Oral histories: lessons we can learn from the past

Abstract

The COVID-19 pandemic has brought to light the importance of hindsight in response to global health crises. Although globalization has amplified worldwide perspectives, many lessons learned from past outbreaks in Indigenous communities have been overlooked. Oral histories are deeply rooted traditions that have played a significant role in the health practices of Indigenous communities across Canada. These practices can provide valuable insights into past epidemics or casualty events and their short- to long-term impacts. They have shaped responses to COVID-19, with Indigenous communities implementing self-determination efforts, such as community closures, contact tracing, and isolation measures. These traditions have heavily influenced population health practices in other contexts, such as the 1700 Cascadia earthquake, smallpox, and tuberculosis outbreaks. However, challenges remain in facilitating disease data transparency and Indigenous sovereignty. Efforts should be made to promote recognizing and respecting Indigenous knowledge and practices within the broader health system.

Background

Our globalized world has produced a wealth of shared knowledge and resources, but tackling an epidemic has never been more challenging. Since the COVID-19 pandemic, we have learned lessons and public health practices on a personal, regional, and global continuum. However, hindsight is 2020. Communities affected by a lived history of disease and epidemics may have been better equipped and prepared for a never-before-seen pathogen. Many Indigenous communities have historically relied on oral histories to facilitate the generational passing of information through stories, lessons, and traditional knowledge. Tania Cameron, a member of Niisaachewan First Nations, was not a rookie in the fight against COVID-19 (1). She and a local group of health directors had tailored their first community pandemic plan in 2002 when SARS broke out. Cultural practices of sharing oral history stories of past epidemics or high casualty natural disasters had served as widespread reminders to be cautious against similar events (1,2).

Practices of oral history storytelling have often set the foundation of Indigenous communities by uniting experiences and even events of trauma (3). However, they cannot be discounted as simple storytelling. Over time, these oral histories have been ‘peer-reviewed’ by other community members, where slight deviations often indicated a personal context concerning the story being told. Previous research had confirmed the validity of this practice. Immune-related alleles directly corroborated oral histories from the Lax Kw’alaams and Metlakatla First Nations, affirming the traumatic impact of smallpox that eradicated almost 60% of their 9000-year-old community at the time of European colonization (4).

Through oral history case studies, the profound impact of significant historical events on Indigenous communities and their ongoing implications for population health practices can be better understood.

1700 Cascadia earthquake

Oral histories of Quileute and Hoh Indigenous peoples depict the colossal fight between the Thunderbird and Whale – now recognized as the 1700 Cascadia earthquake (5–7). This seismic upheaval largely went undocumented by non-Indigenous communities, and geologists only began to tap into the wealth of information contained within these oral histories in the 1990s (8). It was not until researchers incorporated Japanese tsunami records and geologic evidence from North America that the significance of Indigenous oral history became scientifically validated. Nonetheless, for thousands of years, affected Indigenous communities built a culture of awareness which played a pivotal role in imparting knowledge about earthquake safety to subsequent generations (9).

Smallpox

Smallpox and tuberculosis (TB) case studies offer insight towards how oral histories have influenced population health practices. In the case of smallpox, oral histories have served as reminders to communities of the legacy of colonization and its consequences. In the retelling of events by Old Pierre, a member of the Katzie First Nations, the 1782 smallpox insurgence his great-grandfather witnessed was one of extensive loss (10). In the region of what is now Vancouver Island, there were abandoned villages littered with corpses as people ‘crawled away into the woods to die [and others] in their homes’ (10). The estimated three-quarters mortality provided by Old Pierre’s great-grandfather was likely a conservative measure at the time, taking into account the hypothesized virgin soil effect of smallpox (10,11). The epidemic was so severe that ‘only in one house did [Old Pierre’s Great Grandfather find] a baby boy, who was vainly sucking at its dead mother’s breast’(10). Unlike the European settlers who brought over smallpox to the region, this was a novel disease among Indigenous communities, and their lack of immune adaptation to this disease resulted in widespread mortality (4). These past epidemics, where entire villages were wiped out, serve as reminders of disease lethality.

