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Part 1:  Aboriginal Cultures, History, and Sexual and Reproductive Health


Building a Sexual and Reproductive Health Program

Introduction

This Sourcebook is for both Aboriginal and non-Aboriginal health and social service providers — nurses, community health representatives, teachers, public health workers, counsellors and community developers — who work with First Nations, Inuit or Métis people in Northern, rural or urban settings. The many connections among aspects of the individual, family, community and nation are important themes to remember as you work on sexual and reproductive health. The rest of Part 1 explains ways that you can build these themes into the way that you do your work and the programs and services that you offer.

Here are some basics — how to get started, barriers to services for Aboriginal clients, how to make programs and services culturally appropriate, and tips on working with different age groups. And for those who have had more experience, we can all gain from a reminder about the basics!

You can apply many of the suggestions in this section no matter what kind of service you provide, what health issues you want to work on, or who your audience is.
Specific suggestions for different age groups and for school settings are mentioned later in this section. Activities and handouts which have been taken from other resources are also featured. These resources are full of great ideas, far too many to include in this section. You can find out more about these resources by checking the Resource Information section at the end of the Sourcebook.


Involving Community Members

When working in the sensitive area of sexual and reproductive health, as in all other health issues, you will get the best results when community members are active in the design of your program.

However, it is not easy to get people to talk openly until they trust that you will respect them and understand their feelings. So much depends on relationships. Developing trust takes time, especially where cultural differences exist. If you have not established trust in the community, the information you provide may not be accepted or believed. If possible, take time to experience and appreciate life in the communities as a way to build trust.

Talking to each other or to trusted service providers about sexual and reproductive health concerns is an important step for individuals, families and communities to heal. This may be difficult at first because, for many Aboriginal people, talking about sex has become taboo often because of experiences in the residential schools — what the schools taught about sex, and the sexual abuse which some children suffered there.


They say in the old days there was a way to talk about this sex business. But I don’t remember anyone showing me. The mission school just told us sex was bad.30  (click here for footnote)


Barriers to Programs and Services

Here are some of the barriers that Aboriginal people run into when they try to use services or participate in programs. If you want to improve the sexual and reproductive health of Aboriginal people, consider whether the services available present any of these barriers. Do what you can to remove the barriers.

The first step to improving services is to talk to users of the service and ask them what they want and need.

Use focus groups in the community to find out what barriers are affecting them — ask them what would make the services better. Some barriers include:

  • Lack of respect between the client or service user and the service provider — Clients won’t take in information or come back to the program if they feel put down, talked over, judged, etc.
  • Lack of trust — Be client-centred rather than issue-centred; develop a trusting relationship with people over time.
  • Language that is too complicated and lots of written materials — Plain language and a few brochures in plain writing are very important.
  • Too much advice giving — Many Aboriginal people believe in the value of "non-interference," that is, rather than telling someone what to do, make suggestions and tell stories that provide examples and teachings.
  • Programs or advice that "miss the point" — For example, a pregnant teen who has nowhere to live needs help finding a place before she needs advice about how to eat right.
  • Programs that deal with only one issue — Our sexual and reproductive health is connected to so many other issues. It should be dealt with as part of a holistic approach to health and wellbeing.31 (click here for footnote)

 

Tips for Planning Your Approach to Sexual
and Reproductive Health

Here are some tips to remember in offering a service or program in sexual and reproductive health. To work in a way that heals:

  • Be prepared to learn. Build on the knowledge of community members about their community. Include community leadership (Chief and Band Council, Inuit or Métis community leaders), the churches, nurses, community health representatives, teachers, Elders and other leaders respected by community members.
  • Keep an open mind. The best approach depends on the community and may include a combination of health services, workshops, classroom work in schools, individual counselling, celebrations, and so on.
  • Be a resource to the community to help them decide what to do.
  • Work with people so they gain knowledge and skills and are able to help themselves more and more (empowerment).
  • Give people lots of chances to talk, to teach, to learn and to say what they want and need.
  • Involve community Elders to offer their teachings and to lead ceremonies.
  • Be prepared to include sexual and reproductive health teaching in services and programs which have a broader focus. Often people do not want to be seen seeking advice about sex.
  • Remember the central role and responsibilities of the family and community in the lives of Aboriginal people.
  • Be aware of how residential school experiences of many years past may affect families and the community today — for both the people who went to the schools and their children and grandchildren.
  • Don’t expect things to change quickly. As in all community-based programs, it takes time to develop trusting relationships.
  • Make sure that community members, not people from outside, identify the need for sexual and reproductive health services. They should also decide what the priorities are and what to do about them.
  • Make sure you have a carefully planned and culturally appropriate approach approved by the community leadership before you begin to deliver sexual and reproductive health services.
  • If working with children or young people, let their families know about your school program, workshop, youth group or health service plans. Give parents, children and youth the opportunity not to take part if they wish.


