This thesis explores the utility of the conflated term “colonial medicine” by drawing on events during an historical outbreak of amebic dysentery that occurred on several Indian Reservations near Loon Lake, Saskatchewan, during the 1960s and ‘70s, including a series of government-sponsored drug trials conducted to stem the outbreak. Largely devoid of the racialized notions characterizing primary documents used by previous scholars of ‘colonial medicine’, the medical journal articles, government memorandums, and letters written by physicians in connection with the outbreak and trials reveal their immersion in ‘la clinique’, or an anatomo-clinical discourse similar to what theorist Michel Foucault described in Birth of the Clinic. Conversely, conversations with Loon Lake area community members on the subjects of the outbreak and trials reveal their multiplex and nuanced reactions to medical and colonial discourses. Arguably, then, when writing about past events, historians should weigh ‘medicine’ and colonial discourse separately. Essential methodological consideration was given to the Foucauldian concept of ‘disinterring’ popular knowledge. Drawing on Foucault’s edited works Power/Knowledge and I, Pierre Riviére, the subjugated knowledges of Aboriginal community members, physicians, sanitation workers, and government employees gleaned through interviews and text are contrasted as per his example in these works with the false functionalism of ‘scientificity’. Moreover, when considered in tandem, these subjugated knowledges illustrate a ‘structural violence’, following anthropologist Paul Farmer’s methodology for describing such phenomena in Pathologies of Power. Overarchingly, they obscure the paradigmatic dichotomies (‘doctor’/‘patient’, ‘patient’/the healthy person, ‘colonizer’/‘colonized’, ‘oppressor’/‘oppressed’) espoused in medical, colonial, and even post-colonial discourses. This understanding forces the reflexive recognition that–if we accept rhetorician Christopher Bracken’s assertion in Magical Criticism there is a recourse to savage philosophy within academia–what we say as historians has consequence beyond discourse, possibly creating new ‘subjects’ in a Foucauldian, disciplined society.

The role of weather and climate variability on the health of Aboriginal people in Fort Albany and Toronto, Ontario, Canada is explored through four complementary research studies. The first study examined past temperature trends of Fort Albany (using climate records of Moosonee) and Toronto. Temperature variability was found to be greater in Moosonee than in Toronto, and day to day temperature minimum (Tmin) threshold exceedances of 5 degrees Celsius was found to have significantly declined in both Toronto and Fort Albany. The second study explored the effects of climate change on a rural First Nation group in Fort Albany. Observed environmental changes include changes in the timing of seasons, spring melt and ice freeze-up; warmer seasons, an increase in extreme and unpredictable weather, and changes in animal patterns. These changes have affected subsistence harvesting activities and community infrastructure, which have lead to increased health risks, though many community members have exhibited resiliency and adaptation. The third study compared current health status between an urban Aboriginal and non-Aboriginal group. Urban Aboriginal participants were found to be at greater risk to psychological distress and seasonal affective disorder (SAD) than non-Aboriginal participants. Moreover, those who self-rated their health as poor/fair were more likely to exhibit psychological distress than those who self-rated their health as good/very good/excellent. The fourth study compared the effects of weather and seasonal change among a rural First Nation group, an urban Aboriginal group and an urban non-Aboriginal group. Urban Aboriginal participants were most affected by weather while rural Aboriginal (i.e. First Nation) participants were least affected by weather. These studies demonstrate that both urban and rural Aboriginal groups may be at risk to climate change and weather-related changes; though specific implications may differ due to different lifestyles and capacities to adapt to environmental conditions.

Asthma is the second most common chronic condition among Aboriginal youth. This three-phase study aims to understand the psycho-social barriers facing asthmatic Mi’kmaq youth and their parents/caregivers living in Cape Breton, Nova Scotia and facilitate health promoting behaviours at the community-level. A community-based participatory research approach was undertaken to: 1) identify the support needs/intervention preferences of asthmatic Mi’kmaq youth and their parents/caregivers; 2) design and pilot test a culturally appropriate support-education intervention that meets these preferences; and 3) identify the implications of the findings for asthma programs, policies, and practices and determine dissemination strategies. The findings suggest that there is a lack of community-level asthma support available to Mi’kmaq families managing the condition despite a strong desire for these services. This study offers three community-driven recommendations to increase available support: improve school-based asthma policy, develop asthma expertise within each community health center, and implement an annual, culturally appropriate asthma camp.

