HURTING AND HEALING

ATTAWAPISKAT -- Alcohol abuse and its devastating effects are this
supposedly dry reserve's dirty little secret.

The problem has been swept under the carpet by almost everyone in this tiny,
isolated community resting on the western shore of James Bay.

People from the outside won't find anyone here who will admit there's a
problem.

But after just a brief visit to the community's elementary school, it
becomes painfully obvious that innocent lives have been irreparably damaged
by mothers who drank during pregnancy.

An abnormally high percentage of children here suffer learning disabilities
and behavioural problems, prime symptoms of the incurable affliction known
as Fetal Alcohol Syndrome.

Kids rampage around the classroom while teachers try desperately to deal
with the constant disruptions.

Professionals in the health and education fields agree there's a huge
problem in Attawapiskat, but there are few, if any, financial resources to
address it properly.

But the problem goes well beyond the financial. Before anyone can begin to
deal with this tragic situation, the people themselves must admit there is a
problem and seek out the help they need.

People who try to help are met with blank stares from residents and even
members of the band council. For them, admitting the existence of Fetal
Alcohol Syndrome would be a painful recognition that banning alcohol from
the reserve in 1992 failed to stem a serious drinking problem.

Nurses and residents are quick to point out that not everyone in
Attawapiskat is an addict.

But the number of children at the special J.R. Nakogee School indicates the
problems with addiction didn't disappear when alcohol was outlawed.

Most of the children with full-blown FAS are kept close to home.

While many other children invade the dusty gravel roads early every morning,
FAS children are kept in their backyards or at home, away from prying eyes.

But it's impossible to deny the reality of substance abuse on the reserve
when a child with FAS peeks out from behind a curtain.

Families are ashamed of these children because they are living reminders of
their mothers' inability to avoid the bottle during pregnancy.

Many parents won't allow themselves to believe their irresponsible behaviour
has ruined their children's lives. Instead, they tell themselves they've
been cursed with "crazy" children.

David Okimaw, a special education teacher at J.R. Nakogee School, said many
of his 26 special-needs children are victims of Fetal Alcohol Syndrome.

Okimaw has been approached by his students' parents, asking him if their
child was "crazy." He explains that their child is special and will develop
differently than other children.

He's careful not to label the children because experience has taught him
parents may think their child won't thrive, and that school is a waste of
time and will pull them out.

Okimaw says he is one of the few people in Attawapiskat who knows what's
wrong with these children, but he has refused to label them publicly.

Okimaw has been able to obtain diagnoses for the children in his classroom
thanks to Kingston's Hotel Dieu Hospital, which sends staff from its child
development clinic to the reserve twice a year to meet his students.

Parents participate in the interview process and leave with a clearer
understanding of the challenges faced by their children.

This school year the team of doctors has started to test students in all
remedial classes at the suggestion of teachers and with the co-operation of
parents.

Okimaw said parents don't understand what it means for their kid to have FAS
or partial FAS, but they do understand what caused their child to be born
with the syndrome.

"They have to live with that," explains Okimaw. "They know that."

So the parents begin to blame themselves, and see their children as flashing
beacons signalling their failure.

Sometimes they will pull their children out of school, isolating them from
their peers. Or they may send them off the reserve, hoping they'll get the
help they need.

These children's lives progress mostly in isolation because other children
tend to avoid them. They wander around their sandy yards or peep out of
their windows, alone in a community where residents try to convince
themselves the problems with alcohol have been wiped out.

"Some people take it normally and they accept it," Okimaw says. "They know
there's a problem since birth and they respect the way things are."

But as Okimaw explains, the birth of these children isn't enough to turn
Attawapiskat's residents off alcohol. They will continue abusing alcohol
because they have nothing to replace it with.

"If you take away their entertainment you have to give back something in
return," Okimaw says, suggesting more addiction counsellors are needed.

"I wish I had the power to do something. I'd put all the money on social
services and recreation. We don't have enough resources. No way."

Okimaw believes the solution is to bring back traditional ways and respect
for elders and their teachings.

"There's got to be more education aimed at the mother about what alcohol and
drugs can do," says Okimaw, who would like to see new programs targeting
solvent abuse and encouraging a new lifestyle.

William Yovetich, a cognitive psychologist, speech-language pathologist and
professor at the University of Western Ontario, visits Attawapiskat twice a
year to help children exhibiting inappropriate behaviour develop better
communication skills.

