In terms of training, we do provide cultural safety training to all of the locum doctors. That's accessible to them. We are working very closely with the Sioux Lookout First Nations Health Authority, which holds the contracts for locums and works with nurses from the communities. They are federal nurses, by the way. It's about working directly with the community to improve communications and education for the community to understand screening, for one thing.
There are 29 remote communities in northwestern Ontario. We have been able to bring screening closer to communities by providing FIT kits, which are for colorectal screening, to the community for them to access and by providing mobile screening coaches that go to Sioux Lookout. People only have to go to Sioux Lookout instead of Thunder Bay.
There's definitely a lot more work to be done with primary care providers. They go to communities. They're assigned to different communities. It's not the same doctor. There's no chance to create trust or any kind of rapport with the physicians. We still have incidents of community members not feeling that health care providers are listening to them, or they're just being sent home with an aspirin when in fact they have a stage 3 or stage 4 cancer.
There are things we are trying to do to make sure everybody is brought together and is having that conversation. However, we do need more supports when it comes to, as my learned colleagues have mentioned, research to understand why cancer seems to be exhibiting at earlier ages for indigenous people than for people in the rest of Ontario. We do have some studies that substantiate this.
We did an impact assessment to find out what people think of cancer today using a needs assessment we did 20 years ago. Things haven't really progressed all that much in 20 years when it comes to cancer, except that people can now talk about it, whereas before they didn't even want to mention the word because there was such a stigma associated with it.