Indigenous Peoples’ Self-determination and Long-term Care: Sápmi and Nunavut


  • I-An Gao University of Helsinki


This paper examines long-term care for the elderly as a point of departure for critically engaging with the debate on the self-determination of Indigenous peoples. By employing the case of the Arctic Indigenous peoples, the Sámi Parliament (Sámediggi) in Norway and Government of Nunavut in Canada, are utilised as central cases from which to explore the institutionalization and self-determination. The thrust of the paper calls for a critical re-investigation of the contingency of long-term care for the elderly in the context of claims of Indigenous sovereignty.

Specifically, I examine the landscape of population ageing and the organisation of care among the Sápmi and Nunavut populations, focusing on colonisation from a circumpolar perspective. The functions and practices of Sámediggi and Government of Nunavut are analysed to illustrate how self-determination is exercised and to what extent they safeguard the rights of elderly people. Sámediggi and Nunavut government as institutional arrangements that mark significant advancements in Indigenous peoples’ reclamation of power and restoration of sovereign rights are discussed. Unfortunately, the political functions that would allow self-determination and self-government to be effective continue to be limited for the Inuit in Nunavut and the Sámi in Sápmi on the Norwegian side.


Abele, F. (2013). Intergovernmentalism and the Well-Being of First Nations. In G. Otis & M. Papillon (Eds.), The Relational Dimension of Indigenous Governance and Federalism: Theories and Practices: Laval University Press.

Adams M., Mataira, P. J., Walker, S., Hart, M., Drew, N., and Fleay, J. J. (2017). Cultural identity and practices associated with the health and wellbeing of Indigenous males. Journal of Indigenous Studies and First Nations' and First Peoples'. Pennsylvania State University Press. June.

Alcantara, C. and Wilson, G. N. (2013). The Dynamics of Intra-jurisdictional Relations in the Inuit Regions of the Canadian Arctic: An Institutionalist Perspective. Political Science Faculty Publications. 32.

Anaya, J. (2011). The situation of the Sami people in the Sápmi region of Norway, Sweden and Finland. Retrieved from New York:

Andreyeva, T., Poelzer, G. & Exner, H. (2010). Module 1: Self-Determination as a Contemporary Characteristic. University of the Arctic. Bachelor of Circumpolar Studies 322.

Bell J. (2014, January 20). Nunavut is no longer Canada's colony. It needs to end its own deprivation. The Globe and Mail. Retrieved from

Bernauer W. (2015, February 28). Nunavut is still a colony. We should act in solidarity to end its deprivation. Canadian Dimension. Retrieved from

Blackstock, C, Trocmé N. & Bennett M. (2004). Child Maltreatment Investigations Among Aboriginal and Non-Aboriginal Families in Canada. Violence Against Women 10(8): 901-916.

Blackstock, C. (2016). Toward the full and proper implementation of Jordan's Principle: An elusive goal to date. Paediatric Child Health 21(5), 245-246.

Blix, B. H. (2013). The Construction of Sami identity, health, and old age in policy documents and life stories. (Philosophiae Doctor), University of Tromsø, Tromsø.

Blix, B. H., Hamran T. & Normann H.K. (2013). “The Old Sami” – who is he and how should he be cared for? A discourse analysis of Norwegian policy documents regarding care services for elderly Sami. Acta Borealia A Nordic Journal of Circumpolar Societies. 30(1): 75-100.

Bombay, A., Matheson, K., & Anisman, H. (2014). The intergenerational effects of Indian Residential Schools: Implications for the concept of historical trauma. Transcultural Psychiatry, 51(3), 320-338.

Carstens, M. (2016). Sami land rights: the Anaya Report and the Nordic Sami Convention. Journal on Ethnopolitics and Minority Issues in Europe, 15(1), 75-116.

CBC News. (2016). Iqaluit medical boarding home faces 'an explosion' of patients. CBC News.