Yovetich has worked with many children who fit the profile of an FAS or
partial FAS child, but who haven't been diagnosed because of a shortage of
doctors able to do so.

"There's a lot of kids that are suspected but they have not been diagnosed,"
Yovetich says. "There's a lot of special education and communication needs
that are not being met."

Yovetich has been offering his services in Attawapiskat and another James
Bay reserve for the past five years. But he has yet to win the trust of
parents who aren't willing to divulge medical, mental and birth history, or
the extent of their alcohol problems.

"People don't want to talk about it. It's a typical small community, but
it's amplified. The locals look the other way because there's a tradition of
non-interference."

The tiny, remote Cree community which sits next to a bumpy, gravel airstrip
looks more like a Third World settlement than a First Nations reserve.

The small bungalows lining the edge of the airstrip look modern. But each
tiny building is an uninsulated box, split into two two-bedroom homes.

A severe housing shortage has forced 125 families to move in with others,
forcing more than a dozen children and parents to share two bedrooms.

At least one of Attawapiskat's homes has 24 people living in it.

For almost two years Attawapiskat has been powering itself with a diesel
plant, which is now being expanded after someone set it ablaze earlier this
year.

At all hours of the day and night you can hear the roar of all-terrain
vehicles.

The kids who ride the vehicles never rest, tearing through the few gravel
streets, raising clouds of dust which coat clothes and homes with a thick
film of dirt.

This tiny community will freely discuss the housing shortage, lack of
amenities and ban on alcohol, but they keep their addictions and the
resulting damaged children well hidden.

Attawapiskat has been a dry reserve since 1992, when alcohol abuse and the
violence that accompanied it rose to epidemic proportions.

In 1992 the band council passed a bylaw banning alcohol. Peacekeepers were
hired to search all vehicles, people and luggage entering the village. They
also occasionally perform body searches.

Some have been able to sneak by on boat or snowmobile trips to Moosonee,
about 150 km away.

A lot of money can be made. A bottle of liquor can easily fetch more than
$100.

"People find a way," Chief Ignus Gall says. "I think people just want a
challenge. They want to find a way to bring it in."

Those who do escape the searches make more on the sale of a few bottles of
liquor than on their paycheques or welfare.

Others pride themselves on their home brew, a money-making business that
rakes in about $10 a beer.

For those who can't afford the steep prices, there's always hair spray,
aftershave, Lysol and vanilla extract.

But access to these products became more restricted a few months ago when
managers at the Northern Store, one of two stores on the reserve of 1,500,
noticed the products disappearing from the shelves at an alarming rate.

The Northern Store has become the community's conscience, locking up any
product containing alcohol.

"We keep hair spray in a separate locked room," explains the assistant
manager of two years, Devan Kearns. "If someone wants some they have to
ask."

That's when a storage room became a safe, secured with a large silver
padlock, with the key placed under close guard by the store managers.

Now clients who want the alcohol-based products are scrutinized and asked
some tough questions. It doesn't stop them from asking, but it usually means
they leave empty-handed.

"We actually want to help prevent it," Kearns says.

Kearns says he only sells yeast and vanilla extract to the two people in the
village he knows use them to cook. He even goes so far as to examine his
customers' hair to determine whether a $20 bottle of hair spray will
actually be used as a styling product.

"We know who the hair spray drinkers are now," Kearns says, adding that
he'll replace his supply of hair spray with a non-alcoholic brand as soon as
his stock is exhausted.

"We know the dealers. We just tell them we're out of stock."

The Attawapiskat River flows into James Bay, about 5 km downstream from the
reserve, tempting boaters to try their luck with a day-long boat trip to
Moosonee for booze.

Every year a few die on their way back to the reserve. Some can't resist the
temptation to test their merchandise and fall into the cold water and drown.

Others head a few hours down the James Bay shoreline to another Cree
reserve, Fort Albany.

Fort Albany is also a dry reserve, but the booze ban isn't enforced. Alcohol
is easier to find than in Attawapiskat, but the prices are steeper than in
nearby Moosonee.

Others will drop loads of booze from an aircraft into the surrounding bush,
bringing it into the community under the cover of darkness.

Fall's freezing winds bring the hope of new pickup trucks, cheaper
merchandise and bountiful truckloads of alcohol.