What some of the pilot coordinators told us:

At the Grand Council level, we have learned that the success of our Sexual Wellness Program depends on: identifying "movers and shakers" in the community, modeling a good interagency approach and supporting community efforts. You must have a shared belief and common concern, address contributing factors such as addictions, abuse and self-esteem and be willing to think "outside the box." Don’t forget to include the target group in planning!
Tamma Seime, Sexual Wellness Program, Prince Albert Grand Council, Prince Albert, Saskatchewan


... I think a key learning for me was that so many families are broken and hurt. After much discussion I have found that focusing on the healing of the family will contribute most to healthy sexuality. In my dealings with clients, I have found that abuse is a main factor for so many dysfunctions within the family. If even one family member can break the cycle of abuse, it will result in healthier lifestyles for others.
Julie Borle, Métis Child and Family Services Society, Edmonton, Alberta


When working with the community, it is important to always keep in mind the issues that may be facing them. Sometimes meeting basic needs is just as important as getting a message across. For instance, at Ma Mawi, we offer transportation, snack or supper and child care in order to increase attendance. Regardless if people are just attending for the food, they might hear the message and come back in the future for support.
Willow Boulanger, Positive Adolescent Sexuality Support Project, Ma Mawi Wi Chi Itata Centre Winnipeg, Manitoba


We used the Sourcebook as a focus of several meetings with local Aboriginal and non-Aboriginal agencies to explore the community’s capacity to deliver appropriate sexual health services to Aboriginal people in the city. The meetings were extremely beneficial to everyone involved as they provided an opportunity to connect with other organizations, share concerns, brainstorm solutions and create lasting relationships.
Barb McWatters, Planned Parenthood Regina, Regina, Saskatchewan


Respecting Cultural Differences

People from different cultures have different ways of looking at the world and different traditions that affect how they feel, think and act. The differences between cultures based on individualism and those based on interconnectedness have already been discussed. Respecting other cultures is essential whether you are teaching, counselling, providing health services or running workshops. Your program needs to be culturally appropriate — it is important to learn about the history, culture and traditions of the people you are going to work with. This is not a quick and simple task. Each Nation and community is different. You have to be open and work at it.

Delivering culturally appropriate services to Aboriginal clients is part of the professional training of many providers of health care and social services. For example, Canadian nurses are expected to learn about cultural diversity and to develop the needed knowledge, skills and attitudes.32 (click here for footnote)


Some Thoughts on Cultural Approaches

Culture is not simply a matter of customs or traditions. It is also a way of looking at life, a set of shared beliefs and values, a vehicle for understanding the world and one's place in it. There is considerable diversity in Aboriginal cultures, but there are also some commonalities. Here are a few examples of cultural differences that may emerge in your work with Aboriginal individuals and communities:

  • Conventions regarding eye contact, touching, seating arrangements, initiating or ending conversations, may differ from what you have come to expect in working with non-Aboriginal people.

  • Some Aboriginal people are quite comfortable with periods of silence during conversation, which can be unsettling for some non-Aboriginal people. Similarly, some Aboriginal people may tend to be less open during a brief encounter than is often customary among non-Aboriginal people. [This is particularly relevant in the sensitive area of sexual and reproductive health. It will often be necessary to take the time to develop a personal relationship with your Aboriginal clients, especially seniors, before they will talk to you about this area of their health.]

  • Whereas non-Aboriginal people tend to make decisions based on majority rule, many Aboriginal communities are inclined to seek consensus in which all members agree to accept a decision. In communities that follow this practice, make sure there is enough time for discussion so that everyone feels comfortable with the decision.

