David Begay , Ph.D. National Indian Health Board 2012 Tribal Public Health Summit

1. Principles of Indigenous Learning and Its Application to Understanding Health Impacts of Uranium Exposure David Begay, Ph.D. National Indian Health Board 2012 Tribal Public Health Summit May 30, 2012 This work funded by CDC U01 TS000135; 3P20MD004811 - 02S1

2. Presentation Agenda • Overview of the concepts of Indigenous world views and learning • Juxtaposition of Euro-American and Dine’ Perspectives • Comparison of Western & Navajo Research Protocol • Overview of the Navajo Birth Cohort Study (NBCS) Logo • Considerations for NBCS training

3. WorldviewsPeek through the lens of the Navajo mind • Commonalities and differences between Euro-American and Navajo • Interrelationships of all things • All the parts enfold the whole

4. Navajo Worldview and Perspectives • Worldview provides perspective • Order created by natural cosmic process • Process creates organization, structure, and epistemology • Natural order creates natural law of interrelationship and interdependence

5. Juxtaposition Euro-American • Separation of man and nature • View of the universe as mechanical to be manipulated and controlled by man Dine’/ Indigenous • Inseparable organic interconnection between man and nature forms harmonious whole • View of universe as living system of interrelationships with man as an integral part of the whole

6. Juxtaposition Euro-American • Rational, empirical faculties overrule intuitive faculties • Intuitive and subconscious faculties are not valued in reductionist methodology Dine’/ Indigenous • Intuitive, spiritual faculties important • Intuitive consciousness of the unity and interrelationships of all phenomena

7. Juxtaposition Euro-American • Library as repository of knowledge • Value of objectivity research – subjectivity is devalued Dine’/ Indigenous • Nature and elders are repository of knowledge (stories and songs) • Value of participatory research – subjectivity and objectivity are both valued

8. Juxtaposition Euro-American • Emphasis on individuality • Primarily quantitative • Validation through pre-agreed upon set of criteria Dine’/ Indigenous • Emphasis on value of collaboration • Primarily qualitative • Self-validation comes from individual intuitive, community recognition and approval, application to relevant way of life

9. Juxtaposition Euro-American • Scientific methods include hypothesis, experimentation and replication • Reductionistic, breaking down to smallest denominator • Separation of matter and spirit Dine’/ Indigenous • The use of hypotheses, experimentation and replication is of lesser value • Consciously aware of parts as they relate to the whole dynamic system • Unity of matter and spirit

10. Juxtaposition Euro-American • Separation of body and mind • Separation of inanimate and animate • Spirituality not often a way of life Dine’/ Indigenous • Unity of body and mind • Everything in the universe is animate • Spirituality is integral part of life

11. Juxtaposition Euro-American • Religion is separate from state and profession • God is patriarchal noun-god who lives in heaven, separate from man on earth. God is transcendent Dine’/ Indigenous • Spirituality is integral way of life, all-encompassing • Spirituality is intrinsic to entire universe processes, man is inherently interrelated to the immanent.

12. Mattersto Consider • Importance and awareness of indigenous perspectives • Constructive dialogues should include indigenous perspectives

13. Westernand NavajoResearch Protocols • (W) Language of mathematics – measurement based • (N) Language of Spirit – interrelationship based • (W) Interplay between theory and observation or experiment • (N) Validated through centuries of observation and empirical knowledge • (W) Prediction and repeatability using the scientific method and process • (N) Cyclical way of knowing and living in accordance with nature’s teachings • (W) Humans can be viewed as being superior to nature – technology can create distance between people and nature • (N) Humans are integral participants in an animate universe – non hierarchical

14. Westernand Navajo Research Protocols (W) Knowledge is gathered and transmitted by anyone with technical training, often through written journals (N) Knowledge is collectively honored and only imparted to those who are deemed qualified (W) Scientific community vouches for results of experiment, not the character of an individual (N) Navajo community often provides validation connected to the character of the knowledge holders

15. IináNizhóní A Beautiful Life for Mother and Baby Development of the Navajo Birth Cohort Study Logo Logo Created by: Sandy Ramone

16. My Initial Thoughts Child birth is one of the most sacred events for a Diné family Reminds us of White Shell Woman, the Diné emergence story White blanket with stripes is an old design, reflective of age-old teachings that continue today Baby represents all Navajo newborns and their quest for a beautiful life

17. Study will be Navajo Nation-wide: Within the Four Sacred Mountains EAST White Shell Mountain (Mt. Blanca) or Sisnaajiní SOUTH Turquoise Mountain (Mt. Taylor), or Tsoodził NORTH Obsidian Mountain (Mt. Hesperus) or Dibé Nitsaa WEST Abalone Shell Mountain (San Francisco Peaks), or Dook’o’oosłííd

18. The Four Directionsgive meaning to the Study Awareness of Role of Environment in Health Science Education Social Life, Ceremonies 18

19. Why corn stalks appear in the NBCS logo Corn pollen represents life – the growing of the child Corn pollen used as an offering in prayers White corn represents male Yellow corn represents female Provides for our food base

20. Photo courtesy of America West Center, University of Utah Why “IináNizhóní”? • Diné life is holistic – strives for beauty, peace, joy and harmony • Ultimate desire of all NihokááDine’é (“Worldly People”) is to achieve a IináNizhóní (a “life beautiful”) before and after the birth of a child

21. The Navajo Birth Cohort Study This study will look at effects of community uranium exposures on birth outcomes and child development. We, the research team, have a sacred duty to conduct the study with knowledge and respect for traditional Dinéteachings and practices around child birth. Our logo is a constant reminder of that responsibility to the research team and to our communities. Photo courtesy of nativeamericanlinks.com

22. Navajo Birth Cohort Study Helping Your Baby and Future Generations To Grow in Beauty Coming Summer 2012! A research study responding to community concerns about uranium effects on Navajo babies Call 1-877-545-6775 for more information and how you can participate • A collaboration of ― • DiNEH Project (University of New Mexico Community Environmental Health Program, Southwest Research and Information Center); • Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry; • Navajo Area Indian Health Service; and • Navajo Nation Division of Health Principal Investigator – Johnnye Lewis Ph.D., D.A.B.T. Artwork by Sandy Ramone Funding from CDC/ATSDR: U01 TS000135 • All work will be approved and monitored by • University of New Mexico Human Research Review Committee – HRPO# 11-310 • Navajo Nation Human Research Review Board – pending

23. Interface with Existing Clinical Care • Work within existing clinical systems • Standard or routine clinical care • Additional specimens to be collected • Urine and blood at prenatal visit for mom (enrollment, 3rd trimester, delivery) • Urine and blood from dads at time of consent • Meconium at birth • Baby blood from finger sticks • Baby urine at home

24. Considerationsfor Training • Effective communication of sensitive topics in Navajo & English • Pregnancy, birth, development • Birth defects • Developmental concerns

25. Thank You ! Contact us if you have questions: Call 1-877-545-6775