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“Every One of Us Is a Strand in That Basket” Weaving Together Stories of Indigenous Wellness and Resilience From the Perspective of Those With Lived and Living Experience With HIV/Hepatitis C Virus



This article primarily focuses on the stories shared by Indigenous women with living and/or lived experiences of HIV/hepatitis C virus from the Vancouver Downtown East Side who attended the "Awakening our Wisdom" retreat. Weaving together the story of an Indigenous approach to research that informed the design of the retreat and the findings that emerged, a basket is formed that highlights the ways settler-colonialism within Canada has produced a system of health care that has neglected the Indigenous experience. The emerging themes of Connection, Disconnection, and Reconnection offers teachings for Indigenous journeys of resilience and wellness for those living with HIV/hepatitis C virus. These findings may help health care practitioners identify health care places and spaces that are in need of decolonization and offer, from an Indigenous perspective, the next steps forward for a health care system that promotes Indigenous engagement and retention in care.
Research Article
“Every One of Us Is a Strand in That Basket”: Weaving
Together Stories of Indigenous Wellness and
Resilience From the Perspective of Those With Lived
and Living Experience With HIV/Hepatitis C Virus
Luke Heidebrecht, PhD Candidate* Subhashini Iyer, MSc, MPH • Sandy Leo Laframboise •
Claudia Madampage, PhD, MPH Alexandra King, MD, FRCPC
This article primarily focuses on the stories shared by Indigenous women with living and/or lived experiences of HIV/hepatitis C virus from the
Vancouver Downtown East Side who attended the “Awakening our Wisdom” retreat. Weaving together the story of an Indigenous approach to
research that informed the design of the retreat and the findings that emerged, a basket is formed that highlights the ways settler-colonialism
within Canada has produced a system of health care that has neglected the Indigenous experience. The emerging themes of Connection,
Disconnection, and Reconnection offers teachings for Indigenous journeys of resilience and wellness for those living with HIV/hepatitis C virus.
These findings may help health care practitioners identify health care places and spaces that are in need of decolonization and offer, from an
Indigenous perspective, the next steps forward for a health care system that promotes Indigenous engagement and retention in care.
Key words: decolonization, healing, HIV/HCV, indigenous methodologies, land-based research, resilience, wellness
“Any Aboriginal Type EventIs a Gift in
Itself”: Situating the Research
Since I was 15,
I always had to do everything
for myself
including learning.
Im looking for peace,
Im looking for truth,
Im looking for trust,
Im looking for ethics,
Im looking for honesty.
Transparency (Victoria, Sharing Circle, March 24, 2017)
Over an hour into a sharing circle, Victoria reflected
on her experience sitting in a circle of Indigenous
women who were weaving something new and some-
thing safe, or as she said, Im looking for people who
arent afraid to speak the truth, that I can ally with, and
relate to, and talk to.Victoriaand13otherwomen
were invited to participate in a 4-day, Indigenous-led,
land-based retreat that took place in March 2017. The
retreat was called Awakening our Wisdom (AoW) and
was a joint venture of the Positive WomensNetwork,
a Vancouver-based support service organization for
women living with HIV, and Red Road HIV/AIDS
Network, which supports Indigenous women living
with or at risk of HIV and/or hepatitis C virus (HCV).
More specifically, Positive WomensNetworkandRed
Road HIV/AIDS Network organized AoW to provide
healing and wellness opportunities with a harm re-
duction approach for Indigenous women living with or
at risk of HIV and/or HCV (Keira, written personal
communication, February 1, 2021). AoW was pio-
neering because it brought together the HIV and HCV
communities that had previously operated quite sep-
arately. This was in response to the federal govern-
ments evolving syndemic approach to HIV, HCV, and
other sexually transmitted and blood-borne infections
(STBBIs) (King et al., 2009).
Pewaseskwan (the Indigenous Wellness Research
Group), co-located at Simon Fraser University and the
University of Saskatchewan, led the research component
and focused on exploring what healing and wellness
looked like for Indigenous women living with or at risk
of HIV and/or HCV. The term pewaseskwan is a Cree
Sponsorships or competing interests that may be relevant to content are disclosed at
the end of this article.
Luke Heidebrecht, PhD Candidate, is a Research Associate, College of Medicine,
University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Subhashini Iyer,
MSc, MPH, is a Research Associate, College of Medicine, University of
Saskatchewan, Saskatoon, Saskatchewan, Canada. Sandy Leo Laframboise, is a
etis Two Spirit Elder, Vancouver, British Colu mbia, Canada. Claudia Madampage,
PhD, MPH, is a Project Officer, College of Medicine, University of Saskatchewan,
Saskatoon, Saskatchewan, Canada. Alexandra King, MD, FRCPC, from Nipissing
First Nation, is the Cameco Chair in Indigenous Health and Wellness, College of
Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
*Corresponding author: Luke Heidebrecht, e-mail:
Copyright ©2021 The Authors. This is an open-access article distributed under the
terms of the Creative Commons Attribution-Non Commercial-No Derivatives
License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work
provided it is properly cited. The work cannot be changed in any way or used
commercially without permission from the journal.
Journal of the Association of Nurses in AIDS Care March-April 2022 Volume 33 Number 2 189
word that means the sky is starting to clearor the
weatherisimprovingand speaks to the research ap-
proach that the group seeks to reflect, which includes
an optimism for a healthier future, a clearing of our
beings from the clouds of colonization and privileging
Indigenous ways to work alongside Western ways.
The application for funding of AoW was accepted by
the Canadian Institute of Health Research in October
2016, and the study received approval from the Re-
search Ethics Board of SFU in March 2017 (study no.
The retreats goal was to provide a safe space for the
women to consider their individual and collective
wellness journeys as peers. It was also an important
moment for each of the women in their living journeys
to experience healing (Keira, written personal com-
munication, February 1, 2021) as well as being a data-
gathering event for this research. Indigenous research,
as we will unpack, prioritizes relationality (Wilson,
2008) and blurs the boundaries between process and
outcomes, seeing the two as interconnected and inter-
twined or, as Grace so eloquently reflected on her ex-
perience of the retreat,
I just saw this basket that was weaved.
And it feels like even though,
every one of us is a strand in that basket,
it feels like were now weaved.
(Grace, Sharing Circle, March 25, 2017)
The weaving of baskets is an important image for this
article and is something familiar to Indigenous people in
Canada who use different materials to weave their bas-
kets, whether it be sweet grass, a M´
etis sash, or, as is the
case with the Coast Salish people of the Pacific Westcoast,
cedar bark. According to Elder Sandy-Leo, the Cedar tree
has spiritual significance for the Coast Salish people, who
were able to use it to build their lodgings, tools, and canoes
and create clothing and traditional regalia. The tree pro-
vides much for the people, and it is said the Cedar is their
tree of Life. To be a Cedar weaver is more than to make
baskets. There is a short season in which to collect the
cedar bark while the water runs through the tree, and the
weaver, in tune to the land and the tree, approaches this
gathering in a sacred way. In preparing the cedar bark to
weave baskets, the Elders teach that the stories and songs
shared are also woven with good intentions. The weavers
go out to gather together and return to tell stories together.