Coburn, V. (2011). Multiculturalism Policy Index: Indigenous Peoples. Retrieved from Kingston, ON, Canada:

Corntassel J. (2012). Re-envisioning Resurgence: Indigenous Pathways to Decolonization and Sustainable Self-determination. Decolonization: Indigeneity, Education & Society. 1(1): 86-101.

Cunningham, M. (2009). Health. State of the World's Indigenous Peoples. New York, NY: United Nations.

Dahl, J., Hicks, J., & Jull, P. (Eds.). (2000). Nunavut: Inuit Regain Control of Their Lands and Their Lives. Copenhagen: International Work Group for Indigenous Affairs (IWGIA).

De Bruin, A., Mataira, P. J. (2003) Indigenous Entrepreneurship. In De Bruin, A. and DuPois, A. (Eds.), Entrepreneurship: New Perspectives in a Global Age. Ashgate Press. Oxon, UK.

Ducharme, S. (2016). Nunavut elder’s facility in Iqaluit on life support: Too small, underfunded and unable to deal with high needs seniors. Nunatsiaq Online.

Durst, D. (2010). A Turbulent Journey: Self-Government of Social Services. In D. Durst & R. Delaney (Eds.), Social work & aboriginal peoples: Perspectives from Canada’s rural and provincial Norths. Winnipeg: Lakehead University.

Eriksen, T. H. (2001). Small Places, Large Issues: An Introduction to Social and Cultural Anthropology. Sterling, VA: Pluto Press.

Frichner, T. G. (2010). Impact on Indigenous Peoples of the International Legal construct known as the Doctrine of Discovery, which has served as the Foundation of the Violation of their Human Rights. UN Economic and Social Council, Permanent Forum on Indigenous Issues, 9th sess, Agenda Item 4 and 7 of provisional agenda, UN Doc E/C.19/2010/13 (4 February 2010).

Frideres, J.S. and Gadacz, R.R. (2007). Aboriginal peoples in Canada: Contemporary conflicts. 8th Edition. Toronto: Pearson Education Canada.

Göcke, K. (2011). Inuit Self-Government in the Canadian North: The Next Step in the Nunavut Project. ZaöRV, 71, 77-102.

Government of Nunavut. (2014). Sivumut Abluqta: Stepping Forward Together 2014-2018. Retrieved from:

Government of Nunavut. (2015). Continuing Care in Nunavut 2015 to 2035. Retrieved from:,%202015%20to%202035_0.pdf

Government of Nunavut. (2017). Residential long-term care unit in the Kitikmeot Regional Health Centre officially opened. [Press release]. Retrieved from

Gray M., Coates J. Yellow Bird M. & Hetherington T. (2013). Decolonizing Social Work. Ashgate: Burlington, VT

Greenwood, M., & Schmidt, G. (2010). Decentralization and evolution of services to First Nations: The transfer process. In K. Brownlee, R. Neckoway, R. Delaney, & D. Durst (Eds.), Social work and Aboriginal peoples: Perspectives from Canada’s rural and provincial north. Thunder Bay: Lakehead University Centre for Northern Studies.

Henriksen, J.E. (2016). From housing campaign to multicultural understanding: The development of professional social work in Sámi areas in Norway. International Social Work, 59(5), 587-599. doi: 10.1177/0020872816648203.

Hansen, K. L. (2011). Ethnic discrimination and health in Sami settlement areas in Norway-- The SAMINOR study. In S. Soini (Ed.), Public Health -- ethical issues (pp. 147-162). Denmark: Norden.

Harris-Short, S. (2012). Aboriginal Child Welfare, Self-Government and the Rights of Indigenous Children: Protecting the Vulnerable Under International Law. UK: Routledge.

Hassler, S., Kvernmo S. & Kozlov A. (2008). Sami. In T.K. Young & P. Bjerregaard (Eds.), Health Transitions in Arctic Populations. (pp. 148-172). Toronto, Canada: University of Toronto Press.

