To explore the complex issue of Aboriginal child and youth health in Canada, the activities of Many Hands, One Dream are grounded in several key themes.

These themes were developed during a one-day workshop in Ottawa on June 6, 2003. Participants, many of whom are represented on the Many Hands Action Committee, discussed their vision of a future where Aboriginal children and youth in Canada are growing up in healthy, culturally-based environments. The goal of the discussion was to create a picture of a future that national organizations concerned with the health and well-being of Aboriginal children and youth can work toward creating. The only restrictions on ideas for the dream were that they be positive and possible. Ideas were diverse and ranged from the community to organizational to societal levels. A full report of this workshop is available.

Healthy communities: Children have a critical need for healthy communities and environments, in the broadest sense. The elements of a healthy community are many and varied, including: the physical environment (clean water, safe roads, appropriate housing), an engaged citizenry (people who have positive attitudes toward and are prepared to take responsibility for creating safe and healthy environments for children and youth), appropriate and accessible services for all children and youth, strong community ties that reinforce culture and traditions, as well as spirituality. Strategies for improvement should involve leveraging assets and maximizing strengths that already exist within communities.

Healthy families: The health of Aboriginal children and youth is inextricably linked to identity, pride, and self-esteem. These qualities, essential to good health, must be nurtured and supported in family, community and societal contexts. Equipped with a healthy sense of self, Aboriginal children and youth will be better able to manage adversity and maximize their own sense of success and well-being. Strong families play a key role in developing children’s resilience.

Inequity in health and health care for Aboriginal children and youth: Aboriginal children and youth face serious discrepancies in their experience of health and health care. The reasons are varied, and include racism, which affects so many aspects of Aboriginal people’s lives. This is true both at the individual (practitioner-patient/client) and societal levels. There is a need both to acknowledge this experience, better define or articulate the tangible expressions of racism in health and health care, as well as to develop strategies to overcome and eliminate racism in health and health care. There is also a need to integrate traditional medicine practices into the health care of Aboriginal children and youth, to respect it as an asset rather than see it as a barrier.

The impact of social and political exclusion on meaningful participation by Aboriginal organizations: While social and political exclusion certainly affects individuals, it also affects Aboriginal-led organizations working in child and youth health. Exclusion has served to disrupt relationships between Aboriginal and non-Aboriginal health care organizations and health care practitioners. Aboriginal organizations have often been excluded from important processes, or involved too late in the process to allow for a meaningful contribution. Participants envisioned a new relationship where Aboriginal people take a lead role in addressing health issues and establishing relationships with non-Aboriginal healthcare providers and organizations. These new relationships would be characterized by reciprocity, respect and a balance of power. Smaller organizations may also find it difficult to manage all the needs of their clients/communities/networks. Despite knowing what the issues are, they may be constrained by a lack of resources.

The role of the health community: There are many ways that the health community can contribute toward improving the health status of children and youth. One is to help improve the links between professionals working in child and youth health and the community, increasing their understanding of Aboriginal perspectives of health. Another is to encourage and support Aboriginal students to enter into professions that will support healthy children, youth and families, including medicine, nursing, social services, and others. Still another is to promote continuity of care in Aboriginal communities.

The role of the voluntary sector: An engaged sector, aware of the health needs of Aboriginal children and youth and committed to a collaborative process to improve health outcomes, could make a significant difference. The sector could also contribute to more effective health care advocacy: There is a need to develop broad-based, strategic and coordinated efforts—led by Aboriginal organizations—to advocate for public policy changes that will benefit child and youth health (eg., non-insured health benefits, national injury prevention strategy, etc.). National voluntary sector organizations could also help support the development of voluntary sector organizations at the community level.