Tuberculosis

Tuberculosis (TB) was and is a long-term disease of attrition. Similar to smallpox, strains of TB were carried over by European settlers, which wreaked havoc under the conditions of colonization (12). However, unlike smallpox, it has been an ongoing battle bringing about an arsenal of disease expertise among Indigenous populations affected by recurring TB outbreaks. Communities are still grappling with the legacy of colonization – overcrowding, poverty, and minimal infrastructure – all the conditions necessary for high disease spread (1). This now-endemic situation occurs at disproportionate rates, where populations like those in Inuit communities deal with disease rates 296 times that of Canadian-born non-Indigenous populations (13). Métis communities face rates nearly 3.5 times higher, and all First Nations on- or off-reserve at rates 41 times higher than Canadian-born non-Indigenous populations (13). As discussed by Robert Bonspiel, the director of the First Nations Paramedics in Quebec, the ongoing fight against TB has brought over a myriad of knowledge in dealing with contact tracing, isolation and quarantine efforts (1). These familiar practices made dealing with the COVID-19 pandemic novel yet normal for their community.

Towards COVID-19 and beyond

Oral histories of particularly devastating diseases like smallpox and TB have shaped the response against COVID-19. Outside of community-enforced contact tracing, isolation, and quarantine, communities like Heiltsuk, Haida, Ahousaht, Tŝilhqot’in, and Tla-o-qui-aht First Nations in British Columbia (BC) closed their borders to tourists and non-residents (14). ‘People before economics’ was the statement made by the Nuu-chah-nulth Tribal Council president (14). Self-determination, or in other words, sovereignty in health initiatives within communities, has been found to be critically effective against epidemics (2). These self-determination efforts during COVID-19 included staying connected virtually, setting up trailers for self-isolation, roadblocks, and food delivery services for older adults (1).

More efforts must be made to facilitate disease data transparency and Indigenous sovereignty, so that Indigenous communities have the necessary tools to combat outbreaks and apply their oral histories (15). These challenges were apparent when BC First Nations faced issues enforcing a closed community at the onset of COVID-19 (1). Contact tracing efforts were also impacted when provincial disease data was not readily available to Indigenous community leaders (15). There had been a long-term province-wide practice of not collecting disaggregated disease data, such as the number of Indigenous or BC First Nations peoples affected by COVID-19. This operation inevitably affects governmental accountability and support for on-reserve communities that are highly affected by disease. Nevertheless, BC First Nations provide an excellent case of how oral histories of past epidemics have set the groundwork to be extra cautious and vigilant. In the first half of 2020, there were only 90 cases among BC First Nations (1). And by August of 2020, BC First Nations reserves had tested positive at rates that were only a quarter that of their general non-Indigenous Canada-wide counterparts (1).

Applications

Oral histories are invaluable and credible sources of information, containing a wealth of knowledge from lessons learned and traditional practices spanning decades and centuries earlier. By harnessing the wealth of knowledge, awareness, and preparedness through oral histories, existing public health efforts can be significantly enhanced. This consideration allows for better-tailored and culturally appropriate interventions, leading to more effective outcomes for all.

These practices can also facilitate unique perspectives on cultural norms and beliefs that influence health behaviors, such as attitudes towards vaccination or traditional healing practices. For example, an oral history project could involve interviewing community-dwelling members about their experiences with disease outbreaks and how they were addressed within their community, shedding light on effective responses and measures for controlling outbreaks. It facilitates mutual understanding and communication through an insider lens, providing a personal context that is essential in public health fields (16,17). Drawing from these insights, oral histories can potentially help mitigate implicit clinical biases and enhance educational programs on cultural sensitivity by improving understandings of people’s lived experience.

In many ways, this practice sheds light on upstream determinants of health and helps elucidate why communities respond or are affected in certain ways (16). For instance, many Indigenous communities in Canada are disproportionately affected by the drug epidemic, with mortality rates five times higher than their non-Indigenous counterparts in BC alone (18). By collecting stories and experiences directly from community members – leaders, healers, researchers, policymakers and other key stakeholders – we may collectively gain insights into the social, cultural, and historical factors that shape health outcomes and tailored interventions thereafter.

Conclusion

Oral histories are influential in promoting community cohesion, improving health outcomes, and honoring the self-determination and agency of Indigenous communities. To ensure that these lived experiences and lessons learned are genuinely operationalized on the ground in a culturally sensitive and remunerated manner, it is imperative to prioritize Indigenous voices, knowledge, and perspectives. Integrating oral history into public health efforts would provide valuable knowledge regarding the consequences of disease and the lessons learned from them, working towards efforts addressing health disparities in Indigenous communities and beyond.