We recognize the teachings embedded in the practice of
weaving baskets and consider how to apply them to the
process of research. It is our hope that this image will
remain with you in your reading of this article and provide
an image with which to understand its purposes.
Health Inequities and Indigenous Wellness
From an Indigenous perspective, the STBBI health in-
equities experienced by First Nations, Inuit, and M´
etis in
Canada must be framed within the context of coloniza-
tion, including the intergenerational trauma resulting
from residential schools, the Sixties Scoop, and ongoing
child welfare systems (Christian & Spittal, 2008; Fayed
et al., 2018). These systemic factors have created in-
tergenerational narrative reverberations (Young, 2005)
that include the loss of language, traditional cultural
knowledge, and spiritual and relational practices, par-
ticularly family relationships(Young et al., 2015).
These are also at the root for increased burden of various
STBBIs, including HIV, HCV, and HIV/HCV coin-
fection (Craib et al., 2009; Miller et al., 2011), despite
the prevention, treatment, and disease management
services that are available within the Canadian health
care system (King et al., 2009; Sadler & Lee, 2013). As
Indigenous people in Canada see it, HCV is a colonial
illness, which necessitates that healing journeys must not
be reduced to health care but include Indigenous cultural
approaches (Fayed et al., 2018). Colonization and its
domestic sibling, settler-colonialism, explicitly sought to
disconnect Indigenous people from their land and cul-
tures (Snelgrove et al., 2014). This disconnection, com-
bined with a number of historical, socioeconomic, and
structural determinants, is recognized as a key enabling
factor in the health inequities currently faced by many
Indigenous communities in Canada (Alfred, 2009; King
et al., 2009).
Considering HIV, HCV, and HIV/HCV coinfections
as colonial illness prompts us to consider approaches to
health and wellness research that take a stand against
reductionism, honoring the role of both qualitative and
quantitative data, as appropriate. Elders Albert and
Murdena MarshallsetuaptmumkTwo-eyed Seeing
(Martin, 2012; Peltier et al., 2019) was used as a con-
ceptual framework that shaped the various components
of our research. For this project, it meant bringing to-
gether both Western and Indigenous ways of un-
derstanding health and wellness to inform the research
design. Both perspectives were considered in concert
when developing research outcomes, and identifying
prevalent gaps and future recommendations (Coburn,
2015; Shorten & Smith, 2017). The statistical data
highlight the STBBI burden, showing that although In-
digenous people comprised 4.9% of the Canadian pop-
ulation, they represented 24.3% of all people living with
HIV in Canada in 2017 (Haddad et al., 2018; Statistics
Canada, 2017; Negin et al., 2015; Public Health Agency
of Canada, 2016). Looking to British Columbia (BC),
190 March-April 2022 Volume 33 Number 2 Heidebrecht et al.
where this research took place, Indigenous peoples have
been disproportionately represented in BCs HIV epidemic
over the past decade. From 2008 to 2017, 817% of
people newly diagnosed with HIV self-identified as In-
digenous while only accounting for 6% of the general
population (BC Centre for Disease Control, 2019). Al-
though these data should provide ample motivation for
further inquiry, we believe it is important to acknowledge
the ways statistical data further stigmatize Indigenous
people, causing harm by supporting deficit thinking and
non-Indigenous solutions to colonial problems.
In our eyes, when reporting quantitative data related to
Indigenous people, it is important to acknowledge the
background of historical colonial power, the residential
school system, and intergenerational trauma, including
ongoing processes of health inequities and systemic dis-
crimination that continue to cause Indigenous suffering
(Coburn, 2015; Kim, 2019). With this in mind, we see the
statistics speaking to and supporting the argument that
colonialism shapes Indigenous experiences with all na-
tional authorities and institutions and continues to foster
Indigenous peoplesmistrust of health care services spe-
cifically (Jacklin & Warry, 2011; Manitowabi & Maar,
2018). Western health care puts colonialism on display
through a segmented approach; facilities typically focus on
one thing, divorcing physical wellness from mental, emo-
tional, and social wellness and often ignoring the spiritual
components of wellness altogether (Fayed et al., 2018).
The underlying causes of the aforementioned health and
social inequities, we argue, are directly related to the ways
that Western health care has neglected the Indigenous ex-
perience of national institutions and failed to offer who-
listic spaces for Indigenous health and wellness journeys.
Therefore, as Dorothy explains,
Any Aboriginal-type event
is welcoming
and adjusting
for everyone and
that is a gift in itself. (Dorothy, Sharing Circle, March 26, 2017)
The AoW retreat is a response to this understanding of
the statistics and was facilitated by Indigenous people for
Indigenous people, using an Indigenous approach to
research that offered a safe space and formed connec-
tions between health and wellness that many Indigenous
women with living and lived experience of HIV and
HCV have named as absent in their wellness journeys
(Fayed et al., 2018; King et al., 2009).
This article weaves a basket from the warps and wefts
that were gathered, which are the Indigenous women and
their stories shared at the AoW retreat. As the basket takes
shape, we discuss the approach taken for data gathering
and analysis, explaining the ways they support the use of
Indigenous methodologies in health research while cri-
tiquing the potential colonizing impacts of Western re-
search. Once complete, our focus shifts to what the basket
may contain, the teachings found through the stories of
Indigenous womens experiences in health care. The ar-
ticle concludes that the insights gained provide us a min-
imal view of how to identify the health care places and
spaces that require reconceptualization, decolonization,
and gender-specific Indigenous approaches.
“Our Protocols Are Good, They’re Safe”:
Indigenous Data-Gathering Practices
The retreat adopted Indigenous methodologies focused
on strength-based and culture-based methods and, most
importantly, provided a literal retreat for the women
whose lives in the Vancouver Downtown East Side
(DTES) were filled with chaos and crisis. Indigenous
people recognize that land- and culture-based retreats
are effective interventions for restoring and promoting
physical, mental, emotional, and spiritual wellness
(Krementz et al., 2018), and one of the critical goals of
the AoW retreat was to align methods with outcomes.
The Elders bring energy
teachings and learning.
Its been emotional,
Especially knowing any Elders.
The energy they bring,
the teachings they bring,
the learning. (Ava, Sharing Circle, March 24, 2017)
Many of the women, such as Ava, affirmed the ap-
proaches used in data gathering as meaningful, as ex-
emplified in her choice of words to describe her
experience. We recognize the central role that relation-
ships played in supporting this experience and are
reminded that the integrity of any data-gathering
method should not be measured by its adherence to
theory, although that is important, but by listening to the
feedback that participants offer based on their experi-
ences of those methods. This is a key distinction of an
Indigenous methodology that prioritizes giving back
(Kovach, 2009) at all stages of a research project. Avas
words previously mentioned read as an internal
Journal of the Association of Nurses in AIDS Care Every One of Us Is a Strand in That Basket 191
validation and example of how research done with In-
digenous people should enrich their lives (Wilson, 2008).
