Evidence of meeting #14 for Health in the 43rd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was communities.
A recording is available from Parliament.
Liberal
Mike Kelloway Liberal Cape Breton—Canso, NS
That's a great point in terms of the data, the evaluations and the assessments. I appreciate that feedback greatly. Thank you.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mike.
Grand Chief, I see you leaning forward. Does that mean you wish to respond as well?
Southern Chiefs' Organization Inc.
Yes. Just on the health transformation piece, I think that was even prior to COVID-19. I think that's a good thing that the government has done. We've been trying to move as quickly as we can, pursuing the B.C. First Nations Health Authority model where you have first nations being a lot more hands-on and more involved in the strategy and the planning for the communities as well.
Liberal
Mike Kelloway Liberal Cape Breton—Canso, NS
I will just say this very quickly, because I know I'm over my time. Grand Chief, I'd like to, at some point, talk to you about your efforts with respect to securing doctors from Cuba, how you're getting along and how the government can help.
Thank you.
Liberal
Bloc
Luc Thériault Bloc Montcalm, QC
Thank you, Mr. Chair.
In the course of the testimony heard by the Standing Committee on Health, one constant emerges regarding the ability to counter the pandemic and limit the contagion of the virus and its virulent effects.
All living environments that were fragile before the pandemic are environments where it is difficult to contain the virulence of the contagion. That's what worries me, especially when I hear witnesses talk about the lack of resources.
In Quebec, 55% of indigenous individuals live in urban areas. That's rather worrisome.
During this first round of questions, I will have some quick questions for the representatives from Indigenous Services Canada. I would ask that the answers be as brief as the questions.
In order to properly counter a pandemic, it is important to have an accurate picture of the situation. I'd like to know whether the territory of Nunavik has adequate screening measures. I would also like to know whether Canada has sent rapid tests there. These tests are important for people who live in remote regions, especially since people with the virus have to be isolated. Before the pandemic, more than 20% of indigenous populations faced housing and overcrowding problems. Have rapid tests been sent there? Is there an adequate isolation plan?
Canada has sent Rangers to Nunavik, but I don't know if they've arrived there yet. I'd like to know their exact role and mission, and how they will be deployed.
In terms of health, the curve needs to be flattened so that the health care system can provide intensive care. Do the territories have everything they need in terms of human resources and equipment to save the lives of people who are virulently affected by COVID-19?
Senior Assistant Deputy Minister, First Nations and Inuit Health Branch, Department of Indigenous Services
I can answer some parts of the question, and then I'll give the floor to Dr. Wong to see if he has anything to add. Perhaps Mr. Obed might even have information to give with respect to Nunavik.
As you know, the Nunavik regional authority is part of the provincial system. We don't directly fund the health services of the regional authority, which is integrated into the Quebec system. However, the people in the authority do share information with us when necessary. Of course, if they need additional supplies or equipment, they can ask us. In fact, they have submitted a request to us for personal protective equipment. We were able to send them some based on the inventory we have in the department.
When the province of Quebec saw a significant increase in COVID-19 cases, they were concerned about not receiving equipment quickly. They made a request to us, and we were able to meet their needs. The reason I put this in context is that we aren't as integrated into their day-to-day operations as they are, because they are part of the provincial system.
I can tell you, however, that they have asked for the Rangers to be sent, mainly to help them with infrastructure logistics. That goes back to your point about the additional infrastructure needs. Often, the infrastructure exists, but it has to be adapted for different purposes. Facilities need to be disinfected, and it's necessary to ensure that the required supplies, furnishings and equipment are in place so that they can be used for other purposes, such as isolating community members or housing individuals delivering services who are mobilized to provide the additional capacity required to respond to the pandemic.
We are playing a more direct role in first nations communities. We have purchased many temporary structures that can be deployed quickly in the communities. Already 78 different infrastructures are being set up or are ready to be used in the communities to meet these additional needs, especially in small or more isolated communities.
With respect to critical care capacity, it is obviously related to the capacity of the hospital environment across the country. Only two hospitals in Manitoba are under the responsibility of our department, so we're working more closely with them.
We are working with provincial governments to ensure that they have plans to increase critical care capacity and that they can receive first nations patients living in isolated communities. We are working very closely with them to make sure they have plans to evacuate community members early enough, before they get very sick. We can't wait until they are in critical condition. They need to be close to the hospital environment or in the hospital environment as soon as they have complications related to COVID-19.
That's a partial answer.
Dr. Wong, do you have any additional information to provide with respect to Nunavik?
