Authors: Crystal Meares, BSN student; Ji Lee, BSN student; Jong Park, BSN student; Joo Kim, BSN student; Jen Cardinal, BSN student; Nicole Slack, BSN student
Defining the Northwest Native American Culture
Culture is the values, beliefs, behavior, and material objects that together form a people’s way of life. Culture includes what we think, how we act, and what we own. Culture is both our link to the past and our guide to the future. Culture shapes not only what we do but also what we think and how we feel-elements of what we commonly, but wrongly, describe as “human nature.” (Macionis). The Native Americans of the Pacific Northwest are a culture because they have all of these aspects above, solidifying them as a distinct group of people from other groups of people.
Geographical Setting
The Native Americans of the Northwest includes those of the Pacific Northwest west of the Cascades as well as what is considered the Plateau of Eastern Washington and Oregon, stretching into Northern Idaho and Canada. Due to the difference in environmental resources, the Pacific Northwest Coast Native Americans differed from the Plateau Native Americans. Yet much was traded among the tribes from both sides, especially along the Columbia River that afforded transportation and a source of food and commerce. The Plateau Native Americans include local groups such as Walla Walla, Spokan, Yakima, Nez Perce, Columbia, Klikitat, and Umatilla. (Maxwell, p281).
The Northwest Pacific Indians are mostly on the Northwest side of American and British Columbia (Canada). They reside along the lines of Alaska, British Columbia, Washington, Oregon and a small part of Northern California. Part of the area of the Northwest Pacific culture area are islands, including Vancouver Island, the Queen Charlotte Islands, and the Alexander Archipelago, as well as some small chains. Not many tribes go as far as the north of British Columbia, only tribes such as Tlingit and Tongass. Most of the tribes stay to the south of their region; the tribes farthest south include Tututni, Takelma, Chastacosta, etc. Toward the middle there are tribessuch as Bella Bella, Bella Coola and Heiltsuk. (Francesca et al).
General Physical Appearance
The most marked physical characteristics of the Indian race type are generally, dark skin, dark hair, dark eyes and broad faces with high cheekbones.
The hair of most Indians is straight or slightly wavy. Most Indian men have sparse facial hair. They used to shave simply by pulling out the whiskers as they appeared.
The fold of skin which gives Chinese, Japanese, and other Mongolian peoples the appearance of slanting eyes is present in varying degrees among certain tribes of Indians.
While Indians have dark skin, the color ranges from a yellowish brown to a dark reddish brown. They do not have red skin. The term “redskin” may have come from a variety of sources. One of the explanations comes from the fact that many Indians painted their bodies with a mixture of vermilion and grease. White men who traded with Indians quickly learned that vermilion, a bright red pigment, was one of the most valuable trade items. (Flora).
Clothing
COASTAL TRIBES: Coastal tribes wore very little clothing, except in the coldest weather. They made extensive use of cedar bark
and very little use of animal skins. The garments they wore were designed more for shedding water than for providing warmth. They went barefoot even in winter. The women wore skirts of shredded cedar bark, to which they added a buckskin slip on cold days. The upper garment worn on cold or rainy days was also of cedar bark put together with rows of twining spaced 1 to 4 inches apart. The finer the garment the closer the rows were spaced. (Flora).
Coastal Indians were especially fond of necklaces. The most highly prized were made of dentalium shells, slender white tusk-shaped shells gathered near the shores of Vancouver Island. Necklaces of beaver teeth, bear claws, clam shells and bits of abalone shell indicated wealth. Only the very wealthy wore nose and lip ornaments. (Flora).
INLAND TRIBES: The women of the inland tribes were superior in their dressmaking skills. Because of the severity of the winters, they had to wear warm clothing. Their tanned buckskin shirts, skirts, dresses, leggings and moccasins were not only durable and warm, but beautiful as well. The men’s leggings extended from the hip to the ankle and were supported by a belt. The women’s leggings extended from the knee to the ankle and were supported by garters. The leggings were trimmed with fringes and ornaments. Over their buckskin clothing both the men and the women wore robes and blankets woven of fur or feathers. During periods of snow they wore snowshoes with upturned toes. (Flora).
Inland tribes decorated their clothing with the teeth and claws of wild animals, porcupine quills, scalps of foes killed in battle, feathers, fur, bone tubes from small animals, and other natural resources. These decorations were put on the fringe at the bottoms of dresses, shirts and skirts and at the ends of sleeves. They were also used for necklaces, ear and nose ornaments and belts. (Flora).
Language
The main language families in this area were the Nadene in the north and the Wakashan (a subdivision of the Algonquian-Wakashan linguistic stock) and the Tsimshian (a subdivision of the Penutian linguistic stock) in the central area. (Flora).
Three principal languages and several sublanguages were spoken by the coastal tribes of Oregon and Washington. The three principal ones were Nootka, Coast Salish and Chinook. In the interior, east of the Cascades, Salish was the principal language, with several sublanguages. (Flora).
Because there was no single language that all tribes spoke or understood, and because the trappers and traders found it impossible to learn all the various dialects, Chinook jargon developed. This was a mixture of Chinook, French, English and a few words of Russian and other European languages. (Flora).
The tribes had no written language as we know it. This is one reason that so little is known of the native culture before the coming of the white men, who wrote about what they saw. Picture symbols have been found carved in rocks at various places indicating stories and important events in the lives of the tribes at that time. The totem poles of the Indians to the north tell stories of individuals or families. Many symbols were also found carved in wooden and stone household utensils and many of the woven baskets had designs of significance woven into them. (Flora).
