502/jcswb.131

a. Write a 3-2-1 report in the usual fashion.

Question 2 (Regular)

In this question, you will be asked to interpret the pandemic preparation procedures you read about in Question 1, using a medicine wheel developed by The Centre for Wise Practices in Indigenous Health, Women’s College Hospital, Toronto.

This medicine wheel is available as a one-page PDF at:

Kish (Bell), B. K., Kish, S. et al. (n.d.). INDIGENOUS WELLBEING in the Times of COVID-19: Four Directions Virtual Support Hub. https://www.womenscollegehospital.ca/assets/pdf/IndigenousHealth/8.5X11-RGB.pdf

If you have trouble accessing that file, it was also reproduced as the only illustration in the following article (which you do NOT have to read, but which some of you may find interesting):

Richardson, L. & Crawford, A. (2020). COVID-19 and the decolonization of Indigenous public health. CMAJ, 192(38), E1098-E1100. https://doi.org/10.1503/cmaj.200852

At the top level, this medicine wheel is divided into four directions:

East (Red): Spirit, Seeking
South (Yellow): Heart, Engaging
West (Black): Mind, Understanding
North (White): Body, Activating

Each of those four directions itself has a medicine wheel with four directions and colours.

Before you can answer questions based on a medicine wheel, it’s important to familiarize yourself with the concept and how to use it. I have prepared two paths for you to gain the basic, introductory understanding that you will need: one path involves reading, and the other one involves watching videos. You should pick one, but are welcome to try both.

2.a (No marks)

Learn about the concept of the medicine wheel by making use of some or all of the resources below. Note that the medicine wheels they describe may be slightly different than the one you will study (e.g. having the colour yellow associated with the East, rather than the South), but the basic concepts are the same.

Complete the following Reading OR Viewing OR both.

Reading:

Bell, N. (2014, June 9). Teaching by the Medicine Wheel: An Anishinaabe framework for Indigenous education. https://www.edcan.ca/articles/teaching-by-the-medicine-wheel/

Smith, C. M. (2018, October 3). How I use the teachings of the Medicine Wheel in my healing journey. https://healthydebate.ca/opinions/medicine-wheel/

Viewing: (5 + 5 + 10 + 5 + 9 = 34 minutes total)

Tribal Trade Co. (2020, June 19). What is the medicine wheel? (Medicine wheel teachings 101) [Video File]. https://youtu.be/S7nb4rJ_N14

The Preservation Project. (2019, July 15). What is the Medicine Wheel? Teachings by Jeff Ward [Video File]. https://youtu.be/bSw0s8rcuSg

Tribal Trade Co. (2020, April 16). Medicine Wheel TEACHINGS (NATIVE Medicine Wheel System EXPLAINED!) [Video File]. https://youtu.be/LSfrWcmngdY

Tribal Trade Co. (2020, June 25). Medicine wheel colors (Medicine wheel teachings, and what do the colors mean?) [Video File]. https://youtu.be/wBMNxSyIZyU

Tribal Trade Co. (2020, September 3). How to use the Medicine Wheel (For Spiritual Wellness and Overall Health) [Video File]. https://youtu.be/YKVkJm5hhNM

2.b

Now it’s time to go back to the pandemic preparation from Question 1, and the Medicine Wheel developed by The Centre for Wise Practices in Indigenous Health.

Go through the 11 steps of the pandemic planning and preparation from Question 1, and explain what parts of what steps fit into the four quadrants of the medicine wheel drawn by The Centre for Wise Practices in Indigenous Health. For full marks, you should take into account that each of the four directions of this medicine wheel has its own medicine wheel within it.

i. What part(s) of the pandemic preparedness plan corresponds to East (Red): Spirit, Seeking?

 

 

 

 

ii. What part(s) of the pandemic preparedness plan corresponds to South (Yellow): Heart, Engaging?

 

 

 

 

iii. What part(s) of the pandemic preparedness plan corresponds to West (Black): Mind, Understanding?

 

 

 

 

iv. What part(s) of the pandemic preparedness plan corresponds to North (White): Body, Activating?

 

 

 

 

 

2.c

Earlier in this course, you were introduced to how CADTH suggests that decisions about health technology (and related interventions) be assessed.

In particular, the section of the CADTH guidelines dealing with Perspective mentions what it believes should be included in an assessment made from a Societal perspective.

The benefits and costs of a technology or intervention are summarized on page 30 of the PDF version of the CADTH guidelines:

https://www.cadth.ca/sites/default/files/pdf/guidelines_for_the_economic_evaluation_of_health_technologies_canada_4th_ed.pdf

Once those costs and benefits are taken into account, they are analyzed using ICER analysis, and this is used to make a decision about whether or not to engage in the proposed health intervention (or to choose between different possible interventions).

i. How are the ways in which CADTH and the medicine wheel view health interventions (costs, benefits, how to decide what to do) similar?

 

 

 

 

 

ii. How are the ways in which CADTH and the medicine wheel view health interventions (costs, benefits, how to decide what to do) different?

 

 

 

 

2.d

In this question, you will be asked about two-eyed seeing: using a combination of Western and Indigenous ways of knowing to achieve better health care outcomes.

