uncertainties surrounding efficacy and safety issues due to pharmacologi-
cally active constituents in herbal preparations. It is a challenge that calls on
a systematic approach, effective preparation and communication skills
which appreciate that, for example, applying EBM to patients is more than
the strict application of clinical trial data.
Notes and references
- Joe M. Healing: a First Nations’ perspective. In: Traditional/Alternative/Complementary
Health Care Issues, vol. 1. Proceedings of the VIIIth International Conference Traditional
Medicine and Folklore held in St John’s, Newfoundland, Canada, 1994. St John’s:
Faculty of Medicine, Memorial University of Newfoundland, 1998: 129–36. - Quoted in Sandner D. Navaho Symbols of Healing. New York: Harcourt, Brace
Jovanovich, 1979: 17–18. - The reserve is the Conne River Reserve (the Miawpukek First Nation) in Newfoundland,
Canada. The information comes from a forthcoming book: Andersen RR, Crellin JK
(eds), Mi’sel Joe. An aboriginal chief’s journey. St John’s: Flanker Press, 2009. - This note covers terms used in the chapter. (1) North America: Mexico, commonly
included in the definition of North America, is excluded; much traditional medicine there
is closer to that found in South American countries. (2) Aboriginal: this has been selected
(with ‘native’ as an occasional alternative) as, it is hoped, being the most acceptable to
First Nations’ people in the USA and Canada. Some political sensitivity, not necessarily
uniform, surrounds the term ‘Indian’, although it remains acceptable to many. And
although ‘indigenous’ is preferred by others to indicate knowledge in place independent
of influences of European or other immigrants, the impact of post-contact European
influence is often difficult to determine. (3) Patient: the term is still widely used by the
medical profession, whereas many other health professionals are tending more to ‘client’,
although for pharmacists – a point of contact for much self-care (including dietary
supplements) – the term ‘customer’ still applies. Patient is preferred because it continues
to reflect a special relationship with a practitioner. - For the importance of considering aboriginal people in urban locations (and in rural
areas off reserve), see Wilson K, Young TK. An overview of Aboriginal health research
in the social sciences: current trends and future directions. Int J Circumpolar Health
2008; 67 (2–3):179–89. Statistical returns on aboriginal people living in urban areas show
rising numbers in part through a greater readiness to acknowledge aboriginal ancestry.
For activities on reserves, some mindful of integrating traditional and conventional health
services, one can consult, for example, US Department of Health and Human Services.
Indian Health Services. Available at: http://www.ihs.gov/index.asp (accessed October 2008). - The emergence of interest in the USA and Canada has been mostly noted by non-
aboriginal observers, e.g. Waldram JB, Herring SA, Young TK. Aboriginal Health in
Canada: Historical, cultural and epidemiological perspectives. Toronto: University of
Toronto Press, 1995: 204. Although this covers aboriginal people in Canada, analogous
situations occur in the USA. - Much of the interest comes from the discipline of medical anthropology as reflected in
books such as Cecil Helman’s: Helman C. Culture, Health and Illness, 5th edn. London:
Hodder Arnold, 2007. This is singled out here as being a book particularly oriented to
practitioners. - Modern compilations of aboriginal herbal remedies often show significant overlap with
lists representative of Anglo-European traditions. Compare Mackey MA, Bernard L.
Traditional medicine used by the Micmacs of Conne River, Newfoundland. In: I eats
them like that. Changing food patterns of the Micmac of Conne River, unpublished
manuscript, 1985: 78–87, and Crellin JK. Home Medicine: The Newfoundland experience.
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