Bloc
Luc Thériault Bloc Montcalm, QC
I'm sorry for interrupting. Could you speak to the situation in Nunavik, but also the situation in general, because overcrowding—
Liberal
The Chair Liberal Ron McKinnon
I'll let Dr. Wong respond to your question if he has something to add.
Dr. Tom Wong Chief Medical Officer and Director General, Office of Population and Public Health, Department of Indigenous Services
Thank you.
In the area of public health, our priority in the Government of Canada is to make testing available in remote communities. This is very important to us.
Spartan Bioscience, which produces the rapid tests for Canada, doesn't yet have the test boxes because the plant is in the process of producing them. In about two or three weeks, the company will be able to produce enough tests for some locations. We are very pleased to know that in two or three weeks there will be devices available in remote locations.
Liberal
The Chair Liberal Ron McKinnon
Thank you.
We go now to Ms. Ashton. Please go ahead. You have six minutes.
NDP
Niki Ashton NDP Churchill—Keewatinook Aski, MB
Thank you very much, Mr. Chair.
Welcome to all of the witnesses here today.
First of all, I'd like to register a number of key concerns that my colleagues and I share with respect to what indigenous communities are going through. We are very concerned to hear about, including at today's meeting, the absolute lack of funding available to off-reserve indigenous peoples and the fact that there was a deadline connected to this funding. This is an area that needs to be dealt with urgently, recognizing how vulnerable indigenous urban communities are.
I do want to spend the next few moments asking questions of Grand Chief Daniels, as well as President Obed, but certainly would also like to bring the focus to urban indigenous communities at some point as well. Obviously, we're very limited in our time here and I, like many, hope that we can have a virtual Parliament so that we can raise these issues at all levels with the urgency they require.
First, to Grand Chief Daniels, thank you for your powerful presentation. You've talked about huge inequalities that first nations in your region struggle with on a daily basis. I'm wondering if you could talk a bit about announcements or calls that you've already made around the need for Cuban doctors. Why is it that SCO first nations are making that call?
I'm also wondering if you could talk a bit about the need for federal infrastructure funding in communities, whether that's for repurposing spaces right now to create temporary housing; whether it's building a ventilation centre like Berens River has proposed for its area and the surrounding communities; or whether it's some communities, including further north, that have talked about the need for military hospitals. Should there be direct federal funding for infrastructure at this time?
Finally, can you speak to the need for personal protective equipment not just for health care staff, but also for front-line staff who work for first nations?
Could you reflect on some of those key messages? Thank you, Grand Chief.
Southern Chiefs' Organization Inc.
Thank you, Ms. Ashton.
I would just like to state, on the question around the Cuban doctors, that we took a tour to Cuba and asked to have a contingent or a brigade come here to Manitoba. Part of the reasoning behind that was that we had seen a crisis coming. We had already been working to have this happen prior to the pandemic getting to the point where it is. We wanted to see the kind of impact that it could have, because what we've seen in our communities is a lack of services on the ground. We haven't had long-term people in the community. We have rotating nurses coming into some of our isolated communities. We wanted to have long-term, consistent service being provided.
What we saw was the World Health Organization giving a great deal of notoriety to the Cuban health system. We wanted to see if the return on investment would be significant and we wanted to see what kind of return on investment we would get if we were to put it side by side with what we're seeing with the current health outcomes and the current strategy. That was kind of the reasoning. There aren't a great deal of resources, and we understand that, so if we can get better health outcomes through this process then perhaps that's something that we should consider expanding. That was kind of the point with Cuba, and we're continuing, obviously, to try to have doctors come into our communities to help with the health transformation side of things. We could, maybe, have some of our people trained at their international health institute over there. We toured the facility. That was our point there, to get a better return on investment. If we could see that as a reality and a measured investment that could work, then we would like to go there.
Second, in many of our communities, rather than having people go into the urban centres and purchase goods, they actually buy in bulk. Some of the communities are disinfecting the merchandise that comes into the community and then packaging it into care packages. They break open the shipments and break them down into smaller packages. At that point, they didn't have PPE equipment. We wanted to have that in our communities for the people who were doing this, so that they could screen out any potential bacteria that might have been coming into the community. There are examples of that in many of our communities, including Wayway and others—in quite a few actually. That's what they've been doing in the communities, bulk buying.
