Ongoing Health Crisis

3 people have died in O-Pipon-Na-Piwin Cree Nation in the past 2 weeks

CBC News: A remote northern Manitoba First Nation has declared a state of emergency following the deaths of three people in the community over the past two weeks.

“We’ve seen the hurt and pain suffered by our First Nation and we can’t wait any longer. We are dealing with emergencies and tragedy on a daily basis here it seems,” said Chief Shirley Ducharme of O-Pipon-Na-Piwin Cree Nation, a community of just over 1,000 people at South Indian Lake, about 130 kilometres northwest of Thompson. “Our people are dying and as leadership, we have to do something.”

She is calling for the federal and provincial governments to provide immediate help in the form of crisis supports for people battling trauma, addiction and mental health issues. “As we try to navigate what the problems are … we try and gather our thoughts together and support our members. Everybody is impacted,” Ducharme said.

She is also urging the province to limit the hours of operation for the local ferry to control the flow of alcohol entering the community.

People have turned to drugs and alcohol to relieve their pain during the crisis, but the substance abuse just creates a domino effect and causes more problems in the community, she said. “We’ve lost community members and we now see the escalation and violence.”

Manitoba Keewatinowi Okimakinak, a political advocacy organization that represents 26 First Nations in the province’s north, has deployed a mobile crisis response team to assist O-Pipon-Na-Piwin Cree Nation. “They work directly with families who have experienced trauma and will be a part of a response that includes other entities,” MKO Grand Chief Garrison Settee said in a statement.

“We are also going to assist our member First Nation with their call for more housing by advocating on their behalf federally and asking the province to limit the hours of their ferry to control the flow of alcohol into their community.”

• Family and chief call for more community resources after death of woman from O-Pipon-Na-Piwin Cree Nation
• South Indian Lake RCMP investigate homicide of woman, 47

Ducharme also wants a healing centre built in her community, so people can get help closer to home “There is not enough supports and resources available in our community for our community members to heal,” she said.

They travel to larger centres for care, but the wait can be anywhere from six months to a year to get in and “when they come back from the treatment centre, they fall back into the cycle again, because there is nothing here for them as supports to continue with the ongoing healing that they need,” Ducharme said.

She has reached out to the Assembly of Manitoba Chiefs to request its help in designing, developing and implementing a community action plan to address the immediate and long-term needs of the community. “It’s going to be a longtime journey that we all need for this whole community,” Ducharme said.

ABOUT THE AUTHOR

Darren Bernhardt, Reporter

Darren Bernhardt spent the first dozen years of his journalism career in newspapers, at the Regina Leader-Post then the Saskatoon StarPhoenix. He has been with CBC Manitoba since 2009 and specializes in offbeat and local history stories. He is the author of award-nominated and bestselling The Lesser Known: A History of Oddities from the Heart of the Continent.

Toronto Star: The Canadian Press – When the doors close at night at the administration office at Yukon’s Carcross Tagish First Nation, a van hits the road and drives through the communities to offer naloxone to reverse overdoses, drug testing kits, food and even a friendly face to help those struggling because of the opioid crisis.

The nation’s director of health and wellness, Stacey Robinson-Brown, said the new outreach van — a common tool in larger Canadian urban centres — is run three days a week to get more “boots on the ground” after-hours and connect with people who might need support in the communities with a population of just over 700 people. “Not all crises happen before 5 p.m.” she said.

Robinson-Brown said they want to meet people where they are and perhaps help pull them back from deep waters to start a healthier life. “Even if we could change the lives of some people in terms of maybe some of their use, I think that would make a world of difference.”

While Yukon faces Canada’s highest per capita death rate from illicit drugs, First Nations in the territory say toxic drugs are disproportionately affecting their people. Two nations have declared states of emergency as their members overdose and die. 

Carcross Tagish First Nation declared a state of emergency over the opioid crisis in January 2022, when three citizens died of overdoses in the span of six days, Robinson-Brown said. At the same time, there were a lot of non-fatal overdoses that just “never make the news.”

The Yukon government declared a “substance use health emergency” not long after, and earlier this year the First Nation of Nacho Nyak Dun in Mayo declared its own opioid emergency over a situation that was “terrorizing” citizens and families with violence, crime, overdoses and death.

Yukon chief coroner Heather Jones reported 25 deaths last year attributed to toxic substances, 20 of which involved opioids in the territory of about 43,000 people. On a per capita basis, that rate is worse than in B.C., which had the country’s highest death toll last year with 2,272 suspected illicit drug toxicity deaths. 

Of the 20 opioid-related deaths, Jones said 17 happened in Whitehorse, but Robinson-Brown believes that since the coroner only records where a person is when they die — not where they lived — those numbers under-represent the amount of people in communities outside Whitehorse who are struggling. “I’m speculating at this point, but the majority of people who are struggling with or going through an overdose make their way, either by ambulance, or someone else brings them, to Whitehorse because it’s the only general hospital close enough,” she said.

It’s a crisis that can look different in smaller communities compared with urban centres, Robinson-Brown said.  Her department of about 25 people offers everything from social assistance to outreach, justice and other programs to the First Nation’s citizens, a third of whom live on traditional territory.

That means staff often have multiple “different hats” when someone asks for help, she said. On top of that, many families in the small communities are connected and have known each other their entire lives. “We’ve hired several staff who have made comments like, ‘Wow, I never knew these people in this way,’ And it’s difficult to see them because they recall them as being, you know, happy, carefree youth,” she said.

“So, I think it’s really eye-opening when you consider all of the family ties and as well as just being in the community and knowing them in a different capacity.” For some, being able to seek help from someone they know makes the process easier, Robinson-Brown said, while others might be reluctant to share their struggles with someone they have a history with.

Across the territory, First Nations are overrepresented in the opioid crisis. Of the 25 deaths from toxic drugs reported last year, 17 — or about two-thirds — identified as First Nations, Jones said. The Yukon Bureau of Statistics pegs the territory’s overall population as 22.3 per cent Indigenous.

Last week, First Nations from around the territory held marches and lit sacred fires following the First Nation of Nacho Nyak Dun’s emergency declaration and two murders in the community. Shadelle Chambers, executive director of the Council of Yukon First Nations, said such vigils are meant to keep the crisis in the public eye, show solidarity and allow people to process their grief over everything that has been lost.

She said the territorial emergency declaration — which the council pushed for — preceded changes including the expansion of and research into harm reduction options, the expansion of Whitehorse’s safe consumption site to include an area for inhaled substances and research being done on safe supply. “This is a very complex issue and so we can’t expect one government to be able to do this. It’s going to take the community, it’s going to take Yukon First Nations, it’s going to take all levels of government to really look at how we can help address this crisis and work toward solutions,” she said.

The council is near completion of a business case for a proposed Yukon First Nations healing centre, she said. It has also sent almost 300 people to private treatment outside Yukon and is working with hundreds of families in programs specifically designed to keep their children out of the foster system.

Chambers said a strategy is needed to work with youth and families to prevent trauma and look at issues including problems around housing and the cost of living. “You can’t address the opioid crisis without looking at all of the other socioeconomic factors.”

She said the territory is dealing with some similar opioid use issues as Vancouver’s Downtown Eastside, including crime, gang activity and the victimization of First Nations women, but on a smaller scale. “We would hope that because it is a smaller jurisdiction, that we would be able to be more nimble and quick to respond to things but this is a complicated issue. I don’t believe that there’s one quick solution,” she said.

Chambers said there needs to be more financial and human resource supports both in Whitehorse and communities outside of the capital. While Whitehorse residents have access to a program offering a medically prescribed safe supply of opioids, they need to be administered by a pharmacist, which is not an option in rural communities.

“So, how do we look at virtual options? Expansion of these things? How do we ensure that there’s safe drug testing kits available in each community, not just from 9 to 5? We need to support organizations … to do more work in the communities,” she said.

Tracy-Anne McPhee, Yukon’s minister of health and social services, said the territory’s promised substance use health emergency strategy is in its final stages of development and will be released “as soon as possible” along with recommendations. “This substance use health emergency … is not going to go away any time soon. It’s certainly not going to go away during my lifetime in this chair,” she said. She said the government is collaborating with each community to identify their specific needs and tailor its approach accordingly.

The First Nation of Nacho Nyak Dun met with government officials and the RCMP following its emergency declaration. Since then, Premier Ranj Pillai has written to Chief Simon Mervyn to offer a series of potential supports including making more councillors available and development of community-led restorative justice initiatives. 

McPhee said the territory has been working with all communities to expand drug testing capabilities including through local health centres. “We’ve been working tirelessly with Yukon First Nations, with our community partners and other governments to co-ordinate a response, to implement the harm reduction strategies … to expand access to treatment and recovery services and to increase the public education and awareness about the dangers of substance use,” she said.

Chambers said she believes the situation will improve, while she also recognizes that there are systemic issues that First Nations have faced for generations. “The solutions might take decades and generations as well, but it’s really important that we see these small wins every day and that keeps us going.” 

AJBy Ashley Joannou: This report by The Canadian Press was first published March 30, 2023.

APTN: The chief of St. Theresa Point First Nation is making a plea for privacy after two 14-year-old girls froze to death in the northern Manitoba community on March 1. Leaders of the close-knit First Nation, 465 km northeast of Winni peg, said the whole community has been hit hard by the girls’ deaths.

It was -23 C when the girls’ bodies were discovered that morning and while they’re still awaiting the medical examiner’s report, Chief Elvin Flett believes drugs caused the girls’ deaths.

He said they need to be more aggressive to stop drugs from coming into the community.“ We have airports and we have no means to be allowed to search luggage because that’s portal, that’s where all the drugs go through is at the airport,” he told a news conference on Friday.

While there was shared grief at the news conference, there was also anger against the federal and provincial governments over health care funding.

Flett said because of drugs and the violence they cause, the community’s mental health funding is depleted halfway through the year. “We don’t have enough resources to contain the issue that causes the drug influx into our community,” Flett said. “It’s a problem that continues to grow bigger and it affects every aspect of our lives, our safety, and we’re having a difficult time dealing with it simply because of that issue.”

Assembly of Manitoba Chiefs Grand Chief Cathy Merrick said this is why First Nations should be at the table when federal health transfers to the province are discussed and when the Manitoba government sets its budget.

“We know very well that our people are the ones that need the help most in our territories,” Merrick said. “The communities here, for many, many years, have asked the government to provide them with treatment centres, with health centres, with a hospital. With 18,000 people within their region – to no avail to this day. “When the province of Manitoba announced their budget, did not even mention our people.”

Merrick said with the federal government currently trying to develop an action plan on the United Nations  Declaration on the Rights of Indigenous Peoples, First Nations should not have to beg for housing. Merrick pointed to the lack of housing on reserve, as one of the reasons people are struggling, saying that the 3 or 4 houses allotted to any First Nation in a year will never be enough.

She hosted the first-ever Assembly of Manitoba Chiefs Women’s gathering which concluded Friday and says the women and the communities know what they need. “So, Canada must decide if it honestly shed its colonial ways on dictating to us what we need and bravely chart a new course.”

St. Theresa point is preparing to lay the two girls to rest next Tuesday.

Author(s) 

Leanne Sanderslsanders@aptn.ca

Improved care closer to home would bring multitude of benefits to Nunavik, experts say

CBC News: If a patient in Nunavik requires specialized medical care, they have to get on a plane and travel more than 1,400 kilometres to Montreal. 

But a new regional hospital proposed in Kuujjuaq, Que., could help keep some patients closer to home.

“We deserve it. We need it,” said Jennifer Munick-Watkins, the new executive director of the Nunavik Regional Board of Health and Social Services, which has been pressing for a better hospital for years.

Nunavik, the autonomous region of northern Quebec, is currently served by two health-care centres, one on each coast  — Ungava Bay and Hudson Bay.

The hospitals are small and outdated and only offer basic services. Occasionally, specialists are flown in to treat patients, but their availability is limited.

As a result, thousands of patients who need specialized medical care have no other option but to fly south.

That includes everyone from expectant mothers with high-risk pregnancies and patients who need cancer treatment, dialysis or more complex surgeries. It has been this way for decades.

Being unwell far from home and away from family and friends is stressful. “First of all, their first language is Inuktitut, so that means they are already stressed out in ensuring they’re going to have a good translator,” said Munick-Watkins.

Many patients are elderly and need to be accompanied by an escort. Typically, an extended family member will make the trip with them, but it’s disruptive and can cause financial hardship.

Municik-Watikins, an Inuk who grew up in Kuujjuaq, is eager to see the hospital finally built. “I’ve heard about it for years, since I was a little girl,” she said.

The benefits of local care

The journey to Montreal for medical care is common among residents of Nunavik.

More than 5,000 patients and roughly 2,000 escorts travelled to Montreal from Nunavik in 2019-2020, according to Quebec’s Ministry of Health. (In the first year of the pandemic, those numbers dropped slightly.)

• CBC INVESTIGATESInuit come to Montreal for medical care. The lodge where patients stay is riddled with problems

“I think there are a lot of questions that can be posed about the model of health care that has been essentially imposed,” said Richard Budgell, a Labrador Inuk and an assistant professor in the department of family medicine at McGill University who teaches about Inuit health.

Every year, medical transportation between Nunavik and Montreal costs the province tens of millions of dollars.

While patients recover or receive treatment, they stay at Ullivik, a rest home which opened in 2016 near the airport.

But the transition to living in Montreal, albeit temporarily, can be jarring for some Nunavik residents.

An investigation by CBC News found problems with how the centre was managed and patients have repeatedly complained about the facility’s cleanliness, food and treatment by staff.

“What we’re talking about is temporary housing that can go on for a period of weeks, even months for some people who are either ill or injured,” said Budgell. “It’s probably fair to say that almost without exception, nobody really wants to be in that facility.”