Hicks, J. and Graham W. (2000). “Nunavut: Inuit Self-determination Through a Land Claim and Public Government?” In Nunavut: Inuit Regain Control of their Lands and Their Lives, ed. Jens Dahl, Jack Hicks and Peter Jull, 30-115. Copenhagen: International Work Group for Indigenous Affairs.

Hicks, C.B J (2000) Historical synopsis of the Sami/United Nations relationship. Stefansson Arctic Institute. EU Raphael Programme.

Inuit Circumpolar Council Canada. (2011). Health Systems Serving Inuit Communities Across the Arctic. Retrieved from

IWGIA. (n.d.). Self determination of indigenous peoples. Retrieved from

Johnston P. (1983). Aboriginal children and the child welfare system. Toronto: Canadian Council on Social Development.

Kuokkanen, R. (2003). "Survivance" in Sami and First Nations Boarding Schools Narratives: Reading Novels by Kerttu Vuolab and Shirley Sterling. American Indian Quarterly, 27(3), 697-726.

Kuokkanen, R. (2017). Smoke and Mirrors of the Sámi Convention. Retrieved from

Kymlicka, W. (2007). Multiculutral Odysseys: Navigating the New International Politics of Diversity. New York: Oxford University Press.

Littlechild, W., & Stamatopoulou, E. (Eds.). (2014). Indigenous Peoples' Access to Justice, Including Truth and Reconciliation Processes. New York: Columbia University.

Malmedal, W. (2014). Norwegian Nursing Home-- A Care Facility or a Home? Open Journal of Nursing, 4: 337-342.

Marchildon, G. P., & Torgerson, R. (2013). Nunavut: A Health System Profile. London: McGill-Queen's University Press.

McBeath, J. (2007). Module 3. New Internal Political Structures. University of the Arctic.

Menzies, P. (2010). Intergenerational Trauma from a Mental Health Perspective. Native Social Work Journal, 7.

Minde, G.-T. (2015). A Culturally-sensitive Approach to Elderly Care. Journal of Gerontology and Geriatric Research, 4(5).

Minde G (2017) Older Sami Women Living in the Arctic: A Cultural Background that Breaks with Western Conventions. J Comm Pub Health Nurs 3:155. doi:10.4172/2471-9846.1000155

Ministry of Health and Social Affairs (1995) Norges Offentlige Utredninger 1995:6 Plan for helse- og sosialtjenester til den samiske befolkning i Norge [Norwegian Official Report 1995:6 Plan for the health- and social services for the Sami population in Norway] (Oslo: Statens forvaltningstjeneste).

Ministry of Health and Social Affairs (2001) Mangfold og likeverd: regjeringens handlingsplan for helse- og sosialtjenester til den samiske befolkningen i Norge 2002-2005 [Diversity and equality: The government’s action plan concerning health- and social services for the Sami population in Norway 2002-2005] (Oslo).

Minogue, S., & Konek, J. (2016). Unilingual Nunavut elder moves 2000 km for a long-term care bed. CBC News.

Nowlan-Card, L. (1997). Public Government and Regulatory Participation in Nunavut: Effective Self-government for the Inuit. Dalhousie Journal of Legal Studies, 5.

Nunavut Bureau of Statistics. (2017). Canada's Population Estimates. from Statistics Canada

Nunavut Tunngavik Incorporated. (2004). Kangikhiteagumaven: A Plain Language Guide to the Nunavut Land Claims Agreement. In N. T. Incorporated (Ed.). Iqaluit, Nunavut: Nunavut Tunngavik.

OECD / European Commission. (2011). Help Wanted? Providing and Paying for Long-term Care: Noway. Retrieved from Paris:

OECD / European Commission. (2013). Long-term care expenditure. Retrieved from Paris:

Ravna, Ø. (2011). The Process of Identifying Land Rights in parts of Northern Norway: Does the Finnmark Act Prescribe an Adequate Procedure within the National Law? Yearbook of Polar Law, 3, 423-453.

