I mean, that's amazing.
Evidence of meeting #31 for Health in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was plan.
A recording is available from Parliament.
Evidence of meeting #31 for Health in the 40th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was plan.
A recording is available from Parliament.
3:55 p.m.
Supervisor, Health Services, Wellness Centre, Garden River First Nation
Can I just add one thing very quickly?
3:55 p.m.
Supervisor, Health Services, Wellness Centre, Garden River First Nation
This is in terms of the emergency kit we developed. We had done up a poster of one of our elders. The home and community care nurse delivers it with her worker, and they just provide information on health teaching on H1N1, emergency preparedness.
So this is just a picture of one of our elders in the community.
3:55 p.m.
Conservative
The Chair Conservative Joy Smith
Oh, thank you. Hold it up for the cameras.
Beautiful. Thank you.
Now we'll go to Chief Jerry Knott.
Thank you.
August 28th, 2009 / 3:55 p.m.
Chief Jerry Knott Chief, Wasagamack First Nation
Good afternoon, Madam Chair and members of the Standing Committee on Health. I want to thank the committee for your kind invitation to present to the government on the status of preparedness of Island Lake communities on the matter of an anticipated H1N1 pandemic for this coming fall season.
The population exceeds 10,000 residents, comprised of first nation, Métis, and non-aboriginal peoples. The communities are located approximately 600 kilometres northeast of Winnipeg. The communities are remote, accessible by air transportation year-round, except for six to seven weeks within the winter road season during January and February, weather permitting.
All four communities have the limited community infrastructure in place ordinarily granted by society. Most of our homes lack water and sewer facilities. Hauling drinking water in containers is not an uncommon occurrence in our communities. But when you do not have the proper infrastructure, what is the alternative? The alternative for the lack of sewage facilities is to construct makeshift sewage disposal units in very close proximity to the actual living quarters. For the purposes of clarity, I am talking about outhouses.
Our people live in crowded conditions. It is not surprising to find two or three or four family units in one house. The quality of housing, coupled with the wear and tear of overcrowded housing units, has rendered housing conditions deplorable. The present housing backlog will quadruple every two years. Managing the present housing shortage is just abysmal.
The reality is that we are losing our battle, to the point where we cannot provide adequate and decent shelter for our people. Shelter needs for the first peoples are reaching beyond the crisis state. The housing crisis will be further accelerated as young people reach adulthood. With the high aboriginal youth population, the fact is that their time is upon us.
Honourable members of the standing committee, the living conditions of our people that I am describing to you are central to the question of preparedness and response to the potential H1N1 pandemic. The prevailing conditions that I have tried to describe are the actual existing conditions. It's in these conditions that we, the people, are expected to respond to and prepare for the H1N1 pandemic that has claimed thousands of lives throughout the world.
I beg your indulgence. Health care is the right accorded to every citizen in Canada. I believe it may be enshrined in the Constitution. The four communities do not have a primary health care centre. Our communities have nursing stations manned by committed nurse practitioners, who work endless hours to provide medical health care services. Our communities have doctor visits. Our communities do not have any form of residential doctor permanently to respond to the 10,000 residents in our community. The wait time to see a doctor is not an issue; our people are just lucky to see a doctor.
The alternative to lack of immediate access to a medical doctor is the continual medical evacuation of our patients. Thirty-five cases were confirmed as H1N1 this past spring. More than 20 people with the virus were taken by medevac to hospital in Winnipeg for treatment.
The cost of medical response to the last pandemic outbreak demonstrated that communities, governments, and other agencies were not prepared for such outbreaks. The cost for additional nurses and doctors and support resources, coupled with high transportation costs, resulted in extraordinary expenditures to respond to the H1N1 outbreak.
It would be wrong for me to state that we are adequately prepared to respond to the H1N1 virus outbreak for this coming fall. The four communities have instituted the Island Lake region pandemic working group to coordinate the regional planning and to secure resources for a pandemic response. Furthermore, each community has organized a local pandemic working group. Each community has designed their incident commanders, who have the responsibility of coordinating intercommunity responses. There is only so much each of these units can accomplish without the required resources to make plans and to execute plans.
During the last outbreak, the Wasagamack First Nation, my community, had to institute response measures in an effort to contain the outbreak. These measures included quarantining family homes and the community at large, limiting intercommunity travel, launching mass communications processes, educating people on H1N1, meeting with the nurse in charge and incident manager on a daily basis, executing pandemic team recommendations, treating people with traditional medicine, and preparedness.