Indigenous methodologies also facilitate decolonizing
perspectives while avoiding making them the central focus
(Kovach, 2009). Unlike Western methodologies that em-
phasize theory first, Indigenous methodologies emphasize
relationality first. Theory may still provide guidance in the
development of research methods, but it comes second and
is always in service of the relationships, grounded in cere-
monies and the land (Keira, written personal communica-
tion, February 1, 2021). For AoW, much thought was given
to the geographic space where the research would take
place. The Springbrooke Retreat Centre, located on the
sacred ancestral lands of the Kwantlen First Nation, pro-
vided a landscape distinct from the DTES where the women
lived. For example, the lived experiences of Indigenous
women in the DTES are woven with strength, resilience,
and survival in the face of not knowing where their next
meal is coming from, of perpetually needing to secure as
safe a drug supply as possible (prescribed or sourced from
the street), and of negotiating fractured systems not
designed for those they are supposed to serve (Keira, written
personal communication, February 8, 2021).
The retreat was organized to integrate land-based
wellness practices, including sequential sharing circles,
culture-based research, and post-retreat sharing circles,
all of which were audio taped and transcribed. Sequen-
tial sharing circles build on one another and include the
same participants, with the goal of adding layers and
depth to the emerging conversations. This approach
builds trust between those who share the circle and may
create space for deeper understandings of sensitive issues
to emerge as well as facilitate healing (Jacklin et al.,
2016; Marsh et al., 2015; Young et al., 2015). The circles
included six to nine women, and each began with an
introduction and smudging ceremony hosted by an El-
der, who explained the importance of traditional cere-
monies and their significance in the journey of healing.
We can trust that we will be fine,
mentally and
following our protocols.
Our protocols are good,
theyre safe. (Elder Pearl, March 24, 2017)
These words reverberate with Wilsons (2008) expla-
nation that Indigenous research is ceremony; it is most
important that they note the role that Indigenous episte-
mology and ontology play in supporting Indigenous par-
ticipants in culturally relevant and safe research practices.
A key aspect of Indigenous research is awareness of
the pacing of research activities and becoming attentive
to participantsengagement and energy. Knowing when
to break and ensure everybody is on the same page
demonstrates a commitment to prioritizing relationships
in research. The organizers were conscious of the im-
portance of informal activities to support building rela-
tionships and of providing outdoor activities for the
women to find healing in nature. Weaving informality
with formality expressed a particularly Indigenous ap-
proach to research that helped the gathered individuals
become a community of women. One evening, the
women gathered around a sacred fire to share wisdom.
As they began, a sudden and surprising rain dampened
the activity. Inspired by the downpour, the women
agreed to move to the hot tub to share their stories.
Soaking in waters is a sacred part of West Coast tradi-
tions, with modern hot tubs taking the place of healing
hot mineral pools. The women were aware that sharing
their wisdom gained from life experiences needed to be
done in a good way for the betterment of their commu-
nity and for other women experiencing similar issues in
the world. Their creation of healing spaces to share
demonstrates the principle of reciprocity in research
(Keira, written personal communication, February 1,
Weaving stories takes time, just as it is with the
weaving of cedar bark baskets. The process of making a
basket is composed of two parts. The warps or bones
are held together in parallel as wefts are drawn over and
under each bone. In our conceptualization, these bones
are the strong and resilient Indigenous women, and the
wefts are their stories that bond them together. The use
of Indigenous traditions, cultural protocols, and Elders
to facilitate the retreat was essential for process and
nurtured healing, resilience building, and spiritual con-
nection, aspects of research that are largely ignored in the
Western health research.
Weaving the Circles That Form the Basket:
Approaches to Analysis
Following the image of the basket, it has become clear to
us that, as a group of authors, our role is that of the
weavers. Over the course of several months, we have
invited a diverse group to consider our weaving: In-
digenous people and allies, some who have lived and are
living with the experience of HIV/HCV, some who carry
Indigenous knowledge, and others who have journeyed
through and are fluent in Western academics. The pro-
cess of analysis and writing took time and proceeded in a
circular way. Circularity rather than linearity reflects the
192 March-April 2022 Volume 33 Number 2 Heidebrecht et al.
interrelatedness of things (Wilson, 2008), the medicine
wheel being one example, representing the physical,
spiritual, emotional, and mental self (Fayed et al., 2018).
Likewise, we approached analysis in a circular and
interconnected way. At first, four members of our re-
search team, L.H., S.I., C.M., and A.K. spent time to-
gether discussing the retreat itself, our understandings of
the activities, and our initial reflections on the tran-
scripts. Throughout this first phase, we were intentional
about self-location (Peltier et al., 2019), taking time to
bring together our diverse perspectives as a way of
building trust, self-reflexivity, and connection. We met
often to discuss our perspectives and newfound inter-
pretations and to validate our emerging understandings.
It is important to note that we four did not attend the
retreat and so recognized the need to expand our circle.
In the second phase, we incorporated a peer researchers
analysis of the sharing circles. Our intention was to give
primacy to her interpretation, recognizing that our col-
leagues own experience aligns more closely with the
women at the retreat. This analysis served as a guide-
book to help define key concepts and as a lens through
which to critically examine our own analyses and find
alignment. Finally, expanding the circle further, we in-
cluded Elder Sandy-Leo, who was present at the retreat
and who was able to offer important feedback, correc-
tion, and validation. From an Indigenous perspective,
the Western need to compartmentalize and articulate, in
a hierarchical way, the contributions that inform any
research text (Caine et al., 2013) is problematic. Instead,
for us, the relational approach to analysis and writing
means honoring everyone as authors who contributed to
the construction of the ideas, approaches, and stories of
this article. Our weaving of the basket that this research
text embodies brought us together in relationship as we
passed on stories and teachings, engaged in conversa-
tions related and tangential, and shared in laughter, just
as it is with the practice of weaving literal baskets among
the Coast Salish.
“Singing for One Another”: Retelling the Stories of
the Retreat
The process of translating lived stories to written stories
is fraught with tension. We resonate with Clandinins
(2013) reminder that, in composing research texts,
there is no final telling, no final story, and no one sin-
gular story we can tell(p. 205). We enter the circle of
authorship that existed before our participation and find
ourselves faced with retelling only segments of the stories
from the AoW retreat that, as they are woven together,
become something wholly new. We also become
relationally entangled in this process (Clandinin &
Connelly, 1990) and wonder about how we might craft
this new story in a good way, honoring the messages the
women intended to tell. The womens sharing is repre-
sented throughout this work in a style that we first dis-
covered in the work of Young et al. (2015), in which the
authors compose word images.Our adaptation of this
method for representing data is meant to convey the
meaning of what the women say in a manner that is more
closely aligned with the cadence and pacing of speaking.
We also wonder about how this new story that is
forming may contribute to other conversations about
people with lived and living experience with HIV/HCV
and of their resilience and wellness. This sectionthe
analysis of the datais where the basket takes shape.
Leaning into the image of the Coast Salish basket wea-
vers, who share stories and songs together as they work,
as we engaged in conversational methods, we heard
three distinct melodies forming: connection, disconnec-
tion, and reconnection. We hope that our singing
(analysis) may join the healing song Elder Pearl speaks of
in the closing circle:
I dont know why, what prompted me,
one day, compared to the day before,
what prompted me to get clean and sober.