  • Time may be perceived differently in non-Aboriginal and Aboriginal cultures. While non-Aboriginal cultures live by the clock, some Aboriginal cultures are less concerned about meeting deadlines than about fulfilling the purpose of the gathering. As a result, meetings may not start precisely at the scheduled time and may go on until everyone present has had an opportunity to express a view or participate in some other way.33 (click here for footnote)


Cultural differences may be apparent in many areas in addition to those just listed, including family relationships, attitudes about the place of seniors and children in society, views on traditional and non-Aboriginal ways of doing things, perceptions of authority and hierarchy, and so on. The list is virtually endless, making it important to consider cultural factors very carefully in your choice of messages and styles of communicating. Just as there are important differences between Aboriginal and non-Aboriginal cultures that need to be acknowledged, so are there differences between Aboriginal cultures.

  • Do your homework before visiting an Aboriginal community for the first time.

  • Find out about local culture and practises (for example, the traditional sequence of events for a meeting or other gathering, and practises such as presenting gifts to Elders).

  • Ask for direction and assistance from people who are knowledgeable about local customs, personalities and channels of communication.

An assessment of federally-funded Aboriginal family violence projects identified these characteristics of culturally-appropriate programs:

  • value Aboriginal traditions and culture

  • recognize the importance of ritual and ceremony

  • value and use the wisdom of Elders

  • build on the strong sense of community and shared responsibility among members

  • make the connections among issues, within the aspects of the person and between people 
    and their world

  • work to restore balance for the individual, family, community and nation

  • place value on nurturing and mutually respectful relationships

  • honour the central place of women

  • accept and respect the client as a whole person

  • make sure there is as much equality as possible between service provider and service user

  • care about your clients

  • forgive rather than judge and punish

  • remember the holistic connection of body, mind and spirit34 (click here for footnote)

These general ideas about culturally appropriate practises are only a beginning. Whether you are a newcomer or a long-time community member, it is important to understand the history of the community and how its members live their traditions and carry out ceremonies.

 
Using ritual and ceremony is not simply an acknowledgment of culture. All teachers know that people learn best when as many senses as possible are used in the learning process. Aboriginal rituals and ceremonies speak to all four aspects of the individual (physical, mental, emotional and spiritual). An example is the sweet grass ceremony which can be used as a way to prepare for the meeting. Each person wafts the smoke from the burning sweet grass over their face and body in a symbolic cleansing to prepare them to work together — people often stand in a circle and hold hands as a symbol of connectedness as they take turns cleansing. The cleansing is believed to bring positive thoughts, feelings and words to help the work proceed in a positive way. The burning sweet grass glows and smokes and gives off a pleasing scent; the repetition of the movements is soothing; the ceremony takes time and forces people to relax and be "present." The burning of the sweet grass awakens all aspects of the individual and opens them for true learning.
  


Common Ceremonies and Teachings

As Aboriginal people, we have a rich history of ceremonies we use to mark events and to share teachings. Although the government policy of assimilation prohibited many of our ceremonies, today some of them are being practised widely across North America, with variations from community to community.

Many ceremonies include the ideas in The Seven Sacred Gifts, The Seven Sacred Teachings or The Grandfathers’ Teachings. These are the gifts or teachings of the Creator. Although the ideas are generally the same among the First Nations, local variations exist in how they are worded. Here is one version:

The Seven Sacred Gifts

Honesty
Sharing
Compassion
Wisdom
Bravery
Humility
Respect

A common First Nations ceremony today is the Sweet Grass Ceremony or Smudging. An Elder opens and closes gatherings with the Sweet Grass Ceremony and prayer.

It is said that when we light the sweet grass, the grandfathers and grandmothers in the spirit world are as stars — they see us and come close to hear our prayers. Our prayers are carried through the smoke by the grandfathers and grandmothers to the Creator.
When we smudge, we cleanse ourselves by wafting the smoke with our hands over parts of our bodies. The prayer is that our minds have clarity of thought, that our hands do good work, that our legs walk a straight path, that our hearts are strong, and that from our mouth comes the truth.
Sweet grass is a very special gift and is given great respect by First Nations people. When you require a braid for your personal use, tobacco is offered to an Elder. Money is not demanded but may be offered as a gift for the teaching and sweet grass.
The three-stranded braid is also seen as representing our ancestors, ourselves and the children not yet here. The past, present and future are seen as being in this moment and all that we are as a result of our ancestors, and everything we do, contributes to the children of the future.

Other examples of ceremonies are those we use as rites of passage such as the Berry Fast for young girls and the Bear Ceremony for young boys. The Berry Fast was described earlier in the Sourcebook and the Bear Ceremony is described in Unit 7 — Men and Sexual Health.


