Health disparities are, first and foremost, those indicators of a relative disproportionate burden of disease on a particular population. Health inequities point to the underlying causes of the disparities, many if not most of which sit largely outside of the typically constituted domain of "health". The literature reviewed for this synthesis document indicates that time and again health disparities are directly and indirectly associated with social, economic, cultural and political inequities; the end result of which is a disproportionate burden of ill health and social suffering upon the Aboriginal populations of Canada. In analyses of health disparities, it is as important to navigate the interstices between the person and the wider social and historical contexts as it is to pay attention to the individual effects of inequity. Research and policy must address the contemporary realities of Aboriginal health and well-being, including the individual and communitybased effects of health disparities and the direct and indirect sources of those disparities.La traduction du résumé se trouve à la fin de l'article.

CONTEXT Medical students increasingly wish to participate in international health electives (IHEs). The authors undertook to understand from the students' perspective the ethical challenges encountered on IHEs in lowresource settings and how students respond to these issues.METHODS Semi-structured interviews were conducted with 12 medical students upon their return from an IHE. A purposive sampling strategy was used. Inductive data analysis using a constant comparative technique generated initial codes which were later organised into higher-order themes.RESULTS Five themes relating to ethical issues were identified: (i) uncertainty about how best to help; (ii) perceptions of Western medical students as different; (iii) moving beyond one's scope of practice; (iv) navigating different cultures of medicine, and (v) unilateral capacity building.CONCLUSIONS International health electives are associated with a range of ethical issues for students. Students would benefit from formal pre-departure training, which should include an evaluation of their expectations of and motivations for participating in an IHE, careful selection of the IHE from amongst the opportunities available, learning about the local context of the IHE prior to departure, and the exploration and discussion of ethical and professionalism issues. Other factors that would benefit students include having an invested onsite colleague or supervisor, maintaining an ongoing connection with the home institution, and formal debriefing on conclusion of the IHE.ethical issues Medical Education 2011: 45: 704-711

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Concepts of health are powerful statements of cultural ideals, interpreted within and shaped by circumstance and history. For the Whapmagoostui Cree of northern Quebec, ideals of health are found within the narratives of past hunting livelihoods, thus integrating diverse symbols of Cree subsistence and social practices. By addressing the conditions through which this concept of health is constituted, I illustrate how narratives of 'health' are synonymous with Cree social and political well-being. For the Cree, health is not simply physical well-being, but one form of articulating Cree national identity in response to a continued challenge to that identity and is thus located within a text of historical accountings, land, and the production and interpretation of traditional activities.

In this ethnographic study of the Cree, a Canadian indigenous people, I explore the 'pain of being Aboriginal' as a particular form of social suffering. I then describe a particular event, a Native Gathering, which serves, in part, as a form of response to social suffering. For the people of Whapmagoostui, Quebec (Canada), the annual summer Gathering has become a time and a place to examine what it means to be Cree, a conscious and imaginative process that is constituted and enacted within the broader social and political reality. Key words aboriginality • Cree • indigenous people • medical anthropology • response • social sufferingThe pain is about being Aboriginal. (Gilbert, 1995: 147) The issue of (Native) identity continues to be contentious. It has its own very interesting and troubling history(ies), changing by the decade to match the times. (McMaster, 1995: 87)