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By Margaret Munro, Canwest News Service October 19, 2009 5:02 AM Ottawa Citizen
VANCOUVER — Chief Robert Joseph was furious when he first laid eyes on Dr. Keith Dawson and his partner at an aboriginal health meeting.
“I thought: ‘Who on Earth do these people think they are, parachuting into my community,’ ” says Joseph, hereditary chief of Gwawaenuk First Nation in northern B.C. “They’re going to tell us again about what’s good for us, what we ought to be doing. I’ve seen it all my life.
“I sat there fuming,” he says of that first encounter at Vancouver’s native friendship centre three years ago.
But the chief soon found common ground with Dawson, a noted doctor, and Hesham Nabih, an Egyptian oceanographer. The unlikely trio joined forces to create Diabetes and My Nation, one of the few intervention programs that have been shown to make a real difference in fighting what Joseph describes as the “monstrous” problem in aboriginal communities, which have diabetes rates of up to five times the national average.
In a report to be released Monday to the World Diabetes Congress in Montreal, they detail how the program has enabled a small aboriginal community in northern B.C. to get diabetes under much better control.
In fact, the Haisla First Nation is now managing the disease more effectively than the non-native community of Kitimat next door, says Dawson, medical professor emeritus at the University of B.C., who helped develop Canada’s national diabetes treatment guidelines.
By almost every measure — blood sugar, blood pressure and cholesterol — the diabetics in the Haisla community of 700 are doing better than their counterparts in Kitimat, home to 9,000. “They beat the town people pretty badly,” says Dawson.
He and Nabih, a diabetic with a keen interest in helping people better manage the incurable disease, have for years been creating diabetes education and management programs. Joseph helped them tailor Diabetes and My Nation for aboriginal communities.
The Haisla were keen to test the program and a small core group of diabetics signed up in 2007 to try it as part of federally funded pilot project. They agreed to regular checkups and to attend educational meetings.
“The surprising thing was the spill over effect on the community as a whole,” says Dawson.
Word spread from the project’s core group of 11 to the other 50 diabetics in the Haisla village, and many of them started better managing their diabetes through diet, exercise and, as needed, medication. Elders, community leaders and teachers got involved, supporting everything from basketball tournaments to healthier eating initiatives to a young warriors program that had youth build and race a canoe.
When the pilot project ended this spring, 62 per cent of the Haisla diabetics had their blood sugars down to target level, which medical experts believe is low enough to minimize serious complications such as kidney disease, vision loss, and nerve and circulation problems. The Haisla are not only doing better than the diabetics in the community of Kitimat but are well ahead of the Canadian average, says Dawson, pointing to studies that indicate just half of Canada’s diabetics have their blood sugar at target levels.
He says much of the credit goes to Laurel DeGoeij, the diabetes nurse educator leading the Haisla project. “The point is that by having a dynamic nurse and having a program that permeates many aspects of community life, you can achieve success,” says Dawson. “But it does take a large amount of effort, and it does take buy-in.”
Doctors have long told diabetics they can live with and manage the incurable disease. But the message is much more heartfelt coming from Joseph, who struggled for years before accepting his own diabetes.
The modern buffet of rich, sugary foods, sedentary lifestyles, and genetic and cultural factors are all believed to be fuelling the diabetes epidemic. The insidious impact of residential schools is also thought to be a big factor in the aboriginal epidemic having ripped family’s apart and undermined native culture and people’s sense of self worth, says Joseph, who at age six was sent to a school in Alert Bay, B.C., where he was beaten for speaking his native language.
Joseph stresses in the educational materials and videos he produced with Nabih and Dawson the value of traditional healing and foods, as well as western medicine in dealing with diabetes. But self-care is key, he says. “You have to take ownership of the disease.”
The message resonated with the Haisla who embraced the program, which was funded in large part by the $300,000 from the federal Aboriginal Diabetes Initiative. It’s one of the few interventions paid for through the $190-million federal fund with documented evidence of success, says Dawson.
The team now hopes to expand into other First Nations communities, and help keep the momentum going among the Haisla. “You can’t just go in with a program and then leave,” says Dawson.

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