In winter an icy road across the Attawapiskat River forms, leading south to
Moosonee, or as it is sometimes affectionately called, Boozonee.

The band council stations peacekeepers at a roadblock south of the reserve
all winter to stop the flow. When alcohol is seized, it is poured onto the
snow and its owner receives a stern warning.

The maximum penalty for a repeat offender is expulsion from the reserve.

All vehicles and people coming into the village are supposed to be searched.
But some people escape the searches. Others use snowmobiles to go around the
roadblocks.

There's always a way.

Bernadette Iahtail started Attawapiskat's only safe house two years ago.

"There's still some alcohol here," Iahtail confirms.

Iahtail helps people with substance abuse problems and those who have been
abused, by offering her resources and opening two bedrooms in her
dilapidated trailer home.

Iahtail says the reserve has been able to reduce alcohol abuse, but it
remains a problem.

"Right now we're having a very big problem with hair spray," she says,
adding that a bottle of hair spray mixed with juice makes about four drinks.

Others who don't consume alcohol on the reserve will do so openly on trips
into Timmins or Moosonee.

"They don't drink here because of the bylaw but every six months they
binge," explains Iahtail. "They go out to do their shopping and sometimes
their shopping never gets done."

Many are in denial about alcohol abuse since they want to believe the bylaw
has erased all their problems.

"It's not talked about here," says Iahtail, adding that people also refuse
to talk about what alcohol is doing to their families. "They're still in the
denial stage here."

Iahtail was born in Attawapiskat but was removed by the Children's Aid
Society from abusive parents when she was two.

She started with drugs at 11 and mixed in alcohol at 14.

"I'm pretty sure if I was raised in this community it would have turned out
the same," says Iahtail, who has been sober for four years. "Alcohol is an
emotional problem."

She left the reserve a few times as an adult, returning to run the safe
house in 1997.

Abusive behaviour is passed down from generation to generation. Right now
the big problem is trying to reach teens and pre-teens before they begin
experimenting, says Iahtail.

In Attawapiskat about 60% of the population is under the age of 24.

Apart from the safe house, she also helped spearhead the healing lodge
program.

A spectacular log house was built at the end of a winding 5-km dirt road
outside the village to house recovering substance abusers. Isolated in the
forest, the Jules Matinas Healing Lodge keeps its doors tightly locked and
reluctantly lets visitors peep into the small windows.

But more is needed to help addicts kick the habit, says Iahtail. She wants
more assessments and after-care for people who are released from programs.
She also wants help for children of alcoholics or drug addicts.

"There are a lot of partial Fetal Alcohol Syndrome children," she says,
adding that nothing is available in her community to help these children
cope with their developmental and behavioural problems.

Attawapiskat's nurse practitioner Larry Thompson works in the health unit
with a few community health representatives.

He says his plate is already filled with pregnancies and tuberculosis
programs so he can't take on FAS and the many problems associated with the
syndrome.

"In these small little isolated communities it can be so complicated."

Thompson links FAS with the housing problem, which is linked to substance
abuse, lack of education and 80% unemployment rate.

He says that in order to help FAS children and their families, he would need
a doctor to come in more than three days a month, and they would need to be
there specifically to assess the children.

"(Doctors) have what I would call higher priorities," says Thompson.

Even if a child is diagnosed, it won't help the family since Attawapiskat
doesn't have any of the services the child desperately needs, explains
Thompson.

In Attawapiskat there's a dire need for more aggressive educational
programs.

"For you to know what's good for you, you need to have an education,"
Thompson says.

To deal with problems on a reserve, Thompson believes a Native solution is
needed.

He doesn't think a white health care system or poster campaign will work in
Attawapiskat. Instead, more Native healers and locally designed programs
would go a long way toward dealing adequately with the problem of substance
abuse.

But that takes money. Unfortunately that is in short supply, and FAS does
not top the community's priority list.

The health director for the United Chiefs and Councils of Manitoulin says
Natives are more aware of the syndrome than they were in the 1980s, but much
still needs to be done.

The six reserves off and on Manitoulin Island that Nose oversees are said to
have one of the best programs to combat FAS in Canada.

"The awareness level is more than it was five years ago," she says. "I would
be hesitant to say we're 100% there with new moms."

Nose has seen a reduction in the number of FAS and partial FAS children in
the Manitoulin Island area, but the syndrome is still all too visible.