As Always, Communicate Clearly

Before you decide how to share information about an issue, consider all the ways of communicating. For example, this story shows that Inuit seniors often prefer the spoken word to the written word.

There are so many ways to spread the news or share information in a community. Choose the ways which work best in the community where you are working. Some possibilities include:

  • events and ceremonies

  • community notice boards

  • community radio

  • workshops and kitchen table meetings

  • clinics

  • schools

  • personal visits

  • Aboriginal newspapers and newsletters

  • Aboriginal television

  • video presentations.35 (click here for footnote)

Regardless of the way you choose to communicate, make sure that your messages are clear. Speaking and writing plainly means that you do it in such a way that your intended audience gets the message. For example, doctors, nurses and dentists have been trained in a precise and scientific use of language. Using technical words (or jargon) serves them well when they talk to each other at conferences or professional meetings. Using jargon with people who understand the words is acceptable.


Out On the Trail

Sometime in the late 1960s, an Inuk hunter and a white anthropologist were travelling out in the country in Northern Labrador when they were hit by a snowstorm. They stopped, and the hunter quickly built a snowhouse for shelter.

Once inside and sheltered from the elements, the anthropologist commented to his companion that probably more than anything else, the snowhouse or igloo symbolized the Inuit culture to the outside world. He then asked the hunter what he thought symbolized the "white" culture.

After giving the matter some thought, the Inuk hunter replied, "Paper". Unlike his own culture, the hunter said, almost everything done in non-Aboriginal society had a piece of paper attached to it — from birth certificates to death certificates and everything in between. Much of non-Aboriginal life seemed to be tied up with paper: books and magazines, newspapers, letters, reports, certificates and licences.

After agreeing wholeheartedly with the hunter’s observation, the anthropologist took out a notebook to jot it down. For him, as for many people in his culture, it didn’t seem real until it existed on paper.36 (click here for footnote)


But most of us would probably be confused if our doctor handed us a brochure on "Managing Premenstrual Dysphoric Disorder." We would be much happier if our doctor gave us something like "Everything You and Your Wife Ever Wanted to Know About PMS" which tells us what PMS is and how we can cope.37 (click here for footnote)


Write your own materials or rewrite the materials of others so that the meaning is clear for your audience.


People who speak plainly often find it easier to write plainly because plain writing takes a conversational approach to sharing information.


How Different People Learn

Each person has a preferred way for learning — the way which works best for her to receive and use information. These are called "learning styles."

Three common learning styles are:

  • visual learning — prefer to watch

  • auditory learning — prefer to listen

  • tactile learning — prefer to touch, feel, assemble

Research indicates that the majority of people are visual learners. They take in, process and remember more information by watching something happen rather than reading or listening to something.

Research also shows that students remember:

  • 10 percent of what they read

  • 20 percent of what they hear

  • 30 percent of what they see

  • 50 percent of what they both see and hear

  • 90 percent of what they say as they do something
It is evident that people who actively participate in a learning activity will learn more than if they simply listen to someone tell them about it.
When you are leading a group as a teacher or a workshop facilitator, follow the general rule of spending no more than 10 percent of the session talking to the participants. The rest of the time you should have the participants actively involved in the learning process.


The Path That We Walk, Facilitator’s Manual, suggests the following teaching methods which encourage active involvement in the learning process. Take care to select a method that is suited to your topic of instruction.


Methods to Encourage Active Participation in Learning

Brainstorming sessions — A problem or situation is described. Within a set period of time (three to five minutes) participants offer as many ideas or solutions as possible.  All suggestions are accepted without comment or criticism. At the end of the time, the group discusses and comments on all of the ideas together.

Buzz groups — Small groups are each assigned a portion of a problem or situation to discuss within a set period of time. A speaker from each group presents the group's ideas. New speakers present only ideas or information not already mentioned.

Case studies — Individuals or groups receive a description of a "real-life" situation.  They are asked to analyze the situation and present suggestions for how to resolve the problem the case study presents.

Demonstrations — Someone shows how something is done. For example a person might demonstrate on a model how a condom should be put on correctly so it is less likely to burst. Depending on the topic, demonstrations are done by the group facilitator, guest presenters, or individual or groups of participants.

Debates — A topic is selected by the participants or assigned by the facilitator. Debates work best with topics which have two clear points of view such as raising the legal drinking age, or sending young offenders out of their communities. Groups or individuals prepare their position and present their ideas on the topic to the group in a formal structure for debates.

