Executive Summary: Mohawk Council of Akwesasne, Quebec

This page has been archived on the Web

Information identified as archived is provided for reference, research or recordkeeping purposes. It is not subject to the Government of Canada Web Standards and has not been altered or updated since it was archived.

Archived

This page has been archived on the Web.

Our Smart Cities Challenge: To reduce the prevalence of new cases of diabetes at Akwesasne to the rate of the Canadian average. Our goal looks rather humble, to only be as bad off as the rest of the Canadian population. With this statement, however, the people of Akwesasne draw a line in the sand against the existential threat of diabetes. And our work maybe beneficial to others: Recent research reviewing 111 studies worldwide confirmed a disproportionate burden of diabetic disease complications among all Indigenous peoples regardless of their geographic location.

(From: Global complication rates of type 2 diabetes in Indigenous peoples: A comprehensive review)

We recognize that the situation Akwesasne folks now face was ultimately caused by our loss of traditional ways. A steamroller of westernization disrupted our traditional lifestyles, polluted our natural food sources, and dropped on top of the Akwesasne territory three complicating political jurisdictions, not of our making. Our skills and competencies in the old ways lost relevance. Our elders' ability to provide guidance using traditional teachings and ceremonies was derailed. The temptation of western consumptive habits and modern food, that is, frankly disease causing exacerbated our genetic susceptibility for diabetes, as did our now overly sedentary lifestyles. Our traditions sought to preserve our unique relationship with the environment, to make us a sustainable society. This has been replaced by our acceptance of living in a negatively altered state, and of accepting the need for modern medicine, which does not bring us back to health. It does not cure but keeps us in a state of perpetual decreased vitality.

But how to reverse this trend towards ever worsening health? How can we address this problem in a new way?

We became aware of how organizations and industries were re-inventing themselves and disrupting their existing situation for the better through the use of Design Thinking. With our partners, we learned how to get to the root of our problem, and how to come up with ideas to solve the problem.

We wanted to have all of our community involved. We wanted to make our work transparent so our residents' relationships with our public organizations and with each other would be stronger. We wanted our people involved so the solutions that are designed will work for our people because they were part of developing where we are going at every step.

We started by looking over everything we had previously studied. We brought together our people singly, in groups, and remotely through surveys and phone calls. We discussed and identified problems. We thought of over 100 causes and solutions and then arrived at key insights regarding our predicament. We determined that the precursors leading to high levels of diabetes are related to these rather straightforward factors:

• Food Accessibility
• Network Accessibility
• Transportation Accessibility
• Westernization
• Checkup Frequency in Health and Dental
• Healthcare System Disconnection
• Loss of target demographic following primary school.

(These will be explained in detail later in our proposal).

We learned that the way forward for the health of Akwesasne must be a multipronged approach, working on many battle fronts at the same time. In our own traditions of health we remember from a Haudenosaunee perspective Goodmindedness, Peacefulness, and Strength are synonymous with a unified mind, body, and spirit concept. Similarly, our ability to achieve a healthy state will focus on four pillars that summarize our insights: Wellness, Tradition, Access, and Measurement. These Pillars will become themes for our actions in our Smart Cities approach, and take the form of new tools, and a new way of communicating, remembering and teaching. With the help of technology, the way forward is for us to accurately understand our own condition, organize ourselves for change and then make change happen in measurable, adjustable ways.

In the big picture we are where we are because we could not adapt when westernization and industrial technology changed our environment. This is the same story for Indigenous people the world over and is also a story of misused power. While it is regrettable our current environment offers us much less in many ways then it once did, it also has new things in it. Our elders could walk into the bush and point to dozens of things that had nutritional, medicinal or cultural uses. Now our environment has technologies and machines that we need to recognize as useful and use. And not just use, but develop our own skills in their use.

In the years since we were forced to abandon traditional ways and lost our self- sufficiency, the spirit of our community was also damaged. The disruption to Kanikonhriio or Goodmindedness, and Sken:nen or Peacefulness, led to the loss of our strength in looking after ourselves and each other. It weakened our self-worth, our contribution of shared effort, our access to teachings; all were made difficult. Even food in our own territory can no longer be drawn from the river or grown safely.