It is well documented in the literature that Aboriginal peoples have a lower health status compared to the non-Aboriginal population in Canada. The underlining causes for this health disparity are found in the historical and contemporary practices of colonization and social, economic, and political deprivation. This thesis focuses on another of the complex factors which affect Aboriginal health status: the education and training provided to undergraduate medical students on Aboriginal health issues and the social determinants of health in British Columbia. I conducted a critical discourse analysis of the readings materials of three selected courses. I conclude from the analysis that although some of the themes covered by the courses critically present the historical, social and economic contexts for this health disparity, Aboriginal peoples are still characterized as a needy and sick population. Indigenous issues are far from being centrally positioned in the medical curriculum in British Columbia. / Graduate / 0326 / gabipere@hotmail.com

It is well documented in the literature that Aboriginal peoples have a lower health status compared to the non-Aboriginal population in Canada. The underlining causes for this health disparity are found in the historical and contemporary practices of colonization and social, economic, and political deprivation. This thesis focuses on another of the complex factors which affect Aboriginal health status: the education and training provided to undergraduate medical students on Aboriginal health issues and the social determinants of health in British Columbia. I conducted a critical discourse analysis of the readings materials of three selected courses. I conclude from the analysis that although some of the themes covered by the courses critically present the historical, social and economic contexts for this health disparity, Aboriginal peoples are still characterized as a needy and sick population. Indigenous issues are far from being centrally positioned in the medical curriculum in British Columbia. / Graduate / 0326 / gabipere@hotmail.com

The role of weather and climate variability on the health of Aboriginal people in Fort Albany and Toronto, Ontario, Canada is explored through four complementary research studies. The first study examined past temperature trends of Fort Albany (using climate records of Moosonee) and Toronto. Temperature variability was found to be greater in Moosonee than in Toronto, and day to day temperature minimum (Tmin) threshold exceedances of 5 degrees Celsius was found to have significantly declined in both Toronto and Fort Albany. The second study explored the effects of climate change on a rural First Nation group in Fort Albany. Observed environmental changes include changes in the timing of seasons, spring melt and ice freeze-up; warmer seasons, an increase in extreme and unpredictable weather, and changes in animal patterns. These changes have affected subsistence harvesting activities and community infrastructure, which have lead to increased health risks, though many community members have exhibited resiliency and adaptation. The third study compared current health status between an urban Aboriginal and non-Aboriginal group. Urban Aboriginal participants were found to be at greater risk to psychological distress and seasonal affective disorder (SAD) than non-Aboriginal participants. Moreover, those who self-rated their health as poor/fair were more likely to exhibit psychological distress than those who self-rated their health as good/very good/excellent. The fourth study compared the effects of weather and seasonal change among a rural First Nation group, an urban Aboriginal group and an urban non-Aboriginal group. Urban Aboriginal participants were most affected by weather while rural Aboriginal (i.e. First Nation) participants were least affected by weather. These studies demonstrate that both urban and rural Aboriginal groups may be at risk to climate change and weather-related changes; though specific implications may differ due to different lifestyles and capacities to adapt to environmental conditions.

