Indigenous Frameworks & Methodologies

Waniska’s work is centred on Indigenous-derived theoretical frameworks and Indigenous methodologies, which are described below. These frameworks and methodologies, when combined with community-based research, implementation and programmatic science, evaluation, and knowledge translation, exchange and mobilization, will innovate HIV/HCV/STBBI prevention, screening to diagnostics, treatment, care, support, and harm reduction for Indigenous communities.

Indigenous wholistic theory: This emphasizes wellness, or a wholistic state of balance between one’s spirit, heart, mind and body. The concept of wholism captures the multi-dimensional and relational existence of the Indigenous self or person. The self is understood beyond the boundaries of the individual, which is a stark contrast to Western societal emphasis on the individual. The Indigenous self is seen as a spiritual web of relationships with all elements of creation, including other humans, the land and the spirit world. This critical distinction proffers a sharp contrast to mainstream perspectives. These contrasting constructions of the self lead to different understandings of HIV/HCV/STBBI infection.

A trauma-based, resilience-informed model of Indigenous health: Health and wellness deteriorate into un-wellness due to various forms of trauma such as structural racism, social exclusion, residential schools, or removal of children from families. For Indigenous peoples, historical, ongoing, and intergenerational traumas due to colonization and post-colonial policies and practices trigger stress responses that lead to imbalance and adaptations. These may lead to the spiritual, emotional, mental and physical pathologies that characterize disease, which we understand to be end-manifestations of colonization and neo-colonialism. By Indigenizing a wellness approach, we shift to a non-deficit approach, ensure no one is left behind and situate control fully within Indigenous self-determination. It is our contention that a wellness approach would lead to the critical macro-micro changes required to lower HIV/HCV/STBBI rates and to promote living well with those conditions or risks, while shifting the care system to a positive, Indigenous-led trauma-informed care.

Etuaptmumk, or Two-eyed Seeing: A philosophical, theoretical, and/or methodological approach that recognizes the need for both Western and Indigenous paradigms and approaches in research, knowledge translation, and programme planning, development and implementation. This approach provides a balancing lens that emphasizes Indigenous health perspectives while upholding and valuing mainstream perspectives. It draws on the strengths of both theoretical constructs to build and establish meaningful relationships with all people that promote a sense of belonging with the aim to achieve results beneficial to all and activates the wider reconciliatory health agenda that situates the responsibility of Indigenous health care dualistically within Indigenous and mainstream realms.

Ethical Space: A middle ground where two distinct paradigmatic systems (Indigenous and Western) can engage pluralistically to the benefit of all. The fact that two objectivities exist, each claiming their own unique worldview, creates the urgent necessity for an understanding of what constitutes this cultural divide. Ethical Space will represent a location from which a meaningful dialogue can take place between adherents of different worldviews towards the negotiation of a new understanding that ultimately engages different knowledge systems.