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.
Conservative
Chief Public Health Officer, Government of Manitoba
I don't mean to be glib about it. You're asking me a very complex question—
Chief Public Health Officer, Government of Manitoba
—and you're asking me to distill it into a simple answer, so I will do my best.
I think there has been great progress in collaborative work between provincial and federal organizations in both preparing for and implementing the response to the pandemic plan. Has it been perfect? No. If we had more time and it was of interest, could we discuss where there are some areas that need some strengthening and further improvement? Yes. So for me, most of these questions are not a matter of yes or no, or satisfactory or not satisfactory. They're really a matter of keeping moving towards progress, because we have a long way to go before we can address problems like this.
Actually, the evidence is obvious that we have a long way to go in the outcomes.
Conservative
Colin Carrie Conservative Oshawa, ON
I think that with the pandemic plan, the good news is that we do have a plan in place and we are working together.
Would you be able to describe what has been achieved with the first wave? What have we learned? What have we achieved? What successes have we had?
Chief Public Health Officer, Government of Manitoba
The first thing that happens from a public health point of view after any event like we've had is that we understand, as much as we can from our experience, who was mostly affected, who had the most severe outcomes, and how big a problem it was all around. I think we've learned a lot. We're now analyzing much of that data, and again, I tried to summarize that in my opening remarks.
I think so far it looks like, compared to what some people feared, and certainly compared to the 1918-19 pandemic, which many of us were preparing for, overall this has been much less severe than most of us expected from a pandemic. This is not comparable to 1918 so far. It's more comparable to a bad flu season of seasonal flu, with a couple of important differences. One is a higher rate of severe disease among previously healthy people in their twenties, thirties, and forties. The other is—and this is not different by quality, it's different by quantity—a higher differential of severity between aboriginal people and non-aboriginal people. The reason I say it that way is that when we have analyzed seasonal, regular influenza, just like most infectious diseases and other injuries and other health outcomes, there is almost always a differential. That was true for seasonal influenza as well. This differential, certainly in Manitoba's experience, has been more striking, wider, and more severe.
I could speak more about what we've learned about the disease, but if you're asking me what we have learned about our plans and our effectiveness and how to get ready for the next wave, that would be another conversation, which I'd be happy to have if there's time for it.
Conservative
The Chair Conservative Joy Smith
Dr. Kettner, could we just give the national chief a chance?
National Chief Atleo, I have a sense you want to make some comments.
National Chief, Assembly of First Nations
On the point about the health officer, respecting what has been said in the question, in British Columbia the tripartite plan did result in the chiefs—and that's important because it's a jurisdictional matter as well, it's a treaty matter—participating in supporting the appointment of a first nations provincial aboriginal health officer. He's a medical doctor, Dr. Evan Adams. He's of Smoke Signals fame as well, but he is a qualified medical doctor, somebody who is firmly embedded in the communities and is working side by side with them. So the recognition of the treaty relationship is given expression.
There's the notion that with H1N1 perhaps there's agreement about it being too late, as it were, to get the fulsome planning that we might all want. But it's never too late to do the right thing on the broad notion, in that we don't lose this opportunity, the focus, and that we get everything as right as is needed to make sure our people are cared for. But make no mistake about the broader piece of work. I think it would be helpful if this committee also considered that deeply.
Conservative
The Chair Conservative Joy Smith
Thank you, National Chief.
We've come to the end of the first panel, and because of time, I'm going to suspend very briefly. But prior to that, I want to thank you so very much. I know we've had a lot of witnesses today. I'm going to ensure that all your presentations are sent to each member through the clerk's office.
Thank you.
I will suspend while the second panel takes their seats.
Thank you.
Conservative
The Chair Conservative Joy Smith
The committee will now resume. We'll go to the second panel.
I would like everyone to be seated and any interviews to be done outside. I would ask the media to move outside, please, so that we can conduct business.
Thank you.
We have before us Pamela Nolan, who is from the Garden River First Nation; and Maxine Lesage, who is the supervisor of health services for its wellness centre. Welcome.
I very much want to acknowledge Chief Jerry Knott, from the Wasagamack First Nation—welcome, Chief—as well as Joseph Richard Harper, the assistant health director. Thank you so much.
We'll have our other guests continue later on.
We'll start, please, with Ms. Nolan.
Pamela Nolan Director, Health and Social Services, Wellness Centre, Garden River First Nation
Good afternoon, and thank you for inviting us and giving us the opportunity to be here.
We are not politicians, by any means. We represent Garden River First Nation. I'm the health director, and Maxine is the health services supervisor. We're here representing--
Conservative
The Chair Conservative Joy Smith
Excuse me, we're going to have to suspend. I'm sorry. The interviews have continued. We're not going to be able to have televised meetings if we don't have a chance to do our business, so we will have to suspend for a couple of minutes. They have to leave.
Thank you.
My apologies. Could you please continue on?
Director, Health and Social Services, Wellness Centre, Garden River First Nation
Should I start over or just carry on?
Director, Health and Social Services, Wellness Centre, Garden River First Nation
Okay.