"You can see when you step into a classroom and you see all those faces,"
she says.

Compounding the problem is the fact some doctors are reluctant to deal with
social issues and feel uncomfortable asking pointed questions about alcohol
use.

That makes it difficult to determine whether a woman abused alcohol during
pregnancy.

Nose said aboriginal children on the six reserves she serves are more
fortunate than those in isolated communities like Attawapiskat because
there's help on and off the reserve.

The state of medical services in more remote areas, which she says is
decades behind Canadian standards, needs to be addressed to eliminate
substance abuse.

"We don't have in-depth programs on reserves yet," Nose said. "I think they
need more social support. I think you have to work at it a number of
different ways. It is a big issue the communities do have to face."

The first thing that needs to be addressed is the high rate of aboriginal
alcoholism, she said.

"The root of it goes back to empowerment and control of their lives," said
Nose, listing poverty, housing, abuse, unemployment and depression as
reasons for the high alcoholism rate and FAS births in Native communities.

"Alcohol is just a means to alleviate some pain."

Although the rate of FAS nationally is one in 500 births, on some First
Nations reserves it has skyrocketed to one in 25.

But there is hope. The federal government has begun to show an interest in
reducing this preventable syndrome.

A 1992 Parliamentary standing committee on FAS and alcohol abuse made three
recommendations focused on Native communities.

The committee recommended that a special aboriginal committee on alcohol and
the fetus be created, that an aggressive educational campaign be launched
and that programs on FAS be re-evaluated.

However, none of these recommendations was implemented.

A 1993 Royal Commission on Aboriginal People focusing on FAS among First
Nations labelled the syndrome an epidemic.

Presentations from hundreds of people ranging from health workers to band
leaders pointed to the effects of alcohol abuse on aboriginals.

The committee found that FAS children have no specific services inside or
outside Native communities, concluding an FAS child needs help from all
community resources.

Based on the recommendations, an FAS hotline was set up through the Canadian
Centre on Substance Abuse in Ottawa. Karen Palmer, who manages the toll-free
number, has fielded almost 4,000 calls since 1993.

Then the 17-year-old Ojibwa became pregnant and learned how to say no.

She said no to her friends who wanted to party. She said no to smoking. And
most importantly she said no to booze.

Traditional Native teachings promoted by her mother have turned her life
around, but have driven most of her friends away.

With her shoulder-length hair tied back in a pony tail revealing a tanned,
glowing freckled face, the dark-eyed teen proudly talks about the pending
birth of her child later this month.

The teen stopped taking birth control pills in December, and unprotected sex
led to her pregnancy and a dramatic change in lifestyle.

"I quit everything," Sherisse says. "I quit drinking. I quit smoking. I quit
because I know it's bad for the baby."

Sherisse is proud of her change in lifestyle, but she's disappointed her
circle of friends has diminished.

Things at home are kept healthy too, as a form of respect for what she calls
a "gift from the Creator."

"There's no smoking in our home or alcohol," she says.

Living with her mother, stepfather and two stepbrothers, the teen is
thankful she has a large support network.

Now she's preparing to continue her healthy lifestyle after her child is
born, having attended a breastfeeding seminar given at the Whitefish Falls
First Nations Health Unit, a community of 300 a few kilometres north of
Manitoulin Island.

Sherisse's mother Maretta says she was pleasantly surprised her daughter
listened to her advice.

"It makes me very proud of her to see what she's done."

Maretta said her daughter doesn't have any temptations at home, since she
and her husband renounced alcohol 14 years ago and adopted a more holistic
lifestyle.

"We didn't want (our children) to grow up in that environment," explains
Maretta. "We've spent a lot of time talking to her about drugs and alcohol."

The clear, dark green sparkling water surrounding Manitoulin Island is a
reflection of its health system.

Directed by three nurses, five First Nations communities on the northern
part of Manitoulin and the mainland benefit from an exceptional health care
system.

Nurse manager and educator Rosella Kinoshameg has applied Native
spirituality to create a series of teaching models derived from First
Nations teachings to help residents deal with all health issues, including
FAS.

"With all the resources we have in our community we should have no reason,
no excuse for FAS," she says.

Kinoshameg uses knowledge passed down from her grandmother to help Natives
who might not have a traditional family life and lack parental advice.

