Decolonization: Recognizing First Nations Sovereignty

Our People. Our Health. Our Way. 

The Health Transformation Team at the Southern Chiefs’ Organization (SCO) published a report in July 2024 called “Decolonization: Recognizing First Nations Sovereignty.” 

Read our media announcement about the new report here.

You can download a PDF copy of the report here.


The 34 southern Anishinaabe and Dakota Nations represented by the Southern Chiefs’ Organization (SCO) have strived to maintain a relationship with the land and acknowledge this as a sacred responsibility. In turn, this reciprocal relationship has provided the good health, medicinal plant knowledge, traditional food, clean water, and a physical lifestyle that SCO member Nations prospered within for millennia. The right to health was incorporated into SCO member Nations’ laws and pre-dated any Treaties, with ways of life that included health systems, health laws, and governance styles that provided and cared for the whole community.

The Anishinaabemowin and Dakota languages are also key and critical to survival as these languages connect the people to the land and are full of teachings to heal the heart, body, mind, and spirit.

Today, the ongoing effects of colonization and systemic and institutionalized racism have continued to negatively impact all dimensions of health of the individuals, families, and communities in the 34 southern Anishinaabe and Dakota Nations. Colonization led the 34 Nations to a state of ill health, and decolonization will lead the 34 Anishinaabe and Dakota Nations back to good health.

SCO Health Transformation is the arm of SCO tasked with establishing a First Nations-led health system that restores the health of the 34 Anishinaabe and Dakota Nations’ citizens. SCO Health Transformation’s response to Canada’s call for engagement on the Co-Development of Distinctions-Based Indigenous Health Legislation to improve access and address health inequities between Indigenous and non-Indigenous peoples is outlined in this report. The report also notes the legal and policy tools required to address the health inequities.

To further Canada’s and the SCO member Nations’ mutual goal of decolonization in health, it is imperative that Canada recognizes that SCO member Nations have always had, and continue to have, sacred health laws that support their health. Canada must respect and accept the sacred health laws of the 34 Anishinaabe and Dakota Nations, and include SCO member Nations’ direct involvement in any Canadian legislation impacting First Nations health.

Canada’s relationship with the SCO member Nations must be one of mutual understanding of each party’s roles and responsibilities as understood by the Anishinaabe and Dakota Nations, including but not limited to the spirit and intent of the Treaties. This will provide the necessary foundation for a new and improved health care system, where decisions will be made by the SCO member Nations, that will be empowered to govern at a local, regional, and Nation-wide level. A health care system transformed in this way will not only improve health outcomes for First Nation citizens, it will also benefit both the federal and provincial governments economically and reputationally while fulfilling their legal, fiduciary, and Treaty obligations as shared partners on the land that is now known as southern Manitoba. Treaty references have been included throughout the response and inform the recommendations. Where no Treaty relationship was established with some SCO member Nations, this report explains Canada’s obligations apply at least as strongly.

This response goes beyond the standard colonial concept of “health,” defined as freedom from clinical illness or disease. Our definition requires a holistic approach, including recognition of the essential First Nation health determinants of self-determination, territorial sovereignty, and identity. While there is increased recognition of Indigenous determinants of health as a concept in recent research and internationally, within this report, we use the terminology First Nations determinants of health as it more accurately reflects the citizens of SCO member Nations.

SCO Health Transformation takes the position that the current and historic inequalities and deficiencies in health are due to government policies and practices towards health care programs and services provided to the southern 34 Anishinaabe and Dakota Nations. They are a direct result of the social, political, and economic disadvantages that prevent the 34 Anishinaabe and Dakota Nations from achieving and maintaining good health and access to resources that support optimal health outcomes. The need to restore the sacred health laws of the Anishinaabe and Dakota Nations must be embedded and grounded within any First Nation health legislation passed by Canada. This is a step towards decolonization and reconciliation.

Without decolonization, very little will be accomplished other than mere tinkering around the edges of health care via service delivery and maintenance of the status quo.

