The case study involves a 4-year-old male patient named Binesi who has had asthma for several years. The boy comes from an indigenous Anishinaabe family, belonging to Canada’s First Nations people. The patient is faced with several challenges in the environment, which are common for indigenous people. According to Greenwood et al. (2018), indigenous communities in Canada experience health disparities because of environmental issues such as crowded and substandard housing conditions, unemployment, poverty, reduced access to healthcare services, and lower education levels.
In Binesi’s case, the most prominent challenge is housing conditions since the family with five children and asthma problems lives in a small house with poor ventilation and a leaking roof. They also have limited access to healthcare since they have to travel 1,000 km by plane to get to the clinic.
There are multiple social determinants of health that affect the well-being of society. The six social determinants of health critical to the First Nations community include housing, employment and income, education, pressure on the healthcare system, culture, and social relationships (Aalhus et al., 2018). These factors should be considered when assessing and caring for the patient. For example, evaluating housing conditions is important to identify whether they contribute to the patient’s health outcomes, for example, asthma in Binesi’s case. When providing care to indigenous people, it is essential to take into account their appreciation of social relationships and connectedness with the community, for example, by involving family members in patient care.
The healing practices suggested by the Medicine Person included taking capsicum, licorice root, and an herbal tea, as well as rubbing the child’s chest with a topical salve made of milk thistle. Prior to that, Binesi was prescribed Albuterol, Flovent, Montelukast, and Theophylline. Unfortunately, no clinical evidence can be located to prove the safety of simultaneously taking these prescribed drugs and suggested healing practices. However, in general, when a person takes multiple medicines, the risk of herb-drug interactions grows (Ghosh et al., 2018). Taking herbal supplements in combination with medications may increase or decrease the effectiveness of any component, which may lead to unexpected health outcomes (Ghosh et al., 2018).
It is necessary to deliver this information to Binesi’s family in a respectful manner. The parents have to be warned that they should not add any supplements to their child’s medication regime without consulting the doctor. At the same time, the physician should not prohibit using healing practices because they are a significant part of indigenous people’s culture. As Dr. Anderson DeCoteau noted, strictly adhering to Western standards of evidence and disregarding healing practices leads to unmet healthcare needs of indigenous people and undermines their psychological well-being (TEDx Talks, 2016).
In Binesi’s case, the practice of rubbing the chest with a topical salve could be incorporated into the care plan. This would help the family stay connected with their culture and strengthen the relationship between the mother and the child.
Overall, the use of healing practices seems to be beneficial for caring for indigenous people because they are an important part of their culture. Safety concerns emerge when healing practices involve using herbs because if a person is prescribed medicines with narrow therapeutic indices, severe adverse effects may occur (Ghosh et al., 2018). Nurses are well-positioned to advocate for the use of traditional healing practices, so they have to be familiar with the beliefs and customs of indigenous people. In the healthcare setting, nurses should allow patients to adhere to their cultural practices instead of imposing Western values on them. However, it is important to advise patients that if the traditional treatment does not alleviate their symptoms, they should not delay a visit to the physician.
Aalhus, M., Oke, B., & Fumerton, R. (2018). The social determinants of health impacts of resource extraction and development in rural and northern communities: A summary of impacts and promising practices for assessment and monitoring. Northern Health. Web.
Ghosh, N., Ghosh, R. C., Kundu, A., & Mandal, S. C. (2018). Natural products and drug discovery. In S. C. Mandal, V. Mandal, & T. Konishi (Eds.), Natural products and drug discovery: An integrated approach (pp. 467-490). Elsevier.
Greenwood, M., de Leeuw, S., & Lindsay, N. (2018). Challenges in health equity for Indigenous peoples in Canada. Lancet, 391(10131), 1645-1648. Web.
TEDx Talks. (2016). Indigenous knowledge to close gaps in indigenous health | Marcia Anderson-DeCoteau | TEDxUManitoba [Video]. YouTube. Web.