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

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

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

5. JuxtapositionEuro-American Separation of man and nature Separation of man and nature View of the universe as mechanical to be manipulated and controlled by man 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. JuxtapositionEuro-American Rational, empirical faculties overrule intuitive faculties Rational, empirical faculties overrule intuitive faculties Intuitive and subconscious faculties are not valued in reductionist methodology 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 Library as repository of knowledge Value of objectivity research – subjectivity is devalued 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 Emphasis on individuality Primarily quantitative Primarily quantitative Validation through pre- agreed upon set of criteria 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. JuxtapositionEuro-American Scientific methods include hypothesis, experimentation and replication Scientific methods include hypothesis, experimentation and replication Reductionistic, breaking down to smallest denominator Reductionistic, breaking down to smallest denominator Separation of matter and spirit 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. JuxtapositionEuro-American Separation of body and mind Separation of body and mind Separation of inanimate and animate Separation of inanimate and animate Spirituality not often a way of life 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. JuxtapositionEuro-American Religion is separate from state and profession Religion is separate from state and profession God is patriarchal noun-god who lives in heaven, separate from man on earth. God is transcendent 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 Matters to Consider Importance and awareness of indigenous perspectives Importance and awareness of indigenous perspectives Constructive dialogues should include indigenous perspectives Constructive dialogues should include indigenous perspectives

13. Western and Navajo Research Protocols (W)Language of mathematics – measurement based (W)Language of mathematics – measurement based (N)Language of Spirit – interrelationship based (N)Language of Spirit – interrelationship based (W)Interplay between theory and observation or experiment (W)Interplay between theory and observation or experiment (N) Validated through centuries of observation and empirical knowledge (N) Validated through centuries of observation and empirical knowledge (W) Prediction and repeatability using the scientific method and process (W) Prediction and repeatability using the scientific method and process (N) Cyclical way of knowing and living in accordance with nature’s teachings (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 (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 (N) Humans are integral participants in an animate universe – non hierarchical

14. Western and Navajo Research Protocols (W)Knowledge is gathered and transmitted by anyone with technical training, often through written journals (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 (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 (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 (N) Navajo community often provides validation connected to the character of the knowledge holders

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

16. 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. 17 EAST White Shell Mountain (Mt. Blanca) or Sisnaajiní SOUTH Turquoise Mountain (Mt. Taylor), or Tsoodził WEST Abalone Shell Mountain (San Francisco Peaks), or Dook’o’oosłííd NORTH Obsidian Mountain (Mt. Hesperus) or Dibé Nitsaa Study will be Navajo Nation-wide: Within the Four Sacred Mountains

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

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

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

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 Diné teachings and practices around child birth. Our logo is a constant reminder of that responsibility to the research team and to our communities. 21 Photo courtesy of nativeamericanlinks.com

22. Navajo Birth Cohort Study Helping Your Baby and Future Generations To Grow in Beauty Call 1-877-545-6775 for more information and how you can participate 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 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 Coming Summer 2012! A research study responding to community concerns about uranium effects on Navajo babies

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

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

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