Decolonization means returning control of First Nations health, health care, and health care delivery to First Nation citizens and rebalancing the power structure of decision-making where First Nations ways of knowing and doing are recognized as equally as valid as Western ways of knowing and doing. Decolonization of First Nations health care also means that Canada will acknowledge, respect, and accept the sacred health laws of the Anishinaabe and Dakota Nations.

As inherent rights holders as well as rights holders under the United Nations Universal Declaration of Human Rights, the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), Section 35 of the Constitution Act (1982), and under the relevant Treaties, SCO member Nations have the power to decide how to address First Nations health and take control of it, including seeking solutions to the determinants of health that contribute to poor outcomes. Most importantly, decolonization requires the creation of fiscal structures that sustain the administration and operation of SCO member Nations and ensure that there are remedies that correspond to the violations of rights they possess.

Working within this framework, SCO’s response has three interconnected themes that weave their way through the entire document: historical narratives, recommendations, and a fiscal strategy.

The historical narratives make it abundantly clear that colonization is the root cause of virtually all health disparities experienced by the citizens of SCO member Nations. This history, including the formation of the numbered Treaties, forced relocation and land disposition, creation of the reserve system, banning of cultural practices, residential and day schools, the Sixties Scoop, child and family services, the paternalistic relationships with all three orders of colonial government, historical funding arrangements, racist attitudes, attempted assimilation, and the deliberate, systemic perpetuation of First Nations poverty, must all be understood before solutions to improve health outcomes for First Nations’ citizens represented by SCO are proposed.

The impacts of colonialism on the health of First Nations citizens through hundreds of years of devastating laws and policies imposed by The Indian Act and enforced by the federal government have consequences. They include the health impacts of starvation policies, the pass system, residential schools, disproportionate incarceration, child welfare, and the deliberate subjugation of First Nations women, girls, two spirit, and gender-diverse relatives.

The second theme addresses what needs to be done to decolonize and restore the health of SCO member Nations’ citizens, and how the process of revitalizing the sacred health laws of the Anishinaabe and Dakota Nations ought to proceed. Practical guidance for local implementation is provided through 31 fully explained recommendations.

The third theme addresses options for how the proposals for decolonization can be fully funded in a way that honours the Treaties and restores the dignity, sovereignty, and voice of SCO member Nations while benefiting Canada. The fiscal structure we recommend includes taxing authority over SCO member Nations’ traditional territory in amounts sufficient to allow SCO member Nations to maintain healthy communities. This would require a legislated, co-developed fiscal structure allowing for all the social programs and structures First Nations governments choose to maintain for their citizens and traditional territories.

There are two appendices attached to this document that support and augment the content of our response:

  • Appendix 1 provides a detailed overview of the early colonial legal and policy structures that were set up to perpetuate First Nations poverty and poor health.
  • Appendix 2 looks at the history of colonialism specific to SCO member Nations, describing the impacts of colonial development on the health and well-being of SCO member Nation citizens in southern Manitoba. These accounts are supported by extensive references and footnotes.

Taken together, this report plus the two appendices provide a comprehensive, factual, and legally sound approach to transforming the health of SCO member Nation citizens.

Achieving the transformation of health care for First Nations through SCO Health Transformation’s perspective will be of benefit to both the 34 southern Anishinaabe and Dakota Nations it represents and Canada.

The following image shows Colonial Determinants of Health:

This is a visual representation how racism was used to justify and control all aspects of First Nations lives: control over our culture, our land, our economy, and our people. The health impacts of all of the interconnected systems of colonial control are deeply felt today and have resulted in the poor health outcomes experienced by our citizens

The following image shows the path forward to Restoring First Nations Health:

Our citizens need a healthy heart, mind, body, and spirit for our families and Nations to thrive. This image shows how we can restore our inherent right to health and decolonize health care by using a holistic approach to address the systemic barriers and racism that are embedded in current systems.