Tribes
Typical tribes were the Kwakiutl, the Haida, the Tsimshian, and the Nootka. Other tribes are Achomawi, Chemakum, Chukchansi, Clayoquot, Coast Salish, Cowichan, Hupa, Hesquiat, Karok, Klamath, Koskimo, Lummi, Makah, Puget Sound Salish, Quinault, Shasta, Skokomish, Tolowa, Tututni, Willapa, Wiyot, and Yurok Indians. (American Indian Tribes Grouped by Cultural Areas).
Food
Salmon was the staple food, supplemented by sea mammals (seals and sea lions) and land mammals (deer, elk, and bears) as well as berries and other wild fruit.(Flora).
COASTAL TRIBES: The diet of the coastal tribes was heavily dependent upon fish, acorns, and camas root. The camas was eaten in its natural state or cooked, either by boiling or baking. The flavor of a cooked camas resembles that of a baked sweet potato. The Indians preserved the cooked or sun-dried bulbs by pressing them into cakes called pasheco. Sometimes they added a cake of pasheco for flavor when boiling salmon. Camas soup was also a popular dish. There were almost as many names for the camas as there were Indian tribes. (Flora).
The coastal tribes were skillful in hunting porpoises, seals, and sea otters, as well as in catching salmon, halibut and cod. They also gathered great quantities of clams, oysters, mussels and crabs. Few tribes were adventurous enough to hunt the large whales. One tribe that was skilled at this feat was the Makah. (Flora).
INLAND TRIBES: Inland tribes also depended on fish to a great extent, especially salmon. However, meat, berries, nuts and roots formed a greater part of their diet than of the diet of the coastal tribes. (Flora).
Berries were eaten fresh or cooked into a pulpy mass that was then poured into wooden frames lined with skunk cabbage leaves where they remained until dry. (Flora).
While the coastal tribes depended heavily on the camas root, acorns were predominant in southwestern Oregon. They were soaked, hulled, ground to a meal and washed to remove the bitter acids. The meal was cooked into a tasteless but nourishing gruel.(Flora).
During spring and summer runs, Indians took large quantities of salmon from the streams. They smoked or dried everything that they did not eat fresh. (Flora).
Meat was also a part of the diet of the various tribes. In the mountains they found elk, antelope, big horn sheep, and mountain goats. Rabbits and other small game were plentiful on the prairies. Only the eastern tribes hunted buffalo. A buffalo hunt was a great occasion. The men of the tribe were away for weeks at a time because of the long distance across the Rocky Mountains that they had to travel to get to the plains where the buffalo grazed. (Flora).
Housing
The Native Americans of this area used wood to build their houses and had cedar-planked canoes and carved dugouts. In their permanent winter villages some of the groups had totem poles, which were elaborately carved and covered with symbolic animal decoration. (Flora).
COASTAL TRIBES: The floor was hard packed earth, but the Indian women made rush mats to use as floor coverings. (The number of mats that were owned was one measure of wealth among the coastal tribes.) The beds were woven out of beaten cedar bark or rushes. Blankets were woven from animal fur combined with beaten cedar bark. Some tribes kept a special breed of dog with thick, woolly hair. They cut the hair several times a year, combined it with cedar bark to make a yarn which they used to weave their blankets. They also used the down from ducks and geese and the wool from mountain sheep and goats to make their yarn.(Flora).
INLAND TRIBES: Inland tribes carried their houses with them or built temporary ones of earth and sod or grass. The portable tepees were made of buffalo hides sewn together. The average tepee used seven or eight hides and larger ones used as many as twenty. They were frequently decorated with designs which depicted important events in the lives of the occupants. (Flora).
Relationship/Social organization
They had a highly stratified society with chiefs, nobles, commoners, and slaves. Public display and disposal of wealth were basic features of the society. They had woven robes, furs, and basket hats as well as wooden armor and helmets for battle. (Flora).
TRIBAL STRUCTURE: Most tribes had more than one chief, dividing leadership among several men. One chief might assume leadership of the hunt, one might be the war chief, and another might be responsible for the safety of the camp when the warriors were gone on the warparth. (Flora).
One of the responsibilities of a chief was to make amends for crimes committed by a member of his tribe. If one of his braves killed a member of another tribe, he had to offer a member of his own tribe of equal rank as compensation. If the murdered man had been a chief, the chief might offer himself as a sacrifice. In a case like this, he would dress himself in full regalia and walk toward the other tribe’s camp, chanting a tribal song. When he drew near, the enemy would kill him. (Flora).
The shaman, or medicine man, was another important official in the tribe. A shaman could be either a man or a woman who had supernatural power, bestowed through dreams or visions. This position had its drawbacks. If a shaman’s patient died, the shaman had to die too. (Flora).
SLAVES: Some of the coastal tribes kept slaves. Warlike tribes made raids on villages or camps to capture young women and boys. Peaceful tribes bought their slaves from the warlike tribes. (Flora).
The purpose of owning slaves was not for their economic value but for their prestige value. Ownership of slaves was a sign of success in war or was proof that you were of sufficient wealth to purchase them. In some cases, slaves were sacrificed to demonstrate that a chief was so wealthy that he could afford to destroy his valuable possessions. In general, although they did the hardest work and ate what was left after the family had dined, they were not beaten or starved. (Flora).
Traditions
MARRIAGE CUSTOMS: Girls were considered to be ready for marriage at the age of fourteen or fifteen, boys at sixteen or seventeen. The young men usually chose their brides, but the parents of both parties needed to approve the character, social standing and wealth of the prospective spouse. (Flora).
Among the coastal tribes, presige was an important factor in the match. Social classes were measured in terms of wealth, and wealth was determined by the quantity of goods a chief could afford to give away. When the marriage celebrations took place, parents of the couple exchanged many gifts. Immediately after the wedding the gifts were distributed among the wedding guests. The bride and groom received very few gifts, but it mattered little since they moved in with the groom’s family. (Flora).
The inland tribes did not hold formal marriage ceremonies. If a young man could persuade a girl to come to his father’s camp and remain there with him, they were regarded as married. (Flora).