Many of the communities have also been doing that in the urban centres, in Winnipeg. Many of the tribal councils have been involved in that. That's kind of what we're looking at, how best to utilize the limited resources we have while protecting our people. That's what many of our people, those people who are receiving the food and other stuff and protective equipment, have been doing. We've been hoping to support them more. I know there were about two or three weeks when there was nothing there for them. There was a bit of risk happening. Thank god in Manitoba we've done a very good job of flattening the curve, and hopefully we will continue to see zero new infections.
NDP
Niki Ashton NDP Churchill—Keewatinook Aski, MB
Thank you, Grand Chief.
Quickly, to President Obed, I'm wondering what you could share with this committee about what you need to see in your territory from the federal government to support elders, anybody who's over 60 years old, those who, we know, are especially vulnerable to COVID-19.
President, Inuit Tapiriit Kanatami
Nakurmiik. Thank you, Niki.
I think, just from a structural standpoint, an Inuit Nunangat policy approach should be employed any time the federal government is considering specific interventions for our communities. That means not leaving behind Nunatsiavut and Nunavik in a northern policy approach because that's really the way in which a lot of these interventions are structured—north of 60, south of 60. We are a very considerable part of this country, and our policy space should be contiguous from all Inuit regions and then also the urban components as well.
Then you get into the specific considerations for our most vulnerable. We have Inuit in long-term care facilities in the south because of a lack of care facilities in Inuit Nunangat. We have a large number of urban Inuit in the south who require very specific considerations and sometimes fall through the cracks. Luckily, we have our land claim organizations that are specifically considering the needs of elders at this point in time. There have been either direct payments or vouchers that have been given to them so that they can have food, but when it comes to the functioning of the health system, the near-term care and the ability to act quickly in response is going to save lives. Even if we don't have the numbers today, that specific consideration of getting point-of-care testing to our most vulnerable and then being able to treat Inuit where they live, rather than shipping Inuit south, is also going to save lives.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Ms. Ashton.
That concludes round one. We will now start round two. I'm going to be a little more ruthless in our timing going forward.
Please go ahead, Mr. Kitchen, for five minutes, please.
Conservative
Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK
Thank you, Mr. Chair.
Yes, you'll always be ruthless when I come on.
Thank you, everybody, for being here. I appreciate that and the opportunity for you to speak to us.
I noticed that as of yesterday 53 first nation people and 13 Inuit have tested positive for COVID-19. I hope and I pray that we will not see any more of those. The one thing that we haven't been told is how many have recovered, and I'd love to see that information to know how many of those actually have recovered.
My first question is for Ms. Gideon. On your website, you state that the ISC maintains a stockpile of personal protective equipment—PPE—and hand sanitizers in the event of a health emergency in first nation on-reserve communities. Can you tell us how many masks, gowns and gloves are in that stockpile? If you can't, can you provide that for us today? Can you provide that information to the committee?
Senior Assistant Deputy Minister, First Nations and Inuit Health Branch, Department of Indigenous Services
Thank you very much.
I don't know if Dr. Wong has the numbers handy in front of him. Otherwise, we can certainly share that information with you subsequently.
Dr. Wong.
Chief Medical Officer and Director General, Office of Population and Public Health, Department of Indigenous Services
Just to give you an idea, currently we have over a million gowns and close to a million gloves in our stockpile and, at this moment, more than 300,000 N95 masks. Those are just some examples. In addition to that, every time Canada receives a new shipment, part of that goes to the Public Health Agency—the national stockpile—and to Indigenous Services in order to offer PPE to first nations on reserve. We have access to that stockpile as well.
Conservative
Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK
Thank you. I appreciate that.
How much of that stockpile is being distributed to our first nations?
Chief Medical Officer and Director General, Office of Population and Public Health, Department of Indigenous Services
Since January, just to give you a magnitude of scale, approximately 160,000 gowns have been distributed, and just under 500,000 gloves have been distributed. Close to 200,000 surgical masks have been distributed. As for N95 masks, which are used for aerosol-generating procedures, close to 90,000 of those N95 masks have been distributed.
Conservative
Robert Gordon Kitchen Conservative Souris—Moose Mountain, SK
I appreciate that. Thank you very much.
Are there any first nations that are still waiting for a supply of PPE?
Chief Medical Officer and Director General, Office of Population and Public Health, Department of Indigenous Services
Every day we get requests. As of yesterday, 570 shipments from the warehouse have been made in response to requests. On an average day, depending on the number of requests coming in, approximately 20 to 30 requests are waiting to be processed. We operate seven days a week. Some days it's smaller and some days it's bigger. It depends on the number of requests coming in.