I can give you all kinds of reasons, but really, they were no
different than reasons I had the day before.
I believe that
somebody was singing for me, or
somebody was praying for me.
And I cant sing this song, ever, without thinking, we got
Weve got sisters on the streets.
Weve got some old lady isolated in a home,
maybe shes suffering.
Weve got people that are self-medicating right now.
Come on, let our voices carry this song.
So, when were singing for ourselves,
were singing for one another
Were singing for all of them we dont even know. (Elder Pearl,
Sharing Circle, March 26, 2017)
Stories that expressed the healing power of connection
emerged as the women spoke about the friendships they
made during the retreat. They were becoming spiritual
friendswho were able to help interpret one anothers
lived experiences and who offered resonance. Stories were
shared of the ghetto-like settings the women inhabited in
the DTES; one woman offered a pungent reminder of a
Journal of the Association of Nurses in AIDS Care Every One of Us Is a Strand in That Basket 193
common DTES experience where you smell the pain
(Grace, Sharing Circle, March 26, 2017). Memories of
addiction and its disconnecting effects were disclosed,
which one woman expressed with vivid detail, saying,
its like being a shell and
I mean
I remember feeling
being down there,
its like nothings alive. (Grace, Sharing Circle, March 26,
These challenging verbalizations of lived in-
tergenerational colonial reverberations (Young et al.,
2015) surfaced in the safety of connection with new-
found spiritual friends. The previously internalized,
buried, and misunderstood stories were met with fo-
cused silence and listening that offered the storytellers a
quiet and gentle healing presence.
Spaces where spiritual friendships may emerge are rare
and often absent in the womens experiences in the DTES
and within Western health care. The Western systems
disconnected approach that divides the physiological
from the mental, social, and spiritual fosters mistrust for
Indigenous people. In contrast, during the AoW retreat,
the women experienced a newfound flourishing of trust as
they encountered Indigenousways of approaching health
and wellness that were founded on making relationships
that began with following good protocols. One of the
Elders described the process this way, saying,
Its very important that we respect othersspeaking,
dont talk when other people are speakingand I guess,
to have trust and faith
that our ways are trustworthy and reliable
I know that were capable of dealing with our own process and
coming out the other side.
We can do it.
Weve been doing it since the beginning of time
Thats a good teaching for all of us. (Elder Pearl, Sharing Circle,
March 24, 2017)
Protocols of introduction were followed at the outset of
the gathering. We have been doing it since the beginning
of time,said Elder Pearl who spoke about how the act of
sharing stories is simultaneously a reconnection with
oneself and an invitation to connect with others around the
circle. The practice of storytelling in a circle gives power
and opportunity for each to tell their lived stories in turn.
This approach cultivated a listening spirit (Closing circle,
respect othersvoices. The protocol of introduction, when
facilitated by Elders/Knowledge Holders, provides a cul-
turally safe space where one may find connection and
reciprocity in their giving and receiving of their stories
(Keira, written personal communication, February 1,
2021). Several women indicated that they felt as if they
were destined for the spiritual connections they made with
one another, such as Tara, who expressed,
Having that sense of openness is going to create security for me,
so that Im able to
come out and
step out of myself and
grow in a good way and maybe
encourage my neighbor to do the same. (Tara, Sharing
Circle, March 24, 2017)
Creating safe spaces was an important component of
the retreat; the women shared pleasantries in the
kitchen, enjoyed chatting in the hot tub, and even
gathered for a spontaneous musical event when one of
the participants, inspired by the safety she felt and with
a spirit of remembering, played the piano on site while
communication, February 1, 2021). These examples
are contrasted with the spiritual restrictedness that the
women experienced in Western health care where, by
necessity, they felt guardedand, as Savannah ex-
plains it, makes spirituality hard, in a lot of ways
(Savannah, Sharing Circle, March 24, 2017). The war
zonelike (Keira, written personal communication,
February 10, 2021) context of the DTES and the focus
on survival many of these women live, day in and day
out, restricts the flourishing of their spirituality and
connectedness to one another. It was clear from the
conversations that a connection with spirituality is in-
tuitive, as your spirit knows exactly what you need
(Grace, Sharing Circle, March 24, 2017) and provides a
direct link to connect with culture through ceremony,
which one of the Elders described as a way of shaking
loose the trauma:
Our Healers would do things;
the dancing
the rattle
theres the cedar brushing
theres the water theres
the eagle fan
theres the smudge
All that clears energy
And as that energy clears,
its not locked in your body as trauma. (Elder Sylvia,
Sharing Circle, March 24, 2017)
Ava responded, after experiencing the Blanketing
194 March-April 2022 Volume 33 Number 2 Heidebrecht et al.
I got the feeling the energy
the room changed
the energy field changed
I saw all the buffalos ancestors
coming through the room
and just empowering
just going
to every woman in that room
So every time a woman is blanketed
and when an Elder witnessed
it was just like I was blanketed
by so many generations of healing.
(Ava, Sharing Circle, March 24, 2017)
What Ava is also highlighting is that participation in
ceremony may function as a grounding experience for those
so caught up in the disconnecting inner-city ghettosin
which they livelike the DTES; these are among Canadas
poorest neighborhoods, rife with poverty and strife (Keira,
written personal communication, February 10, 2021). El-
der Sylvia told of the importance of paying attention to the
teachings afforded by being on the land, beingbythe
waterand being near treesand experiencing the
calmness and that good feeling that comes from the land
(Elder Sylvia, Sharing Circle, March 26, 2017). Elder Rose
reminded us that connecting with the land need not be done
only through formal ceremony but by simply going out
and harvesting cedar branchesgoing down to the water
and being in a canoe and paddling,and experiencing the
landas it is (Elder Rose, Sharing Circle, March 25, 2017).
These stories reveal that land-based retreats like the AoW
provide a safe space for connecting to the land, to the an-
cestors, to culture, and to spirituality. Pamela confirms,
I feel more relaxed here
Weve got trees
Weve got our Mother Nature close by
It makes learning a lot easier. (Pamela, Sharing Circle, March
26, 2017)
Settler-colonialism in Canada is a system adept at taking
and holding land for settler-collectives and normalizing
systemic discrimination by attempting to submerge In-
digenous issues, framing them as particular and peculiar
to Indigenous people (Snelgrove et al., 2014). For In-
digenous people, Western society represents an exten-
sion of the settler-colonial system that influences
IndigenousWestern relations. Eurocentric thinking has
given birth to the idea of institutionalized monoculture
(Ermine, 2007), which has been made manifest through
sociopolitical structures in Canada such as the residential
school system, state policies that imposed interpretations
of treaties on Indigenous people, and, of course, an ap-
proach to health care and access (Zambas & Wright,
2016). These are not only non-Indigenous systems but, for
Indigenous people who navigate them, their image is re-
created by the colonial gaze (Ermine, 2007) along with
their narratives of health. Colonized systems perpetuate
colonial logic, stifling the Indigenous imaginative and
sustaining the deficit-framed vernacular of health care
providers in relation to Indigenous people. Tara explains
their experiences navigating a settler-colonial system,
highlighting the emotional and social costs:
Its so challenging
and burdening,
because I see my friendsstories
and theyre hiding
because of the stigma
and the ignorance
thats come to the health care system. (Tara, Sharing Circle,
March 24, 2017)
Victoria describes her experiences with health care
providers and the feeling of being reduced in a Western
story of health that ignores her colonial experience:
Id like them to see me
just for who I am
a truthful,
human being.
