For thousands of years, stretching from the shores of the Chukchi Peninsula of Russia, east across Alaska and Canada, to the southeastern coast of Greenland, known as the Arctic, live people with epic tale in the history of human settlement and the endurance of culture, known as Inuit. Inuit culture in not monolithic culture, but rather varies from region-to-region, community-to-community, also even vary in practice. Inuit people are divided to groups based on environmental factors, language and certain cultural features. Nunavut has an Inuit population of 30,000. It has been created on April 01st, 1999 and encompasses one-fifth of Canada’s landmass. The territorial capital, Iqaluit, is the largest community with a population of over 6,500 and according to statistics that number is increasing quickly. Nunavut is divided into three regions, Qikiqtaaluk or Baffin Region in the east, Kivalliq in the central Arctic along the western coast of Hudson’s Bay, and Kitikmeot in the west.

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“There are five primary distinct Inuit language dialects spoken throughout Canada. These dialects are: Inuvialuktun, spoken in the Inuvialuit region in the Northwest Territories; Inuinnaqtun (primarily in some communities in western Nunavut); Inuttitut (Eastern Nunavut); Inuttitut (Nunavik); and Inuttut (Nunatsiavut)” (Statistics Canada, 2009). “There are two different ways people in Nunavut write the Inuit language: Qaliujaaqpait (or Roman orthography) and Qaniujaaqpait (syllabics)” (Office of the Languages Commissioner of Nunavut, 2013). In 2008, the Inuit Language Protection Act and Official Languages Act were passed in Nunavut to ensure the preservation and revitalization of Inuit languages. This research also has demonstrated that Inuktitut, as the strongest language in the Arctic, one of the very few Aboriginal languages in the world that is not in danger of being lost (Norris, 2007). Government of Nunavut is also making Inuktitut as a daily working language.

Eva Aariak, East Member of the Legislative Assembly stated, “ Language and culture is very important to us” (2010). While, many aboriginals have adopted various features of modern life, Inuit cultures continued to live according to traditional values, recognize the importance of keeping it alive and holding tier traditions very high. As

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a result, elders play a critical role within the Inuit community, since they are thought to be the best source of knowledge of the practices and teachings that govern their society. The oldest family members are looked upon as elders because their age is believed to reveal the amount of wisdom that they hold (Fienup-Riordan, 1990). Inuit communities have a leader, acting as a spokesperson.

They make decisions, and community has rights to disagree with them, but as being highly respected as working closely with elders’ teachings and in the best interest of the community in mind. In traditional areas, leaders are called shamans, who are believed to be able to cross the boundary that separates the physical and spiritual worlds, have the power to act as healers, predict future events, and ability to transform themselves into animals (Bennett & Rowley, 2004).

Any culture faces some difficulties in maintaining traditional values while living in the modern world, and for Inuit population they are facing changes in gender roles, youth become more exposed to southern lifestyle and modern life, living in modern communities, hunting is not economical way to secure food to eat, etc, all due to rapid transformation from traditional to modern style of living. This transition hasn’t been an easy one, despite advantages, as there were significant disruptions of the traditional culture and values that had guided Inuit for millennia. Aboriginal people in general, are also experiencing some health inequalities.

The National Collaborating Centre for Aboriginal Health has developed a model called The Integrated Life Course and Social Determinants Model of Aboriginal Health, which describes health inequalities in Canada (Reading & Wien, 2009). “In the model, determinants of health are categorized as proximal, intermediate and distal” (Kryzanowski & McIntyre, 2011). Proximal determinants include conditions that have a direct impact on individual physical, emotional, mental or spiritual health. These proximal determinants are health behaviors, employment and income, education and food insecurity. Intermediate determinants, including health care systems, educational systems, community infrastructure and resources, environmental stewardship, and cultural continuity, are considered to be the origin of the proximal determinants.

Distal determinants are economic, social and political contexts that construct both intermediate and proximal determinants. But, as Inuit take holistic view of health and strongly believe that significant improvements to Inuit health can be made addressing current socioeconomic condition, and new model has been designed called Holistic Model for the Selection of Indigenous Environmental Assessment Indicators (Kryzanowski & McIntyre, 2011). The holistic model conceptualizes individual and community determinants of health within external social, economic and political contexts and thus provides a comprehensive framework for selecting indicators of indigenous health. Indigenous health is the product of interactions among multiple determinants of health and contexts. Nurse has to have understanding of what culture is, develop cultural awareness, and be cultural sensitive in order to be cultural competent. Culture is a dynamic lived process that is inclusive of beliefs, practices, and values.

“Culture, however, is more than beliefs, practices and values that can be reduced to a list of personal characteristics” (Kleinman & Benson, 2006). “Cultural characteristics differ within the same ethnic or social group because of differences in age, gender, sexuality, life history, political association, class, religion, ethnicity, and even personality”(Aboriginal Nurses Association of Canada, 2009). The development of cultural awareness is the beginning step toward understanding that there is difference (Gregory, 2005).

Cultural sensitivity is expressed through behaviors that are considered polite and respectful by the other (Giger et al, 2007). Giger et al, also presented a congenial definition on cultural competence, as an “ongoing process that involves accepting and respecting differences and not letting one’s personal beliefs have an undue influence on those with a differing worldview from one’s own. Cultural competence includes having general cultural and cultural-specific information so the health care provider knows what questions to ask” (2007). “Achieving cultural competence means: learning about the culture of the other; being able to assess from the culture of the other; sharing in the culture of the other; the ability to communicate between and among cultures; and the ability to demonstrate skill outside one’s culture of origin” (McNaughton, 2002).

Cultural safety, is the most important concept then any noted above, because understanding the cultural safety nurse can better address inequalities in health care, by “improving health care access for all nations, acknowledge that we are all bearers of culture, expose the social, political and historical context of health care and interrupt unequal power relations” (Ramsden, 2000). “There is growing recognition that if the mainstream health care system in Canada is to be effective in helping to improve the health of First Nations, Inuit, and Métis clients, it must provide culturally safe care” (Royal College of Physicians and Surgeons of Canada, 2013). Inuit has undergone radical changes in a very short period of time and the commitment to maintain traditional values while living in the modern world is difficult not just for Inuit but also for any culture.

The Inuit language is one of the only three Aboriginal languages in Canada spoken by a large enough population base that long-term survival is likely (The State of Inuit Culture and Society, 2010). They continue to promote their language at home, also developing a bilingual education system and the capabilities of bilingual post-secondary school graduates. Nunavut’s health status continues to lag far behind the rest of the country. Ministration to public health and social conditions must strengthen to improve health status, and also support economic development in Nunavut. “Accountability and quality care are the new emphases for the health systems around the world, and for the Inuit in Nunavut should be no different” (Nunavut Economic Outlook, 2010). They are being faced with many challenges and paying a high price for this rapid transformation, but they continue to honor the past and accepting the modern lifestyle and working towards the future.

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