Field trips — Participants visit a place, like a daycare centre, or see an event. They are then asked to report, either orally or in writing, on their reactions to the experience.

Guest speakers — Guest speakers usually have special knowledge in a certain area and they add variety and importance to a topic. This method gives participants an opportunity to talk with a person with specific experience from outside of their group.

Lectures — A lecture is a talk or presentation on a topic. The attention span of listeners will be limited unless the lecture is combined with a variety of presentation styles and visual images. Reserve lectures for topics in which participants have a keen interest and always provide them with an opportunity to ask questions or discuss.

Handouts and worksheets — These materials allow participants to practise and apply knowledge and skills. For best results, worksheets should be completed in small group sessions and the results presented and discussed with the larger group. Worksheets can be used to allow students to respond personally to topics or situations which they may not otherwise want to discuss in a group situation.

Role plays or simulations — The facilitator sets the scene and provides the specifics of the situation. The facilitator clearly defines the role for each character usually sharing it privately with each character. The "actors" have time to practise and then they all present their scene. The facilitator stops the activity after a certain time or if emotions begin to run too high. The observers comment on what they have seen. The actors describe their thoughts and feelings about the roles they played.

Peer group counselling — An individual presents a problem to the group. The problem may be real or fictional. Group members listen and then offer advice and suggestions. The facilitator monitors the group and provides guidance but does not participate directly.

Videos and films — Videos can be useful to add to a topic of discussion but should not replace other methods. Short videos (15 minutes or less) are best. Participants need time to ask questions and discuss what they have seen.

Question box — This strategy is a good way to deal with sensitive topics which participants may not be willing to ask about openly in front of others. Participants write our questions and submit them without a name. The facilitator can randomly select a few questions to answer in each session. However, be prepared to answer regardless of the question. It may a good idea to collect (in a box) and review all of the questions and answer the most frequently asked items during the next group session.38 (click here for footnote)

 

Working in Groups

Working in groups is a common method in programs dealing with topics of sexual and reproductive health. Leading groups effectively is a challenge, especially when a group will be working on sensitive issues.

People in the North have always cared for each other. However, we have been living through some very tough times in our northern towns and communities. Wife-beating, child sexual abuse, sexual assault, addiction — on top of all the problems that come when there are no jobs, not enough houses and few chances for training.
People have now started talking more openly about these problems. Caring people in every community are looking for ways to help each other. They talk about these problems and try to heal themselves and their community. Workshops, healing meetings and support groups are some of the ways people can help each other.39 (click here for footnote)



From Dark to Light: Regaining a Caring Community

From Dark to Light: Regaining a Caring Community is a project of the Status of Women Council of NWT and the Women’s Community Action Team. The project supports workshops, healing meetings and support groups in communities. A seven-booklet binder is available.

The From Dark to Light "Facilitator Book" explains many things that are useful in helping people to work in groups:
  • what to do to help people
  • basic steps in a workshop
  • how to plan a workshop
  • how to plan each meeting of the group
  • different types of groups
  • stages groups go through
  • tools for working with groups
  • how groups act and change
  • challenges
  • take care of yourself
  • agreements for working together
The topics of the other six From Dark to Light booklets are:
  • spousal abuse
  • child sexual abuse
  • sexual assault

 
  • parenting skills
  • healthy relationships
  • support groups for abusive men

 


The From Dark to Light "Facilitator Book" summarizes a number of other challenges when working in groups and offers the following advice. Other sections of the "Facilitator Book" suggest ways to work with groups to help with these challenges.

Challenges When Working in Groups

  • How Fast Can the Group Go?
    When you are new at leading a group, you may find that you plan too many activities. The group has to rush to finish them all by the end of the meeting. If you plan fewer activities, the group can take their time with them and get more out of each one they do. Move to the next activity when the group is ready, not just because the agenda says it’s time.


  • Think About the Group
    It is hard not to watch yourself and wonder if you are doing okay. Don’t get lost in your own thoughts about how you are doing as a facilitator. You need to think about what people are saying and how they are feeling. This is one of the hardest things to do when you are leading a group. You need to listen, watch, and listen again. This can make you tired. Be sure to get enough rest.


  • Make People Feel at Ease
    It is important that the group trust and feel good with each other. You need to do things at the start that will make the group feel this way. When people learn to work well with others in the group, they will be able to talk about and work together on their own needs.