Doctor of Philosophy(PhD) / Indigenous health is one of the most pressing issues confronting contemporary Australian society. In recent years government officials, medical practitioners, and media commentators have repeatedly drawn attention to the vast discrepancies in health outcomes between Indigenous and non-Indigenous Australians. However a comprehensive discussion of Aboriginal health is often hampered by a lack of historical analysis. Accordingly this thesis is a historical response to the current Aboriginal health crisis and examines the impact of colonisation on Aboriginal bodies in Queensland during the early to mid twentieth century. Drawing upon a wide range of archival sources, including government correspondence, medical records, personal diaries and letters, maps and photographs, I examine how the exclusion of Aboriginal people from white society contributed to the creation of racially segregated medical institutions. I examine four such government-run institutions, which catered for Aboriginal health and disease during the period 1900-1970. The four institutions I examine – Barambah Aboriginal Settlement, Peel Island Lazaret, Fantome Island lock hospital and Fantome Island leprosarium – constituted the essence of the Queensland Government’s Aboriginal health policies throughout this time period. The Queensland Government’s health policies and procedures signified more than a benevolent interest in Aboriginal health, and were linked with Aboriginal (racial) management strategies. Popular perceptions of Aborigines as immoral and diseased directly affected the nature and focus of government health services to Aboriginal people. In particular the Chief Protector of Aboriginals Office’s uneven allocation of resources to medical segregation facilities and disease controls, at the expense of other more pressing health issues, specifically nutrition, sanitation, and maternal and child health, materially contributed to Aboriginal ill health. This thesis explores the purpose and rationales, which informed the provision of health services to Aboriginal people. The Queensland Government officials responsible for Aboriginal health, unlike the medical authorities involved in the management of white health, did not labour under the task of ensuring the liberty of their subjects but rather were empowered to employ coercive technologies long since abandoned in the wider medical culture. This particularly evident in the Queensland Government’s unwillingness to relinquish or lessen its control over diseased Aboriginal bodies and the continuation of its Aboriginal-only medical isolation facilities in the second half of the twentieth century. At a time when medical professionals and government officials throughout Australia were almost universally renouncing institutional medical solutions in favour of more community-based approaches to ill health and diseases, the Queensland Government was pushing for the creation of new, and the continuation of existing, medical segregation facilities for Aboriginal patients. In Queensland the management of health involved inherently spatialised and racialised practices. However spaces of Aboriginal segregation did not arise out of an uncomplicated or consistent rationale of racial segregation. Rather the micro-histories of Fantome Island leprosarium, Peel Island Lazaret, Fantome Island lock hospital and Barambah Aboriginal Settlement demonstrate that competing logics of disease quarantine, reform, punishment and race management all influenced the ways in which the Government chose to categorise, situate and manage Aboriginal people (their bodies, health and diseases). Evidence that the enterprise of public health was, and still is, closely aligned with the governance of populations.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.

This ethnographic study in medical anthropology is a critically interpretative analysis of fieldwork documentation I recorded during field research conducted in the mining city of Mount Isa in the far northwest of Queensland during the 1980s. Eighteen months of participant observation research was undertaken over four fieldtrips (1981-82, 1983, 1985 and 1988) at inter-connected locations: two urban reserves for Aborigines and the people I refer to as the Reserve Dwellers, as well as the local hospital and a group of hospital resident medical officers who I refer to as the Residents. During the field research I found that both Reserve Dwellers and the Residents experienced a difficult relationship during their interactions in medical consultations in the hospital clinics. Now in this dissertation I ask an overarching question of my time-lag field data. It is How can we understand the problematic relationship between indigenous reserve-dwelling help-seekers and biomedical practitioners at their local hospital clinics in the 1980s. To describe this problematic relationship I analyse time-lag data from my diaried participant observation at both the reserves and the hospital; semi-structured interviews with the hospital Residents; case studies and case histories of consenting help-seekers from the Reserves; and illustrative transcriptions of consultations between Residents and Reserve Dwellers that were tape recorded by the Residents during hospital clinics. The contemporary ethnomedical system of the Reserve Dwellers was inclusive of biomedicalized clinics and the Residents as clinicians at this remote hospital in the 1980s. I provide an ethnographic account of a changing contemporary indigenous ethnomedical system and describe the lifeways of the Reserve Dwellers in the 1980s; their pattern of help-seeking at their local hospital including grievous happenings; and their experiences in outpatients clinics and the emergency section of the local non-indigenous hospital. Their lifeways and help-seeking were in many ways defined by the collective sociality of Kalkadunga and other regional indigenous cultures as impoverished, very sick survivors of a genocidal contact history less than 100 years before. This local history is also reconstructed. The Residents view of local indigenous illness, help-seeking, and experiences of biomedicalised hospital clinics further describe the socio-cultural reality of the time. I found that the Residents had an insightful, even predictive assessment of local illness burden. At the same time, they held strong views about a pattern of help-seeking in the outpatients and emergency clinics that was considered disruptive of hospital routines. I also describe how they expressed their difficulties interacting with Aboriginal help-seekers including the taking of biomedical histories. My thesis is that a localized socio-clinical reality was shaped by a synchronic, coeval relationship between Reserve Dwellers enculturated within a changing, contemporary ethnomedical belief system that incorporated biomedicalized hospital clinics, and the Residents as clinicians enculturated within a culture of biomedical science at a remote hospital. I argue that the lifeways and pattern of help-seeking of the Reserve Dwellers, as well as the Residents’ views about sick indigenous help-seekers, formed this particular socio-clinical reality. It was then consistently replicated by problematic socio-clinical interaction and biomedicalized praxis that inhibited investigation and curative outcomes for the Reserve Dwellers and other indigenous help-seekers.