Yet the strength of our community can be reinvigorated, especially if we tackle the issue of diabetes. We can make use of new technologies such as mobile communication to help us function like a community again. Systems can be introduced that will make us strong together by keeping us in touch, by responding to each other's requests for help or to learn; we can share our learnings and join one another in healthy activities, and get to know one another.

Our health challenges are made harder because we don't know one another. Not in the causal sense of knowing but in the sense that our health services don't have proper information on our individual health. The fracturing of our community across jurisdictions and health districts means we can hardly even know ourselves in the sense of having an accurate medical history, often spread across provinces and countries. So how can we understand the health status of our community or plan to improve it? A mobile application, designed for the purposes of organizing us and our information can give us back this glue that can make us a community again. Modern tools can make our problems understandable, and allow us to find insights into our condition so we can develop ways to reverse our maladaptation to this still relatively newly imposed environment.

Now, in thinking about how technology can help Akwesasne, and what the Smart Cities challenge may permit us to accomplish, we started with a new way of thinking as a group. Design Thinking helps organizations innovate, which is really just a word for adapting. And this approach allowed us make up time for those years when we weren't adapting; we wanted to move ahead but had trouble deciding what needed to be done. Now we have gone over what we know, focussed on a challenge, engaged our community, developed some momentum and made a plan that uses smart technologies as an antidote for the issues caused by previous modernization.

Akwesasne has recognized the Smart Cities Challenge as an opportunity to face our hardest challenge. It has brought our community together and we have found a way to organize ourselves to move forward. While much of the world's technology had caused problems for us in the past, we will now use technology as a raw material to regain our vitality.

Our plan for adoption of technology will be on our terms. Our project probably does not seem earth shattering, which is a rate of change we find disconcerting, anyway. Through the use of about a dozen electric vehicles, the construction of 3 greenhouses adopted by the school curriculum, and a mobile application we can put in everyone's hand we plan to attack the 4 pillars of our challenge. With this limited investment in machines and software we will address the insights about our predicament.

Key to organizing the strength of our community will be the mobile and administrative coordination tool we are calling the Akwesasne Community Application. This brings everything together by providing communication amongst our people, coordination of services, access to food and community programs, measurement of service efficiency, and tracking of individual health. With these tools and oversight, we will make progress on our challenge, and reduce the rate of new disease to the rate of other Canadians. It would be nice to target the rate of diabetes in our people of 200 years ago, but for now it will be a major goal to achieve the health of other Canadians.

Our success will represent a watershed in our history. This will be where we began to defeat the most significant health risk for our people. This is where we began to improve the most significant factor for achieving a happy life, that being good health. Our elders knew how to make the most of what the environment offered; we can use that approach again. Tech is like a new herb, we must understand and use it. We will put it to use without obliterating the traditions that are our identity. We will use it while maintaining harmony with the environment.

We can use new things like e-cars and e-buses to get where it is important to go, without adding to the toxic load by burning oil. We can use greenhouses to replace our polluted food sources and gain back a measure of self-sufficiency. Mobile and computer programming can bring back the sharing and helping on which our strength as a nation was based. Digital tools will give us access to our collective memory and to the wisdom of our traditions, from which we regain pride necessary for our progress as a people. Our traditional teachings shows how strength is based on things working together. We will use that approach to work on many things at once to reverse the main threat to our health.

We believe this solution is extensible. Our package of ideas, with its mobile technology, databases, integration of health devices, location sensing, health diagnostics, statistics, transportation logistics, electric vehicles — these are all details to be adjusted for each case. At the center, however, will be the open-source system that is the hub of the services, and this is a non-proprietary system suitable for hosting anywhere. What we have learned, the approaches we take, the way we integrate the very new with the old will surely be helpful to aboriginal nations across Canada and the world over.

We are not the only people whose nation has been knocked out of harmony with the environment because of colonialism. We are not the only aboriginals whose communities were disfigured by imposed change and 'progress'. Regardless of cause, other indigenous people around the world are vulnerable to developing diabetes at the rates we are. They would surely benefit from our experience with this project. They would be welcome to our technology.