DEATH AND BURIAL CUSTOMS: The tribes all believed in the existence of a soul, or spirit, in man. Burial practices varied from tribe to tribe. In one type of burial the corpse was dressed in the best clothes and wrapped in a blanket. They then buried the body in any convenient spot with the head pointed to the west. Since they believed that the soul was in the head and the land of the dead was in the west they felt this would ensure the soul’s easy departure. (Flora).
In some areas the dead were buried in a pit, or “cyst”. The floor of the pit was covered with matting. Cedar boards were placed vertically around the sides. The body and the deceased’s personal possessions were then placed in the grave and all was covered with matting. After filling the grave and piling stones on top, the mourners burned the projecting pieces of cedar off to the ground. It did not take long for the desert winds to hide the grave completely with sand. (Flora).
Some coastal tribes wrapped their dead in cedar bark matting and placed them in cedar boxes. They lashed the boxes to branches high in a tree, put them in caves, or buried them in the ground. (Flora).
Tribes along the lower Columbia built low hutlike structures on islands in the river. Such an island was called a memaloose, or death island. The body was wrapped in a blanket and placed in a shallow pit, often in a sitting position. Over the pit they placed a protective cover of poles, slabs of wood, and bark. (Flora).
The largest one of these islands, called Memaloose Island, is in the Columbia Gorge below The Dalles. While Bonneville Dam was being constructed, the remains of the Indians buried on Memaloose Island were removed to another burial ground. The only grave remaining on the island is that of a white man, whose burial there caused the tribes to stop using the island for their burials. The white man’s grave marker was being used as a navigational signal in the 1960s. (Flora).
How was Pacific Northwest Indian Culture Organized?
The Pacific Northwest Indians had many rituals and traditions; some were similar for many different tribes others varied from tribe to tribe. Some cross tribal rituals included bathing, also known as washing, which is similar to the potlatch. In this ceremony, people would give away material possessions, in a hope that it would help them gain physical and spiritual health. It was similar to a spiritual cleansing. Another tradition that was very important was whaling. For many tribes such as the Makah and the Nootka whale hunts were performed from large wooden canoes, there was usually a “chief harpooner” who would direct the rest of the group, generally this position was passed down from father to son, and it was these men who would get first pick of the meat after the hunt. Also, many people constructed totem poles outside their homes. Influential members of secret societies and shamans would determine the importance of the faces carved into the poles. The Pacific Northwest Indians were among the best Native American ‘woodworkers; they carved many things, such as chests, boxes, masks, and much more. Families were associated based on their kinship ties; these ties were based on the mother’s side of the family. However, in the south, such ties were usually based off the father’s side. The basic family unit consisted of a household with either group or blood relations. (Francesca).
Beliefs/Attitudes
Animism is widespread among Native American, who lives respectfully within the natural world on which they depend for their survival. Animism is the belief that elements of the natural world are conscious life forms that affect humanity. Animistic people view forest, oceans, mountains, and even the wind as spiritual forces. Many Native American societies are animistic, which explains their reverence for the natural environment. (Macionis).
One concept was that salmon were supernatural beings who voluntarily assumed piscine form each year in order to sacrifice themselves for the benefit of humankind. On being caught, these spirit-beings returned to their home beneath the sea, where they were reincarnated if their bones or offal were returned to the water. If offended, however, they would refuse to return to the river. Hence, there were numerous specific prohibitions on acts believed to offend them and a number of observances designed to propitiate them, chief of which was the first-salmon ceremony. This rite varied in detail but invariably involved honouring the first salmon of the main fishing season by sprinkling them with eagle down, red ochre, or some other sacred substance, welcoming them in a formal speech, cooking them, and distributing their flesh, or morsels of it, communion-fashion, to all the members of the local group and any guests. The maximal elaboration of this rite occurred in northwestern California in what have been called world-renewal ceremonies; these combined first-salmon rituals, first-fruits observances, and dances in which lineage wealth was displayed. Elsewhere the first-salmon rituals were less elaborate but still important, except among the Tlingit, who did not perform them. (Northwest Coast Indian).
Another religious concept was the acquisition of personal power by seeking individual contact with a spirit-being, usually through prayer and a vision. Among Coast Salish all success in life—whether in hunting, woodworking, accumulating wealth, military ventures, or magic—was bestowed by spirit-beings encountered in the vision quest. From these entities each person acquired songs, special regalia, and dances. Collectively, the dances constituted the major ceremonials of the Northwest Coast peoples; known as the spirit dances, they were performed during the winter months. (Northwest Coast Indian).
In the Wakashan and northern provinces, it was believed that remote ancestors who had undertaken vision quests had been rewarded with totemic symbols or crests. Displaying these hereditary crests and recounting the traditions of their acquisition formed an important part of potlatches. In the Wakashan area certain ceremonial cycles called for the dramatization of the whole tale of the supernatural encounter, which in some cases included the spirit-being’s possession of and its eventual exorcism from the seeker; such dramas were performed by dancing societies. (Northwest Coast Indian).
Shamanism differed from other acquisitions of supernatural power only in the nature of the power obtained—that is, power to heal the sick through extraction of disease objects or recovery of a strayed soul (see soul loss). It was commonly believed that some shamans, or medicine men and women, had the power to cause infirmities as well as to cure them. Witchcraft was used to kill others or to make them ill and was believed to be carried out by malicious persons who knew secret rituals for that purpose (see witchcraft: Witchcraft in Africa and the world). (Northwest Coast Indian).