Although the new hospital wouldn’t eliminate all medical transportation, better access to medical care in the North could reduce the number of trips — and improve quality of care.  “If care is being provided in your own community or at least in your own region, then the likelihood of that care being culturally safe for Inuit is better,” said Budgell.

“People don’t mind going from a smaller community to Kuujjuaq or Puvirnituq as much as they might mind coming to Montreal.”

Building it, then staffing it

Details of what services would be offered at the new regional hospital are still being worked out. The Nunavik health board and the Ministry of Health are in the planning stage.

Since the province set aside $462 million in 2018-2019 for the project, construction costs have climbed dramatically, so the final bill may be much higher, said Marie-Claude Lacasse, a spokesperson for the Ministry of Health.

Once the clinical plan is complete, an exact location will be determined and a timeline and budget will be finalized, said Lacasse. Building the hospital is the first hurdle. Finding the people to staff it will be another challenge, said Munick-Watkins.

Nunavik is already struggling with a severe shortage of doctors and nurses, particularly on the Hudson Bay side of the region. “We don’t close the hospitals or the CLSCs. We just make sure the services are still there, but sometimes it’s only when emergencies occur,” said Munick-Watkins.

Given the labour challenges, the government would be wise to invest in programs that train health professionals from the Inuit population, said Christopher Fletcher, a professor in the department of social and preventive medicine at Université Laval.

Fletcher used to oversee the First Nations and Inuit students in medicine program and thinks the success it achieved in attracting Indigenous students could be replicated in other disciplines, particularly nursing.

Fletcher said research shows patients have better outcomes when the health-care provider and the patient share the same background and language.

• When their child’s doctor is 2,800 km away, Inuit families face tough choices

Equal pay for equal work could be a good starting point in attracting more Inuit into the health profession, said Munick-Watkins. Right now, Inuit employees in the Nunavik health network are paid less than employees recruited from the south. 

The working conditions are also unequal, as those from the south receive a housing allowance and other perks.

She said both health centres are unionized and have collective agreements. “We’re going to have to figure out how we’re going to iron this out in the coming weeks and months ahead,” she said.

ABOUT THE AUTHOR

Leah Hendry

Leah Hendry is a TV, radio and online journalist with CBC Montreal Investigates. Send tips to montrealinvestigates@cbc.ca.

• Follow Leah on Twitter

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Inuit life expectancy is 10 years shorter than the average Canadian, according to Statistics Canada.

Nunavut News – “Tackle lack of basic health care for Indigenous peoples, then worry about racism, Nunavut’s MP says”. Nunavut member of Parliament Mumilaaq Qaqqaq says the lack of medical care available in Nunavut currently is proof that the Government of Canada doesn’t care about Inuit. “The complaints I’m getting about health care are about access to health care more than about discrimination… (it’s) the shortage of resources in notable areas like mental health,” said Nunavut Conservative Senator Dennis Patterson. Nunavut Tunngavik Inc. (NTI) submitted a statement indicating that broader social conditions affect the health of Inuit in Nunavut, such as income, education, adequate housing, stress/trauma and food security.

NTI also expressed support for the Canadian Public Health Association’s recommendations:

• to adopt a formal statement condemning racism;
• undertake system-wide reviews of regulations, policies, processes and practices to identify and remove any racist systems and approaches;
• identify and remove racist laws, regulations, procedures and practices;
• provide mandatory, rigorous and system-wide anti-racism and anti-oppression training for all staff and volunteers within their organizations;
• enhance public health surveillance systems by collecting and analyzing race and ethnicity data in an appropriate and sensitive manner; and
• monitor organizations for stereotyping, discrimination, and racist actions and take corrective actions.

Release of the Virgo Final Report: “Improving Access and Coordination of Mental Health and Addiction Services: A Provincial Strategy for all Manitobans” specifically emphasizes the discovery made during the system review that for almost every service encountered, the largest percentage of people being served were of Indigenous background.

The report acknowledges the “history of colonization and historical trauma, and ongoing challenges with respect to social determinants of health. More importantly, we believe the overall system of services will not improve significantly in terms of access or coordination without a concerted and sustained effort to better meet the needs of the province’s Indigenous people.

Of the many issues brought forward unique to Indigenous people, two were particularly salient:

• the need for more culturally informed services, including land-based programs, and support for those community members whose customary language is their own native language and who have trouble understanding words and concepts expressed in English.
• Last, the “jurisdictional issue”— a fundamental challenge to be addressed going forward as it underlies significant issues related to access and coordination. This was one of the top priorities identified in the validation events.

Other specific issues identified previously with respect to the preceding Strategic Priorities, including,

• the need for more local, and more flexible, services, including longer term treatment and pre-and post-treatment supports;
• the need for better integration of SUA and MH (substance use/addiction and mental health problems and illnesses) services;
• the need to fill specific gaps for youth and women; and
• a critical need for Withdrawal Management Services (WMS), transitional stabilization to support access to treatment, housing, transportation and crisis services, including post-crisis healing opportunities.

https://www.gov.mb.ca/health/mha/docs/mha_strategic_plan.pdf

The Globe and Mail: In his past career as a civil-rights lawyer, David Eby would have been first in line to argue against involuntary treatment for mental health and addictions issues. But as British Columbia Premier, he is now pushing to expand the province’s capacity to compel it because the alternative, he argues, is worse.

“I don’t think it’s respectful of people’s human rights to let them die in the streets,” he told The Globe and Mail’s editorial board, adding that the focus on deaths from toxic drugs don’t even capture the scale of the problem. Last year, there were 2,272 suspected fatalities in B.C. from the crisis. “For every person that fatally overdoses, there are at least three people that are seriously brain-injured. And until you’re sufficiently brain-injured to the point of permanent long-term care, then people are being really spat out from the emergency room back into the community. So it’s cruel and it’s a miserable existence.”

But some of Mr. Eby’s strongest allies are reticent – even resistant – to embrace involuntary treatment as a solution. For critics, the past abuses of human rights and the horrific conditions of earlier so-called asylums remain front-of-mind. The B.C. Civil Liberties Association (BCCLA), where Mr. Eby previously served as executive director, is firmly opposed, while his new Minister of Mental Health and Addictions, Jennifer Whiteside, is tiptoeing around the subject.

Last year, almost 20,000 British Columbians were involuntarily hospitalized in B.C. under the Mental Health Act – a number that has been climbing. Some of them are discharged in as little as 48 hours. And there are not enough long-term options to actually treat complex mental health and addiction issues.

As the toxic drug crisis continues to defy efforts to reduce the death toll, Mr. Eby says the province needs to expand the availability of involuntary care and to update the Mental Health Act to provide clearer options for intervention.

But the contrast between Mr. Eby’s passionate rationale for expansion and the caution demonstrated by Ms. Whiteside has sowed confusion around the province’s intent.

Mr. Eby, in his mandate letter to Ms. Whiteside when he appointed her in December, directed her to identify the scale of the need for more involuntary care beds. It is a politically sensitive task, and the Minister of Mental Health and Addictions strongly emphasizes the need for consultation, particularly with Indigenous communities – who are dying at five times the rate of B.C.’s general population owing to suspected drug toxicity.

The NDP government has started down this road before: In 2020, Health Minister Adrian Dix tabled amendments to the Mental Health Act to allow for secure care of young people after an overdose. The bill was abandoned in the face of opposition.

Last summer, Mr. Eby raised the prospect of expanded involuntary care when he was running for the NDP leadership. His position was strengthened months later, when the province released a government-commissioned report on repeat offenders and random stranger attacks, which included recommendations for new kind of involuntary rehabilitation facility for those who present a risk of harm to others.

Mr. Eby’s proposal, however, was condemned by the BCCLA, which called it “misleading, immoral, and reckless.” Pivot Legal Society, where he once worked as a lawyer representing marginalized residents of the Downtown Eastside, also criticized his plan as misguided and stigmatizing.

Under the provincial Mental Health Act, a person can be detained in a psychiatric facility if a physician deems it necessary for their health and safety, as well as the safety of others. The province has 1,984 beds within the health care system designated for involuntary care.

Mr. Eby said there is not enough capacity in the system to help treat people who are at risk from the toxic drug supply, and doctors who are responsible for making a decision about involuntary care don’t have clear direction on what they can do: “The emergency room docs are struggling about whether or not they have the authority to intervene at that point.”

The Premier singled out the Red Fish Healing Centre for Mental Health & Addiction as his preferred model for expansion: “There’s general agreement that we need two or three more just to respond to the need.” The facility, located in Coquitlam, includes a care unit with 15 beds for involuntary patients with concurrent, complex mental illness and substance use issues along with a history of aggressive or other high risk behaviours. Patients are typically there for three months.

B.C.’s overdose crisis needs life-saving interventions more urgently than decriminalization

Grant Charles, a professor at the University of B.C.’s School of Social Work, said the province has poorly-connected supports and insufficient resources for mental health and addictions, especially for early intervention. That needs to be fixed for the long term, Dr. Charles said. And to deal with the present-day crisis, he says the routine 48-hour detentions are not enough.

“We can get stuck in this argument that people with addictions have free will and we should respect their human rights, but the nature of being addicted means we don’t have full free will,” he said. Dr. Charles welcomed Mr. Eby’s commitment to move forward on this file: “It’s potentially a sea change, and it’s more significant coming from a human-rights lawyer.”

The BC Liberal Opposition has produced its own mental health and addictions plan that offered up Red Fish as the path forward, and promised to expand free and accessible treatment and recovery options including involuntary care “where necessary.”

During a debate in the legislature Tuesday, Liberal Leader Kevin Falcon said he isn’t sure if the government agrees or not. He asked Ms. Whiteside if she supports expansion, but her response was evasive. “We will continue to work with physicians, work with our health authorities with respect to the tools that they currently have under the Mental Health Act when it comes to circumstances under which an individual may need to be involuntarily admitted,” she replied.

In an interview, Ms. Whiteside stressed that involuntary care “is a significant tool to withdraw someone’s liberty” and she is focused on voluntary care options. She is prepared to listen to front-line physicians if they think the Mental Health Act is a barrier, but she believes the problems can be remedied without reopening the legislation.

“What we hear from front-line providers is that they need the places in order to be able to have somebody in detox, withdrawal management, and then on to treatment. So that’s where we’re focusing our efforts,” Ms. Whiteside said. For her, amendments are an “if,” not a “when.”

Justine Hunter: Follow Justine Hunter on Twitter: @justine_hunter

Community Food Centres (CFC) – Release of “Beyond Hunger – The Hidden Impacts of Food Insecurity in Canada”. Even before COVID-19, food insecurity affected nearly 4.5 million Canadians. In the first two months of the pandemic, that number grew by 39 per cent. Food insecurity now affects one in seven people, disproportionately impacting low-income and Black, Indigenous and People of Colour (BIPOC) communities. “Beyond Hunger illustrates that food insecurity is about equity and income,” says Saul. “We urgently need a national solution that goes beyond emergency food assistance. We need a solution founded in solid policy that addresses inadequate social programs, systemic racism and precarious employment.”

Why Food Insecurity happens in Canada:

• People are stuck in low wage and precarious jobs
• Canadians are struggling with a rising cost of living
• Colonialism and systemic racism
• Low social assistance rates trap people in poverty
• More and more people are living alone
• Food in the North is unaffordable

Findings:

• 81% say it takes a toll on their physical health
• 79% say it impacts their mental health
• 57% say it is harder to find and keep a good job
• 53% say it is a barrier to finding meaning in life
• 58% say it limits their ability to take part in social activities
• 46% say it limits their ability to celebrate their culture

We believe government policy is necessary to address the real cause of food insecurity. Policy is what will increase incomes and make life more affordable — for everyone. Here are four policy changes for the federal government to act on:

1. Invest in income supports for low income Canadians
   • Increase income benefits for single adults who suffer disproportionately from food insecurity by:
     • Ensuring low-wage workers have equal access to Employment Insurance
     • Improving existing tax benefits so they provide more income by making them refundable
     • Creating a tax credit specifically for working-age adults
   • Ensure low-income Canadians, especially First Nations living on reserve, have better access to tax filing supports and benefit services
2. Make life more affordable for Canadians
   • Speed up the implementation of the Canada Housing Benefit, which supports people who can’t afford their housing
   • Increase federal funding for early learning and child care
   • Move forward with a universal public pharmacare program
3. Set targets and improve reporting on food security
   • Set targets to reduce food insecurity
   • Ensure Statistics Canada reports on food insecurity annually and collects better race-based data
4. Ensure progress on food insecurity is achieved equitably
   • In partnership with Northern leadership, continue to reform Nutrition North Canada
   • In partnership with Indigenous leadership, create an Indigenous food sovereignty fund
   • In partnership with Black communities, create a fund to decrease food insecurity for Black Canadians
   • Apply a racial equity lens to all poverty and food-security policies

https://cfccanada.ca/getmedia/57f5f963-af88-4a86-bda9-b98c21910b28/FINAL-BH-PDF-EN.aspx?_ga=2.197064812.159489303.1604624936-1692352870.1604624936

ITK president worried about meeting 2030 goal to eliminate TB in Inuit Nunangat

CBC News: The Indigenous services minister says the Liberal government made a mistake in the federal budget by appearing to back away from its promise to eradicate tuberculosis in Inuit communities.

In the document released last week, the government announced $16.2 million over three years for “interventions to reduce rates of tuberculosis” — a departure in language from its commitment to eliminate the infectious disease from the four regions that make up the Inuit homeland, known as Inuit Nunangat, within seven years.

Patty Hajdu told CBC News the word “reduce” was an error. “The goal from our perspective has always been to eliminate tuberculosis,” the minister said. “I regret that the reduction is phrased in that way in the budget and I think it was quite honestly an error of (the Department of Finance).”