We represent, really, the grassroots, because we are the first response in the community.
Our community has a membership of approximately 2,000 people. We are located outside the city of Sault Ste. Marie, in Ontario.
We first began our pandemic planning in 2005, post-SARS. SARS really had an impact on us and our community. Although we don't have any close contact with H1N1—it hasn't been in our community, really; we've only had two cases in the Algoma district—we felt that we needed to take it seriously, because we understood that the disease didn't have any boundaries. It didn't matter where you lived, where you came from, whether you were first nations, who you were, it was going to come. We thought we might even be a little more at risk because of our prevalence or high rate of chronic disease and because we're first nation populations.
So we asked what we were going to do, because it's just the two of us. We have a few nurses in our community and some health educators. If the pandemic hit, if we had a pandemic in our community, what were we going to be able to do, just the two of us? We decided that we should start getting ready. We said we needed to start teaching people how to take care of themselves and each other by giving them the information they needed to be able to do that. So that's where we started.
In regard to some of the initiatives we have been working on, creating, and developing in our community, we're going to pass some things around here. This is probably not the usual way you do things here, but we didn't know. We have never been here before, so we're not really aware of what we can or can't do.
Director, Health and Social Services, Wellness Centre, Garden River First Nation
If we can't do something, just let us know.
The first thing we did was develop this kit, which we called “My flu kit”. We thought it would be a good idea if we hand-delivered it to every single person, every household in our community. There's a thermometer in it, there's a fridge magnet, there's information on flu, there's handwashing gel--different things that you can use to get people thinking about the flu.
Conservative
The Chair Conservative Joy Smith
Might I interrupt you for just a moment? It's not bilingual, but I have permission from the clerk to pass it around. If you wanted to give some packages to the clerk, we could send them to the offices so each person could have one. We can't hand them out right now, but please continue.
Director, Health and Social Services, Wellness Centre, Garden River First Nation
Okay.
The flu magnets that we developed are in the kits, and we thought people could just stick those on their fridges so it would be a really quick reminder of what they could do if they were experiencing flu symptoms.
We always put information in our community newsletter. We're fortunate enough that we have a newsletter. It's online, it's for the community, people can subscribe, and it's a really quick, easy way of getting information out. So we'll just pass that along.
We also developed a pandemic plan. Our pandemic plan is a living, breathing document. It's updated on a regular basis. As we're building our plan, things keep getting added and changed. I want Maxine to talk about a couple of sections in the plan that are really neat, that we think are really going to help us.
Maxine Lesage Supervisor, Health Services, Wellness Centre, Garden River First Nation
Ahniin. Boozho. Welcome to everybody here today. Thank you for inviting us. We are very honoured, and we'd like to say hi to everybody in our community back home.
Conservative
Supervisor, Health Services, Wellness Centre, Garden River First Nation
Yes, very quickly, there are approximately 12 sections in the chart, but I just wanted to point out that probably the most interesting and useful sections would be our at-risk list that we've developed. That would be for our vulnerable clients, the chronically sick, physically handicapped, and the children, especially the age groups that are targeted by H1N1 right now. We've developed these lists so that we have phone numbers and contact lists.
Director, Health and Social Services, Wellness Centre, Garden River First Nation
We also developed an emergency preparedness guide. There's a section in here on the pandemic. We talk about what we do before an emergency, during an emergency, and after an emergency. This was delivered to every house in our community as well.
We also purchased this book, Do I Need to See a Doctor?. We didn't develop this, but we felt it was an awesome resource. It's really easy to understand. It's illustrated well. We felt our community could really understand this information.
We also developed a flu kit, an emergency response kit, and this went to all the people in our community who were at most risk. So 40 to 45 people got this, and here's a list of what's in this kit. We dragged this all over Ottawa today, wondering, should we bring this kit, should we not? We don't know. We're asking people, calling, what do we do? We took the scissors out, we put them back in. We took the canned stuff out, put it back in. Anyway, here's the flu kit, and here's the list of what's in it. We tell people, “Here's your list. Keep it and replenish it if you take anything out, and then put in what else you think is necessary.” It's available to take a look at later.
We did a couple of other things. We have an outreach team in our community, promotion, prevention workers. We're not just a health centre, we're a wellness centre. We have health and social services in our community. What we've done is asked our prevention and promotion workers to be part of our team, and they give the message on H1N1 as well. They all have scripted messages. When they call people to invite them out to their activities, they say, “Although we'd really like to have you out to our activity, in light of flu season, we ask that if you're not feeling well, could you please stay at home.” We do all these little extra things. It's not just the clinical area working on pandemic planning and preparation; it's a whole team effort, a whole community effort.
What I wanted to say before I'm finished is that--and I know we're wrapping up--I've noticed something in Canada. This is just my personal observation coming into your community and your area, but I walked through two checkpoints, two stations, and was never screened once for H1N1. There were no handwashing facilities. I think it's really important, if you're really serious about giving the message, that you have to do it all the time.
Conservative
The Chair Conservative Joy Smith
May I take some leverage here, as chair, and say thank you? I'm blown away.