Values/Norms
The Pacific Northwest Indians believed that “The people were here when the Pacific Northwest emerged from its icy womb and donned its forest raiment. Raven, Changer and Coyote, the demiurge (a Platonic deity who orders or fashions the material world out of chaos) of the myth-time, tamed its monsters, made it habitable for humankind and taught people how to live well in it. For 500 generations they flourished until newcomers came and transformed it yet again.” The Northwest Pacific Indians believed that when a boy reached the age of manhood, usually 12 or 13, he was to seek his Guardian Spirit. His Guardian Spirit would help him throughout his life. These Guardian Spirit usually the shape of a of a familiar person or animal. The Guardian would help the boy throughout his life. Your Guardian Spirit would enter you and teach you many different things, both practical and ceremonial. For example, a fisherman’s Guardian Spirit would teach him how to perform ceremonials dances and songs as well as ho to use a spear to fish. The Northwest Pacific Indians were very kind and peaceful people. “They preferred a potlatch anytime to a war party.” So, next time you are about to get into a HUGE fight, remembered the words of the Northwest Pacific Indians “Peace is precious.” (Francesca).
While groups in the northern province tended to be matrilineal—passing status, property, and education through the maternal line—those in the other three provinces were generally patrilineal. Marriages were usually arranged by parents, who openly wished to see their children rise (or at least not fall) in status. As with up-marrying slaves, members of the middle classes of a group could marry up if they had distinguished themselves in some way; the children of these marriages would inherit the status of the higher-ranking spouse. If the spouse of lower rank was not distinguished in some way, the children would accrue the lower status; as this was generally seen as an undesirable outcome, such matches occurred relatively rarely. (Northwest Coast Indian).
Changes in status were generally marked by public ceremonies. Formal rituals were considered necessary at each of two or three critical stages in a person’s lifetime—birth, a girl’s attainment of puberty (there were no boys’ puberty rites in the area), and death—because at those times the participants in these events might be especially vulnerable or so filled with power that they could inadvertently harm others. A newborn infant was believed to be in danger of harm by supernatural beings; the infant’s parents were simultaneously in danger and potentially dangerous. Mystic forms of vulnerability and volatility also accrued to girls at puberty, to the close kin of a deceased person, and to those who prepared and disposed of the dead. Such perils were avoided by isolating the persons involved—either within a boarded-off cubicle in the house or in a simple structure out in the woods—and by limiting their diet to old dried fish and water. At the conclusion of the isolation period, a formal purification ritual was performed. The intensity of the restrictions varied considerably, not only in different parts of the coast but even within individual houses. Often the pubescent daughter of a chief, for example, was secluded for many months, whereas her low-ranking house sister might have to observe only a few days of confinement. (Northwest Coast Indian).
Over most of the coast there was a very great fear of the dead. A body was usually removed from the house through some makeshift aperture other than the door and disposed of as rapidly as possible. An exception occurred in the northern province, where bodies of chiefs were placed in state for several days while clan dirges were sung. Disposal of the dead varied. In the northern province, cremation was practiced. In the Wakashan and part of the Coast Salish areas, large wooden coffins were suspended from the branches of tall trees or placed in rock shelters. Other Coast Salish deposited their dead in canoes set up on stakes. In southwestern Oregon and northwest California, interment in the ground was preferred. (Northwest Coast Indian).
Mental Process/Learning
Story-telling and songs, usually to the accompaniment of the rattle or small hand-drum, filled in the evening. The Indian was essentially musical, his instruments being the drum, rattle, flute, or flageolet, eagle-bone whistle and other more crude devices. Each had its special religious significance and ceremonial purposes, particularly the rattle, of which there were many varieties. Besides the athletic and gambling games, there were games of diversion played only on rare occasions of tribal necessity with sacred paraphernalia in keeping of sacred guardians. The Indian was fond also of singing and had songs for every occasion — love, war, hunting, gaming, medicine, satire, children’s songs, and lullabies. (Northwest Coast Indian).
The children played with tops, whips, dolls, and other toys, or imitated their elders in shooting, riding, and “playing house”. (Northwest Coast Indian).
An interesting aspect of Northwest Coast culture was the emphasis on teaching children etiquette, moral standards, and other traditions of social import. Every society has processes by which children are taught the behaviour proper to their future roles, but often such teaching is not an overt or deliberate process. On the Northwest Coast, however, particularly northward of the Columbia River, children were instructed formally. This instruction began at an age when children were still in their cradles or toddling, and all elder relatives, particularly grandparents, participated in it. Lessons were often delivered gently and humorously through the telling and retelling of folktales; trickster tales recounting Raven’s exploits were especially entertaining, as his troubles were so obviously the result of his dissolute, lazy, gluttonous, and lecherous personality . Children born to high status were given formal instruction throughout childhood and adolescence. (Northwest Coast Indian).
Technology and the visual arts
The indigenous peoples of the Northwest Coast drew from the heavily wooded environment for much of their technology. Woodworking was facilitated by the abundance of easily worked species of trees, especially the giant arborvitae (Thuja plicata, also known as red cedar) and the redwood (Sequoia sempervirens). The trunks of these trees could be split into planks or hollowed out into canoes, containers, and other useful objects. (Northwest Coast Indian).
The peoples of this region were noted for their artistic skill, and many everyday items were decorated in some way. More than most other groups in North America, Northwest Coast visual arts emphasized symmetry, neatness of finish, and embellishment through carving and painting. Traditional carving implements included adzes, mauls, wedges, chisels, drills, and curved knives, all made of stone; sharkskin was used for sanding or polishing wooden items. (Northwest Coast Indian).
As far south as the Columbia River, wooden boxes were made of red cedar boards that were kerfed—cut nearly through transversely. The wood was steamed at these points until it was flexible enough to shape into the form of a box. Dishes often were hollowed out of pieces of wood, sometimes plain, sometimes in the form of animals or monsters. Other items made of wood included spoons and ladles, canoe bailers, trinket boxes, chamber pots, masks and rattles used in ceremonies, magnificent memorial or totem poles and interior house posts, housefronts and screens, halibut hooks, and even the triggers of animal traps. Sometimes items were made from the horns of mountain goats, bighorn sheep, or elk, which were carved by essentially the same methods as wood. Occasionally sculptures were carved from stone. (Northwest Coast Indian).
