It is an honour to be here representing the Inuit land claim of Nunatsiavut, as an Inuk and as a former director of health for that region.
On the map you will see the Nunatsiavut land claim, the last of the four Inuit regions of Canada to be proclaimed, in relation to the rest of Labrador, and of course it is part of the province of Newfoundland and Labrador.
Nain is the most northerly community in the province of Newfoundland and Labrador. The population varies between 1,200 and 1,500. It is the administrative capital of the land claim. The word Nunatsiavut means beautiful land, and I think if you look at the photos you will see why.
Nain is nestled among many hills, and while that makes it picturesque, it creates very particular challenges for flying. It is the only community in Labrador where a medevac flight cannot go in after dark. This obviously increases the stress on the staff in the clinic and also the staff in Goose Bay when they are trying to manage patients.
Mount Sophie is in Nain. This is the view from the clinic. This is the weather vane. If the staff in Nain say they can see Mount Sophie, you can fly; If you can't see Mount Sophie, you can't fly.
This is the outside of the clinic in Nain, which is responsible through Labrador-Grenfell Health for delivering primary care both through this clinic and through the hospital or the health centre in Happy Valley-Goose Bay. The secondary level of care including diagnostic, surgery, obstetrics, and access to physicians comes from here. On a good day with fair weather we could be up to Nain and back within four hours, if we didn't need time to stabilize a patient in Nain.
We have a collaborative model of care. The community side of care, public health, home and community care, is delivered by the Nunatsiavut Department of Health and Social Development. Their staff is in Nain.
What was our role in this process? There were several committees at different levels, and I would like to acknowledge the deputy minister of health and social development, Michelle Kinney, who I am replacing here today, but who's been a very strong advocate for this project throughout its implementation. We're also responsible for endorsing it, meaning because we had a voice in what happened with this project, Inuit were much more readily open to it as part of change.
If the Inuit can be part of change, then obviously it increases our access to health care. We use data from non-insured health benefits as part of our data-sharing agreement. At the moment Nunatsiavut is the only aboriginal group in Canada which manages its own non-insured health benefits program. We were involved in the development of the evaluation and we were also champions among Inuit.
We used the fact that we were an Inuit land claim sitting at a table with our colleagues through Inuit Tapiriit Kanatami to promote this type of technology as a way forward for improving access to health care for Inuit in Canada.
As you've just seen, we had seen computer footage of Rosie in Cape Breton, but it was still hard for us to conceptualize how that would work for us in the clinic in Nain. We didn't know what Rosie could do. We didn't know how the community would accept her. We didn't know whether it would truly bring service closer to home, or what the outcomes would be.
What we did know was that people in Nain, as in most Inuit communities, do not always want to have to travel for medical service. They have to leave families and their homes and they are often gone for days or even weeks. We knew that supporting nurses, helping the nurses feel more confident in their decision-making, improves their retention, and if we improve their retention, we're more likely to have culturally safe care. We knew that Nain was ideal for this pilot because of the restrictions on flying. They have fairly stable staff, and they've worked for several years with the traditional telehealth system, so they would be much more comfortable with the technology.
We knew that as a government we would do everything we could to support this project. We knew that the philosophy Dr. Mendez brought to this project matched what we believe. We believe we have to do much more to bring care to the Inuit and not Inuit to the care.
What did we learn? Rosie very quickly became a member of the staff, and I think the nurses now would feel a loss of confidence if she were to leave the clinic and they lost that support piece they've had.
The community actually loved her. They called her that old robot doctor. She saved lives. She saved travel time. She became an integral part of health delivery in Nain, so much so that the Nunatsiavut government has recently purchased Rosie Two, which has even greater capacity for the community of Nain.
What about the future? We believe we have to do several things. We certainly have to continue with the excellent work being done. We think we need to expand the use to make sure we're using it in the best capacity we can. We have to explore some increased utilization with other peripherals. More importantly we need to continue to document the improved service delivery through all avenues, using presentations and opportunities such as today, through newsletters and professional journals, so we're sharing the story of what can be done with the rest of Canada.