Id like them to see me
as an equal, if anything,
somebody that they can learn from.
(Victoria, Sharing Circle, March 24, 2017)
Her words resound with a call to be re-storied in a way
that honors the sovereignty of Indigenous people. Like-
wise, Jennifer reiterates,
I want to be heard,
I want them to hear my voice. And, I want to be a part of my
health care.
I deserve to actually be a part of it,
because its about me.
(Jennifer, Sharing Circle, March 24, 2017)
The women at the retreat expressed a desire to be
recognized and seen as Indigenous. Each of them shared
stories that came together, echoing like many hands
beating the drum together. One such story was shared by
Journal of the Association of Nurses in AIDS Care Every One of Us Is a Strand in That Basket 195
My teachings,
my inner drum,
held me strong in what I knew to be true.
I think thats very important for all of us to know
our own truths,
and to not take on what a doctor or so-called
professional may tell us.
Cause its really easy to do when youre that sick
youre at their mercy
I just really pray that the medical community recognizes the
medicine that
our Elders,
our Ancestors,
have given us.
(Grace, Sharing Circle, March 24, 2017)
As we listened to the womens stories, we realized that
they were speaking about their disconnections from
Western health care as a symptom of colonialism. Their
experiences with health care professionals further com-
pounded those symptoms as the women spoke of the fear
of judgment they often felt. It should be remembered
that, for these women, sharing the painful stories they
have lived, even in the safe space of the sharing circles,
represented both a powerful opportunity for healing but
also an unfamiliar, and therefore potentially unsafe,
experience. Outside of this Indigenous-led space, how
must it feel for an Indigenous woman to tell her stories to
the representatives of the causes of that pain? We are
reminded of Boler (1999), who reflects on the tension in
storytelling, suggesting that testimony is traumas
genre(p. 167). She cautions that there are risks in re-
ducing ones story to an overly tidy package(p. 177).
This risk is taken time and again by the women who offer
their medical histories to near anonymous health care
professionals. Linda illuminates on this point:
Are people going to judge me?
Are people going to say anything if I see them out on the street?
Are they going to acknowledge me? (Linda, Sharing Circle,
March 24, 2017)
We recognize the ways that judgments, whether di-
rectly expressed or reverberating through the colonial
structures of Western health care, play a role in dis-
connecting Indigenous women with lived or living ex-
perience with HIV/HCV. Judgments received in health
care spaces perpetuate disconnection and, according to
Grace, are like an infection that spreads this colonial
disease of reducing each other to component parts.
What makes me feel unsafe
is when someone, including myself,
doesnt see the spirit in someone. (Grace, Sharing Circle, March
24, 2017)
Indigeneity is conceptually a reengaging with and mak-
ing visible Indigenous ways of knowing, being, and do-
ing without wondering how to translate, interpret, or fit
within the settler-colonial system. Rather, Indigeneity
asserts decolonization and an unsettling of structures,
such as health, that have been shaped by colonial
thinking (Maaka & Fleras, 2009). Indigenous culture,
philosophies, and practices provide a wealth of knowl-
edge and guidance for wholistic healing and a concep-
tualization of wellness that encompasses the physical,
mental, emotional, and spiritual aspects of life. Indige-
neity, as the women expressed, represents a different
starting point for Indigenous health and wellness that is
parallel, self-determined, and sustainable (Poonwassie
& Charter, 2001).
When asked to describe their wellness journeys in one
word, the women described it as: complete, relaxed,
sisterhood, learning, education, aware and calm,
cleaned, and connected. We recognize that these words
take on their full meanings in the context of an In-
digenous community; the retreats structure and setting
offering a vision of what that looks like and a needed
escape for these women, whose lives are so shaped by the
colonized and colonizing structures of the DTES. Com-
ing together, sharing, and connecting demonstrated the
communal practice of resilience-building and formed a
foundational element of the womens healing. Dana
speaks of her experience at the retreat saying,
We all come from different walks of life,
but we all have one thing in common
were sisters.
And I think were very strong,
as a whole,
like sisterhood,
standing together,
strong. (Dana, Sharing Circle, March 26, 2017)
Colonization has created the conditions for discon-
nections from community-sustained traditional healing
practices and land-based activities. A Western concep-
tualization of resilience is often defined by individual
traits such as optimism, cognitive flexibility, and the
ability to do well despite hardships, adaptivity, active
coping skills, problem-solving ability, and social skills
(Iacoviello & Charney, 2014; Iarocci et al., 2008; Kir-
mayer et al., 2011). We recognize in the womens sharing
that Indigenous peoples resilience is supported by their
distinct cultural and traditional knowledge, connecting
an individual to a greater community, environment,
history, traditions, and language (Everyone Equal,
196 March-April 2022 Volume 33 Number 2 Heidebrecht et al.
2020; Kirmayer et al., 2011). Victoria explains how
cultural and community connectedness played a role in
her healing and wellness:
I fled family violence,
many times in the middle of the night,
with my kids,
and I always had a place to go.
Theres sweat lodge grounds,
and teepee,
theres berries
and fruit
and you can just go there and be safe.
My daughter was six months old,
shes (x age) now,
when I first went on that land and sat in that circle,
with our Cree relatives, our M´
etis relatives.
Many of us dont have a voice until theyre here.
But collectively,
were so strong,
were so beautiful.
Ive gotten so much from each person,
whos just been in this room. (Victoria, Sharing Circle, March
26, 2017)
In the following excerpt, as well, we hear one of the
women describe how reconnecting to Indigenous ways
and people has helped her voice her inherent resilience.
Ive got a lot to offer,
we all have a lot to offer.
But when youre drinking and drugging,
you have nothing to offer.
All you feel is pain and sorrow, and
thats where I came from.
I dont want to go back there,
Im determined not to go back there.
(Linda, Sharing Circle, March 26, 2017)
For another woman, knocking down the pillars of
suffering and painwas her way of articulating resilience
by naming a structure of inequity, the colonial-pillars,
that has supported a system wherein the colonized are
bound in cycles of survival rather than flourishing.
Western health care is often myopically caught up in
perpetuating suffering and pain for those living with
HIV/HCV by focusing the colonial gaze on symptoms
instead of confronting the systems that that have been
created by and for settlers. In contrast to the discon-
nection experienced in Western health care, one of the
women offered a counterexample of the power of
reconnection, citing the role Indigenous women with
lived and living experience of HIV/HCV has played in
her healing:
I started to get into joining retreats and gatherings,
not being alone,
living with this disease, and
being able to disclose in a good way, and
learning how to do it safely.
So, my wheels been really a lot more balanced lately.