• Budget 2023 continues ‘repetitive injustice’ of underfunding First Nations, says national chief
• Indigenous groups hope for infrastructure dollars and economic development in budget

Natan Obed, president of the Inuit Tapiriit Kanatami (ITK), welcomed the admission but said he’s still concerned about Ottawa keeping its promise to Inuit. I’m really disheartened by the terminology,” Obed said. “We are worried about Canada’s commitment.”

$16.2M falls well short of $131.6M request

In 2018, the Liberals pledged to cut the rate of tuberculosis in Inuit Nunangat by at least half by 2025, and then to eradicate it completely by 2030. The rate of tuberculosis among Inuit living in Inuit Nunangat remains 300 times the national average, Obed said, adding government funding is lacking.

The government initially set aside $27.5 million to eliminate tuberculosis. The additional $16.2 million announced in the budget amounts to roughly a quarter of the $131.6 million that the ITK requested to get the job done. “It is not a terribly complicated illness and there are not terribly complicated solutions toward eliminating tuberculosis,” Obed said.

“But we certainly aren’t going to do those things with less money than we did in the first five years that the government has worked with us on the elimination pledge.”

Hajdu said she believes that objective is still within reach.

She promised to work with the ITK and other Inuit organizations to meet the target, and to address the issue in renewed bilateral health-care deals with the provinces and territories. “If everyone really puts their mind to it, with the number of different kinds of pots of money that will address the needs of people living with tuberculosis or at risk of contracting tuberculosis, we could eliminate tuberculosis by that deadline,” she said. 

Hajdu also said the budget is designed to address the social determinants of health that continue to fuel tuberculosis in Inuit communities, such as food security, housing and health care.

Obed said he also believes eliminating tuberculosis from the district by 2030 is possible, but only if the federal, provincial and territorial governments step up their funding.

He said Inuit-designed regional action plans that cover community screening, housing, health infrastructure and reducing the stigma associated with tuberculosis need to be implemented.  “It would be really unfortunate if the only time in Canada’s history that the Canadian government has pledged to do something with us to lower our rates of socioeconomic gaps, that it decides that it no longer wants to walk this path together before the timelines are even up,” he said.

ABOUT THE AUTHOR

Olivia Stefanovich, Senior reporter

Olivia Stefanovich is a senior reporter for CBC’s Parliamentary Bureau based in Ottawa. She previously worked in Toronto, Saskatchewan and northern Ontario. Connect with her on Twitter at @CBCOlivia. Story tips welcome: olivia.stefanovich@cbc.ca. 

The goal to eliminate TB by 2030 can happen if lessons learned from COVID are implemented. This includes investing in health and telemedicine.

Policy Options: by Elizabeth Rea,  Tina Campbell,  Petra Heitkamp

Because of the pandemic, tuberculosis deaths globally have increased for the first time in over a decade. Concerning considering that before COVID, TB was the leading infectious-disease killer in the world.

In Canada we also see disruptions in services, damaging our progress toward TB elimination as part of the United Nations sustainable development goals (SDGs). Overall rates of TB are low in Canada, but the federal government has committed to ending TB by 2030 with a focus on Inuit Nunangat. This goal was reaffirmed on World TB Day 2021 by the national Inuit organization Inuit Tapiriit Kanatami (ITK) and the Canadian government. Relevant milestones in these efforts include ITK’s launch of an Inuit-specific TB elimination strategy and the establishment of a task force in 2017.

The federal government aims to achieve TB elimination by addressing social determinants of health. The subnational governments are responsible for TB clinical, laboratory and preventive services, and public health programs including contact follow-up, epidemiology and outcome monitoring. But cross-national (federal-provincial-territorial) co-ordination, data and surveillance are critical for success.

Apologies and promises are not enough to end TB in the North

What Canada needs to do to end TB

Pharmaceutical policy excludes the most vulnerable

As research shows, the impact of COVID-19 has included staff diversions to deal with the pandemic and a de-prioritization of essential public-health activities such as contact-tracing and TB preventive treatment. Alarmingly, findings also indicate delays in diagnoses, which have resulted in more severe illness.

The ripple effects may prove further damaging as the disease spreads to family and community members. Recent outbreaks in Nunavut and Saskatchewan show that Canada is not immune to the devastating long-term implications of the pandemic on health care.

A survey by Stop TB Canada provides additional details of the negative effects of the pandemic on TB services. Provinces and territories are struggling with burned-out health-care workers.  One TB staff member said: “75 per cent of our workforce [was] diverted to [the] COVID-19 response team and they continue to remain there.”

Yet, the pandemic has brought health-system improvements and innovations that are  opportunities. These include initiatives like telemedicine, new investments in laboratory systems, substantial medical research and development, and broad access to paid sick leave.

The pandemic has shown that investments in public health are essential to the well-being of our society. We need to build on the innovations in response to COVID-19 to “build back better” and refuel our TB response in Canada. The TB workforce and services are the backbone for any future respiratory pandemic.

Stop TB Canada has five specific calls for action to eliminate TB in Canada:

Convene a national TB elimination taskforce: It is not enough for the federal government alone to make commitments on TB. Given the recent outbreaks in Saskatchewan and Nunavut, the provincial governments must increase the response and support to communities in need. Health-care and public-health teams need to be specifically made available to provide services for TB and freed up from other duties.

Health services need to be provided with adequate funding and diagnostic and treatment supplies to deal with the outbreaks. Preventive measures need to be improved. A national parliamentary inquiry by the Health Committee would be a good method to review progress on TB elimination toward the SDGs. It could also note systemic solutions for a more equitable health system. At the same time, discussions in parliament and cabinet related to pandemic preparedness, such as Bill C-293, need to build on TB lessons and infrastructure.

Step up the TB response in First nations and Inuit communities: Canada has committed to a 50 per cent reduction in TB across Inuit Nunangat (the Inuit homeland) by 2025 and to eliminating TB by 2030. Delivering on these promises is an essential component to our nation’s commitment to reconciliation. Action is needed. A concrete example is to ensure that the diagnostic platforms (GeneXpert), for COVID testing, remain there with TB test cartridges. This avoids the diagnostic delay from transporting specimens hundreds of kilometers to southern laboratories.

“TB testing capacity needs to be a priority, especially in high incidence locations. Despite the devastating effects of our current TB outbreak, there is no capacity for utilization of Gene-Xpert for TB testing while people are being tested multiple times for COVID. Opportunities to diagnose Active TB are missed,” says Tina Campbell, a nurse in Saskatchewan and co-chair of Stop TB Canada.

Invest in TB vaccines and product development in Canada: New TB drugsand vaccines are badly needed. Massive research investments led to multiple highly effective COVID vaccines coming to market within a year. Yet, there is only one TB vaccine – the century-old and ineffective Bacille Calmette-Guérin vaccine. The pandemic has highlighted Canada’s dependence on importation of vaccines. Let’s build on our domestic expertise in medical sciences to step up vaccine capacity and TB research specifically, and meet Canada’s “fair share” expenditure on TB research.

Urgently improve TB data and surveillance systems: COVID highlighted the need for strong surveillance, integrated digital health information systems, and rapid information sharing. These are essential for analyzing trends quickly and tailoring interventions for specific areas and populations. Nearly 100 countries now report monthly to quarterly TB case notifications, and developing countries are moving to digital real-time TB surveillance. In contrast, Canada’s most recent national TB data is from four years ago with only a single infographic update for 2020.

Address health inequity: Canada’s chief public health officer Theresa Tam stated: “The COVID-19 pandemic has heightened awareness about the health and social inequities that exist in Canada, and the need to address the social determinants of health that lead to health disparities.” Crowded housing, poverty, inadequate access to health care, stigma and other social inequities are central to ending TB (and many other illnesses).

Canada must implement a comprehensive multi-sectoral TB strategy, including the needs of both Indigenous Peoples and newcomer Canadians originally from high-TB-incidence areas. TB response and systems are a pathfinder for addressing underlying issues of inequity and social determinants.

Canada is only TB free when the world is TB free. Neither COVID nor TB stop at national borders. In light of COVID-19-related disruptions in TB programs globally, Canada needs to invest $1.2 billion, its fair share, in the Global Fundto fight AIDS, TB and malaria. These resources would help to rapidly recover health and TB programs and prevent further increased disease burden and death.

We are starting to think about “living with COVID-19” – but we don’t have to “live with TB.” The pandemic is an inspiration to step up our fight to truly eliminate TB in Canada and around the world. Investing in health systems contributes directly to pandemic preparedness. The health workforce, testing and treatment infrastructure and preventive methods have all proven to be of significant use for the pandemic and also provide the foundation for the future. Canada has an opportunity now to build equitable health systems that serve the most vulnerable populations, eliminate TB and strengthen our preparedness all in one.

CTV News: Nunavut’s health minister says the COVID-19 pandemic disrupted efforts to eliminate tuberculosis in Inuit communities, and questions remain over whether targets to stamp out the disease can be met. “COVID has had a huge impact on every area of health care, and that includes TB,” said John Main. “While we were putting so much effort toward dealing with COVID, we did have to slow the pace of work on other areas.”

Five years ago, Ottawa and Inuit Tapiriit Kanatami, a national advocacy group, announced plans to reduce active tuberculosis across Inuit Nunangat by at least half to no more than 100 cases per 100,000 people by 2025, and eliminate it entirely by 2030. Inuit Nunangat, or Inuit homeland in Canada, is made up of more than 50 communities in Nunavut, the Northwest Territories, Quebec and Labrador.

Public Health Agency of Canada data indicates reported rates of active tuberculosis dropped significantly among Inuit between 2019 and 2020 from 188.7 cases per 100,000 to 72.2. Health officials in Inuit Nunangat, however, say that’s partly due to reduced screening. Indigenous Services Canada says the rate of tuberculosis among Inuit increased to 135.1 in 2021.

Main said Nunavut is now “getting things back on track.” The territory signed a tuberculosis information sharing agreement with Nunavut Tunngavik Inc., a group representing Nunavut Inuit, in November. Main said they are also working to finalize a three-year plan to guide elimination efforts.

“It’s been made clear to me the amount of hardship and stigma that can be associated with TB, as well as the elements of historical trauma around tuberculosis,” he said. “That’s what we’re including as part of our work at every level, is this understanding of our role as health-care providers and that sometimes we need to listen and not just talk.”

Main added the territory is strengthening relationships with communities affected by the disease. In Pangnirtung, where an outbreak was declared in November 2021, staffing support has been provided alongside the Canadian Red Cross, epidemiological analysis, and improved education and awareness efforts.

Main said whether the 2025 and 2030 tuberculosis elimination targets will be met is “the big question.”

“At this point I can’t say, but it’s certainly not going to stop us from doing everything we can towards that goal,” he said. “I’m not going to say that I can look into a crystal ball and see what’s going to happen in the next two years, but I’m hopeful, cautiously optimistic I would say.”

The Nunavik Regional Board of Health and Social Services said community screenings have resumed in the region and it is working to better target services, including recruiting local public health officers. As of January, a vaccine that protects young children against complications and severe forms of tuberculosis has been available in all communities in Nunavik.

While the risk of developing tuberculosis in Canada is very low, rates are higher among Inuit.

Between 2015 and 2019, the reported rate of active tuberculosis among Inuit living in Inuit Nunangat was approximately 300 times that of Canadian-born, non-Indigenous people, says Indigenous Services Canada.

Health-care barriers, poverty, food insecurity and overcrowded housing with poor ventilation are among the contributors to the disproportionate rates. Main said challenges in Nunavut include a lack of health-care staff and infrastructure.

The latest federal budget has earmarked $16.2 million over three years to fight tuberculosis in Inuit communities. Inuit Tapiriit Kanatami said that’s roughly a quarter of what’s needed for the next phase of tuberculosis elimination. “This modest investment in Inuit health priorities does not fulfil our joint commitment with the Government of Canada to eliminate tuberculosis in Inuit Nunangat by 2030,” President Natan Obed said in a statement. “But we remain optimistic that future federal budget cycles will unlock the funding needed to honour this commitment.”

A study published in the scientific journal Infectious Disease Modelling in December 2022 evaluated tuberculosis elimination strategies in Nunavut. It suggested that under current plans, the 2025 reduction target is not achievable and eliminating tuberculosis will extend beyond 2030. The study identified challenges including prolonged delays to case detection, limited access to diagnostic tools and services, as well as inadequate capacity for contact-tracing and rapid start of treatment.

Indigenous Services Minister Patty Hajdu said the budget’s approach is “incremental but also substantial” and comes with other investments such as bilateral health transfer agreements with the provinces and territories. She said the targets are ambitious but realistic.

“They’re realistic in the sense that if everybody is determined to reach those targets then we can,” she said. “It is going to require everybody to be very focused.”

• Emily Blake, Staff, The Canadian Press, Contact

This report by The Canadian Press was first published April 16, 2023.

This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship.

RELATED STORIES

• Ottawa commits consultation money for Indigenous resource sharing in Budget 2023
• WHO: Tuberculosis cases rise for the first time in years
• Inhaled Canadian COVID-19 vaccine to enter Phase 2 human trials
• ‘We’re getting through this’: Nunavut hamlet fighting COVID-19 and TB at same time
• Indigenous people more likely to be hospitalized with influenza: study

Globe and Mail – A group of doctors is urging officials in Nunavut to offer an effective but costly drug to all Inuit babies living in remote communities in the territory to protect them against a respiratory virus that disproportionately leads to their hospitalization. But Nunavut’s chief medical officer disagrees, saying there isn’t enough evidence to support such an approach. Palivizumab, the only available prophylactic treatment for RSV, is currently given to infants in Canada who are considered at high risk of complications, such as those born prematurely or who have underlying heart or lung conditions. But it is not routinely administered in Nunavut to healthy Inuit infants who are born at full term.