The Island Lake region had 35 confirmed cases of H1N1 in its first outbreak, which is 28% of the confirmed cases in northern Manitoba. The communities are bracing themselves for a higher incidence. The absence of economic well-being and the prevailing social challenges of our community present a formidable undertaking that must be addressed, not merely to respond to a pending outbreak but to plan to develop a long-range response to the present conditions of our communities.
On behalf of Island Lake first nations, we recommend that governments respond with the following: acquiring an assortment of adequate antivirals; engaging and supplying medical staff and resources reflective of the population and some circumstances; supplying assorted and accessible preventive goods, such as antibacterial lotions, etc.; plans for field medical unit and operations; upgraded medical equipment at the nursing stations; and financial resources to respond to the standard acceptable measures for first nations communities' prevention and intervention.
After mentioning the recommendations to address the immediate pending pandemic outbreak, strategy planning is crucial to the ongoing well-being of our people. The H1N1 pandemic outbreak is not our first experience with epidemics. Our history tells us that in comparable tragedies suffered by our nation, we have survived such pandemics in spite of circumstances, intended or otherwise. Our people continue today. In spite of the present danger of H1N1, our people—
4:05 p.m.
Conservative
The Chair Conservative Joy Smith
Chief, I'm so sorry, but we're way over time. Do you mind, Chief, wrapping it up so we can get to the questions? Thank you.
4:05 p.m.
Chief, Wasagamack First Nation
Okay.
The economic and housing crises are questions as well for long-term purposes.
In closing, I want to commend the Standing Committee on Health for its diligence in the search for preparedness of first nations to respond to the pending H1N1 pandemic. The answer is no. The communities are vulnerable, and if tragic consequences should occur, then we should not be surprised. We, as communities, can only plan and execute what's available through the limited resources we have at our disposal.
Thank you.
4:05 p.m.
Conservative
The Chair Conservative Joy Smith
Thank you, Chief.
I would like to welcome to the panel today Chief Albert Mercredi from the Fond du Lac First Nation. Chief, would you like to give your presentation, please? I understand you have Mr. Robillard with you as well. I welcome you both. Thank you.
I also acknowledge Joseph Harper. I forgot to do that when you were sitting down, sir. Thank you for being here.
Go ahead.
4:05 p.m.
Chief Albert Mercredi Chief, Fond du Lac First Nation
Thank you, Madam Chair, members of the House of Commons Standing Committee on Health, and other participants in the panel discussion. I wish to express my appreciation on behalf of the Athabasca Health Authority for this opportunity to share our experience to date in preparing for the next wave of the current pandemic influenza, H1N1.
In a very real sense, the Athabasca Denesuline have been preparing for pandemics at least since the first contact with Europeans. The region of the Athabasca Health Authority, or AHA, is in northernmost Saskatchewan and encompasses approximately 150,000 square kilometres of much larger traditional territory of the Athabasca Denesuline. The total population of the AHA region is 3,500, of which more than 90% are Denesuline and other aboriginal peoples. More than 80% of the population lives on reserve at Fond du Lac and Black Lake first nations, while the remaining residents live in the three provincial communities of Stony Rapids, Uranium City, and Camsell Portage.
The Athabasca Health Authority was created through the independent and unanimous agreement of the members of the first nations and the provincial communities a decade ago in order to create an integrated and interjurisdictional health organization committed to the provision of comprehensive health service to all residents on an equitable basis. There were a number of foundation agreements to which AHA members, the Government of Canada, and the Government of Saskatchewan are parties, and both levels of government continue to provide significant funding to AHA operations. The Athabasca Health Authority's vision and mandate is funded on the principles and understanding that are currently described as “population health”.
In a region primarily populated by aboriginal peoples, we understand very clearly that the colonization; loss of control of territory, resources, and the ability to make a living from the land; dependency; poverty; inadequate infrastructure, housing, and culture; and community and family crises are determinants of health. Our approach to pandemic preparedness begins with the same understanding. We can never really be adequately prepared until we have addressed the determinants of health that make our region and our residents so vulnerable to the disease.
Two documents attached to this presentation contain summaries of the current measures and the determinants of health and health status of the Athabasca region in northern Canada. Copies can be picked up through the office of the MP who represents our constituency.