Artists in the northern province emphasized low-relief carving accented by painting; their motifs were the hereditary crests of the clans or parts of the crests. Different groups in the northern province expressed themselves in somewhat different styles. Haida art, for instance, tended to be massive and to comprise highly conventionalized balanced elements. In Tsimshian carving and painting, there was an effort to leave no open space in or between the conventionalized motifs; filler elements such as eye designs and miniature figures were used intensively. Tlingit art was slightly less conventionalized, with relatively little use of filler elements. (Northwest Coast Indian).
Present demographics and significant statistics about Northwest Native Americans in the U.S.
As can be seen from the above map, the distribution of Native Americans is heavily concentrated in the western part of the U.S. This is important in the implementation of nursing care in the western states because nurses in the western states are more likely to be caring for Native Americans in their practice. There are more male Native Americans than females. Many of them do speak a second language, and less than half “do not speak English very well.” The average household income was $6,000 less than that of the rest of the U.S. population as of the 1990 census – the latest available from the U.S. census website. These statistics should be taken into account when caring for the Native American patient because these aspects affect access to care, as well as efficacy of nursing care. (American Indian and Alaska Native Populations).
Current Status of Northwest Native Americans
This culture area consists primarily of coastal areas of Southeast Alaska, British Columbia, Washington, and Oregon. There is roughly a native population of 250,000 and growing. The Northwest Native Americans have changed culturally since first contact with the settlers primarily due to numerous policies implemented in the 1930’s aimed at assimilating the Native people into mainstream Ameropean life. During the last two decades of the twentieth century, the federally recognized tribes of Washington have attempted to have the terms of the 1850 treaties honored by the federal and state governments in order to preserve more of their traditional ways of life, as well as establishing secure income and rights for their people. The rights these tribes are lobbying for include fishing rights, the ability to utilize their reservation resources to bring economic stability to the tribe, and to take advantage of the special status Indian tribes enjoy such as through gambling casinos which help to fund the needs of the tribes (such as healthcare) and tax-free markets. (Polaski). See the video from NorthWest Indian News for further discussion on issues concerning local Native Indians at http://www.nwin.tv/NWIN38.html.
One of the more remarkable aspects of many Northwest Indian’s cultural heritage that has been preserved is their love for music and art. The Northwest Indians have many instruments which include drums made of animal hides, plank drums, log drums, box drums, wood clappers and rattles. Their songs included playing of music, dancing, and chanting. Music was and still is played at celebrations and potlatches. Potlatches are festival ceremonies that celebrate the tribe’s wealth. Bartering is done through gifts, such as dried foods, sugar, flour, and other material objects. Art is another vital part of this many Northwest Indian tribes. It is not only beautiful and practical in everyday life, but also tied into the land by depicting their histories on cave walls, totem poles, the Big Houses of the Pacific Northwest coast, buffalo hides, long houses, and tipis. Art served as representation of their birth places, lineages and nations. (Buerge).
Northwest Native Indians made their living primarily by hunting, trading, and gathering. Usually the men would hunt for elk and fish, while the woman picked berries, herbs and clams. Both sexes would participate in trading. For example, the Chinook Indians were known to be expert traders and that they would travel thousands of miles to bargain with other clans/tribes. (Thrush).
The health care environment of Northwest Native Americans
Health risks/high risk behaviors common to Northwest Native Americans: The average life expectancy for Northwest Native Americans is 71 years of age. Infant mortality rate is not that different from the national population; infant mortality due to sudden infant death syndrome and accidents is greater by factors of two and three. Northwest Native American children between ages one and four have a 70 percent higher mortality rate than the general population, while those aged five to fourteen have a 40 percent higher rate. Mortality due to accidents and homicide is greater by a factor of two for both age groups, in contrast to the national population. For Northwest Native American adults, relative to the national population, age-adjusted mortality rates are lower for heart disease and cancer, the two most common causes of death, but nearly three times higher for death due to accidental injuries and diabetes, four times higher for death due to liver disease, and 50 percent higher for death due to pneumonia, influenza, suicide, and homicide. (U.S. Census Bureau).
Cultural taboos: Most tribes had at least one taboo, if not more. Some examples of taboos would include a lifecycle event or rite of passage. For example, salt was not allowed to be eaten by boys when their voices were changing in puberty. Another example would be when a women turns to childbearing age, she is forbidden to eat mink or otter because they were considered very powerful and would result in misfortune. Also, menstruating women were not allowed to touch or eat meat because it would bring bad luck to the woman. These types of taboos are important to be aware of for the nurse so nursing care may accommodating and appropriate to the Northwest Native American patient. (Thrush).
Integration of Western Medicine with the care of American Indians in the Pacific Northwest
In the past few decades, American Indians residing in the Pacific Northwest have had an increasing amount of access to healthcare and related services. Western medicine and traditional American Indian healing practices differ significantly, and it has been an important milestone in the healthcare community to offer such accommodation for this culture. As with any culture, there are specific health risks to be aware of when caring for American Indians, and we are becoming more and more aware of these risks as time goes by. While much improvement has occurred related to the care of this culture in the Pacific Northwest, perceived discrimination still occurs. The bottom line is that we must be culturally aware in order to be culturally competent, and American Indians living in the Pacific Northwest belong to a culture that we as a healthcare community are becoming more aware of.
Part of American Indian culture involves the use of traditional healers. This practice varies between the several tribes within the Pacific Northwest; however it is known that most American Indian medicinal practices are strongly linked with religion and lifestyle. Health maintenance and restoration is achieved in these cultures through the alteration or correction of behaviors that may have caused imbalance between physical, mental, and spiritual self. While some perceived imbalances are treated through traditional ceremonies or with herbal remedies, many American Indians practice Western medicine as well (Arendt).