Rodon, T. (2014). "Working Together": The Dynamics of Multilevel Governance in Nunavut. Arctic Review on Law and Politics, 5(2): 250-270.

Shewell, H. & Spagnut, A. (1995). The First Nations of Canada: social welfare and the quest for self-government. In J. Dixon & R.P. Scheurell (Eds.), Social Welfare with Indigenous Peoples. London: Routledge.

Shewell, H. (2016). Why Jurisdiction Matters: Social Policy, Social Services and First Nations. Canadian Journal of Native Studies, 36(1): 179-202.

Shih, C.-F. (2005). Taiwan Indigenous Peoples' Collective Human Rights and a Comparison with the US, Australia, New Zealand and Canada. Paper presented at the Human Rights Academic Conference, Taipei.

Shih, C.-F. (2011). Canada's Inuit Indigenous Peoples' Slef-Govenment. Taiwan Indigenous Peoples' Studies, 10, 1-36.

Sinclair, R. (2007). Identity lost and found: Lessons from the sixties scoop. First Peoples Child & Family Review. 3(1): 65-82.

Sinha, V. and Kozlowski, A. (2013). The Structure of Aboriginal Child Welfare in Canada. The International Indigenous Policy Journal, 4(2). Retrieved from: DOI: 10.18584/iipj.2013.4.2.2

Smith, L. T. (1999). Decolonizing Methodologies: research and indigenous peoples. New York: Zed Books.

Statistics Norway. (2016). Sami, 2014-2015. from Statistics Norway

Stępień, A., Petrétei, A., & Koivurova, T. (2015). Sámi Parliaments in Finland, Norway, and Sweden. In T. H. Malloy, A. Osipov, & B. Vizi (Eds.), Managing Diversity through Non-Territorial Autonomy: Assessing Advantages, Deficiencies, and Risks. Oxford Scholarship Online: Oxford University Press.

Sykes Assistance Services Corportation. (2015). Long Term Care in Nunavut 2015. Retrieved from

Tamburro, A. (2013). Including Decolonization in Social Work Education and Practice. Journal of Indigenous Social Development, 2(1), 1-16.

The Truth and Reconciliation Commission of Canada. (2015). Honouring the Truth, Reconciling for the Future: Summary of the Final Report of the Truth and Reconciliation Commission of Canada. Retrieved from

UN Commission on Human Rights, Report of the Sub-Commission on Prevention of Discrimination and Protection of Minorities on its 34th session : study of the problem of discrimination against indigenous populations., 10 March 1982, E/CN.4/RES/1982/19, available at: [accessed 13 July 2017]

UN Human Rights Council, Report of the Special Rapporteur on the rights of indigenous peoples, Addendum : The situation of indigenous peoples in the Republic of the Congo, 11 July 2011, A/HRC/18/35/Add.5, available at: [accessed 14 July 2017]

Van Dusen, J. (2016). Overhaul of elder care needed as dementia rates set to skyrocket in Nunavut: report. CBC News. Retrieved from

Wien, F., Blackstock, C., Loxley, J., & Trocmè, N. (2007). Keeping First Nations children at home: A few Federal policy changes could make a big difference. First Peoples Child & Family Review, 3(1): 10-14.

Wilmer, F. (1993). The indigenous voice in world politics : since time immemorial. Newbury Park, Calif.: Sage.

Wilson, W. A. (2004). Indigenous Knowledge Recovery Is Indigenous Empowerment. The American Indian Quarterly. 28.3&4359-372.

Wilson-Raybould, J. (2016). Special Statement at the Opening Ceremonies of the United Nations Permanent Forum onIndigenous Issues, 15th Session [Press release]. Retrieved from

Yellow Bird, M. (2013). Neurodecolonization: Applying Mindfulness Research to Decolonizing Social Work. In M. Gray, J. Coates, M.