Health Committee on Aug. 28th, 2009

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Maxine or Pamela, do you have any suggestions for us in terms of taking your example and making it a national project? One idea I've thrown out before would be to appoint an aboriginal adviser to the minister and to the Public Health Agency, as we've done in Manitoba with Dr. Cathy Cook--just someone to coordinate and pull it all together. Does that make sense, or is there another way?

[Pamela Nolan]

I think in order to find out what we've done, you're going to have to have somebody who has power come to our community, because we feel--and I think any other community is going to feel the same way--that they're not going to know that any of this was any good. We had no idea that what we were doing in our community was any different from what other people were or were not doing. We were shocked to find that out when Dr. Bennett came to our community. We kept saying, “Is she kidding us?” We didn't believe that she was so impressed with what we were doing, because we assumed other people were doing exactly this. We would never have known.

So I don't know if a position at that level is going to really find out what's happening at the grassroots level. It might have to be more about communicating with the communities, trying to pull that information out from me, saying, “Okay, Garden River health director, what have you been doing for the pandemic? Where are you now, what have you produced, and what are you willing to share?” Bringing the grassroots people together in a more coordinated fashion--I think it would work this way instead of that way.

I'm not really sure if I....

[The Chair, Conservative, Joy Smith]

Thank you.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

Fair enough. Can I have one more quick question?

[The Chair, Conservative, Joy Smith]

Make it very fast.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

You're equipped in terms of prevention and getting your message out. Are you equipped in terms of actually delivering the vaccine, if and when it arrives?

[Pamela Nolan]

We have our plan.

[Maxine Lesage]

In our pandemic plan, there is a section that talks about mass immunization. So when that happens, when the H1N1 vaccine is ready, we've identified different designated points on our reserve that we want to get set up so that nurses and health workers can come in. I heard you talking about vaccinating earlier, and who would be in a position to vaccinate. We would set up all of these volunteers as well to help us out. We're ready to go. We have our lists. All our team is together. Everyone has been alerted. This is what we need to do, so we're ready to go.

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Lesage.

We'll now go to Mr. Clarke.

[Rob Clarke, Conservative, Desnethé—Missinippi—Churchill River, SK]

Thank you, Madam Chair, and thank you to the witnesses who are attending here today. I know some of you have travelled a great distance to get here.

Chief Mercredi, thank you. Regarding your area and the AHA, or Athabasca Health Authority, can you explain more what steps you've taken for the H1N1 or pandemic planning? I toured the community and I noted that there were some supplies that had been stored as well. Can you explain what steps are being taken in regard to the H1N1?

[Chief Albert Mercredi]

Thank you for the question.

From the Athabasca perspective, the region that I come from and the community I represent are very unique. We work together as a region, meaning we have Denesuline people, we have Métis, we have Cree, and of course, people from the outside who come in and live in our region. We work together as a team. I personally believe that in a time of economic crisis throughout the world and with the plague that is coming down, which we as a nation do not even know how we're going to deal with, by working together, planning together, preparing together, and putting in some of our knowledge by backing each other up, all nationalities, we create a position where I believe a region can work together. In that respect, to make a long sentence short, that is my vision.

[The Chair, Conservative, Joy Smith]

Mr. Robillard, would you like to make some comments as well, please, sir?

[Vince Robillard, Chief Executive Officer, Athabasca Health Authority]

First of all, I'd like to thank the Standing Committee on Health for inviting us here today, and good afternoon. I have to commend the other communities as well for all of the work they've done.

As the CEO of the Athabasca Health Authority, I will say that we have worked relentlessly since April with all of our partners, both federal and provincial, to ensure that we have a comprehensive pandemic preparedness plan ready. It has taken a lot of work to ensure that the partnerships are there with our communities, our outside agencies, and the medical health officers throughout the ministry of health in the Province of Saskatchewan, as well as working with our federal partners through Health Canada. We wouldn't be in the position we are right now if that cooperation had not taken place.

We're in a unique position. We're funded by both provincial and federal authorities. So that cross-jurisdictional boundary whereby we work on first nations reserves as well as in provincial communities is part of our day-to-day operations, and we're comfortable with that. But we also understand and know from the first nations side not just the health status and determinants of health but also the day-to-day issues they face. So we have to find balance with everybody to ensure that we work hand in hand in the best interests of these communities with the resources we have in hand.

As we've said in the past, it takes a team effort to ensure the best service delivery to any resident, no matter their race or colour. We don't discriminate; we try to work with our partners. People have talked about taking their plans through a test run, hopefully. For us, the litmus test will be the actual pandemic itself, to see if we are as prepared as we say we are.

Thank you.