When caring for others, it is incredibly important to be conscious of the risks related to culture and ethnicity that span your patients. There are multiple health risks that American Indians live with simply because they are American Indians. The top ten causes of death among American Indians are heart disease, malignant neoplasm, unintentional injury and adverse effects, diabetes mellitus, cerebrovascular causes, liver disease, pneumonia and influenza, COPD, suicide, and homicide (CDC). American Indians are very susceptible to these disparities, especially if they also fall under other risk categories specific to the disease.
Indian Health Services, or IHS, is an organization which functions through twelve different offices in the United States. Its goal is to improve all aspects of health for American Indians and Alaska Natives and to assure that these groups receive access comprehensive and culturally acceptable health services. Pacific Northwest American Indians are served by the Portland Area IHS office. The Portland area office provides access to services which include medical, dental, and optometry offices, community programs for ambulatory care delivery, outpatient mental health and alcohol/drug services, environmental health, all-inclusive facilities, and rehabilitation facilities (Roubideaux).
Although many are working to continually provide more resources for American Indians in the Pacific Northwest, discrimination is still perceived. In a study that compared levels of discrimination reported by people from different ethnicities and cultures, American Indians were actually the most likely to perceive discrimination when compared to African Americans, Asian Americans, and whites. In fact, multiracial American Indians (American Indian/white) are even more likely to perceive discrimination than full American Indians. What is interesting is that unlike African or Asian Americans, American Indians tend to perceive discrimination based upon reasons unrelated to race. Some of these reasons include age, gender, disability, insurance type, and income level. It has shown that perceived discrimination can actually play a large role in mental and physical well-being among minorities, which may be a factor in the high rate of health disparities found in American Indians today (Johansson et al).
The most important things we can do when caring for American Indians here in the Pacific Northwest come from being knowledgeable about the practices and beliefs that occur in surrounding tribes. Different tribes practice varying traditional or Western remedies, and it would be culturally insensitive to place all American Indians into one group when considering this. Healthcare providers should work collaboratively with traditional healers when possible to provide the patient with competent care that encompasses all aspects of health. Caregivers should also be aware of the risks associated with Native American ethnicity, as well as normal risks of other proportions. Being aware of perceived discrimination can allow us to avoid that perception by the patient, which will in turn encourage them to come in and receive services when needed. Some actions we as nurses can take to become more culturally aware and competent could involve attending community events, and seeking consultation by traditional healers in order to better understand health status of American Indians in the Pacific Northwest.
Case Study Example
This is an analysis of a research article titled “Conductiong Focus Groups Cross-Culturally: Experiences with Pacific North West Indian People.” (Strickland). The goal of this article is to design community-based intervention programs to increase the numbers of women seeking a papanicolaou test and to help them understand about conceptualization and communication about pain (C. June). First of all, the researchers analyzed major barriers for achieving the goal of the focus groups. The researchers analyzed the communication patterns of each tribe that might affect the research; for example eye contact is not appropriate when talking about private or painful materials. The researchers also noticed the elder members of the tribes preferred not to speak until others have spoken. The following table compares two tribes, the Sahaptin and Coastal Salish, that were used in this study:
| Recommended | Sahaptin Tribe | Coastal Salish Tribe | |
| Focus group goal | To elicit interactive dialogue to gain group norms/perspective | Difficult, but possible with small groups | Difficult, but possible with extended time after meals |
| Participants | Should not be relatedShould not participate more than once | Elders and traditionals may not talk the first meeting so much be invited more than once | Same as Sahptin |
| Eye contact | Not appropriated with discussing private, painful matters | Same as Sahaptin | |
| Length | 1-2hrs | Need 2-4 hrs. for rituals, e.g. prayers, songs, food, and “Give Away” | Same ans Sahaptin or longer |
| Incentive | GiftsFoodMoney | “Give Away”FoodMoneyPresent made by community and presented in “give aways” | “Give Away”FoodMoneySame as Sahaptin |
| Room | “U” | Circle | Circle |
| Moderator role | Depends on study goal | Depends on study goal | Depends on study goal |
There were many interesting culturally diverse aspects to be considered by the researchers when conducting these focus groups. As mentioned, eye contact when discussing private and painful matters was not appropriate, and the elders of the tribes did not speak until everyone else had their say. The time it took to conduct the focus groups was lengthy due to many members being late (especially the elderly ones), the use of food and the exchange of items in a potlach style before the researchers could formally begin and giving the elders time to respond at the of the meeting. “From the investigators’ years of experience in work in Indian communities, understanding of the patterns of communication, and feedback from community leaders, it was recognized that the elders would have considered comments about levels of participation and openly asking for participation rude, aggressive, and culturally inappropriate” (Strickland p195). The cultural competency of the investigators enabled them to be sensitive to the needs of the tribal members enabling both parties to obtain the goal of sharing and listening to stories related to the healthcare needs of these American Indians.
As nurses in the United States, we will likely have Native American patients. Because Native Americans have their own cultures that differ from ours, we need to assess their cultural perspective in order to provide culturally competent care. The culture assessment is done by communication for which understanding their communication patterns it vital. As this article depicts, having a basic understanding of the appropriate ways in which to communicate with Native Americans is instrumental in understanding their needs, emotions and concerns.