  • Make the Group Part of Decisions
    The group needs to make agreements at the very start of the workshop about the purpose of the group and how the group will work. Because they have decided on the rules, they will be willing to stick to them and make things work. It is okay if someone doesn’t agree sometimes. The group can talk over the problem and decide together what to do.


  • Crying
    Sometimes people will cry at a healing meeting. You may even find many people crying all at once. This often happens. Tears are cleansing and crying releases grief which people have kept to themselves. Listen to the person’s story and ask others how it makes them feel to hear this. Give each person a chance to talk and cry. You may need to take lots of breaks for people to get the energy to carry on. (Going for walks can help if it is a long meeting.)

This is not the time for learning new skills, giving advice, or working in small groups. The one thing that helps here is for people to learn that they are not alone. Later, at a time when you are talking about the details of a topic, you can use their stories to show what you mean. But don’t do that until you have heard from everyone and people feel "emptied out".


  • Report Child Abuse
    If someone in the group talks about child abuse or child sexual abuse that is happening now, the law says you have to report it to Social Services or the [police]. At the start of the workshop, you need to tell the group that this is what you have to do.


  • People in Crisis
    Sometimes people come to the group when they are in a crisis. For example, they have been beaten, or there is a death or an accident. Take them to a private place and ask them if they wish to stay and what they need right now. If they cannot do what they need to on their own, then ask them who they would like to have go with them. Help them do what needs to be done. If they want to stay, ask them if they want the others to know what happened and how they want to tell them.


  • Touching
    Some people like to hug and touch each other a lot and others don’t like this. Part of the agreements that you make at the start of the group can be about this. In fact, one of the agreements can be that people can "not take part in any activity that makes them uncomfortable". If you want to touch someone to comfort them, ask if it is okay first. Some people, especially survivors of child sexual abuse or sexual assault, do not like people touching them. In men’s groups, it is important to say that all touching will be gentle, and there will be no play fighting or aggressive acts of any kind.


  • Be Clear
    When you are doing a talk, try to make it short. Have your main ideas written on a flip chart. That way you can easily see if you have said everything you wanted to. It also helps the group to understand and remember what you say. Examples help to show what you mean. Always have the group take part as much as you can. Ask questions or ask for examples or stories from people’s own lives. Sometimes it helps to have a handout that people can follow along with.


  • Bring Good Humour
    Use jokes where you can. People will listen more easily and relax. However, never joke about violence or pain.


  • Check on People
    Use the breaks to find out how people are feeling. If someone seems to feel bad, ask them how they are doing. Often they will be more open about their feelings when they are not in the meeting room.


  • Keep it Simple
    For evening meetings, don’t plan many activities that need a lot of equipment and materials, for example, videos, magazines, books. If you do, you end up thinking more about these tools than about the group and the topic. One activity that needs these things is often enough for one meeting.


  • Nobody Speaks
    Don’t panic if no one is talking. If it is at the start of the group, people may be shy. Work in pairs or small groups to talk about a topic and ask each group to report to the big group. There may be many reasons why people don’t speak. They don’t understand the questions or the topics, they need to know more to be able to think about it, or they are tired. Check with the group. Don’t forget that sometimes people don’t answer your questions right away. They may need a certain time (2 or 3 minutes) to think about an answer.


  • Arguments
    Sometimes two people will argue or someone will argue with you. Thank them for their ideas and ask the other people for their ideas on the topic. Do the same thing if someone is doing all the talking.


  • You Don’t Know the Answer
    Facilitators don’t have to know everything! Don’t worry. When you don’t know something, just tell the group and let them know you’ll find out. After the workshop you can ask an expert or read a book or watch videos on the subject.


  • Things Are Going Wrong
    Don’t be too hard on yourself if you find that something is not working. This sometimes happens. You can be honest with the group about it and move on to something else. If nothing seems to work, ask people what is happening. You can use a talking circle and a check-in to find the problem and come up with a solution.40     (click here for footnote)



Working with Youth

Working with youth presents unique opportunities for turning their boundless energy toward learning. All of the general suggestions made in the sections above apply to working with youth — making sure the community is on side, involving Aboriginal community members, speaking and writing plainly, responding to how different people learn, and leading groups.

For a useful general source of up-to-date information and activities on sexual and reproductive health for children and youth, try Beyond the Basics: A Sourcebook on Sexual and Reproductive Health Education.


