Boozhoo. Aahni.
I'd like to thank the chair, vice-chairs and members of the standing committee for the invitation to appear before you. My name is Dr. Nel Wieman and I am originally from Little Grand Rapids First Nation in Manitoba. I'm a psychiatrist by training, and the current president of the Indigenous Physicians Association of Canada, also known as IPAC.
I also work as the acting deputy chief medical officer at the First Nations Health Authority in British Columbia. I am joining you from the traditional ancestral and unceded territory of the Coast Salish peoples—the Musqueam, the Squamish and the Tsleil Waututh.
These are some of the key messages IPAC would like to convey, organized around various themes, regarding support for indigenous communities and individuals as we are going through the second wave of COVID.
Regarding IPAC, the Indigenous Physicians Association of Canada is the national representative organization of indigenous physicians, residents and medical students. We have approximately 250 members who are studying, training, living and working across this country from coast to coast to coast. We also know there are other indigenous physicians and medical learners out there.
IPAC members have a collective intent to collaboratively use our skills, abilities and experiences to improve the health and wellness of indigenous peoples across the country. This includes advocating for individuals, families and communities who have experienced COVID-19 infection and outbreaks, those who remain at risk of infection and those who are at high risk of experiencing severe courses and outcomes related to COVID-19 illness, including death.
However, IPAC cannot represent the many diverse views of all indigenous people across Canada, in this instance regarding the supports needed as part of the response to COVID-19.
During the COVID-19 pandemic, indigenous physicians have participated in the response in a variety of ways: as primary care providers on the front lines in indigenous urban, rural and remote communities, either in person or virtually; as specialists working in communities or in hospitals, including academic teaching hospitals; as public health physicians contributing to the COVID-19 response in cities and health authorities; as administrative and medical education leadership in health organizations and universities; and also in governments at the local, regional, provincial and federal levels.
We have also created a series of public service announcements—five altogether—which feature eight to 10 indigenous physicians from across the country. The PSAs convey culturally safe and relevant information on themes important to our communities and nations during COVID and highlight our indigenous strengths and resilience.
IPAC members have also served during the pandemic on various committees and advisory groups, including the Public Health Agency of Canada's health professionals forum and on more focused initiatives such as providing review and input into developing Canada's COVID-19 immunization plan.
We respect all indigenous peoples' right to self determination. Support for first nations communities should recognize and reinforce first nations' self-determination and systems of self-government. One example is the ability of communities to declare closures and/or limit access during the pandemic. Communities also express self-determination and the capacity to assess or declare their need for funding for emergency measures. Such a decision should only need to come from the community itself and there should not be an additional layer of verification required from an external body.
IPAC continues to be concerned about the health and wellness of indigenous people across the country during COVID. We are especially concerned about the mental health and wellness aspects, and note the particular challenges when there is concurrent substance use.
In B.C., we are dealing with dual public health emergencies: COVID-19 and the opioid crisis. We are seeing that the significant rise in overdose events and deaths are particularly tragic, unintended consequences of the imposed public health measures to reduce the spread of COVID-19. Indigenous people are unfortunately overrepresented in the overdose crisis. We are supportive of increased funding for harm-reduction services, treatment programs and building up capacity for establishing a safe supply in order to separate people who use drugs from the toxic street supply.
IPAC draws particular attention to the capacity of indigenous communities to access health services, including primary care, virtual services and timely COVID testing, which has been mentioned already. There are long-term investment needs including medical transportation and infrastructure, Internet access to telehealth, necessary medical equipment, technology and supplies. The pandemic has only highlighted the disparities in health services to indigenous people.
There is also a need for sustainable, healthy homes. COVID-19 thrives in inequity. During the pandemic the overcrowding and poor conditions of some homes mean that self-isolation is impossible, and the spread of the virus within a family group is inevitable. Given the past harms and devastating experiences of indigenous people during pandemics, historically and in more contemporary times, it is important to clearly articulate messaging around COVID-19 and the public health response.
For example, we are concerned about vaccine hesitancy when one becomes available, in part, because of indigenous peoples' past experiences with medical experimentation and poor treatment. We do advocate for indigenous people to be a high priority when vaccines become available, given their health and exposure vulnerabilities.
Indigenous people want access to their own health systems, including funding for elders, traditional medicine people and healers. Many of us see this as vital to our own health and well-being.
Finally, yesterday's release of the B.C. provincial inquiry report into anti-indigenous racism in the health system, in plain sight, reminds us that we have a long way to go to create a health system for indigenous people that is safe to access during the COVID-19 pandemic and beyond.
Meegwetch.