Final Thoughts
For the conclusion of this blog, we would like to reiterate some of the things we have learned about the Northwest American Indian. Luther Standing Bear Oglala Sioux said that, “The American Indian is of the soil, whether it be the region of forests, plains, pueblos, or mesas. He fits into the landscape, for the hand that fashioned the continent also fashioned the man for his surroundings. He once grew as naturally as the wild sunflowers, he belongs just as the buffalo belonged….Out of the Indian approach to life there came a great freedom, an intense and absorbing respect for life, enriching faith in a Supreme Power, and principles of truth, honesty, generosity, equity, and brotherhood as a guide to mundane relations.” The Northwest Native Americans that we studied include Native American peoples ranging from Northern California into the Canadian western provinces and Alaska. These people tend to be darker complected, to have brown skin. Not red, as they have been referred to frequently in the past. The northern tribes have Mongolian backgrounds and therefore have narrow or slanted eyes. While their patterns of dress vary, the Native Americans were all resourceful and their clothes reflected their way of life, the food they survived on, and the work they did to maintain their well being. Customarily, they lived off of the land eating anything from fish, big game, or berries and some planted and harvested grains and corn.
The Native American tribes worked together symbiotically. Their cultures were quite varied from tribe to tribe. The tribes were all very different some being matrilineal and some patrilineal. All of these had their own way of working together which they highly valued. Native Americans taught through dances and pictures, proverbs, and storytelling. They passed their culture along in the tradition of narration.
…… everything on the earth has a purpose, every disease an herb to cure it, and every person a mission. This is the Indian theory of existence.
Mourning Dove Salish (1888-1936)
From the time the Europeans came to the Americas, they have tried to assimilate the Native Americans into their own culture. This has caused great difficulties for the Native Americans, in their struggle for identity, equality, and for their economic stability. It has only been in the last several decades that the government has been working with the Native American tribes to help them win this struggle.
However, their culture has remained rich and virtually unstained by the white man. The Native Americans have a very strong musical and artistic lineage that thrives even today. Native American children ages one to fourteen have a higher mortality rate than the rest of the country. The most common causes of death for the Native American adult are accidental, diabetes, and liver disease related. Native Americans have a 50 percent higher rate of death due to pneumonia, influenza, suicide, and homicide. Native Americans are traditionally superstitious and most cultures have medically related wives tales that reflect these superstitions. “There is no death. Only a change of worlds.” – Chief Seattle [Seatlh], Suquamish Chief
“Being Indian is an attitude, a state of mind, a way of being in harmony with all things and all beings. It is allowing the heart to be the distributor of energy on this planet; to allow feelings and sensitivities to determine where energy goes; bringing aliveness up from the Earth and from the Sky, putting it in and giving it out from the heart.” – Brooke Medicine Eagle
Some things we need to remember as health care providers when caring for the Native American people, is simply that they are people. They have a background that includes a rich culture, a family, and love for one another. That being said, American Indians have a strong belief in nature. They believe that every herb has a purpose, and every disease has a natural cure. It is important not to try to push medicine on a member of this culture and to be open to listen to their concerns. Many Native American cultures use traditional healers, so be willing to work collaboratively with their healers as necessary; also to be willing to teach without being patronizing to them and to learn from them while keeping an open mind. Remember that just because they believe differently, doesn’t mean they are wrong, or that they are stupid. Be cognizant that this specific subculture has been subject to diverse discrimination throughout their history, and what they need from their HCP is understanding, unity, and assistance.
In closing, I would like to refer to a poem by Cheewa James from Catch the Whisper of the Wind
“Learn how to withhold judgment
Learn to listen
Get in touch with your own inner self
Look at life with joy
Don’t ever cry over something that cannot cry over you.”
Resources for the nurse and Northwest Native American patient
Following is a list of helpful online resources for Northwest Native American patients as well as nurses who care for them.
Northwest Portland Indian Health Board
“Established in 1972, the Northwest Portland Area Indian Health Board (NPAIHB or the Board) is a non-profit tribal advisory organization serving the forty-three federally recognized tribes of Oregon, Washington, and Idaho. Each member tribe appoints a Delegate via tribal resolution, and meets quarterly to direct and oversee all activities of NPAIHB. NPAIHB Delegates create and update a strategic plan, which contains four main functional areas: health promotion and disease prevention, legislative and policy analysis, training and technical assistance, and surveillance and research. NPAIHB houses a tribal epidemiology center (EpiCenter), several health promotion disease prevention projects, and is active in Indian health policy.”
National Institute of Health: Medline Plus: Health Topics: Native-American Health
http://www.nlm.nih.gov/medlineplus/nativeamericanhealth.html
“Every racial or ethnic group has specific health concerns. Differences in the health of groups can result from: Genetics; Environmental factors; Access to care; Cultural factors. On this page, you’ll find links to health issues that affect Native-Americans.”
U.S. Department of Health and Human Services: Indian Health Service
“The IHS is the principal federal health care provider and health advocate for Indian people, and its goal is to raise their health status to the highest possible level. The IHS provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 562 federally recognized tribes in 35 states.”
WWW Virtual Library – American Indians: Index of Native American Health Resources on the Internet
http://www.hanksville.org/NAresources/indices/NAhealth.html
Links to: general web resources; resources for teachers; public health/government resources; tribal/native health organizations; university programs; Indian health boards and centers; other organizations and websites.
Also includes book recommendations.