From (Martin, 2012):

“Two-eyed seeing is a concept introduced to the world of research by Mi’kmaw Elders Albert and Murdena Marshall from Eskasoni, a First Nation in Cape Breton, Nova Scotia. […] It stems from the belief that there are many ways of understanding the world, some of which are represented by European-derived (Western) sciences and others by various Indigenous knowledge systems and sciences. Albert Marshall contends that aspects of both Western and Indigenous ways of knowing about the world are important for Indigenous communities. If we learn to appreciate multiple perspectives, we can draw on what is useful and relevant to inform and build upon our existing knowledge. Essentially, we can learn to ‘see through both eyes.’ Two-eyed seeing stresses the importance of being mindful of alternative ways of knowing (multiple epistemologies) in order to constantly question and reflect on the partiality of one’s perspective. It values difference and contradiction over the integration or melding of diverse perspectives, which can result in the domination of one perspective over the others. As a result, one “eye” is never subsumed or dominated by the other; rather, each eye represents a way to see the world that is always partial. When both eyes are used together, this does not mean that our view is now ‘complete and whole,’ but a new way of seeing the world has been created — one that respects the differences that each can offer.” (Martin, 2012, p. 31)

We will cover two-eyed seeing in class, but just in case you feel you need more information (or if you’re starting work on this assignment early!), I recommend the following sources:

Peltier, C. (2018). An Application of Two-Eyed Seeing: Indigenous Research Methods with Participatory Action Research. International Journal of Qualitative Methods, 17, 1-12. https://doi.org/10.1177%2F1609406918812346

The Peltier paper is shorter (12 pages) and provides details about applying Two-Eyed Seeing, which may make it easier for some students to ‘get’ what two-eyed seeing is all about.

Martin, D. H. (2012). Two-Eyed Seeing: A Framework for Understanding Indigenous and Non-Indigenous Approaches to Indigenous Health Research. Canadian Journal of Nursing Research, 44(2), 20-42. https://cjnr.archive.mcgill.ca/article/view/2348

This is a longer article (22 pages) that discusses the philosophy of two-eyed seeing. I’m aware that some students have been very interested in the philosophy behind the techniques we study in class – this paper may appeal to those students.

i. Do the pandemic preparation procedures you read about in Question 1 count as an example of two-eyed seeing? Why or why not? For full marks, be specific and give examples.

 

 

 

 

 

ii. In the context of Canadian health care, two-eyed seeing has been used mostly in the context of health interventions in which Indigenous people are important participants. Do you think that two-eyed seeing should be restricted to health interventions in Indigenous communities, or is it more widely applicable? Briefly explain your reasoning.

 

 

 

 

 

Question 3 (Challenge)

In this question you will be considering a recent change in BC regarding access to care for gender-affirming surgeries for transgender patients along with a World Health Organization definition update with regards to Transgender Care in BC.

“Previously, to receive publicly funded gender-affirming breast augmentation or chest construction procedures, people had to travel to Vancouver or Victoria. For those seeking lower surgery, people were required to travel to Montreal or out of the country.”7 (BC Gov News, 2018)

Now, people across the province will have easier access to gender-affirming surgeries and will not be required to travel out of province for lower surgery.

“Reconstructive gender-affirming surgeries will be available within Vancouver Coastal Health starting in 2019. In addition, trans people throughout the province now have improved access to publicly funded gender-affirming chest and breast surgeries. A total of 14 surgeons will provide these surgeries in Burnaby, Kamloops, Kelowna, Port Moody, Prince George, Vancouver and Victoria.” (BC Gov News, 2018).

The World Health Organization updated the global manual of diagnoses and no longer classifies Transgender health issues as a mental or behavioural disorder.

“ICD-11 [International Statistical Classification of Diseases and Related Health Problems] has redefined gender identity-related health, replacing diagnostic categories like ICD-10’s “transsexualism” and “gender identity disorder of children” with “gender incongruence of adolescence and adulthood” and “gender incongruence of childhood”, respectively. Gender incongruence has thus broadly been moved out of the “Mental and behavioural disorders” chapter and into the new “Conditions related to sexual health” chapter. This reflects evidence that trans-related and gender diverse identities are not conditions of mental ill health, and classifying them as such can cause enormous stigma. Inclusion of gender incongruence in the ICD should ensure transgender people’s access to gender-affirming health care, as well as adequate health insurance coverage for such services.”8 (WHO, 2019).

7 BC Gov News. (2018, November 16). B.C. brings gender-affirming surgery for trans people closer to home. Retrieved March 25, 2022, from https://news.gov.bc.ca/releases/2018HLTH0106-002209
8 WHO. (2019). Who/europe brief – transgender health in the context of ICD-11. World Health Organization transgender health in the context of ICD-11. Retrieved March 25, 2022, from https://www.euro.who.int/en/health-topics/health-determinants/gender/gender-definitions/whoeurope-brief-transgender-health-in-the-context-of-icd-11
You will review the BC Government news release, WHO Brief, and find other sources as you feel necessary to answer the following questions.
https://news.gov.bc.ca/releases/2018HLTH0106-002209
https://www.euro.who.int/en/health-topics/health-determinants/gender/gender-definitions/whoeurope-brief-transgender-health-in-the-context-of-icd-11

In the following question you will discuss how these recent policy/access to care changes relate to Canada’s Social Determinants of Health, and the Medicine Wheel explored in question 2.

For each question, clearly state whether you are referring to the BC Government News Release, WHO Brief, or both of them.

3A

Choose two of Canada’s Social Determinants of Health, clearly state your chosen social determinants of health, and discuss how they relate to the above articles.

i. Social Determinant of Health 1: _______________

Discussion:

 

 

 

ii. Social Determinant of Health 2: _______________

Discussion:

 

 

 

 

3B

Choose two directions from the Medicine Wheel developed by The Centre for Wise Practices in Indigenous Health in Question 2, clearly state your chosen directions, what they stand for, and discuss how they relate to the above articles.

i. Medicine Wheel Direction and Meaning 1: _______________

Discussion:

Community-based pandemic preparedness Community-based pandemic preparedness Community-based pandemic preparedness Community-based pandemic preparedness Community-based pandemic preparedness Community-based pandemic preparedness Community-based pandemic preparedness

 

 

 

ii. Medicine Wheel Direction and Meaning 2: _______________

Discussion: