Contributed by Alain Cuerrier, Montreal Botanical Garden and ISE North America Representative
In 2002, I was approached by a pharmacologist, Pierre Haddad, who wanted to help native people prevent and tackle diabetes that prevailed then and now within their population. Diabetes is up to 5 times more prevalent among First Nations communities than in the non-native population of Canada. We decided to form a multidisciplinary team and we were blessed with acceptance from Thor Arnason, a well-known phytochemist and ethnobotanist, as well as Tim Johns, another well-known figure in the world of ethnobiology. At the core of the study is the Cree Nation that has accepted our project on their land. The project, funded by the CIHR, started in 2003 and we became the CIHR Team in Aboriginal Anti-diabetic Medicines. We started the project with the development of a Research Agreement (accessible through the CIHR-TAAM web site) that covers all aspects of the ISE Code of Ethics and protects the rights of the Cree people to have control over their traditional knowledge; it was almost 6 years before the Agreement was officially signed.
After a first round of interviews, we ranked plants based upon a Syndromic Importance Value equation that takes into account the number of times a plant is mentioned, the number of diabetes symptoms it is used for, and the ranking that clinicians did on the 15 symptoms we used in our interviews. The first 8 plants were assessed for their phytochemistry and we ran a number of bio-assays. Results showed that most plants were good candidates for treating people struggling with diabetes. With such interesting data we soon realised that we could play a seminal role in translating traditional medicine (TM) into an acceptable language for nurses and physicians working in the modern clinics in the Cree communities. Then, the team added new researchers: Steffany Bennett to look at neuropathy and Brian Foster at possible drug interactions. Also, physicians working with the Cree Board of Health and at University of Montreal took part in the project. The Cree Board of Health played a central role and was from the start supportive of our project.
Along with enlarging the number of bio-assays and understanding the phytochemistry within the first 8 plants, we decided to open our work to another set of 9 plants. Interviews done in 3 more communities gave further insight on possible plant candidates. Two additional communities joined the project in 2011.
At each step, the Cree people have been involved through monthly steering committee conference calls and biannual meetings (in the South and in the North). We also took part in their Cultural Gatherings and presented the project findings at their Health Fair and General Assembly meeting. We took pride in discussing the results with the Elders and Healers. They are also conducting an observational study within their Nation, a study that we all decided to call Putting Traditional Medicine First.
In parallel with these research elements and, in part, answering a call from the Elders and Healers, we have been pursuing an impact assessment of harvesting some of their medicinal plants. Another related study examines the change in metabolite concentrations along a South-North gradient. But the real outcome is to see the pride that Cree have over their TM and also the renewed interest that the project has generated within the Cree Nation. Thanks to the Elders and Healers that made this project an interesting one. Meegwetch!