For most people, symptoms of RSV infection are indistinguishable from the common cold, although an estimated 1 to 3 per cent of infants in developing countries experience complications requiring hospitalization. Inuit babies in Canada, however, have an exceptionally high rate of RSV complications. Among some Inuit communities on Baffin Island, as many as half to two-thirds of babies are hospitalized with lower respiratory lung infections, mostly owing to RSV, according to Anna Banerji, an expert on Indigenous and refugee health and associate professor of pediatrics at the University of Toronto who helped start the petition. Although it is not entirely understood why, experts believe Inuit infants are disproportionately affected because of a combination of genetic and environmental factors, including food insecurity and a lack of adequate housing arising from a history of forced settlement.

Girls found outside and St. Theresa Point Chief believes drugs a factor in their deaths

CBC News · Posted: Mar 05, 2023 9:17 AM EST | Last Updated: March 5

The family of one of the 14-year-old girls found dead outside after a frigid night on a northern Manitoba First Nation says she was struggling to cope with the loss of her mother, Ashlee Shingoose, who disappeared in Winnipeg nearly a year ago. 

Island Lake RCMP were called around 8 a.m. on Wednesday after the teens were found outside a home in St. Theresa Point First Nation. One of the girls found dead was Dayna Shingoose. “We didn’t know anything about it until that morning, when we heard that Dayna was frozen,” her grandfather Albert Shingoose told CBC.

Police previously said they believe the two girls were outside for a period of time on a night when the temperature dropped to –23 C. They were taken to the nursing station, where they were pronounced dead.

Albert said Dayna left their home around 8 p.m. the night before the two girls were found. The teen wanted to hang out with friends, he said. “Her grandmother told her it was too cold for her to go out, and we were trying to hold her back, but she didn’t want to stay home.”

Albert had just recently returned to the community after spending a month searching for Dayna’s mother Ashlee in Winnipeg. He said his granddaughter, who lived with him and her grandmother Theresa, had been taking it hard and was depressed over her mom’s disappearance.
“She was waiting, waiting for her mom. And I kept on telling her, I’ll try and find her, I’ll find your mom…'” he said.

• Winnipeg police offer renewed hope to father whose daughter has been missing nearly a year

“She was a good girl. She always tried to help people out all the time. She was always there for her friends.”

Dayna’s uncle, Darnell Harper, is a police constable for the First Nation. He told CBC that he was the one who found the girls on Wednesday morning. “When we got there, I already knew Dayna was deceased because she was frozen,” he said. “I kind of felt like I lost a daughter because I looked after her when she was born.”

Harper said even though Dayna was depressed with the loss of her mother, he tried to keep her away from trouble by telling her about the drugs he saw being trafficked into the community. “To me, it’s getting out of hand,” he said. “I would always show her the good way.”

Worsening influx of illegal drugs

The community of St. Theresa Point is being hit hard by her death as they await autopsy results.

St. Theresa Point First Nation Chief Elvin Flett said the other girl who was found with Dayna, Emily Mason, still had a pulse when they were discovered lying on the snow in between two houses. “They tried to revive her, but they were unsuccessful,” he told CBC.

Flett believes the girls took drugs before they froze. “They definitely did not die of hypothermia because there’s a couple of houses nearby,” he said. “How could anybody just lie down and sleep? … Something they ingested caused them to pass out.”

He used to hear about people on the First Nation using gasoline, mouthwash and hairspray to get high, but said crystal meth began wreaking havoc on his community when it started coming in about five to six years ago. “It’s gotten so big that we can’t handle it anymore, it’s become virtually a crisis,” said Flett. “This is what we face everyday.”

Uncontrolled drug trafficking

Underfunded policing and security programs by the province are hurting his community, he said. The Pallister government cut their funding by 50 per cent around 2016.

The First Nation cannot control the influx of illegal drugs coming into the community because the province has told them they are not allowed to search people arriving there after people complained. “The government is allowing drug trafficking to happen so easily, and we can’t do anything about it,” Flett said.

• First Nations in Manitoba lack adequate security measures, including police, chiefs say

The First Nation is working extensively to provide the girls’ families with the support they need, he said, but more funding is needed from the province for policing. “We need to have the provincial government work with us and provide us with finances to deal with these things.”

CBC has reached out to the province for comment.

‘It hurts’

Harper said his niece’s death has taken a toll on their family and he’s trying to be strong for them, including Dayna’s 11-year-old brother. “I’m there watching over them.”

Albert said Dayna’s brother is taking her death very hard, but the family is trying to comfort him through it. He expects Dayna’s autopsy to be completed next week. The families of both girls will hold services in Winnipeg before their bodies are taken back to St. Theresa Point, he said.

Albert and his wife Theresa will continue their search for Dayna’s mother in Winnipeg, but until then he said they are finding strength in family. “We talk together, we cry together, we laugh together as a family,” he said. “Sometimes it hurts and we cry. It’s a healing journey.”

With files from Stephanie Cram

RELATED STORIES

• Winnipeg police offer renewed hope to father whose daughter has been missing nearly a year
• First Nations in Manitoba lack adequate security measures, including police, chiefs say

NationTalk – There is no national fire protection code that mandates fire safety standards or enforcement on reserves. All other jurisdictions in Canada including provinces, territories, and other federal jurisdictions (such as military bases, airports, and seaports) have established building and fire codes. The Aboriginal Firefighters Association of Canada (AFAC), NIFSC’s parent organization, supports the development of a national First Nations Fire Protection Act and is willing to work with First Nations leadership as a technical resource.

In the absence of legislation act or regulations, AFAC and the NIFSC are addressing identified gaps to improve fire safety in Indigenous communities by supporting them in creating fire safety standards, doing fire protection and response research, and establishing fire safety bylaws and building standards. Indigenous Peoples across Canada are over 5 times more likely to die in a fire compared to the rest of the population. That number increases to over 10 times for First Nations people living on reserve. Inuit are over 17 times more likely to die in a fire than non-Indigenous people. Rates among Métis were higher than non-Indigenous estimates (2.1), but these rates were not significantly different.

Fire-related injuries resulting in hospitalization are also disproportionate to Indigenous Peoples. First Nations people are over 4 times more likely, Métis are over 1.5 times more likely, and Inuit are over 5 times more likely than non-Indigenous people to be hospitalized due to fire-related injuries.

What has led to this situation?

Many social determinants contribute to the higher fire-related mortality among Indigenous Peoples. These include poverty, inadequate housing conditions, housing without smoke alarms, and more.

Core capital funding provided by Indigenous Services Canada (ISC), which includes funding for fire protection, is flexible. This means community leadership can use designated fire protection funds if the community has more immediate or pressing needs (e.g., a school needing repairs or social housing maintenance). Without a fire protection mandate or regulatory maintenance of fire protection standards for Indigenous communities, fire services and fire and life safety can be deprioritized or forgotten.
https://nationtalk.ca/story/new-study-shows-that-indigenous-peoples-across-canada-are-between-5-and-17-times-more-likely-to-die-in-a-fire-compared-to-the-rest-of-the-population

How the NIFC Project will help Indigenous Communities

• Offer culturally sensitive and relevant fire and life safety training and education programs that are created for and delivered by Indigenous Peoples. These services are available to First Nations populations living on reserve, leadership, and individuals working or volunteering in emergency services.
• Launched close to 80 programs and services that provide training and ongoing support to more than 600 First Nations communities in Canada. Programs include:
  • education, support, and training in the areas of community fire safety, community governance support, community infrastructure and engineering support, fire department management, fire investigation services, and fire department operations.
  • Training, education programs and services being offered by the NIFSC Project have not previously been available to First Nations communities, whereas they have been available in most other communities in Canada
• improve fire-related mortality and morbidity amongst Indigenous Peoples is through more accurate data collection. The creation of the National Incident Reporting System (NIRS) will, over time, provide the data regarding fire incidents in Indigenous communities that has been missing.

Na-Cho Nyäk Dun council passed resolution after 2 homicides in Mayo last weekend

CBC News: An emergency declaration by the First Nation of Na-Cho Nyäk Dun in the wake of last weekend’s double homicide in Mayo, Yukon, is calling for a number of strict measures to try to quell the local drug trade — including highway check stops, evictions, and tight controls on who can be on settlement lands.

But some of things may not be enforceable by police, according to the RCMP.

The First Nation’s chief and council passed a resolution Tuesday, declaring a state of emergencyrelated to opioids in the community. It says the opioid emergency is “terrorizing” the public with “violence, crime, overdose and death,” and demands immediate action. “The Council must act now and work with the Yukon government, RCMP and Village of Mayo to address this opioid emergency, in a coordinated manner, before other [Na-Cho Nyäk Dun] citizens are lost to this emergency,” the resolution states.

It proposes an action plan that may include measures such as an increased police presence in the First Nation’s territory, and requirements for visitors to register before entering settlement land and for non-citizens to vacate the community between 8 p.m. and 7 a.m. It also proposes to evict tenants from First Nation housing units if they’re involved in illegal activity. 

The action plan could also involve check-stops on all roads into Mayo “to disrupt, interrupt and stop opioid distribution.” The action plan would be developed with the Yukon government, RCMP and the Village of Mayo, the resolution states.

RCMP Supt. Lindsay Ellis said Thursday police are “committed to continuing to discuss how this state of emergency may involve the RCMP,” but did not endorse any of the specific measures proposed. “I think it’s important to note that on the resolution it says that these measures ‘may include,'” Ellis said.

She said police can only act in ways that are compliant with Charter rights. “I will say that, you know, there’s a lot of case law around check stops,” she said. “If they were implemented in the manner that they are worded, [they] would likely be in breach of the Charter, and we would likely not be participating in that.”

Homicide investigation ongoing 

Police have not explicitly tied the weekend homicides in Mayo to the drug trade, though an RCMP news release on Monday about the investigation states police “are aware of the impact of the substance use emergency on the community of Mayo, as with other Yukon communities.”  

It also states police believed there was no immediate danger to the public related to the homicides. Nobody has been arrested in connection with the deaths. Ellis told CBC News on Thursday morning that an investigative team is still in Mayo and things are progressing “really well.”

She said police are still encouraging anyone with information about the two deceased men — Ben Symington, 35, and Michael Bennett, 22, of Whitehorse — or the shootings on Saturday to contact them.

• ‘It’s heartbreaking’: Mayo residents shaken up after double homicide

“We understand that it’s difficult in a small community, but we’re also really heartened because we’ve had a lot of co-operation from the citizens of Mayo, the citizens of the First Nation of Na-Cho Nyäk Dun, and we’re really hopeful that that we’ll be able to resolve this,” Ellis said. “My heart and our thoughts still go out to the families that are impacted by this and also the community.”

Premier suggests ‘more aggressive approach’ to substance use emergency

The First Nation’s emergency declaration and calls for an action plan also had MLAs talking in the Yukon Legislative Assembly on Wednesday.

Health and Social Services Minister Tracy-Anne McPhee called the action plan “critical” “It is critical that all partners come to the table. The Yukon government will be one of those partners,” McPhee said. Asked whether she supports all the proposed measures in the First Nation’s resolution, McPhee told reporters “that’s not for me to say.”

“This is a statement by, a declaration by, the Na-Cho Nyäk Dun. They absolutely need to say what it is that they think should be in the action plan. We will work together with them to support that however we can,” she said.

Premier Ranj Pillai also spoke in the legislature Wednesday, saying he’s spoken with Na-Cho Nyäk Dun Chief Simon Mervyn and Mayo Mayor Trevor Ellis. A meeting is scheduled with Yukon government officials, RCMP and local leaders on Monday morning, the premier said.

“We commend Na-Cho Nyäk Dun for taking the approach they’re taking, the leadership that they’re showing in their community,” Pillai said. He also pointed to his government’s plan to increase funding for the RCMP, included in this year’s territorial budget.  “I think we do have to take a very significant approach, maybe a more aggressive approach in all our communities. But Yukoners have to come together. This is not just one government that’s going to solve it,” Pillai said.

• ‘Our people are dying’: Mayo residents say Yukon gov’t efforts to address substance use fall short

Still, Opposition MLA Brad Cathers of the Yukon Party accused the government of showing a “real lack of action on prevention, treatment and enforcement,” despite declaration of a Yukon-wide substance use emergency more than a year ago. 

Cathers is pushing for more addictions treatment services in Mayo, as well as more RCMP resources. “We believe that simply declaring a substance use health emergency is not a substitute for action,” he said.

With files from Elyn Jones and Joseph Ho

The Narwhal – Human Rights Watch released “My fear is Losing Everything: Climate Crisis and First Nations’ Right to Food” in Canada. The report details how longer and more intense forest fire seasons, permafrost degradation, volatile weather patterns and increased levels of precipitation are all affecting wildlife habitat and, in turn, harvesting efforts. The report also outlines how there are more hunting and foraging risks due to warming temperatures. For instance, it’s harder — and sometimes impossible — to hunt caribou because the ice and permafrost they travel on isn’t stable enough for hunters.

“Climate change threatens to decimate these food systems, risking further serious consequences for livelihoods and health,” the report states. The report also found that climate change is driving up prices for less-nutritious, store-bought alternatives that need to be brought in from the south. This is in part due to the fact that roads constructed from snow and ice are becoming less reliable because of warmer winters, meaning food needs to be flown in, which is far more expensive. This compounds the risk of food poverty for First Nations people, the report states.

Canada gets a failing grade on mitigating the effects of climate change, according to the report. The country is among the top 10 emitters of greenhouse gas emissions in the world, with per capita emissions upward of four times higher than the global average, the report states, noting that between 1990 and 2017, emissions increased by roughly 19 per cent, mainly due to mining and oil and gas production. Canada is warming roughly twice as fast as the global average; in the North, it’s even worse, with temperatures rising three times as quick.

The report also found that climate change is driving up prices for less-nutritious, store-bought alternatives that need to be brought in from the south. This is in part due to the fact that roads constructed from snow and ice are becoming less reliable because of warmer winters, meaning food needs to be flown in, which is far more expensive. This compounds the risk of food poverty for First Nations people, the report states.

