Project History

In 2008, Dr. Margot Latimer and Dr. Allen Finley of the IWK Health Centre Complex Pain Team noticed something startling; only an estimated 2 out of 800 children referred to the Centre in its 17-year history were Indigenous.

As a result, Dr. Latimer partnered with Sharon Rudderham, Eskasoni Health Centres Health Director, and a team of First Nations community leaders, clinicians, Elders and researchers from the IWK Health Centre and Dalhousie University. The UnPAAC (Understanding Pediatric Pain in Aboriginal Communities) project was established and Mi’kmaw participants shared their stories through art and conversation sessions. Consistent stories of Mi’kmaw children’s stoicism was found as well as a link between pain and hurt expression, assessment, and treatment.

The Issue

A child’s expression of their pain experience is complex, and related to social and cultural factors. The way Indigenous children’s pain is assessed and treated by non-Indigenous health care providers can be ineffective, and have a range of negative effects.

Under-treated pain can lead to learning disabilities, heightened medical fears, anxiety, chronic pain, impaired development, poor school outcomes and inadequate health care that can continue later in life.

Challenges of Assessment and Treatment

  • Children and youth are often stoic and hide their pain. In fact, the Mi’kmaq language does not have a word for pain. This can lead to misunderstandings by non-Aboriginal health professionals.
  • Children and youth often do not cry, complain or verbally express their pain. Cultural traditions and a legacy of oppression and abuse has led to Aboriginal children developing this reaction.
  • Children and youth feel unheard. When participants sought out treatment for health issues, they felt they were ‘not being listened to.’
  • Common pain assessments are not culturally appropriate. Many health providers use a numerical scale or facial expression to assess patient pain. Historically, Indigenous people express their experiences through story and description.
  • Perceived discrimination. Participants reported that health professionals stereotyped community members as having alcohol and drug problems. This led to feelings of distrust and frustration, and delays in seeking further treatment.

Surviving the Survivor [7.45 mins]

In this award-winning piece for The National, former CBC reporter Wab Kinew shares his personal story of how residential schools affected three generations of his family.

 Find out more

Experience Indigenous children telling their stories in their own words.