Eskasoni First Nation members participated in the UnPPAC work, funded by the  Nova Scotia Health Research Foundation. They invited us into their homes and community and shared their personal, sometimes difficult, stories in the hope of contributing knowledge and improving the health and lives of Indigenous children. The Eskasoni community remains a key partner in the ACHH Initiative work.

Challenges of Assessment and Treatment

Several factors were identified through the UnPPAC work as impacting how Indigenous children’s pain is assessed and treated.

  • 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-Indigenous 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 Indigenous children developing this reaction.
  • Children and youth often feel unheard. When participants sought treatment for health issues, they feel they were ‘not 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 depiction.
  • 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 treatment.

Healing Through Stories 

These video clips show how Indigenous families have been negatively impacted by their health care experiences, and how the residential school system’s legacy of abuse has contributed. The ACHH Initiative work is dependent on the Indigenous communities who have provided their insights, wise counsel and a shared commitment to improving the lives of children and reducing their hurt.

These videos present stories and findings from our first study.

Seeking Care

“Nine hours I waited” [4:49]


“Who am I to complain” [3:40]

Self Management

“We use a lot of humor… you distract yourself from feeling the pain” [1:58]

More Resources

To read and learn more about the UnPPAC work, you can access the publication written by members of the ACHH Initiative team below.

Youth Art

Find Out More

See how The ACHH Initiative research grew from UnPPAC and evolved into Indigenous children hurt and pain research in the Maritimes.