[Rob Clarke, Conservative, Desnethé—Missinippi—Churchill River, SK]

At the Athabasca Health Authority, can you explain the geographic challenges you face on a daily basis—I know that northern Saskatchewan is quite remote—and also the challenge that could come into play with the H1N1 virus?

[Vince Robillard]

We're in the northernmost part of Saskatchewan, and as a health authority, all of our communities are isolated. They are air accessible, and we have winter seasonal roads. So for us transportation is always a challenge in the best of days, and we have a high cost of living to prove it. But in saying that, we've become very, very cognizant of the fact that we need to come up with innovative ways to deliver these services and also to create those vital partnerships necessary to make any venture successful.

We're of the opinion that we're on the right track, and we'll continue to strive even harder in the future.

[The Chair, Conservative, Joy Smith]

Thank you so much.

I want to thank our witnesses for being here today and being part of the second panel. I'm going to call Dr. Butler-Jones to the table, but you've had amazing testimony, and thank you for it.

I'm not going to suspend the meeting, but I am just going to ask that we change quickly because of the time element. Thank you.

So we'll go right into the second phase of this. We have Dr. Gully, Dr. Butler-Jones, and Ms. Shelagh Jane Woods. You've already had the presentations, so we'll go right into a five-minute round of questions and answers.

Who are we going to start with? Who wants to start?

Dr. Bennett, do you want to start the questions?

[Carolyn Bennett, Liberal, St. Paul's, ON]

The purpose of this was just to give the officials a chance to respond to what they heard with the witnesses, so maybe we could just put it open to that.

[Mike Wallace, Conservative, Burlington, ON]

If we're doing a regular meeting, I want to be on the list.

[The Chair, Conservative, Joy Smith]

Okay.

Dr. Butler-Jones, did you want to make any comment on what Dr. Bennett was just saying?

[Dr. David Butler-Jones]

I'm not sure where to start. So many pieces were covered. Clearly, as you parse it out, there are the issues or the challenges for many communities, aboriginal communities, remote communities, in terms of their capacity, in terms of issues of housing, sanitation, water, etc. These are long-standing challenges that ultimately are essential to good health and to the resilience of communities.

The other that I think I heard spoken to was how different communities have approached the issues and planning. As an aside, it was quite gratifying for me because I used to be the medical officer in Algoma, and Garden River was one of the reserves that I related to. And I was the chief medical officer in Saskatchewan when we actually set up the conditions with public health medical officers, nurses, and others so that the services on and off reserve were coordinated between the province and the federal government and with the band councils' support. So to actually see some of those things pay off, I think, is very gratifying.

But it does speak to the many challenges, ultimately, and the value of the sharing of experience and expertise across communities. I'll leave Shelagh Jane and Paul to speak to some of the things that they're looking at around that.

In terms of the advice, whether or not it's a structured position, we've often talked about that, but we've also been consulting with national aboriginal groups and others in terms of the most effective way to engage around public health. Representatives of AFN, ITK, and others are involved with us on an ongoing basis in terms of our planning, reviewing our plans, the development of plans, etc. So I think that's important. And whatever best ways we can do that, we're obviously interested.

And then, finally, it is about how we actually apply this, given the diverse country that we are, at the time of the pandemic. I remember a great many years ago working with municipalities, band councils, etc., around emergency planning, around pandemic planning, and it's obvious that in spite of all that work over these years, across the country communities are at very different stages of planning. We might have hoped that we would have another year or two, or three or four, to get those things in place, but obviously we don't. So right now it really is key to focus our attention around addressing those issues that we can in the short term, recognizing that there are many, as members have identified, long-term challenges to be addressed to ultimately get at this in the long term.

But in the short term, access to vaccine, access to antivirals, access to knowledge and information and the kinds of resources that communities can do, I think, is key. I very much appreciate the committee's comments, and certainly those of the witnesses today.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Shelagh Jane, what would you say about Regional Chief Garrioch's assessment of the preparedness in his region?

[Shelagh Jane Woods]

I would say that evidently I'm going to go back and talk to my Manitoba colleagues and all of my regional colleagues to make sure we have a really good handle on things, that they have their plans in place, which I've talked about before, to make sure they're putting their focus on the communities that appear to be most in need. That's what I'd like to—

[Carolyn Bennett, Liberal, St. Paul's, ON]

And that would include resources?

[Shelagh Jane Woods]

I don't know. I have to have a discussion first with them to see where they are in their planning, what they're strategies are.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Shelagh Jane, if I may, is it possible to know where those 600 communities are in the planning, whether they have a plan or not? I think someone needs to be looking at these plans. We saw one from Garden River versus a community a short way away that hadn't started one and didn't know to order supplies. Unless someone's bringing in these plans and looking at them, we just can't assess the level and we can't be saying there's 90% coverage when we hear it's two out of 30.

Is there a website where you could—