During the first six years of AHA operations, various emergency preparedness plans have been developed to respond to natural and industrial disease crises, both at the community and, more recently, at the regional level. With the assistance of Health Canada's First Nations and Inuit Health Branch and Saskatchewan Health, community-based pandemic plans have been developed. During the past year, through agreement of the AHA board and the regional leadership, AHA has been developing, in cooperation with local communities, an integrated and comprehensive regional pandemic influenza preparedness plan.
There is now a regional operational plan for preparing and responding to a pandemic influenza outbreak. Again, the attachment to this presentation is part of the presentation and documents that we distributed to our MP. While further development and refinement of the regional plan continues, there's support throughout the region to work within the provisions and protocol of the plan as it continues to evolve.
Discussions, partnerships, and collaborations continue outside the Athabasca region with health and environmental agencies and transportation and various material and service sectors to address a range of issues related to the security of the supplies during a pandemic. While we have made significant progress in planning, our preparedness will be limited by our capacity to implement the regional pandemic plan. Currently our community primary health care--
4:10 p.m.
Conservative
The Chair Conservative Joy Smith
Chief, I'm sorry to interrupt you. If you wouldn't mind, sir, could you wrap up, because I let you go way over time. That's so we can have questions.
Thank you.
4:10 p.m.
Chief, Fond du Lac First Nation
In conclusion, we are requesting additional resources to take us into this pandemic stage and be prepared for it. We are requesting funding for pandemic coordinators in our communities and additional primary health care nurses to assist us at the community level during this crisis.
Thank you for this opportunity, and in my own language, [Witness speaks in his native language].
4:10 p.m.
Conservative
The Chair Conservative Joy Smith
Thank you very much, Chief Mercredi. We appreciate your input in this very important meeting this afternoon.
We will now go with the will of committee. I'm asking that we have another five-minute round so that everybody can have a chance to answer questions. At the will of the committee, can I have your permission to do that?
4:10 p.m.
Some hon. members
Agreed.
4:10 p.m.
Conservative
4:15 p.m.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Thank you, Madam Chair, and thank you to everyone for travelling such long distances to be with us.
Ms. Nolan, can you tell us what officials got in contact with your community, with you, to suggest developing a pandemic plan?
4:15 p.m.
Director, Health and Social Services, Wellness Centre, Garden River First Nation
We weren't really approached by any one individual. We were told there was a pandemic planning template that was produced by Health Canada. We pretty much just thought we needed to get ready and we just went with it--with or without the resources or assistance from anyone.
4:15 p.m.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Did the officials come back and check and see it was being done, and did you get funding for this?
4:15 p.m.
Director, Health and Social Services, Wellness Centre, Garden River First Nation
No, no one really knows what we've done. No one knows that we've produced this or this or whatever we've done to get ready. We were lucky that you visited our community, and now a lot more people know what we've done.
4:15 p.m.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Well, we celebrate what you've done. It's remarkable, the planning that you have done. Were you given information on what supplies you could order, or did you do that on your own?
4:15 p.m.
Director, Health and Social Services, Wellness Centre, Garden River First Nation
No, we worked with a pandemic planner at Health Canada. We did attend a pandemic planning session for Ontario funded by Health Canada and held in February 2009. We were told that we were getting a list of pandemic supplies sent to our community--which we did get. We have gloves and so on.
4:15 p.m.
Supervisor, Health Services, Wellness Centre, Garden River First Nation
Yes, we have supplies that Health Canada had sent initially. I think they did that across the board for the communities.
But we've been doing this post-SARS. In January 2005, when the ministries were mandated to get these plans done, we started. We've just been slowly building, and without much help.
4:15 p.m.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Did you feel supported through this? And how did those supplies come?
4:15 p.m.
Director, Health and Social Services, Wellness Centre, Garden River First Nation
The supplies were sent in bulk, in boxes. They just arrived. They were just there. We thought, “Okay. So what do we do with these?” We had to sort through the boxes, find out what was in them, unpack everything, and find space to put things in our already overloaded, packed wellness centre. We had to find out what was in those boxes.
4:15 p.m.
Supervisor, Health Services, Wellness Centre, Garden River First Nation
We pretty much had to scramble on our own to figure out what we were going to do to make the best of it.