The Yukon takes native health a step further at Whitehorse hospital
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* Heather Kent

A sunrise ceremony this summer marked the launch of an innovative native healing building at the Yukon's Whitehorse General Hospital - the latest addition to the hospital's highly successful native healing program.

The room's doors face east and west, representing the circle of life, and it has 12 wooden panel walls, a stone floor and a central fireplace for sweetgrass ceremonies. Mainly, it is used as a place for dying patients and their families to meet. Nurse Donna Hogan, director of the native health program, says doctors also use the room to talk to families about death and dying and to discuss issues such as organ donation, while native lawyers use it to help patients prepare wills. Following a patient's death, she says, "appreciation of life" ceremonies in the healing building give families an opportunity for closure. FIGURE

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/10/1312/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/161/10/1312/F1)

Figure. Healing room: meeting aboriginal needs

Hogan thinks the changing atmosphere surrounding death and dying is the greatest shift she has seen in native health care. "Not that long ago, [dying] was a frightening experience. Now patients are much more open."

The native health program was launched in 1993, 2 years after administration of the hospital was transferred from the federal to the territorial government. The Council for Yukon First Nations, as well as individuals, had proposed the program in response to the alarming health status of natives living there. A Health Canada report released at the time drew bleak conclusions about the Yukon's First Nations, which were experiencing the highest death rates from injury and poisoning (including alcoholism) among Canada's aboriginal population. Aboriginal males in the Yukon also had the highest suicide rate in the country.

Today, aboriginal people account for about half the admissions to the 49-bed hospital, but their care has changed greatly. The native health program is staffed by 10 Yukon First Nations professionals, including a child life worker and specially trained health and social liaison workers. Many of the staff are fluent in the 7 First Nations languages spoken in the Yukon, but interpreters are brought in if needed. Traditional food, such as moose and caribou stew, is served daily.

Dr. Frank Timmermans, the medical officer of health and a surgeon at the hospital for 20 years, says that the health workers have made his job much easier by improving communication with patients' relatives. In rural areas, a lot of patients don't have telephones, he explains, and "the simple fact of keeping people informed is way better than it used to be."

The types of patients Timmermans sees have changed too. Where there was once a 24-bed children's ward, which was usually full of children with gastrointestinal and similar complaints, there are now only 4 pediatric beds. Timmermans attributes this to the improvement in the Yukon's infrastructure.

Hogan says alcohol is "still the biggest problem" underlying patient admissions, although this is also improving. Timmermans says there has been a "fairly steep" decline in alcohol-related admissions at the hospital.

Once patients have received medical attention, the health and social liaison workers delve into why the injuries or illnesses occurred, whether alcohol or physical or sexual abuse was involved, and the state of the patient's support system. Often, says Hogan, abuse dates back to time spent in residential schools.

The staff try to get patients back on track with social agencies. However, Hogan says there is a major need for more trained health workers in the community. She hopes to contract a staff member soon to carry out health promotion. Hogan points to diabetes and fetal alcohol syndrome as 2 of the major, preventable problems in the Yukon. She seeks more efforts to promote an active lifestyle and have people take responsibility for their health.

Dr. Marlyn Cook, a First Nations physician from Manitoba, travels extensively throughout Canada - including stops in Whitehorse - to teach doctors how to incorporate native medicine into their practices. Cook, who attended the sunrise ceremony, says First Nations people have to "take back their own medicines from the land," and that doctors and natives need to "acknowledge that aboriginal people have a very powerful way of healing." She considers the Whitehorse program as a positive approach and would like to see a healing room in all native communities.

"We have a lot of good things in our traditional medicine and there are a lot of good things in Western medicine," says Cook. "We need to balance them."