Indigenous women and their knowledge are needed to develop equitable elderly care

Indigenous people view care from a broader perspective and may offer key insights regarding how we can reimagine and reclaim care. Postdoctoral researcher Wasiq Silan investigates viable strategies aimed at enhancing Indigenous people’s health and well-being. 

Many challenges face welfare systems vis-à-vis elderly care. Discussions surrounding such challenges often focus on new technologies and the need to cut costs or focus on the crisis in attracting workers to the field. But how can we develop social welfare systems that provide care which is equitable, sustainable, and high-quality? This is the question Wasiq Silan, a PhD in the Social Sciences and Postdoctoral researcher, aims to answer through her research project Care in Relationships: Re-centring Indigenous Older Women's Voices. This research project highlights the importance of the relational aspects of care.   

‘Care not only takes place at the level of the physical body; it occurs in interconnected ways, whereby the relational element to care is important. If the relational element does not occur, then care is not provided.’    

Wasiq Silan’s findings demonstrate the need for governments and welfare systems to facilitate Indigenous people’s knowledge and their local ways, rather than making decisions and policies without listening to the people receiving such care.  

‘The importance of this research lies in recognising that there are locally situated ways of being, and knowing that these communities can provide care for themselves. It should not be this top–down way of making decisions. These communities and their own way of doing things should also be considered. The policy implication is as follows: How do we facilitate this relational care which already exist rather than suppress it?’  

Wasiq Silan recognises the challenge within the care industry related to attracting workers, but she does not believe that technology will fix all of our problems.    

‘We cannot just keep putting into place more expert-led developments or more AI technology, and simply digitalise the entire care system. At the end of the day, we will find that the government only spent more money resulting in less care. Then, there will be nobody who wants to remain in the nursing industry, because it will just become a dead industry if they do not see what is really at stake here.’     

Indigenous women’s voices not heard in decision-making

Wasiq Silan is an Indigenous Tayal woman from Mstaranan, known as the Nanshi River Valley in the northern part of Taiwan. She is committed to developing Indigenous methodologies, namely, incorporating local Indigenous ways of producing knowledge into research methodologies. 

By going into the Indigenous community and participating in a daily club with her grandmother, Waisq Silan learnt more about care. Through her research, Wasiq Silan observed that within the welfare system the voices of certain groups have not been heard, realising that policy regarding care is not neutral.    

‘I realised that this high-quality elderly care, which has been much talked about in many social welfare states, does not foster a kind of justice. It does not include voices from certain groups, like the experiences of my grandmother and her childhood friends, as Indigenous women, who do not work in these masculine spaces. Their voices are ignored.’    

Currently, bureaucrats and the state lie at the centre of decision-making regarding care within the welfare system. Her research project aims to address this gap in the welfare system by investigating what viable strategies exist to enhance Indigenous health and well-being through the lens of Indigenous knowledge. 

‘Ultimately, the idea is to expand our notion of how care could be for the elderly or for planetary health. Whilst such types of care may take different routes, I view them all as interconnected.’       

Wasiq Silan’s research project adopts a comparative lens to the Sámi community to examine Indigenous women’s voices and how they view care in various contexts. Furthermore, knowledge is not only relevant for the Indigenous traditional territory, since in both Finland and Taiwan Indigenous communities move beyond their traditional territories, for example many of the youth move to the cities. Therefore, her research also examines how these communities reinvent or extend the cultural life in various ways and how welfare systems intersect with them. 

Power imbalances and cultural safety curriculum 

 The dominant narrative around Indigenous communities’ self-determination focuses on land and natural resources. Less often, the narrative centres on softer areas such as language and care.   

Care is the site of a power struggle and a barometer for self-determination, the ways in which we have control over how care is organised, who organises and provides care, and the logic of care. Care is not neutral. It is not just what we think it is; it also contains Indigenous sovereignty and Indigenous self-determination.’    

Wasiq Silan’s view is that changes need to be made regarding power imbalances, so that equal care systems can be developed by empowering people and listening to their needs.   

‘At the moment in Taiwan, there is a very imbalanced hierarchy of an ongoing welfare colonialism or this idea of benevolence, of “yes, I take care of you, I know what is best for you, and I know what you need.”’   

Politics are central to how care is organised and practiced in welfare systems.  

‘Care is not just about the number of nurses, the number of social workers, and human resources for this and for that. It is not this top­–down way of organising care from the state perspective, but more from the Indigenous care paradigm. I want people to see that Indigenous care paradigms exist and that it is about politics. Furthermore, politics is not something that only happens in parliament, but that politics impacts everyday life.”

One implication of this research is highlighting the importance of greater participation from Indigenous communities and granting them a seat at the table when it comes to making decisions around care and what kinds of care a community wants.   

‘This research could also serve as a bridge to helping more people, young people, to feel more comfortable. That is, they can participate in the social welfare system, participating in designing a better social welfare system that could be high quality for everyone, instead of for just this one particular majority, but not the other people.’    

For Indigenous people, racism, discrimination, and stigma have contributed to the lack of culturally safe care and support services. Another implication of this research is that it may help develop cultural safety curriculums, such as for nursing students and social work students. Cultural safety is of high importance since, if this relational aspect is not working, then the care is not provided regardless of having all the needles and all the techniques at your disposal.   

Reimagining and reclaiming care   

Wasiq Silan’s research offers knowledge crucial to reimagining what care is and how to develop the care system in a different way.  

‘This research is very important. Informed by the feminist ethics of care, we do not want to reinvent the wheel, but we want to recentre Indigenous women’s voices. Being critical of neoliberal metrics, it helps us to reimagine and reconnect to what care is.’ 

Through her research, Wasiq Silan has found that there are many different elements to care. Because human well-being is also connected to the sustainability of our planet, Wasiq Silan encourages us to view care from a broader perspective.     

‘Care is not about how many times you wash bodies, how many visits you do for long-term care, but these nuances of the relational elements of what makes us human. It has a policy dimension, as well as a philosophical dimension, about who we are as humans who want to live together with other people and other species on Earth. Care is not just a biomedically defined, neoliberal boosted way of ruling people. Rather, it should be viewed more broadly, and it could also be a window to our survival, which could also include care. It is about reimagining and reclaiming care.’  

 

Wasiq Silan is a researcher at Centre for Research on Ethnic Relations and Nationalism (CEREN) in the Swedish School of Social Science at the University of Helsinki. She is currently working at the National Dong Hwa University as an assistant professor in the College of Indigenous Studies in the Department of Indigenous Development and Social Work.