Canada gets a failing grade on mitigating the effects of climate change, according to the report. The country is among the top 10 emitters of greenhouse gas emissions in the world, with per capita emissions upward of four times higher than the global average, the report states, noting that between 1990 and 2017, emissions increased by roughly 19 per cent, mainly due to mining and oil and gas production. Canada is warming roughly twice as fast as the global average; in the North, it’s even worse, with temperatures rising three times as quick.

Human Rights Watch lays out several recommendations for the federal government, including that:

• Canada deem the right to food a basic human right
• strengthen its climate change policies to reduce emissions
• improve climate adaptation measures in First Nations and
• support a transition toward renewable energy, including for First Nations, in the COVID-19 stimulus package

https://thenarwhal.ca/climate-change-indigenous-food-insecurity-report/

Private ambulance service is still seeking its licence after 2021 incident

CBC News: A private ambulance service in Cross Lake, Man., hasn’t been operating for two years now, with frustrations mounting from operators and community members who want to see things back up and running. “You know, it’s a matter of life and death for some of our citizens,” said Chief David Monias of Pimicikamâk Cree Nation.

The Michelle Memorial Ambulance Service, which covers Pimicikamâk, approximately 500 kilometres north of Winnipeg, had its licence revoked after an ambulance driver was caught driving under the influence in 2021. Since then, operators, like service co-ordinator Ron Hayes, have been doing what they can to regain their licence to assist the community.

The biggest hurdles to overcome, according to Hayes, are the inspections that are conducted by a licensing branch out of Winnipeg. “The first inspection came up with some issues, that’s fine, we fixed those up,” he said. “They sent another guy up, he came up and did the next inspection.” “After all the calculations, the next inspection, they had a whole huge big list of other things like that wasn’t even on the first list.”

Hayes said items on the list included replacing expired medications, needing a smaller sharps container (where sharp objects are placed after use), fixing or removing a broken camera in the building, and adjusting a bolt on the passenger seat in the back of the ambulance, among other things. “We were so ticked off again, because they’re just making it worse and worse,” Hayes said. “My boss in Cross Lake, he’s taking the ambulance and getting it safetied and getting stuff done to it.”

Ambulance maintenance and purchasing new medications are dealt with in Thompson, Man., which is about 125 kilometres north of Cross Lake

Trying to help 

Hayes said many people in the community have been reaching out to the ambulance for assistance due to the provincial service being too busy. “We had someone call,” he said. “I guess it was last year sometime, I forget the date, they called asking for an emergency ambulance. “The transportation guy phoned the other ambulance service and they were busy, they couldn’t go, so he went there and took him in and that young person died.”

In a community of around 8,500, Monias said he doesn’t understand why more isn’t being done by the province to bring back the service

“It’s a vital service that’s required,” he said.  “I don’t think that that will be acceptable anywhere else. I don’t know why they’re not pushing forward to get our ambulance licensed.”

New community health centre

A new hospital is set to open in the Cross Lake community come May or June, according to Monias, which has him concerned about what future holds. “What I’m scared of is that, you know, we will have a state-of-the-art centre,” he said. “And how are we going to be able to respond to emergencies in an efficient manner, in a quicker manner?

“It’s really crucial that they license them so we can have our ambulance going.”

Hayes echoed these frustrations, saying he’s been working and receiving for 20 years and has never had a problem with the licence until now. “I just feel like the level of professionalism has dropped,” he said, referring to the province’s licensing and compliance branch. “I mean that that’s how I see it.”

The province responded that the Michelle Memorial Ambulance Service must resolve the issues identified by the inspectors to regain its licence. “Those conditions have not yet been met,” said the spokesperson. “At this time Cross Lake is being served by Cross Lake Fire and Ambulance Service.”

ABOUT THE AUTHOR

Ethan Butterfield, Reporter

Ethan Butterfield is a reporter based in Thompson, Man. Following previous reporting positions in Saskatchewan and the Northwest Territories, Ethan works to cover Manitoba’s northern sector and engage with its various communities. Ethan has also been a part of various documentaries that have found success on the festival circuit. He can be reached at ethan.butterfield@cbc.ca

Improving health outcomes for Indigenous people at risk of substance-related harms and overdose across Canada

Health Canada: The ongoing effects of colonialism and institutional racism are closely linked to the disproportionate harms that the overdose crisis and increasingly toxic drug supply have had on Indigenous Peoples. The Government of Canada is committed to addressing these harms and connecting all Indigenous communities with the targeted, trauma informed, and culturally safe mental health and substance use supports they need.

Today, the Honourable Carolyn Bennett, Minister of Mental Health and Addictions and Associate Minister of Health, announced nearly $10 million in federal funding for 16 projects across Canada through Health Canada’s Substance Use and Addictions Program (SUAP).

The funding announced today will directly support people in Indigenous communities and allow innovative community-led projects to serve the many communities and people who need them. That said, more needs to be done to help Indigenous individuals, families and communities across the country access life-saving substance use services and supports.

We will continue to work in partnership with Indigenous leadership, all levels of government, partners, stakeholders, people with lived and living experience of addiction, and organizations in communities across the country to save lives and improve health outcomes for First Nations, Inuit and Métis.

Quotes

“Indigenous Peoples carry a disproportionate burden of the harms related to the overdose and toxic illegal drug crisis. This crisis has only intensified due to the pandemic, making it imperative that we act now. Today’s funding will make a significant difference in helping First Nations, Inuit and Métis communities struggling with substance use connect with the culturally sensitive and trauma informed substance use and mental health supports they need.”

The Honourable Carolyn Bennett
Minister of Mental Health and Addictions and Associate Minister of Health

“First Nations, Inuit and Métis peoples continue to experience significant impacts to their physical, mental, emotional and spiritual health due to historical and ongoing processes of colonization. The funding from Health Canada’s Substance Use and Addictions Program  makes it possible for Native Child and Family Services of Toronto to provide critical and culturally grounded health care services across the City of Toronto. Community members accessing these services continue to be disproportionately impacted by the ongoing impacts of the COVID-19 pandemic, including the escalating opioid crisis. Harm reduction is health care, and we are grateful to Health Canada for supporting us in delivering these important services in ways that are reflective of and co-developed with the community we serve.”

Jeffrey Schiffer, PhD
Executive Director, Native Child and Family Services of Toronto

Quick facts

• The Government of Canada has made significant recent investments to improve mental wellness in Indigenous communities, with an approximate investment of $645 million in 2021-22. These investments are made to meet the immediate mental wellness needs of communities by supporting Indigenous-led suicide prevention, life promotion and crisis response, including through crisis line intervention services, and enhancing the delivery of culturally-appropriate substance use treatment and prevention services in Indigenous communities.
• In addition, since 2017, through SUAP, the Government of Canada has supported over 300 projects across the country to respond to substance use issues. This includes 40 current projects led by or for Indigenous communities.
•  The initiatives announced today stretch across the continuum of care (prevention, harm reduction, treatment), and vary from community-based service delivery projects like drug checking to treatment, recovery and education projects.
• Budget 2022 announced $100 million over three years to support harm reduction, treatment, and prevention at the community level.
•  This builds on the $116 million provided in Budget 2021 and $66 million in the 2020 Fall Economic Statement for the Substance Use and Addictions Program.

Toronto Star – After more than 50 years of failed negotiations, the federal government committed $90M for a care home that will treat those poisoned by mercury. The deal includes:

• $68.9M in a trust for operational and servicing costs over 30 years and an agreement to periodically review the funding levels.
• $19.5M previously announced for construction costs for the facility.
• The new care home, once completed, is expected to offer palliative care, physiotherapy, counselling, traditional healing and have both in- and outpatient services. It will be able to treat 22 in-patients.

Over the past three years, the Star and scientists have revealed that fish near Grassy Narrows remain the most contaminated in the province; that there are mercury-contaminated soil and river sediments at or near the site of the old mill; and that the provincial government knew in the 1990s that mercury was visible in soil under that site and never told anyone in Grassy Narrows or nearby Wabaseemoong (Whitedog) Independent Nations. Scientists strongly suspect that old mercury still contaminates the mill site and pollutes the river.

Grassy Narrows First Nations has been fighting all levels of government for over 50 years since the paper Mill in Dryden dumped over 10 tons of toxic mercury into the Wabigoon River upstream of Grassy Narrows in northern Ontario.

Toronto Star – Ontario’s former environment minister called for a clean-up of mercury contaminating Grassy Narrows First Nation, historical cabinet memos obtained by the Star show. But nothing was done by the government of the day to clean up the polluted river and lakes, and more than 30 years later the fish that feed the community are still contaminated. The March 30, 1984, recommendation to cabinet from then-Environment Minister Andrew Brandt said the government should endorse a $2-3 million remediation plan to “cover the mercury sediments” in the nearby Clay Lake on the English-Wabigoon River, but hold off on the more disruptive and costly option of dredging the river system pending further study.

What had prompted the former environment minister’s advice was a scientific report by the 1983 Canada-Ontario Steering Committee on the English-Wabigoon River System. The report said the mercury had contaminated sediments in the surrounding rivers and lakes and that the fish would be contaminated for generations if the mercury wasn’t cleaned up. (Today, one meal of Walleye from Clay Lake contains up to 150 times the safe dose of mercury recommended by the U.S. Environmental Protection Agency.) The committee recommended, among other things, to place clean sediment in the water so that it settles on the bottom of Clay Lake to stabilize the mercury-contaminated sediment — a method called resuspension — as well as some dredging of the river. A small pilot project done for the 1983 report tested the method of resuspension in Clay Lake and found it reduced mercury levels in fish “by ten times.” The provincial government should not appear reluctant to take action on the report’s recommendations,” wrote a senior environment ministry staffer in a briefing note circulated within the department in the spring of 1984”. 37 years ago and the Indigenous people of Grassy Narrows First Nation and Wabaseemoong First Nation are still waiting – and dying!”

First Nations people die from illicit drug toxicity at 5 times the rate of B.C.’s general population

CBC News: As of last week Avis O’Brien (N’alaga) marked 16 years in recovery from addiction.  “I was on the Downtown Eastside [of Vancouver] as an Indigenous youth,” said O’Brien, who is Haida and Kwakwaka’wakw. “I was homeless; I was surviving my heroin addiction through sex trade work.” 

What she credits for saving her life is reconnecting with her culture. 

“I didn’t know physiologically or somatically what was happening when I was engaging in those practices but they felt really good and it was providing me with the kind of relief that I needed to stay on my path,” she said. 

Her business, N’alaga Consulting in Courtenay, B.C. on Vancouver Island, creates addictions programming for treatment centres rooted in Indigenous knowledge and healing. Her programs fill a gap she felt was missing when she was starting recovery. 

“There was no access to elders, there was no cultural teachings, no land-based healing. It just did not exist,” O’Brien said.

Statistics from the B.C. Coroners Service released on Jan. 31 show confirmed or suspected illicit drug toxicity claimed the lives of at least 2,272 people in the province last year.  The report said in November and December about 6.4 people a day died from illicit drug toxicity. 

• VIDEOFirst Nations women overrepresented among B.C. toxic drug deaths: doctor
• First Nation in B.C. declares state of emergency over ‘unrelenting’ impact of drugs and alcohol

B.C.’s First Nations Health Authority reports First Nations people were dying from illicit drug toxicity at five times the rate of B.C.’s general population. For First Nations women specifically, compared with non-Indigenous women in the province in the first half of 2022, the rate was 8.8 times higher.

O’Brien’s programs are based on the work of people like Michael Yellow Bird and Riel Dupuis-Rossi, who studied the science behind the impacts of colonization on Indigenous people and how cultural connection can heal. O’Brien’s dream for Canada? As many addiction treatment centres as there are churches. 

“We need land-based, culturally rooted, trauma-informed from Indigenous social justice lens treatment centres,” she said.

Dream of a new treatment centre 

Cory Cliffe, from the Wei Wai Kum First Nation in Campbell River, B.C., has a vision to create an addictions treatment centre serving 20 to 40 people offering culturally influenced care, something that played a big part of his journey recovering from addiction.  “Culture is medicine,” said Cliffe.

“I can’t stress that enough.” 

Two years ago he co-founded 7 Generations Stewards Society, a First Nations non-profit offering services including cultural workshops, employment and skills training, mental health and wellness and addictions programming.

Cliffe said a treatment centre serving North Vancouver Island would help centralize services 7 Generations offers. “The idea is to create something where everybody feels at home and like their culture has had an influence on it,” said Cliffe. 

The First Nations Health Authority website lists 10 treatment centres in B.C. for those seeking addiction services. 

Tsow-Tun Le Lum Society in Snaw-Naw-As First Nation on Vancouver Island offers substance misuse and trauma programming.   “It’s always been hugely important that the foundation of what we do is based in culture,” said Nola Jeffrey, executive director of Tsow-Tun Le Lum, who is Tsimshian and Coast Salish from Lax Kw’alaams. 

Jeffrey said their wait list varies between three and six months for one of the 20 beds available — even after creating a second substance misuse program eight years ago, when wait times stretched over one year. 

A new centre is being built further south in Duncan, B.C., with space for 32 people and includes more space for residents in the dining room, an area for group work, an exercise and yoga studio and arts and crafts rooms. The build, though, was impacted by inflation; what was a $12.5 million project before COVID-19 now costs $19 million. Tsow-Tun Le Lum has $16.5 million for the project and Jeffrey said the remainder will come through grants and donations.

The centre is funded by the First Nations Health Authority, Correctional Services Canada — which pays for clients from federal institutions — and grants from banks and private donations. 

Jeffrey said the centre is funded to serve 32 people, even though the demand is much higher. But keeping the centre small is important, he said, for Tsow-Tun Le Lum to feel welcoming and not like an institution.   “People really can’t do their healing work unless they feel safe,” Jeffrey said.  “What we do is we bring them in and we surround them with that safety and that love.”