Beyond the Basics

Beyond the Basics is a tool for educators who deliver sexual and reproductive health education to 9- to 18-year-olds. This extensive 400-page manual contains lesson plans for different age groups on a wide range of sexual health education topics including: values, puberty and reproductive health, self-esteem, sexual identity, relationships, communication and decision making, contraception and safer sex, and STIs and HIV. Designed for use in the classroom and in community agencies, the Sourcebook complements existing programs and curriculum guidelines set by provincial and territorial Ministries of Education. Beyond the Basics is the ideal resource for any educator teaching sexual and reproductive health education.41 (click here for footnote)


As with any group, youth at different ages have specific needs, interests and talents which you can build on to encourage active learning.


Pilot coordinator Tamma says:
Youth need to be recognized and appreciated as peer counsellors, because they are the ones who are getting through to our children. Youth have told me that, even though they don’t have letters behind their names (like professionals), they do contribute by sharing their stories for others to learn from … they have been through what many of our young people are presently experiencing and they have overcome adversity.
Tamma Seime, Sexual Wellness Program, Prince Albert Grand Council, Prince Albert, Saskatchewan


The Path That We Walk program is an example of a youth program which tackles the problem of violence. It is a good example of using a broad approach to a sensitive community issue.


The Path That We Walk

The Path That We Walk program began in Wikwemikong on Manitoulin Island in Ontario as an intervention for youth in conflict with the law. The program has been expanded to all youth and community members concerned about developing youth leadership in the Wikwemikong community. The program goal is to involve parents, their children, the schools, child and family services, health services, the police and courts, and the community at large.

The Path That We Walk program guide consists of eight sections or parts. The first seven are based on the seven grandfather teachings: wisdom, bravery, honesty, truth, humility, respect and love. The sections cover local history and culture, choices and decision making, communication, family and clan systems, health and wellness, respect and emotions, and the mind. The final section addresses job readiness skills and the program wrap-up — a community feast and give away.42 (click here for footnote)


The Path That We Walk: Facilitator’s Manual offers many ideas which are useful to group leaders and educators no matter what topic the youth are concerned with.

It also offers hints about asking and answering questions, deciding on session rules, using smaller groups, what to do when things go wrong, using equipment (overhead projectors, flip charts, black or white boards, videotape players, etc.), and working with handouts. The Facilitator’s Manual briefly describes how the program encourages a continuing relationship among the community’s service providers and their agencies, the school and youth in the community.


 
Session Rules of Courtesy and Mutual Respect

Youth can develop or agree to rules such as:

  • Listen when others are talking.
  • Give everyone a chance to speak.
  • Don’t tease or insult others.
  • Don’t gossip or talk about what others have done.
  • Don’t criticize other people’s ideas.

 

  


One exciting way that youth can be involved in their own learning is in a performing theatre troupe. They learn about issues as they develop skits to be presented to children and other youth. They are able to share their new knowledge both as actors when they perform and as peer counsellors when they are not performing.


Pilot coordinator Ursula says:
We’re really excited about using theatre or making a video to explore youth sexuality issues. The Sourcebook gave me lots of ideas and reminded me how important it is to involve youth in each step. This is taking a lot longer than I expected. We are all busy with school, relationships, etc. We’re moving forward slowly to develop the idea and find funding.
Ursula Johnson, Youth Program, MicMac Friendship Centre, Halifax, Nova Scotia



Kamamakus Youth Theatre

Kamamakus (Cree for butterfly) is a youth performing troupe in Prince Albert, Saskatchewan. The troupe provides innovative education to address high-risk behaviours contributing to Hepatitis C, HIV/AIDS and other STIs, substance abuse and gangs. The troupe members have reached many youth through the telling of their stories. The self-esteem of each of the troupe members has blossomed, reflecting the metamorphosis of the butterfly. They have become peer counsellors and excellent role models for youth.



Reaching Elders

Involving identified community Elders and older adults in your approach to sexual and reproductive health is important for two main reasons:

  • Elders and many Grandmothers and Grandfathers are the keepers of traditional culture and knowledge. They are respected community members who can contribute their wisdom to your approach in their community.

  • Community Elders and older adults may have sexual and reproductive concerns which are experienced by most people as they age. Aboriginal seniors who are survivors of residential schools may be struggling with more serious sexual issues. They may be uncomfortable about discussing sexual problems.

If you want Aboriginal seniors to hear about your program or service, here are some hints:

Reach out — Don’t wait for Aboriginal seniors to ask for information — they may be reluctant to ask. Take the initiative to reach out to them. Consult with community helpers. Take time to understand seniors’ information needs and make it easy for seniors to obtain information easily as part of their regular daily activities.