Im not alone. (Jennifer, Sharing Circle, March 24, 2017)
The advantage of participating in retreats that in-
clude land-based activities, ceremony, and Indigenous
approaches to data-gathering is the opportunity to
practice resilience-making together. An Indigenous
approach to research is ceremony (Wilson, 2008). This
is not something named explicitly, but the collective,
rather than individualistic, orientation of the various
activities such as the sharing circles, as well as the in-
formal spaces made available for the women to use,
emphasizes not only you are not alonebut draws
connections to deeper cultural support systems that
speak to the emotional, social, and spiritual aspects of
wholeness and oneness. Through the retreat, the
women grew together in relationship and demon-
strated the power of resilience-making as they shared
nication, February 1, 2021).
Discussion: Filling the Basket
We have woven a basket and now wonder what it might
carry. The process of weaving the stories into this article
has, of course, reduced the complexities and depth of the
whole retreat. However, it has also created something
new that we hope is usefula vessel that will carry dif-
ferent meaning for different readers. There are no gener-
alizable implications or correct understandings of the
future of Indigenous health and wellness to befound in the
basket, but there are transferrable (Clandinin & Con-
nelly, 1990) teachings that the women shared based on
their experiences about Indigenous journeys of strength,
resilien ce, and wellness. We conclude by thinkin g with the
stories we have been weaving (Clandinin, 2013) and fill
the basket with our thoughts and recommendations for
doing research in a good way with Indigenous people who
have lived and living experience of HIV/HCV.
Land-Based Indigenous Research
The land has played a fundamental role in grounding
wellness journeys and expressions of resilience for In-
digenous people and is viewed as a living, breathing,
conscious being that heals and teaches (Krementz et al.,
2018). Describing her experiences of being on the land
Journal of the Association of Nurses in AIDS Care Every One of Us Is a Strand in That Basket 197
at the AoW retreat, one woman remarked: Ihealmore
this way than I ever have in my life(Grace, Sharing
Circle, March 26, 2017). We celebrate with her and
mourn for the ways her comment reveals the in-
tergenerational effects of disconnection to the land. A
move to inner-city environments for Indigenous people
has further compounded the effects of disconnection to
the land and created residential instability (King et al.,
2009). The women find that they are placeless people,
not at home in inner-city ghettos,andoftenun-
welcome guests in their home of origin due to their
perceived lifestyles (Keira, written personal communi-
The land provided a neutral space to perform cere-
monies, connect with ancestors, and reawaken In-
digenous wisdom. As such, the women at the retreat
trusted the land to provide spiritual guidance. As Brenda
shared her inspired understandings about land-based
healing, she reflected that it can be cultivated even in the
urban-enclosed environments of the DTES:
If Im having a panic attack or I cant seem to get my head out of
a depression
Ill go to the water
and I will just look at the lights on the water
Ill go out in the middle of the night
and just watch the lights of the city on the water.
And it brings me joy
it brings me hope.
The beautiful thing about the tide
its twice a day,
all the time,
never stops.
So, I know if Im sick,
Im gonna be well.
I can be sick,
but Im gonna be well.
(Brenda, Sharing Circle, March 24, 2017)
In an Indigenous paradigm, land plays a crucial role in
reconnection with self and developing a sense of control
and competency (Sinko et al., 2019), which are charac-
teristic expressions of regaining sovereignty. Some
women who had grown up on the land spoke about the
activities that they had participated in and the tasks they
had watched their family members practicing such as
hunting, fishing, foraging, building, and maintaining
homes and equipment. Rosemary shared about both her
parentsactive ways of living on the land, reflecting on
the inherently wholistic world that was created for her:
They both worked,
as a trapper
my mom, shes a short woman,
but she picked up a big, broad axe, and made ties.
You see that train going by?
They put the rail over it.
She went out shooting,
and up picking berries,
we had our vegetable garden,
we had a root cellar,
we had it all.
I never knew what hunger meant till I left home. (Rosemary,
Sharing Circle, March 24, 2017)
Rosemary experienced the way living on the land as a
family and agency in ones own wellness was inter-
twined. The wealth of skills, wisdom, capacity, and self-
reliance their families knew served as a source of
abundant inspiration. Land-based retreats are recon-
necting to ancestral and family stories and inspire a
profound expression of togetherness and Indigeneity.
Indigenous Ceremony as Research
The women repeatedly expressed a desire to have regular
access to culturally safe circles of support and guidance.
Their experiences at the AoW retreat represented a re-
prieve from their daily fight to survive in the DTES and
an access to ceremony and nature. One woman spoke of
the importance of coming together, sharing stories, and
spending time connecting with women through
It shouldnt have to be a once-in-a-blue-moon special event
Cause we are going to be going back to the city,
and theres lots of calamities,
and noise,
and the busy life there again.
A lot of things that will take us,
start challenging us with our peace of minds,
and our nurturing that weve been getting for the past
few days. (Jennifer, Sharing Circle, March 26, 2017)
A lack of consistency in wellness programs for In-
digenous women living with HIV/HCV was understood
to be a barrier in their wellness journeys. These stories
remind us about the ways that research fails to give back
(Kovach, 2009), honor relationships, and provide heal-
ing experiences. It is clear to us that research with women
living with HIV/HCV should align with the values of
long-term relational connections that the women desire.
Grace critiques her experiences with support networks
that fail to demonstrate these kinds of commitments:
Those type of people,
not ones that are evolving to their next program,
198 March-April 2022 Volume 33 Number 2 Heidebrecht et al.
they just donated what they needed to donate and then they
thats not the way,
its supposed to be a connection
And connection meaning that,
making yourself available,
you open the door and then you disappear,
is not quite what I had in mind.
(Grace, Sharing Circle, March 24, 2017)
Indigenous practices are grounded in the land, and the
land is grounded in the people. Integrating ceremonies in
research demonstrates a recognition of the importance
of land and ceremony in Indigenous ways of being. In the
eyes of Indigenous people, Western health care often
disregards the spiritual component of wellness or, at
best, it is imbued with the foreign and colonizing ap-
proaches of Western spirituality, shaped by those who
have been an integral part of the traumatizing of In-
digenous people. Time after time, Indigenous people
have demonstrated that land-based ceremonies are an
integral part of who they are and, when bonded together,
represent a decolonizing practice.
Reconciliatory Approaches to HIV/HCV Care
Finally, we consider the insights offered by the women and
how they relate to resilience, healing, and wellness for those
living with HIV/HCV. In the eyes of Indigenous people,
HCV has been conceptualized to be a colonial illness
(Fayed et al., 2018), which we extend to include HIV,
considering the probability of HIV/HCV coinfections.
Likewise, it should not surprise that Western health care,
which we have argued represents colonialism for In-
digenous people, further wounds and traumatizes. Health
care, having deconstructed wellness into component parts,
has erected boundaries around the health component and
restricted Indigenous access to care resources and profes-
sionals due to identity-based judgments and racism. This,
we argue, facilitates and perpetuates a structure of colonial
dependency. The experience of engaging with Western
health care is, as the women describe, disconnecting from
their Indigenous identities and wellness journeys. HIV/
HCV care that remains tethered to health rather than open
to an Indigenous approach to wholistic wellness reduces
the journey of healing to an entrapment within a cycle of
dependency on a colonial structure that simply treats
physical symptoms.