Works Cited
American Indian and Alaska Native Populations. (2009, June 9). Retrieved November 6, 2009, from http://www.census.gov/population/www/socdemo/race/indian.html
American Indian Tribes Grouped by Cultural Areas. (2000). Retrieved November 6, 2009, from http://memory.loc.gov/ammem/award98/ienhtml/tribes.html#nw
Annenburg Media. (2009, May). Arctic, Northwest Coast, and California Tribes. Retrieved November 7, 2009, from http://www.learner.org/interactives/historymap/indians2.html
Arendt, A., RN, BSN (n.d.). American Indian and Alaska Native Health Care. Retrieved November 7, 2009, from http://www.cwru.edu/med/epidbio/mphp439/American_Indian.htm
Buerge, D. M. (n.d.). Native Americans of the Pacific Northwest: An Introduction. Retrieved November 6, 2009, from http://content.lib.washington.edu/aipnw/buerge1.html
CDC Office of Statistics and Programming. (1997, May). 10 Leading Causes of Death: American Indian & Alaskan Native. Retrieved November 7, 2009, from http://www.cdc.gov/ncipc/osp/indian/indians.htm
Cheewa, J. (n.d.). Catch the Whisper of theWind. Retrieved November 8, 2009, from http://www.gaia.com/quotes/topics/native+american#ixzz0WFDf7SNO
Curtis, E. S. (1910). On Spokane River. Retrieved November 8, 2009, from http://memory.loc.gov/cgi-bin/query/D?curt:3:./temp/~ammem_njyI:
Flora, S. (1978). Northwest Indians. Retrieved November 6, 2009, from http://www.oregonpioneers.com/indian.htm
Francesca, B., Jillian, D., Nora, E. H., & Maya, H. (1978). The Northwest Pacific Indians: Time and Culture. Retrieved November 6, 2009, from http://people.ucls.uchicago.edu/~cmanner/NAproject2007/timeCulture8/index.html
Haney, E. K. (1990). The Eath and I are One. Retrieved November 8, 2009, from http://images.google.com/imgres?imgurl=http://www.arts.ok.gov/p/permart/paintings/haney/earth.jpg&imgrefurl=http://www.arts.ok.gov/capitolart/permart/paintings/haney/earth.html&usg=__EfqXMpR2Ao4oSclrU
Johansson, P., Jacobsen, C., & Buchwald, D. (2006). Percieved Discrimination in Health Care Among American Indians/Alaska Natives. Retrieved November 7, 2009, from http://www.ishib.org/ED/journal/16-4/ethn-16-04-766.pdf
Karkavelas, Will. (2002). Native American Languages. Osaka University. Retrieved November 6, 2009, from http://www.lib.utexas.edu/maps/united_states/early_indian_west.jpg
Macionis, J. J. (2007). Sociology: eleventh edition. Upper Saddle River, NJ: Pearson Education, Inc.
Manataka American Indain Council. (2009, July). Smoke Signal News. Retrieved November 7, 2009, from http://www.manataka.org/images/Indian%20Woman%20and%20Girl.jpg
Maxwell, J. A., Berenson, R. J., Fisher, H. E., Borrowman, M., & Conefrey, R. (Eds.). (1978). America’s Fascinating Indian Heritage (p. 281). Pleasantville, NY: Reader’s Digest.
Medicine Eagle, B. (n.d.). Native American Legends: Great Words from Great Americans. Retrieved November 8, 2009, from http://www.legendsofamerica.com/NA-Quotes.html
Native Spirit Canyon. (n.d.). Retrieved November 8, 2009, from http://www.rene50.nl/nativeamericans/NAmericans-NativeSpiritCanyon.JPG
Northwest Coast Indian. (2009). In Encyclopædia Britannica. Retrieved November 06, 2009, from Encyclopædia Britannica Online: http://www.britannica.com/EBchecked/topic/420049/Northwest-Coast-Indian
NorthWest Indain News. (2009, May). NWIN – #38. Retrieved November 7, 2009, from http://www.nwin.tv/NWIN38.html
Oglala Sioux, L. (n.d.). Quotes From Our Native Past. Retrieved November 8, 2009, from http://www.ilhawaii.net/~stony/quotes.html
Polasky, R. (2002). Native Americans of the Pacific Northwest. Retrieved November 6, 2009, from http://www.archaeolink.com/indian_tribes_of_the_pacific_nor.htm
Roubideaux, Y., Dr. (n.d.). Indain Health Service: Introduction. Retrieved November 7, 2009, from http://www.ihs.gov/PublicInfo/PublicAffairs/Welcome_Info/IHSintro.asp
Strickland, J. C. (1999). Conducting Focus Groups Cross-Culturally: Experiences with Pacific Northwest Indian People. Public Health Nursing, 16(3), 190-197. Retrieved November 7, 2009, from http://www.ncbi.nlm.nih.gov/pubmed/10388336
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Perhaps one of the most intriguing practices of the Cherokee tribe is story/legend telling. The Cherokee people keep their traditions and culture alive through oral story telling. The culture of the Cherokee Indians is very interesting and one of a kind way of life.
are a little bit different. It is not required to believe that tales are true, like it is of myths and legends. Tales are used to teach strong moral messages and life lessons. The main characters in tales are usually animals who either do great things, or get into a lot of trouble and learn a lesson. There are some symbols that occur in these oral stories often. Examples of these are the numbers four and seven. Four represents familiar forces and is also signified by the four cardinal directions, while seven represents the seven clans of the Cherokee. Seven can also represent directions, and includes above, below and within. Also, the seven pointed star is the emblem of the Cherokee.
about $25,000, where as the average U.S. income is about $41,000. This significant differance does have an impact on further eduaction after high school. And while many are employed, only 31 unemployed, most hold blue collar jobs (557 people). This seems to be a continous cycle when I was reading the statistics. The majority of people, 112, have an income of $15,000- $24,999. Only two people are at the low end with an income of $10,000, and 5 people are at the high end with an income of $150,000- $199,999. But no one has an income over $200,000. Approximately 110 people are rental occupied homes and 400 owner occupied homes. The median time travel to work is 30 minutes. The most common way to get to work is by carpooling or driving at 37%. Only 5% work at home. The most common crime is property crime at 6% and burglary and theft at 3%. Violent crime consists of 2%.
This includes being sedentary, of poverty status, and poor nutritional quality. The traditional Cherokee culture was mobile and ate well. These factors contribute to the obesity that plagues this group of people today.
..............N 322 Student Presentation Blogs 
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