First Nations people have traditionally passed their knowledge of everything
from cooking to raising a child verbally from mother to daughter.

But as in all other societies, more families are being torn apart by
divorce, and outside forces like television have eroded tradition.

Kinoshameg is keeping with tradition by teaching that each individual is
born with seven sacred gifts given to them by the Creator. She also applied
the circle and the Medicine Wheel so her patients can view life in a
holistic manner.

"The Medicine Wheel has been around for a long time," says Kinoshameg,
adding she simply tailored it for expectant mothers.

"It belongs to our ancestors. The teachings are there. The ways are there."

Parents must cherish it and do everything possible before and after the
birth to ensure it develops properly.

Of the few programs up and running on First Nations reserves, almost all
address FAS as part of a larger problem and involve a number of health care
and social service professionals.

The most successful initiatives tend to view the syndrome as a manifestation
of a number of conditions in the community.

The erosion of Native traditions coupled with the shortage of Native nurses
and doctors is hurting First Nations communities, Kinoshameg says.

She says aboriginals tend to respond better to Native nurses and doctors.
They're much more likely to open up about their problems and be more
receptive to suggestions when they come from their own people.

Unfortunately, there is a shortage of Native nurses and other health care
professionals.

Bitter over the shortage of money to deal with the growing FAS problem, Dr.
Gideon Koren has turned to his own prevention strategy with the Motherisk
program.

But his program is controversial. Rather than focusing on preventing
alcoholism, he tries to prevent pregnancy among substance abusers.

"The only prevention is not prevention of addiction," he says. "It is
prevention of pregnancy."

Koren doesn't believe a pregnant alcoholic would stop drinking for the sake
of her child, so he hopes to prevent the pregnancy and the irreparably
damaged fetus.

As a bonus he believes his strategy will prevent unwanted pregnancies,
because alcohol often leads to promiscuous behaviour and unprotected sex.

Koren said the best product he's seen on the market so far for women with
drinking problems is the Norplant system, which offers five years of
worry-free birth control through a small implant.

"There is a huge consensus that the baby be protected," Koren says, adding
that he's found a good response to his prevention program.

Koren is now conducting a study to see what measures would need to be taken
to get alcoholic women to consent to Norplant.

Koren says both the government and distillers need to start devoting more
time and money to FAS.

"We need programs, not campaigns," says Koren, pointing out it costs society
more than $2 million to treat an FAS victim over the course of his or her
lifetime.

Koren says the pamphlets and posters aren't enough to make pregnant women
think twice about abusing alcohol. Apart from an FAS help line, he feels the
federal government has fallen short on programs designed to help Canadians
cope with the syndrome.

The federal government has left it up to the provinces to develop their own
programs.

Saskatchewan took the lead early on, but British Columbia now has developed
an impressive network of private and government initiatives to combat this
problem.

There are no hospital-based intervention programs for drinking mothers
except at Vancouver's Grace Hospital.

"I'm very bitter that the industry which makes billions of dollars until now
hasn't funded any fetal research," said Koren. "Breweries have not yet put
one cent on FAS research. No one is demanding them to do it."

But Dr. Christine Loock, a professor of developmental pediatrics with the
faculty of medicine at the University of British Columbia and a leader in
B.C.'s FAS programs, says progress is being made.

"We're creating a society where alcohol is less acceptable and that's good,"
says Loock, who believes educating women about the effects of alcohol is the
most important way to prevent FAS.

"Pregnancy is a very powerful motivator."

The biggest challenge is to motivate an alcoholic to kick her habit, says
Loock.

To prevent families from being torn apart and to encourage women to stay off
the bottle, Loock promotes keeping the baby and mother together if the
child's mother stops drinking.

Loock has faith in the motivational factor of pregnancy, believing that if a
woman is encouraged and has access to support programs that will help her
stop drinking for the sake of her unborn child, she will.

"There needs to be more research," says Loock. "FAS is common, it's
expensive and it's preventable."

Here's where you can find help:

Websites:

www.ccsa.ca

www.arf.org/isd/infopak/arbd.html

Phone numbers:

Canadian Centre on Substance Abuse, FAS hotline: 1-800-559-4514

FAS Alcohol Syndrome Support Group, Dorothy Asselstine 613-259-3270 or
Cattis Esbensen 1-800-667-2617

Motherisk (Toronto) 416-813-6780

Checked-by: Don Beck