Long waits pose challenges 

Dr. Nel Wieman is the acting chief medical officer at the First Nations Health Authority and is Anishinaabe from Little Grand Rapids First Nation in Manitoba. Wieman said a major gap in these programs is capacity.

People are sometimes told to wait weeks or months when seeking treatment — too long, Wieman said, — and due to a toxic drug supply, many die waiting for help.  “In some ways that’s on us as a society, right?” Wieman said. “We haven’t made that space for people to seek and access service when they need it and when they want it.” 

But, Wieman said, there is no one solution for every community’s needs.

More treatment beds, outpatient treatment and a more widely available safe supply programs are things Wieman points to, but for certain, Wieman said, culturally informed care is wanted. 

“We hear all the time from B.C. First Nations people and communities, that they very much want to see culture and traditional healing as part of the services that are provided to them,” said Wieman. 

ABOUT THE AUTHOR

Jackie McKay, Reporter

Jackie McKay is a Métis journalist working for CBC Indigenous covering B.C. She was a reporter for CBC North for more more than five years spending the majority of her time in Nunavut. She has also worked in Whitehorse, Thunder Bay, and Yellowknife. Follow her on Twitter @mckayjacqueline. 

The First Nations Health Authority has unveiled a plan to curb the deadly toll.

Odette Auger TodayTheTyee.ca

Odette Auger (Sagamok Anishnawbek) is a freelance reporter whose work has appeared in APTN, IndigiNews, Watershed Sentinel and Asparagus Magazine. This reporting beat is made possible by the Local Journalism Initiative.

The Tyee: The B.C. First Nations Health Authority opened its gathering to present a grim report on toxic drug toxic deaths in 2022 with a song, a prayer of hope and unity for the families and friends affected by toxic drugs. 

The report found toxic drugs have been taken a disproportionate toll on First Nations members, who were almost five times as likely to die of drug poisoning in 2022 than non-Indigenous B.C. residents. Although representing only 3.3 per cent of the province’s population, Indigenous people represented 16.4 per cent of toxic drug poisoning deaths in 2021.

The numbers are also dire for women. In 2022, 36.5 per cent of the First Nations people who died were women, twice the rate for non-Indigenous people. “When I think about toxic drug deaths, I think about pain. I think about self-medication. I think about the causes of that pain. I think about systemic failure to look after those in pain,” said Grand Chief Doug Kelly (Stó:lō).

Dr. Kelsey Louie, (Tla’amin) the authority’s acting deputy chief medical officer, said First Nation individuals and communities have been “particularly, disproportionately impacted by the toxic drug supply — with a loss of life that is unacceptable.”  Louie said the authority’s approach begins with listening to communities and families who had lost loved ones to learn how to expand “our role in preventing toxic drug poisonings. And stop the harm being done today.”

Kelly said the crisis requires a broad response. “Our children are vulnerable. Parents, families, communities, teachers, schools, coaches, everyone that comes into contact with children have an opportunity to support them, grow them, develop them, heal them,” he said. Health authority CEO Richard Jock, (Mohawks of Akwesasne) said the COVID-19 response has dominated public health, and the authority knew mental health would be the next challenge.  “We certainly didn’t anticipate the level of effects from toxic drugs that we’re seeing today.”

The level and nature of drugs are changing, he said, and partnerships with First Nations communities and provincial and federal governments also need to change.  Jock said the toxic drug emergency is now the First Nations Health Authority’s top priority and it was “gearing up our response for deploying and redeploying resources, both human and financial, to meet these emerging and changing needs.”

Part of the work is tackling barriers and obstacles in the health system, said Jock, recognizing intergenerational trauma. “We need to acknowledge that the trauma is a key element and underlies much of the issues that we’re facing today, including toxic drugs.” 

Acting chief medical officer Dr. Nel Wieman (Little Grand Rapids First Nation) said action is needed on a public health emergency entering its eighth year. “It starts to feel more like the status quo, and we cannot accept this. We have to treat this for what it is — a public health emergency.” “First Nations communities across B.C. have lost too many loved ones to an increasingly toxic drug supply. And that loss of life is now more than 1,000 family members and friends,” Wieman said. “It gives me great sadness to report that in 2022, there were 373 deaths among First Nations people.” That is a 6.3-per-cent increase over 2021.

Wieman said the disproportionate impact on Indigenous people is linked to the history of trauma in people’s lives, along with intergenerational trauma.  And First Nations people report less access to mental health, wellness, and substance use treatment that is culturally safe and appropriate, she said. “Systemic racism toward First Nations is a barrier to health care.”

First Nations are also are more likely to face poverty and housing challenges, which are among the social determinants of health. “These are also predictors of substance use disorders,” Wieman said. Wieman said the health authority recognized the disproportionate on First Nations women. It has “pivoted our toxic drug crisis response to have a greater focus on First Nations women, and has dedicated a portion of our harm reduction outreach and engagement programs to support women, especially in urban areas.”

The speakers agreed on the need to build hope and address the causes of toxic drug deaths. Wieman said there’s a need to “change our understanding of the root causes of substance use and addiction, and work together to address the stigmas surrounding drug use and the people who use drugs.”

Katie Hughes, the health authority’s vice president for public health response, says “Our strategy is to build on First Nations people’s strengths and resilience, address root causes, and provide holistic healing and wellness supports to First Nations people regardless of where they live.”

Hughes also outlined new initiatives. The authority will meet people where they are in their wellness journeys, she said. Treatment centres will move to a healing and wellness approach, and will expand to regions that are underserved. The authority is investing in land-based healing initiatives and expanding healing pathways for those who have lost a loved one to this crisis. 

It’s also focused on “efforts and investment in additional areas, including securing new funds to enhance wraparound services directly in communities,” said Hughes. That includes First Nations-led overdose prevention and mobile harm reduction services and working with the province to provide detox and treatment beds specifically for First Nations people. 

“We’ve recently utilized one-time funding to partner with eight treatment centres across the province that provide withdrawal management and treatment services to support individuals at higher risk who require immediate access,” she said.

The health authority also wants to expand peer support networks. Grand Chief Kelly has a deep connection to the crisis. He lost his daughter during her healing journey of recovery and shared what he had learned.

BC Budget Focuses on Increasing Treatment Options in Drug Crisis

READ MORE 

“Conditional love doesn’t work,” he said. “Do not shame your child or your loved one. Do not judge. Simply be there. Simply be there. Walk with them,” he said.  Culture, language, spirituality can all guide loved ones to wellness, he said, but if supports and resources are offered conditionally, for example only if people attend abstinence models of treatment, they are not meeting needs. 

Kelly spoke of Indigenous housing organizations that kick out young women when they’re struggling. “We have to create shelter that’s going to have that approach of unconditional love,” he said. “Kicking ’em out puts them on the street, and that’s a direct path to self-destruction and death. So I’m hopeful that each and every one of you will raise the profile of these public issues, —housing, safe shelter.”

“We have to work together to improve services from all of the agencies that come into contact with children,” said Kelly, “To make sure that the health-care system is providing quality care each and every time they engage someone in pain, that they look after them in a good way.” 

Crystal meth addiction is rampant in community, support needed, leaders say

CBC: The chief of James Smith Cree Nation and other Indigenous leaders are calling on the provincial and federal governments to fund on-reserve addiction treatment centres following the horrific stabbing rampage on the Saskatchewan First Nation and neighbouring town of Weldon.

“We’ve got to protect our community, fight against drugs and alcohol,” James Smith Chief Wally Burns told reporters at a news conference Thursday.

Rob Head, chief of the Peter Chapman Band — one of three nations that make up James Smith Cree Nation — told CBC News some of his own family members are addicted to crystal meth and require facilities for long-term treatment.

“It’s something that requires between 30 days to 90 days of treatment just to be able to get yourself back to a normal way of thinking,” he said. “Other than that, you’re pretty much addicted. If you don’t go into treatment, it’s not something that you can just quit cold turkey.”

Substance use is more common in Indigenous communities because of colonization, the residential school system and intergenerational trauma, advocates and Indigenous leaders say.

Drug addiction, especially to crystal meth, is rampant in James Smith Cree Nation, according to Head.

• How the Stoney Nakoda Nation is marking Overdose Awareness Day
• Blood Tribe receives critical funding to expand addiction support program, policing

“I can’t believe how fast it creeped into our First Nations and it took control of all of our young people that have tried it,” he said. James Smith residents have also told CBC that the drug problem is out of control. “We’ve got to tackle it before it gets any bigger than it is now,” Head said. 

James Smith Cree Nation doesn’t have any facilities that can provide long-term support to people struggling with a crystal meth addiction, according to Head. 

The community has Sakwatamo Lodge, which is a 42-day residential treatment program. “We need like 30 days, 60 days, 90 days of detox just to get people back to normal and then they have to go into to therapy and treatment. And those kinds of things are not here in First Nations country,” Head said.

There are 10 treatment centres in Saskatchewan specifically for First Nations people, according to the Government of Canada website. 

• ‘We all have to come together,’ says James Smith Cree Nation chief after stabbing tragedy

Alleged assailant’s long drug history

One of the alleged assailants in a violent string of stabbings over the Labour Day Weekend had a long history of drug use, as documented in court records. Parole Board of Canada documents from February of this year reveal that Myles Sanderson, 32, struggled with drug and alcohol use in late childhood and started using cocaine at age 14.

RCMP say they don’t yet have a motive for the killings and may never get one, now that he’s dead. 

The attacks left 10 dead and 18 others injured. Those tallies don’t include Sanderson or his brother Damien, 31, who also died. Both were charged with first-degree murder. 

On Tuesday, Minister of Indigenous Services Patty Hajdu said on social media that the government is committed to “advancing the immediate, medium, and long-term goals and needs” identified by James Smith Cree Nation.

Everett Hindley, provincial minister of mental health and addictions, said on Wednesday that he had met with Indigenous leaders in multiple communities to discuss ways to tackle mental health and addictions challenges, and will work with Ottawa on the matter. 

The Matawa Education and Care Centre (MECC), – formerly, the ‘Matawa Learning Centre,’ yesterday released their report entitled ‘Matawa Education and Care Centre 5th Annual Report on the Seven Youth Inquest – Academic 2020-2021.’ For the first time—it included an alert regarding MECC’s potential inability to meet inquest recommendations 64, 71, 81, 83, 84, 85, 114 as a result of the lack of federal government commitment to funding the Jordan’s Principle and Choose Life programs past March 2022. The continuation of these programs has been advocated over the past number of months and more recently, in a joint Nishnawbe-Aski Nation (NAN), Keewaytinook Okimakanak (KO), Northern Nishnawbe Education Council (NNEC) letter to Indigenous Services Canada Minister Marc Miller on June 10, 2021.

Without this commitment, MECCC will lose the following programs and services for its students:

* Mental Health Staff and Services;
* Special Education Staff and Services;
* Outdoor Education Staff and Services;
* Elders Program;
* Cultural Program;
* Staff Professional Development;
* Student Education and Training;
* a partnership with St. Joseph’s Care Group which includes in-school access to a:
* Clinical Supervisor;
* Mental Health and Addiction Counsellors;
* Child and Youth Workers;
* Nurse Practitioner;
* Psychologist;
* Family Therapist and
* a Psychiatrist.

“It is incumbent upon Canada to provide funding via a stable and predictable mechanism that allows for long term strategic planning and discretionary decision making as stated in Inquest Recommendation #12,” said MECC Principal, Brad Battiston. “Stable reliable funding moving forward will provide adequate academic and mental wellness programming for our students.

‘We can feel the grief amongst the people, the hurt,’ says Chief Billy-Joe Tuccaro

CBC News: A First Nation in northern Alberta has declared a state of local emergency following a string of suicide and suicide attempts among community members.  The Mikisew Cree First Nation says immediate medical intervention is needed in Fort Chipewyan, Alta., to address a mounting mental health crisis among members.

Suicides and suicide attempts have been increasing in the remote community accessible only by plane, boat or ice road, about 280 kilometres north of Fort McMurray, the MCFN said in a statement Tuesday. 

Community leaders fear that if additional mental health resources don’t arrive soon, the trend will have a tragic ripple effect among members. “Leadership is also gravely concerned about the imminent potential of suicidal clusters, suicidal ideations, and suicidal planning among our youth,” the statement reads. “Our nation urgently needs mental health support in our community to address the immediate and short-term crisis and sustained funding for mental health and addictions in the long term, focusing on health promotion, prevention and reclaiming cultural identity.” 

The state of local emergency was declared Monday following a vote by the chief and council.

Raw: Mikisew Cree First Nation Chief Billy-Joe Tuccaro

WATCH | Chief Billy-Joe Tuccaro discusses the situation in Fort Chipewyan, Alta.

To view the above video, click on the following ink:

https://www.cbc.ca/news/canada/edmonton/mikisew-cree-first-nation-suicide-mental-health-emergency-1.6821877

In a video posted to social media, Chief Billy-Joe Tuccaro said the community has called on the federal and provincial governments, including Alberta Health Services and Indigenous Services Canada, to provide immediate support and long-term, sustainable funding for community mental health supports. 

Rick Wilson, Alberta’s minister of Indigenous relations, said he is “deeply concerned” by the situation. “One death to suicide is too many,” Wilson said in a statement. “I am committed to working with my government colleagues, including at the federal level, to understand what we can do to support Mikisew Cree First Nation and all Indigenous communities impacted by the loss of life due to suicide.”

CBC News has requested comment from the federal government. Alberta Health Services declined to comment. 

The community is also calling for a mental health crisis response team to be immediately dispatched to the community, Tuccaro said.  He did not provide an exact number but said multiple suicides have been reported.  He said outside support is needed to end a pattern of self-destructive behaviour in the community. “We can feel the grief amongst the people, the hurt,” he said.