Use personal contact and word of mouth — Aboriginal seniors tell us that they like to receive information personally from other people. Community helpers like to share information in this way and they regularly meet and speak with seniors.

Make your program or service holistic — Be prepared to help seniors with issues beyond sexual and reproductive health.

Form lasting partnerships — Invest time and effort to develop lasting partnerships with your community contacts. They can keep you up-to-date on what seniors in the community need. Advisory committees of seniors and community helpers are effective ways to stay in touch, to see whether your efforts at helping are working, and to celebrate successes.43 (click here for footnote)


Dealing with Disclosures of Abuse or Violence

Working with people on the topic of sexual and reproductive health can present diverse challenges. Perhaps the greatest challenge is a disclosure by a client or group member about sexual abuse or other violence.

Whether you are a teacher, a counsellor, a facilitator of a meeting or workshop, or a health care provider, you should be prepared and know what to do in case of a person’s disclosure of abuse either in a group or when you see him or her alone.

Make sure you know your professional and legal obligations related to situations such as child sexual abuse, family violence or sexual violence involving youth. Know how to support a person who needs to talk about experiences of abuse or violence. Be prepared to offer support and know where the safe places in the community are for the person to go for more help.

 

The print version of the Sourcebook also contains information on print, web-based and audio-visual resources, and sample materials on Aboriginal cultures, history, and sexual and reproductive health

 

30  Marmalade or Jam ... A Recipe for Understanding AIDS, Health Promotion Unit, Department of Health and Social Services, Government of the Northwest Territories, Yellowknife, no date, p. 5.  (back to paragraph)

31  Adapted from: "Defining Cultural Competence: An Organizing Framework," Mario A. Orlandi. In Cultural Competence for Evaluators: A Guide for Alcohol and Other Drug Abuse Prevention Practitioners Working with Ethnic/Racial Communities, U.S. Department of Health and Human Services, Washington, 1995, pp. 293-9.  (back to paragraph)

32  Nursing Now, Issues and Trends in Canadian Nursing, No. 7 (February 2000): 1, Canadian Nurses Association, Ottawa.  (back to paragraph)

33  Reaching Out: A Guide to Communicating with Aboriginal Seniors, Division of Aging and Seniors, Health Canada, Ottawa, 1998, pp. 8-9.  (back to paragraph)

34  Beginning a Long Journey: A Review of Projects Funded by the Family Violence Prevention Division, Health Canada, Regarding Violence in Aboriginal Families, Health Canada, Ottawa, 1997.  (back to paragraph)

35  Reaching Out: A Guide to Communicating with Aboriginal Seniors, Division of Aging and Seniors, Health Canada, Ottawa, 1998, pp. 24-7.  (back to paragraph)

36  Reaching Out: A Guide to Communicating with Aboriginal Seniors, p. v.  (back to paragraph)

37  Adapted from Directory of Plain Language Health Information, National Literacy and Health Program, Canadian Public Health Association, Ottawa, 2000, p. vii.  (back to paragraph)

38  Adapted from: The Path That We Walk: Facilitator's Manual, Karen J. Pheasant and Colleen Wassegijig, Wikwemikong Board of Education and Wikwemikong Health Services, Wikwemikong, Ontario, pp. 14-5.  (back to paragraph)

39  From Dark to Light: Regaining A Caring Community ("Facilitator Book" and six activity booklets), Status of Women Council of the NWT, Yellowknife, 1995, p. 1.  (back to paragraph)

40  From Dark to Light: Regaining a Caring Community ("Facilitator Book"), Status of Women Council of the NWT, Yellowknife, 1995, pp. 38-40.  (back to paragraph)

41  Beyond the Basics: A Sourcebook on Sexual and Reproductive Health Education, Planned Parenthood Federation of Canada, Ottawa, 2001.  (back to paragraph)

42  The Path That We Walk: Facilitator’s Manual, Karen J. Pheasant and Colleen Wassegijig. Wikwemikong Board of Education and Wikwemikong Health Services, Wikwemikong, Ontario, 1997. (back to paragraph)

43  Adapted from: Reaching Out: A Guide to Communicating with Aboriginal Seniors, Division of Aging and Seniors, Health Canada, Ottawa, 1998, pp. 21-2.  (back to paragraph)

 
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