Thinking with the womens stories, we are envisioning
recommendations for a system of HIV/HCV care that is
bundled together in a wholistic approach to healing that
incorporates physical, mental, emotional, and spiritual
components of a persons life in community. As much as
the AoW retreat provided a model for Indigenous-led,
culturally safe, and land-based research, it was, at the
same time, a model for and an Indigenous approach to
HIV/HCV care. It was not an indigenized Western
model, which does not fundamentally change the In-
digenous experience of navigating a colonial system.
Instead, the women speak of the retreat as a space to
connect with peers for collective healing and to recon-
nect with their Indigeneityan experience altogether
foreign within the confines of Western health care ser-
vices. Employing etuaptmumk (a Two-eyed Seeing ap-
proach), we wonder with the women about how to
include the elements of Western HIV/HCV care within
Indigenous models like the AoW retreat that are
untethered from the imposed colonial boundaries. Fur-
ther research into such a model must also lead to pro-
grammatic research that results in sustained service
delivery, not only being Indigenous-led and -centered
but also specific to Indigenous women and grounded in
relevant lived experience and surrounded by the wisdom
from our Ancestors, transmitted through Elders and
Knowledge Holders. This decolonizing approach will
advance reconciliatory approaches to HIV/HCV care in
ways we have yet to explore.
Alexandra King reports receiving consultancies/
honoraria from pharma (AbbVie and Gilead). Sandy
Leo Laframboise reports receiving honoraria from
Pewaseskwan (the Indigenous Wellness Research
Group). Luke Heidebrecht, Subhashini Iyer, and Clau-
dia Madampage report no financial interests or potential
conflicts of interest.
This study was funded by Canadian Institute of Health
Research (CIHR; Grant #371496; PI: A. King)
Author Contributions
L.H. contributed to this article by conceptualizing,
designing methodology, performing data analysis,
project administration, writing, reviewing, and edit-
ing. S.I. contributed to this article by curating and
analyzing data, designing methodology, managing
resources, visualization, writing, reviewing, and edit-
ing. S.L.L. contributed to this article by conducting
Journal of the Association of Nurses in AIDS Care Every One of Us Is a Strand in That Basket 199
research and data analysis, providing resources, su-
pervision, validation, writing, and reviewing. C.M.
contributed to this article by analyzing data, writing,
reviewing, and editing. A.K. contributed to this article
by conceptualizing, acquiring funds for the retreat,
conducting the research, providing guidance and val-
idation, reviewing, and editing.
The quote that is the title is taken verbatim from a story
shared by one of the women at the Awakening our
Wisdom retreat. The authors believe her words speak to
the essence of this article that weaves together the many
stories that were documented. The authors offer their
sincere gratitude for all the women and the Elders who
gathered and who offered their stories. The authors
approached their writing as entering into ceremony and
recognize their relationships do not end with the publishing
of this piece. The authors would also like to thank Peer
Researcher Kristin Dunn for her insights and analysis,
Ruth Smith for meticulous transcriptions, and Jessica
Bright and Ashley Henry for their contributions in research
planning, data gathering, and supporting the retreat. The
authors are also grateful to those who organized and
facilitated the retreat.
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Key Considerations
mMy inner drum held me strong in what I knew to be
true—Indigenous women, in the Downtown Eastside
(Vancouver), are strong and resilient.
mI just really pray that the medical community
recognizes the medicine that our Elders, our
Ancestors, have given us—Settler-colonialism is a
root cause of many structural, social, and health
inequities experienced by Indigenous people;
Indigenous women have been particularly
disadvantaged by the hegemonic, patriarchal
constructs that settler-colonialism creates and
mIt shouldn’t have to be a once-in-a-blue-moon special
event—Health, healing, and wellness systems for
Indigenous women must respect their sovereignty
and structurally sustain culturally safe and reaffirming
land- and culture-based healing and wellness.
mAny Aboriginal-type event is welcoming and adjusting
for everyone, and that is a gift in itself—Wellness
research with Indigenous women requires decolonial
and Indigenous approaches and methodologies that
privilege relevant Indigenous ways of knowing, being,
and doing.
mOur protocols are good, they’re safe—Wellness
research should include ceremonial research, which
is a valid Indigenous research methodology, as well as
having therapeutic value.
mEvery one of us is a strand in that basket—Connection
and reconnection, with oneself, with each other, with
culture, and with Mother Earth are among the best
medicines against the intergenerational,
intersectional disconnection imposed by settler-
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Journal of the Association of Nurses in AIDS Care Every One of Us Is a Strand in That Basket 201
Since its introduction in 2007, the UN Declaration on the Rights of Indigenous Peoples (UNDRIP) has been adopted by 144 countries worldwide. In a ten-point statement released in 2017, Indigenous leaders in the HIV and AIDS community established a list of truths and actions to be used for advocacy to end AIDS among Indigenous Peoples through self-determination, justice, and human rights. 15 years after the UNDRIP and 5 years after the 10-point statement, this Review asks where we are in terms of upholding the UNDRIP and the International Indigenous HIV and AIDS Community statement in relation to HIV and AIDS, and what is needed to better uphold and respond to these directives. HIV in Indigenous populations continues to intersect with multiple forms of oppression, racism, and discrimination, which are yet to be eliminated from laws, policies, and practices. Eradicating white supremacy and Indigenous-specific racism across all health systems is a bare minimum requirement to uphold Indigenous rights within health care, and must be accompanied by support for Indigenous, self-determined, culturally tailored, and community-specific health and wellness services.
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Working with Indigenous communities involves responsibility, relationship, respect, and reciprocity (Kirkness & Barnhardt, 2016). Our research consists of a partnership with Nipissing First Nation to explore their citizens’ understanding of wellness. Our aim is to tell a collective story of wellness based on the experiences of Nipissing First Nation citizens. As part of our relational process, our research team engaged in an exercise of self-location in preparation for working with Nipissing First Nation stories. This process involved looking back into our own stories of wellness from three temporal points: as children, youth, and adults. Our collective perspective of wellness involved three main themes of relationship, identity, and determinants of health. This exercise helped researchers become aware of their own subjective lenses about wellness. Awakening to our own stories helped us to recognize the ethical space that existed between us as researchers, the stories we will gather, and the perspectives of our community advisory committee. Engaging in this exercise illuminated the need for a continual reflexive stance, consistently being mindful about the privilege we hold as researchers and the invisible stories that creep into an analysis. The process of self-location was an essential element in beginning our research journey. It prepared us for working respectfully and reciprocally with the community that honours the ethical space we collectively share.