“As the chief of the Mikisew Cree First Nation, I too get these calls about our membership wanting to hurt themselves. It’s something that I take near and dear to my heart.

Tuccaro said the band and council can no longer turn a blind eye to the crisis unfolding in the community. “Today, there is no more words,” he said. “Today is a day of action. We can not stand by anymore and pretend that this is not a real issue.”

In the video, Tuccaro urged anyone who is struggling to get help. He also shared a warning, urging parents to monitor their children’s social media activity. Some sites are promoting risky behaviour among teenagers in the community, he said.  “Please, speak to your children,” he said. 

Co-ordinating response

Allan Adam, chief of the Athabasca Chipewyan First Nation, said  ACFN plans to issue its own declaration and support a coordinated response to the suicide crisis in a community that also home for many ACFN members.

He said the two bands should work together to help “get a grip” on the crisis.  “It’s affecting our young people our most,” Adam said in an interview from Fort Chipewyan Tuesday. “That’s a big problem here in the community. “But they’re not the only ones. It’s people in general that are having all these issues.” Adam said the community is in the throes of a mental health crisis, exasperated by addiction to opioids and other drugs. People in the community who are suffering from depression often turn to drugs, leading to social disorder within the remote hamlet. 

Mental health supports are important but the community must also focus on eliminating the drug trade, Adam said. “These drug dealers need to be dealt with,” Adam said. “Some of them are not from the community and they’re plaguing our community, disrupting everything.”

The Mikisew Cree First Nation takes a zero-tolerance approach to manufacturing, selling or possessing illegal drugs on the First Nation. 

• Not in Chip: Northern Alberta hamlet campaigning against drugs

In February, the band issued a bylaw authorizing Wood Buffalo RCMP to search homes on reserve lands or buildings owned by the First Nation in an attempt to eliminate the drug trade. The band warned that offenders could be banned from the reserve or properties owned by the nation. “It’s time we banded together and deal with the issue,” Adam said. “If not, this crisis is going to keep on going.” 

Suicide rates have consistently been shown to be higher among First Nations people, Métis and Inuit in Canada than the rate among non-Indigenous people. According to a 2019 report from Statistics Canada, the suicide rate among First Nations people in Canada was three times higher than the rate among non-Indigenous people. 

If you or someone you know is struggling, here’s where to get help:

• Talk Suicide Canada: 1-833-456-4566 (phone) | 45645 (text between 4 p.m. and midnight ET).
• Kids Help Phone: 1-800-668-6868 (phone), live chat counselling on the website.
• Canadian Association for Suicide Prevention: Find a 24-hour crisis centre.
• This guide from the Centre for Addiction and Mental Health outlines how to talk about suicide with someone you’re worried about.

ABOUT THE AUTHOR

Wallis Snowdon, Reporter

Wallis Snowdon is a journalist with CBC Edmonton focused on bringing stories to the website and the airwaves. Originally from New Brunswick, Wallis has reported in communities across Canada, from Halifax to Fort McMurray. She previously worked as a digital and current affairs producer with CBC Radio in Edmonton. Share your stories with Wallis at wallis.snowdon@cbc.ca.

First week of inquest into Moses Beaver’s death in Thunder Bay, Ont. focuses on events in Nibinamik

WARNING: This story discusses mental distress and suicide. 

CBC News: Calls to improve mental health care resources in remote First Nations in northwestern Ontario continue to be at the forefront of the inquest into the death of Moses Amik Beaver. The 56-year-old Woodlands artist from Nibinamik, an Oji-Cree First Nation, died in Thunder Bay, Ont. in February 2017 after he was found unresponsive in his cell in the Thunder Bay District Jail.

It remains unclear exactly how Beaver died; the jury is expected to hear more on Beaver’s official cause of death in the coming weeks. More than six years later, an inquest into his death – which is mandatory under the Ontario Coroner’s Act when a person dies in custody – has started putting together the pieces of how and why Beaver came to his death.

The jury consists of one white man, three white women and one Indigenous woman.

Beaver is one of 13 people who have died in the Thunder Bay District Jail since 2002. His inquest comes on the heels of an inquest completed in November into the deaths of Don Mamakwa of Kasabonika Lake and Roland McKay of Kitchenuhmaykoosib Inninuwug.

Who was Moses Beaver?

The jury first heard from Melanie Huddart-Amik, the mother of Beaver’s youngest son, who explained the story behind his name Amik. It was his great grandfather’s surname, before missionaries anglicized it to Beaver. While Beaver has been described as an artist with mental health issues, Huddart-Amik said it is important for the jury to know he was much more than that.

Beaver was the family patriarch, a beloved father of four “with land-based skills second to none.” He could survive alone in the wilderness with a single tool. He made sure everyone in the First Nation had working smoke detectors. He taught Huddart-Amik how to swaddle their son in a tikinagan, or cradleboard, and treat diaper rash with bear grease, she told the jury. 

• Inquest for Oji-Cree artist Moses Beaver begins 6 years after death while in custody
• Report on troubled Thunder Bay police board brings hope but also doubt amid warning change will take time

He was also someone who experienced “almost insurmountable loss in his lifetime,” she said, contending with several deaths in the family as well as intergenerational trauma. “Moses in many ways was larger than life itself but he was a human being who, like anyone else, struggled and made mistakes but who strove to be a better person,” Huddart-Amik said. “He forged on in a quest to improve, to learn more and become a solid role model that his sons and community could be proud of.”

How Beaver ended up in the Thunder Bay District Jail

Jurors heard detailed accounts of what transpired between Jan. 14 and 18, 2017 in Nibinamik, when Beaver was experiencing a mental health crisis. The initial plan was for Beaver to get psychiatric care at the Thunder Bay Regional Health Sciences Centre, registered nurse Paul Hesche told the jury. Hesche was the charge nurse at Nibinamik’s nursing station in 2017 but has since retired. 

After the Thunder Bay Regional Health Sciences Centre said it could not receive Beaver, he was to be sent to Sioux Lookout Meno Ya Win Health Centre, which is not a schedule 1 psychiatric facility. The hope was that after receiving medical clearance in Sioux Lookout, Beaver could be sent for treatment in Thunder Bay, Hesche said. But there were barriers to getting Beaver transported to Sioux Lookout, including a lack of available security to assist in his medical evacuation, winter weather delaying the Ornge air ambulance service, and a higher-priority call for Ornge in another First Nation that bumped Beaver down the triage, the jury heard.

While Beaver awaited transportation, community members acted as security for him due to a lack of police officers. By the time a member of the Nishnawbe Aski Police Service came, Beaver had been in distress for days. He was ultimately charged with two counts of assault and one count of breaching a court order, and was placed in custody before being brought to the Thunder Bay District Jail on a Nishnawbe Aski Police Service plane, the jury heard. 

During that five-day period, Beaver attempted suicide twice, first at a residence and then in a Nishnawbe Aski Police Service cell, witnesses told the jury.

Recommendations for more efficient, effective care

There has been a clear consensus from all witnesses that mental health care must be improved in remote First Nations. Safe rooms, also called secure rooms, came up numerous times as a potential solution. These spaces provide a secure environment for mental health patients where they cannot harm themselves or others and can be monitored by medical professionals.

Nibinamik’s nursing station is staffed by two nurses. Doctors, including witness Dr. Megan Bollinger of Sioux Lookout, travel to the First Nation to provide care but are not always available.  Hesche and Bollinger said having a safe room in Nibinamik sounds great in principle, but would require more staff, security and infrastructure. Staff would also require training in mental health awareness and de-escalation.

• IN DEPTHReport calls for urgent, transformational change for troubled Thunder Bay police and oversight board
• Thunder Bay Police Service appoints new chief as it grapples with major challenges

“It’s very easy for someone to say outside of the northern community, we should do this, we should do that,” Hesche said. “Our reality is different than Sioux Lookout and Thunder Bay and Lake of the Woods, and that needs to be taken into consideration.”

Hesche called for continued investments to improve phone and internet technology in Nibinamik, and for a greater security/police presence. Members of the Nishnawbe Aski Police Service echoed the latter sentiment in requesting more resources to better deliver services. As Det. Insp. Brad Duce said of Beaver’s case, “there was just no mode of keeping him safe” before he was placed into custody.

Calls for action must prioritize patient first, says doctor

One of the biggest challenges Dr. Bollinger has seen while working in remote First Nations is strained communications between service providers. Often, patients are caught in the crosshairs of two systems, she said, neither of which will take responsibility for a situation. In the end, that only burdens the patient and their community further.

Bollinger’s recommendations included:

• Improve communications between First Nations leaders and families, health care providers, air ambulance personnel, police, and correctional services staff
• Make telehealth and remote psychiatric evaluations more accessible
• Make medical records more accessible to health care providers
• Ensure psychiatric care that is culturally-sensitive and trauma-informed
• Facilitate more direct medical evacuations to psychiatric facilities

More resources needed for medical evacuations, jury hears

According to Dr. Bruce Sawadsky, chief medical officer for Ornge, a pilot project began last April with a team dedicated to mental health patient transfers only. The team is on call from 9 a.m. until 9 p.m. every day. About 300 mental health patients have been transferred over the past year, he told the jury.

To continue, the pilot project must receive permanent, secure funding. Ideally, Sawadsky said there would be a second aircraft to provide 24-hour coverage for mental health transfers. This would be a suitable recommendation for the jury to consider, he said.

The geography of northern Ontario and its unpredictable weather are obvious barriers to transporting patients, but Bollinger said people must keep in mind the systemic reasons behind why First Nations are so detached from centralized resources. “There’s a reason why there are all of these geographical challenges,” Bollinger said. “There’s a colonial history to these issues, and so we are turning geography into a proxy for race and patients are not getting the services they deserve.”

During week two of the inquest, the jury is expected to hear from witnesses who observed Beaver at the Thunder Bay District Jail and who provided him care there.

If you or someone you know is struggling, here’s where to get help:

• Talk Suicide Canada: 1-833-456-4566 (phone) | 45645 (text between 4 p.m. and midnight ET).
• Kids Help Phone: 1-800-668-6868 (phone), live chat counselling on the website.
• Canadian Association for Suicide Prevention: Find a 24-hour crisis centre.
• This guide from the Centre for Addiction and Mental Health outlines how to talk about suicide with someone you’re worried about.

ABOUT THE AUTHOR

Sarah Law, Reporter

Sarah Law is a CBC News reporter based in Thunder Bay, Ont., and has also worked for newspapers and online publications elsewhere in the province. Have a story tip? You can reach her at sarah.law@cbc.ca

Jury delivers 63 recommendations focused on improving mental health care for Indigenous people

WARNING: This story discusses mental distress and suicide.

CBC News: The jury overseeing the inquest into the death of Moses Beaver has deemed the means of his death to be undetermined — which is the finding his family was hoping for. The inquest into the 56-year-old Oji-Cree Woodlands artist’s death began on April 17, more than six years after he was found unresponsive in the Thunder Bay District Jail. Inquests are mandatory under the Ontario Coroners Act when a person dies in custody.

A jury of three white women, one white man and one Indigenous woman heard from 32 witnesses about the mental health crisis Beaver experienced in Nibinamik First Nation, and the crisis he continued to experience at the Thunder Bay District Jail leading up to his death.

Deliberations began Wednesday and the jury delivered their verdict Friday: Moses Beaver died on Feb. 13, 2017 just after 10 p.m. at the Thunder Bay Regional Health Sciences Centre, with the means of his death labelled “undetermined.”

During closing submissions, one of the family’s lawyers, Caitlyn Kasper of Aboriginal Legal Services, explained why the family believes a finding of undetermined is most fitting. “In this case, the family says there is evidence that points to suicide but also much that points away from it,” Kasper told the jury Wednesday. “It is the submission of both the family and our interpretation of the evidence before you that if not for the severity of his illness, Moses would not have chosen to end his life.”

The jury heard testimony that Beaver attempted suicide twice in Nibinamik before being brought to the Thunder Bay District Jail on Jan. 18, 2017. But they also heard from Beaver’s eldest sons that their father was against suicide. Writings found in his jail cell also indicated he understood the devastating impact of suicide, the jury heard.

“It is in some ways a deeply unsatisfying verdict because it does not deliver the certainty that we might have hoped for. On the other hand, though, it is an honest and a fair verdict, and one that may best reflect the limits of the evidence that you have available to you,” Kasper said. “What we do know is that his life was invaluable and that his loss had a profound impact on those who loved him.”

The jury delivered 63 recommendations to prevent future deaths similar to Beaver’s — including ways to make sure someone in his condition is transported to hospital, not jail. 

Improving mental health care for Indigenous people

It isn’t mandatory for an inquest jury to provide recommendations, but the jury did receive more than 50 suggested ones from counsel before deliberations began. The very first recommendation serves as a legacy for Beaver, who taught art workshops in schools. It asks the provincial and federal governments to fund an art program at Nibinamik Education Centre, and an additional school in Nishnawbe Aski Nation territory on a rotational basis, where an artist helps students create work that expresses traditional knowledge. 

The rest of the recommendations were focused on improving mental health care within remote First Nations and correctional settings like the Thunder Bay District Jail and the new Thunder Bay Correctional Complex that is scheduled for completion in fall 2026.

They include providing more resources for mental health treatment within First Nations, making mental health transports more direct and dignified, and ensuring all parties involved follow a common protocol so everyone knows their role and can be held accountable for it.

We have all been deeply impacted and will carry a piece of him with us.- Statement from the jury overseeing Moses Beaver’s inquest

That would prevent situations like Beaver’s, where the jury heard that delays, misinformation and miscommunications between the community, Ornge and police ultimately resulted in Beaver being transported to jail instead of a hospital.

