Chiefs and councillors from 23 Northern Manitoba First Nations said May 24 that health care in the region is in a crisis as they declared a state of emergency regarding medical services.
The declaration came after the Keewatinohk Inniniw Okimowin Council met for two days in Brokenhead Ojbiway Nation to discuss and make important decisions regarding health care transformation.
One of the topics was what the elected leaders called a critical nursing shortage at Manitoba’s 21 federally operated nursing stations.
The statement said that nursing stations were open to emergencies only from May 16-23 as a result of lack of staff.
“Who would bring their family member there knowing that the services are stretched that thin?” said Pimicikamak Cree Nation Chief David, interim char of the KIOC. “To protest, we should gather a busload of patients from our communities and bring them south all at once to access services. We are calling on the government to come to a roundtable and discuss solutions immediately.”
The leaders said nursing stations rarely if ever actually have the amount of full-time equivalent staff that they are supposed to. A spokesperson for Indigenous Services Canada told the Thompson Citizen that as of May 26, all of the nursing stations it operates in the province were operating at or slightly below their minimum staffing levels and that for the week of May 30, only one community was expected to be operating at just below minimum staffing levels. The department spokesperson said that residents of First Nations served by nursing stations are urged to seek non-emergency care during the regular operational hours of 9 a.m. to 5 pm.
“This will help those who need to access urgent care after-hours for emergencies. Health care workers at the nursing station are doing all they can to ensure everyone receives the care they need in a timely manner,” said ISC spokesperson Nicola Moquin, who also pointed out that nursing stations are only one component of health care for First Nations people in remote Manitoba communities. “They are part of a multidisciplinary, inter-jurisdictional team that includes: health professionals such as physicians, paramedics, dental therapists or hygienists; community health workers in areas such as home care, addictions and diabetes; and access to tertiary care facilities in urban centres such as Thompson, The Pas and Winnipeg.”
The state of emergency declaration pointed out deficiencies with the provincial health care system in Northern Manitoba as well.
“Thompson General Hospital has become a triage centre,” said Pimiciakamak Coum. Donnie McKay. “We need to look at ways to take control — make our own policies, services and facilities up north instead of sending them down south.”
Coun. Cheyenne Spence of Nisichawayasihk Cree Nation said the differences in health care services between the province’s north and south are stark.
“When we got to Thompson there is nothing to look after patients that need special care,” said Spence. “When we travel to Winnipeg or Brandon, the care is available. Why can’t we get the same care in Thompson?”
A spokesperson for the Northern Regional Health Authority, which oversees provincial health services and facilities across the north, apart from in Churchill, said the organization is making efforts to provide better care for Indigenous northerners, including those who live on-reserve. So far, the health authority has worked on a joint statement with Manitoba Keewatinowi Okimakanak and Keewatinohk Inniniw Minoayawin (KIM)to end anti-Indigenous racism in health care, added elders to their health care providers, created a wisdom council and expanded spiritual care to include access to Indigenous practices like smudging. A social worker position has been added to support indigenous patients in the Thompson General Hospital emergency department and cultural training, including First Nations-inspired land-based education for NRHA staff and board members, has also been expanded.
“We understand, and we all want these solutions implemented without delay but it will take work and time to solve this very complex, multifaceted issue,” the spokesperson said. “We are committed to working with all of our partners, especially our indigenous communities and leadership, to find and implement sustainable solutions that meet the health needs of the people we serve in support of our vision of healthy people, healthy north.”
Dr. Barry Lavallee is chief executive officer of KIM, which was created after MKO signed a memorandum of understanding on health transformation with the federal government in 2018, with the goal of giving First Nations more control over federal government functions respecting health care for Northern Manitoba First Nations. He says the under-resourced health care system in First Nations is systemic racism.
“Nursing shortages and shortages in physician-led care, limited access to diagnostic care, lack of appropriate health infrastructure in communities, and the lack of a co-ordinated systems-based response for urgent and emergent issues like the nursing shortage – all of this is racism, full stop, and has been worsening instead of improving over time,” Lvallee said. “System leaders have nothing to be proud of and should really hang their heads in shame. Many will try to lay blame on the pandemic but that is only one of the contributing factors. The truth is that although the pandemic has shed new light on gaps in care and really, the ‘Jordan’s Principle’ of health services for First Nations people overall – it is time for systems to stand in discomfort and take the hits for their neglect due to racism.”
KIOC members hope the emergency declaration will lead to roundtable discussions with the federal government to address immediate, short-term, medium-term and long-term solutions to issues such as nurse shortages, on-reserve health care infrastructure in need of modernization and improving the provincial and federal integrated response system for urgent or emergent crises
“More and more we are being called to advise federal and provincial systems on solutions however, we know that we cannot let the systems call the shots anymore,” said KIM chief operating officer Moriah Davis. “They have done a poor job and it is time for Indigenous people to take back control. We cannot give up on the collaborative possibilities, even while we call out the systems working with us. It is better that they move from a place of shame to one of allowing equal footing by First Nations in decision-making while they take appropriate responsibility for health care services. We also expect that systems will continue to support us as we begin taking steps to lead from a stronger platform with the northern First Nations.”