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Indigenous populations in Canada have experienced social, economic, and political disadvantages through colonialism. The policies implemented to assimilate Aboriginal peoples have dissolved cultural continuity and unfavorably shaped their health outcomes. As a result, indigenous Canadians face health inequities such as chronic illness, food insecurity, and mental health crises. In 2015, the Canadian government affirmed their responsibility for indigenous inequalities following a historic report by the Truth and Reconciliation Commission of Canada. It has outlined intergenerational traumata imposed upon Aboriginals through decades of systemic discrimination in the form of the Residential School System and the Indian Act. As these policies have crossed multiple lifespans and generations, societal conceptualization of indigenous health inequities must include social determinants of health (SDOH) intersecting with the life course approach to health development to fully capture the causes of intergenerational maintenance of poor health outcomes. To provide culturally sensitive care for those who have experienced intergenerational trauma, health care providers should be aware of and understand two key SDOH inequity influencing the indigenous life course, including the residential school system and loss of socioeconomic status, over time due to colonialism.
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Little research has focused on the trauma healing processes of survivors of gender-based violence (GBV) worldwide. Even less research has utilized cross-cultural comparison to understand shared or culturally-distinct healing goals, creating a gap in understanding how to provide adequate, culturally relevant, and trauma-informed care to survivors. The purpose of this study was to cross-culturally compare shared healing influences and themes of the trauma recovery process in samples of Irish and American female survivors of GBV. To gather healing data, an ethnographic narrative interview was used with 19 American and 12 Irish female survivors who self-identified as having experienced GBV. Thematic analysis was used to examine and compare desired healing outcomes, focusing on the definitions, influences, and meanings of healing experiences. Our analysis revealed shared healing objectives of reconnecting to the self, others, and the world. Within reconnecting with the self, shared themes included regaining control and feelings of competency. Within reconnecting to others, shared themes included building and maintaining relationships, living one’s life authentically, and feeling heard and understood. Within reconnecting to the world, shared themes included feelings of serenity, finding fulfillment, and having hope for a brighter future. Although these themes were shared, the way they manifested in each culture was often different. A vital component of the healing dynamic in the Irish sample was survivors’ mothering responsibilities and feelings of unconditional devotion to their children. Conversely, the American sample focused on personal growth and resolving feelings of weakness. This information reveals shared as well as cultural nuances of important healing objectives following GBV. The present study’s results can be used to create culturally sensitive and relevent healing spaces for survivors. These results can also inform intervention and messaging strategies aimed at promoting healing in these populations.
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Background: Human immunodeficiency virus (HIV) is a global public health issue with an estimated 1.8 million people newly infected in 2017. Objective: To provide a descriptive overview of reported cases of HIV in Canada by geographic location, sex, age group, exposure category and race/ethnicity, from 1985-2017, with a focus on the most recent data. Methods: The Public Health Agency of Canada (PHAC) monitors HIV through the national HIV/AIDS Surveillance System, which is a passive, case-based system that collates non-nominal data voluntarily submitted and validated by all Canadian provinces and territories. Additional data sources presented here include data on immigration-related medical screening for HIV by Immigration, Refugees and Citizenship Canada and data on infants perinatally-exposed to HIV submitted by the Canadian Perinatal HIV Surveillance Program. Data were collated, tables and figures were prepared and descriptive statistics were applied by PHAC and validated by each province and territory. Results: A total of 2,402 new HIV diagnoses were reported in 2017 in Canada; an increase of 3% compared with 2016 and an increase of 17.1% since 2014. The national diagnosis rate increased slightly, from 6.4 per 100,000 population in 2016 to 6.5 per 100,000 population in 2017. In 2017, while Ontario continued to account for the highest number (n=935) and proportion (38.9%) of reported HIV cases, Saskatchewan reported the highest provincial diagnosis rate (15.5 per 100,000 population). In 2017, the diagnostic rate for males at 9.9 per 100,000 population was higher than for females at 3.2 per 100,000 population. As in 2016, the 30-39 year age group had the highest HIV diagnosis rate at 14.8 per 100,000 population. The "gay, bisexual and other men who have sex with men" exposure category continued to represent almost half (46.4%) of all reported HIV cases in adults. In 2017, the absolute number of HIV-positive migrants entering Canada increased to a total number of 835 migrants. One mother-to-child HIV transmission was confirmed in a mother who did not receive any perinatal antiretroviral therapy and two transmissions were confirmed in mothers who did receive perinatal antiretroviral therapy. Conclusion: Similar to the annual changes that have been reported since 2014, the number and rate of reported HIV cases in Canada in 2017 increased slightly compared with 2016. Additional data and analysis are needed to determine the extent to which these findings reflect an increase in HIV transmission, an increase in HIV testing, changes in reporting practices and an increase in the number of HIV-positive people migrating to Canada.
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Background: The distribution of hepatitis C (HCV) infection in Canada signals a widening gap between Indigenous and non-Indigenous people. Current evidence demonstrates that the rate of HCV infection among Indigenous people is at least five times higher than the rest of Canada. This analysis provides a reconciliatory response, which exposes the colonial etiology of the HCV gap in Canada and proposes potential anti-colonial approaches to HCV wellness and health care for Indigenous people. Methods: This analysis applies Two-Eyed Seeing as a reconciliatory methodology to advance the understanding of HCV burden and identify the key elements of responsive HCV care in the context of Indigenous nations in Canada. Results: The analysis underlines the colonial distribution of HCV burden in Canada, highlights Indigenous perspectives on HCV infection, hypothesizes a clinical pathway for the underlying colonial etiology of HCV infection, and identifies Indigenous healing as a promising anti-colonial conceptual approach to HCV wellness and health care among Indigenous people. Conclusions: In the eyes of Indigenous people, HCV infection is a colonial illness that entails healing as an anti-colonial approach to achieving wellness and gaining health. Future empirical research should elaborate on the colonial HCV pathway hypothesis and inform the development of a framework for HCV healing among Indigenous people in Canada.
Despite the availability of prevention and treatment services, the ongoing process of colonization has significantly contributed to disproportionate rates of HIV, hepatitis C (HCV), and HIV/HCV coinfection among Indigenous peoples. This inequity highlights a deficit in health care's ability to provide effective and culturally relevant services. Indigenous peoples have used land-based cultural practices to promote wellness since time immemorial, yet they have rarely been evaluated as health interventions. Given the severity of these health inequities, it is imperative that gaps in research and services be addressed quickly and in “good way,” whereby the research undertaken is a sacred endeavor that is connected to ceremony and ancestral wisdom and contributes to healing. Land-based cultural-wellness retreats represent a fruitful path toward wholistic wellness and decolonization. The purpose of this review is to understand the theoretical utility of and wise practices for conducting land-based cultural-wellness retreats for Indigenous peoples with HIV, HCV, or both.
Although narrative inquiry has a long intellectual history both in and out of education, it is increasingly used in studies of educational experience. One theory in educational research holds that humans are storytelling organisms who, individually and socially, lead storied lives. Thus, the study of narrative is the study of the ways humans experience the world. This general concept is refined into the view that education and educational research is the construction and reconstruction of personal and social stories; learners, teachers, and researchers are storytellers and characters in their own and other's stories. In this paper we briefly survey forms of narrative inquiry in educational studies and outline certain criteria, methods, and writing forms, which we describe in terms of beginning the story, living the story, and selecting stories to construct and reconstruct narrative plots. Certain risks, dangers, and abuses possible in narrative studies are discussed. We conclude by describing a two-part research agenda for curriculum and teacher studies flowing from stories of experience and narrative inquiry.