The jury also recommends Indigenous Services Canada engages with First Nations about building safe or secure rooms — while ensuring there’s enough physical space, staff and training to facilitate them — so someone like Beaver, who was shifted between a small, aging and understaffed nursing station and his family’s house, has somewhere to go where they cannot harm themselves or others.

Furthermore, the jury recommended Nishnawbe Aski Nation, which oversees 49 First Nations across Treaty 9 and 5, receive funding to develop a culturally-safe mental health care plan for remote First Nations in northwestern Ontario.

Better care, conditions in corrections

Ongoing mental health and cultural awareness training was another big ask, especially for front-line workers in correctional settings. Particularly when it comes to Indigenous inmates, whom witnesses testified make up to three-quarters of the Thunder Bay District Jail’s population and experience more frequent and complex mental health and addictions issues.

There was a big focus on Indigenous-run, Indigenous-led solutions. The jury recommended improving inmates’ access to native inmate liaison officers, Elders and other Indigenous service providers. At the new correctional complex, they suggested building a dedicated outdoor cultural space and a mental health unit, with cells that do not lend themselves to self-harm.

• IN DEPTH Moses Beaver’s sons tell inquest their requests for help for Oji-Cree artist were brushed off
• IN DEPTH Moses Beaver inquest hears calls for better communications, psychiatric care at Thunder Bay jail

After hearing repeated testimony about the overcrowded and understaffed jail, the jury also recommended at least five hours of stimulating activity a day for inmates and an hour of outdoor time. As for accountability, recommendations around health accreditation to improve the standard of care in correctional settings for Indigenous people were also made, along with the suggestion of an Indigenous Advisory Committee looking at the provision of health care and correctional services.

The recommendations were issued to several parties, including:

• Governments of Canada and Ontario.
• Indigenous Services Canada.
• Nishnawbe Aski Nation.
• Nishnawbe-Aski Police Service and OPP.
• Ministries of Health, Attorney General and Solicitor General.

NAN welcomes jury’s recommendations

Nishnawbe Aski Nation issued a release Friday following the jury’s verdict, supporting the recommendations made. “Over the past several weeks, this inquest has revealed systems designed with fatal flaws that ignored the realities of the people and communities they should have served. Under-resourced systems left an entire community with only two nurses and no police officer. “In the final weeks of Moses’ life he was, though innocent, imprisoned by a justice system that did not care for his life or treat his illness,” said deputy grand chief Anna Betty Achneepineskum in the release.

While the jury’s verdict is not legally binding — which means no one is required to follow the recommendations — the Office of the Chief Coroner does ask those who received recommendations to respond within six months on whether they were implemented and if not, why.

However, perhaps the most meaningful recommendation, No. 63, is for the Office of the Chief Coroner for Ontario to conduct an annual review of past inquests that deal with mental health and addiction issues experienced by First Nations people — looking at recommendations made in the past and the patterns across those that haven’t been implemented. “We urge the governments of Canada and Ontario to review the recommendations and to make it a priority to implement the recommendations so that no First Nations individual is denied the required care when in extreme crisis,” Achneepineskum said. 

• More mental health resources needed in remote First Nations, jury hears during Moses Beaver inquest
• Inquest jury finds ‘undetermined’ cause in Oji-Cree man’s death in Thunder Bay, family wanted homicide finding

The jury also delivered a statement following the verdict. “Although we didn’t have the privilege to meet Moses in person, we have been honoured to learn about who he was, how important he was to so many, and what an asset he was to his community,” one of the jurors read to Beaver’s family through tears.

“We have all been deeply impacted and will carry a piece of him with us. Our hearts are heavy with the events that Moses had to endure and the tragedies you’ve all experienced. It is our hope that these recommendations honour his memory for you.”

If you or someone you know is struggling, here’s where to get help:

• Talk Suicide Canada: 1-833-456-4566 (phone) | 45645 (text between 4 p.m. and midnight ET).
• Kids Help Phone: 1-800-668-6868 (phone), live chat counselling on the website.
• Canadian Association for Suicide Prevention: Find a 24-hour crisis centre.
• This guide from the Centre for Addiction and Mental Health outlines how to talk about suicide with someone you’re worried about.

ABOUT THE AUTHOR

Sarah Law, Reporter

Sarah Law is a CBC News reporter based in Thunder Bay, Ont., and has also worked for newspapers and online publications elsewhere in the province. Have a story tip? You can reach her at sarah.law@cbc.ca

NAN leader asks inquest, now in 4th and final week, why recommendations from previous inquests not in place

WARNING: This story discusses sexual abuse, mental distress and suicide.

CBC News: Over the past three weeks, the jury probing the inquest into the 2017 death of Moses Amik Beaver has heard numerous calls for better mental health care in remote First Nations and the Thunder Bay District Jail, as well as a reminder that much of what witnesses have recommended has been heard before.

Beaver, a Woodlands artist from Nibinamik, an Oji-Cree First Nation in northwestern Ontario, was 56 when he died by suicide while he was in custody. The inquest — which the Ontario Coroner’s Act says is mandatory when a person dies in custody — is entering its fourth week.  Since 2002, 13 people have died in the jail. At least seven of them were Indigenous. Inquests have been completed into 10 of those cases. The most recent was the joint inquest into the deaths of Don Mamakwa and Roland McKay that ended in November.

Those inquests have yielded hundreds of recommendations, but many of them have not been implemented, according to a CBC News review of the eight inquests completed from 2002 to 2020.

Anna Betty Achneepineskum, deputy grand chief of Nishnawbe Aski Nation, testified last week — as did Beaver’s family — at the inquest into the artist’s death. Achneepineskum said she’d like to know why many of the recommendations that came out of previous inquests haven’t been put in place.

Family says concerns dismissed by police, jail staff

Nishnawbe Aski Nation, which represents 49 First Nations in northern Ontario, has itself issued countless recommendations, resolutions and reports over the years related to the challenges facing First Nations, including mental health crises, Achneepineskum testified. “We continue to advocate for the federal and provincial government to … address the disparity in terms of the lack of resources and services for First Nation citizens, because this is not just isolated to the citizens of Nishnawbe Aski Nation — this is right across Canada.” 

That disparity, she said, is deeply entrenched at an institutional level. “You have to remember that the Indian Act, which is one of the most, I would say, racial pieces of legislation, is the foundation of the policies that exist within any of the government departments where a First Nation citizen is involved,” she said.

Beaver’s eldest sons, Gershom, Shallum and Jerome Beaver, addressed the jury together on Thursday. They spoke of their father’s kindness, his land-based skills and his artistic talent.

Since my father’s [2017] death, the legal system and how Indigenous people are looked after when they are ill hasn’t changed.- Gershom Beaver testifies at his father Moses Beaver’s inquest

They showed videos of their dad explaining how to smoke meat and describing what he liked about holding art workshops at schools, before the three displayed some of his artwork on a large screen at the front of the room. The brothers also spoke of the trauma their father endured, including several losses in his family and his experiences at day school, where they say he was sexually abused.

Gershom said he and Shallum tried to get their father out of the Thunder Bay jail and into the hospital multiple times in 2017, but staff seemed to brush off their concerns. When Shallum was previously in the Thunder Bay jail, he said, an inmate two blocks down from him died by suicide. That experience fuelled his fears his father might suffer a similar fate. “I knew how important it was that he got the right help,” Shallum said.

The brothers were told their father was on a suicide watch as of Feb. 9, 2017, but the Correctional Service Oversight and Investigations (CSOI) report on Beaver’s death shows he was taken off suicide watch on Jan. 24, 2017, and then removed from enhanced supervision on Feb. 8, 2017. “Since my father’s death, the legal system and how Indigenous people are looked after when they are ill hasn’t changed,” said Gershom.

Nibinamik First Nation, 385 kilometres northeast of Sioux Lookout and 500 kilometres north of Thunder Bay, also faces multiple challenges, including a lack of mental health training with no centre to facilitate it, a small, aging nursing station, and hazardous housing conditions. “Eighty per cent of the homes we have in our community are not livable and would be condemned anywhere else in Canada outside of a reserve,” Gershom said. “When it rains outside, it rains inside. The mould is so bad that my brother almost lost three fingers on one of his hands and my dad needed a puffer to breathe.”

Gershom said he moved to Thunder Bay a decade ago because of how the mould affected his son. “Anishinabek are faced with grief and trauma with little to no help; we just continue walking and hope for the best.”

Concerns with Beaver’s treatment in jail: CSOI report

Last week, the jury saw the CSOI report, completed in May 2017, into Beaver’s death. Among the concerns documented were:

• Beaver did not see a psychiatrist until three weeks after he was brought to the Thunder Bay jail.
• Jail staff’s log books did not meet ministry standards with respect to entry recording.
• There was an overall lack of documentation and attention to detail on Beaver’s health-care file by registered nurses and primary care physicians.
• After Beaver’s suicide watch was lifted, his reintegration plan was not properly filled out.
• Beaver’s breathing should have been assisted with ventilation when he was found unresponsive at the jail.

Although Beaver died by suicide while in administrative segregation, the CSOI report does not include a review of the jail’s policies and procedures related to segregation, the coroner’s jury heard.

Audit of former recommendations needed: NAN

Achneepineskum’s recommendations for the jury include properly resourced safe rooms in First Nations, sustainable funding for Telehealth Ontario and in-person care, and access to not only western medicine, but to traditional knowledge keepers and elders.

• AUDIOThird week of inquest into death of Moses Beaver begins
• IN DEPTHMoses Beaver inquest hears calls for better communications, psychiatric care at Thunder Bay jail

She also raised the idea of having mobile mental health teams visit First Nations for a week at a time to provide thorough assessments and referrals to other services. But as the jury prepares its own set of recommendations, Achneepineskum said there must be accountability for what hasn’t been implemented in the past — and answers as to why.

• AUDIO Inquest into death of Moses Beaver of Nibinamik First Nation continues
• More mental health resources needed in remote First Nations, jury hears during Moses Beaver inquest

“We would be able to have a very thorough audit and we would be able to utilize that as we continue to lobby for funding and resources, and also getting our communities to buy in and embrace certain initiatives,” she said.

A primary goal of coroner’s inquests is for the jury to come up with recommendations to prevent deaths in similar circumstances from happening. “[Moses] being deprived of proper medical services — including a comfortable house, a safe house for him to be able to live in — impacted him,” Achneepineskum told the jury. “Just remember that he was a person that needed help, and that he was a father, and a grandfather, and a husband and a son.”

If you or someone you know is struggling, here’s where to get help:

• Talk Suicide Canada: 1-833-456-4566 (phone) | 45645 (text between 4 p.m. and midnight ET).
• Kids Help Phone: 1-800-668-6868 (phone), live chat counselling on the website.
• Canadian Association for Suicide Prevention: Find a 24-hour crisis centre.
• This guide from the Centre for Addiction and Mental Health outlines how to talk about suicide with someone you’re worried about.

Support is available for anyone affected by their experience at residential schools:

A national Indian Residential School Crisis Line has been set up to provide support for former students and those affected. People can access emotional and crisis referral services by calling the 24-hour national crisis line: 1-866-925-4419.

ABOUT THE AUTHOR

Sarah Law, Reporter

Sarah Law is a CBC News reporter based in Thunder Bay, Ont., and has also worked for newspapers and online publications elsewhere in the province. Have a story tip? You can reach her at sarah.law@cbc.ca

The territory received proposals from two facilities, but neither met its criteria for Indigenous-led services

CBC News: The N.W.T. government’s search for an addiction treatment facility with Indigenous-led programing isn’t going well. 

The territory’s Health and Social Services Department was taking proposals from facilities it could work with early in the year, but the contract opportunity closed on Feb. 1 and none of the proposals met the territory’s criteria.  Two organizations posted bids for the contract: Glonan Support Services based in Alberta and EHN Canada which operates treatment centres in B.C., Alberta, Ontario, Quebec and Nova Scotia. 

Jeremy Bird, a spokesperson for the department, said neither proposal met the territory’s criteria because they were not Indigenous facilities, and one of them was not accredited.  “It is very disappointing that we didn’t receive any successful bids from the RFP [request for proposals], and we recognize that this means a continued gap in the availability of an Indigenous option for N.W.T. residents seeking treatment,” he wrote in an email. 

“We are diligently exploring options to address this gap and hope to have more to share shortly.” 

The territory is looking to fill a gap in service after its contract with Poundmaker’s Lodge in Alberta ended last fall. The Indigenous-run addictions treatment facility stopped working with the N.W.T., saying the territory lacks a “cultural understanding” of the work it does. 

There are five other treatment centres where N.W.T. residents can go for free addictions treatment in Alberta, British Columbia and Ontario — but none are Indigenous-run. 

Fewer people will seek treatment: counsellor

Jean Erasmus, a counselling therapist in Yellowknife, said the gap left by the unfilled contract is “huge” and means fewer people will get treatment for addictions to drugs and alcohol.  “Counsellors are going to be working even harder to help people who are really struggling,” said Erasmus, who runs Dene Wellness Warriors alongside Roy Erasmus. They provide counselling and wellness workshops, counsellor training, and are in the early stages of starting a trauma healing lodge — separate from a treatment centre — in K’atl’odeeche First Nation. 

Roy illustrated how frightening it can be for someone from an N.W.T. community to go to a non-Indigenous treatment centre. He said he remembers a young woman from a small community along the Mackenzie River who went to the same university he attended, needing to be walked from class to class by an older sister. 

“There were more people walking around in the hallways than there were in her community, and primarily non-Indigenous people, so she was scared,” he explained, adding that the decision to go to a treatment centre is already difficult enough.

“There’s definitely a gap that has to be filled. Our clients, when they ask for assistance … they’re always wanting to go to an Indigenous treatment centre,” he said. 

ABOUT THE AUTHOR

Liny Lamberink, Reporter/Editor

Liny Lamberink is a reporter for CBC North. She moved to Yellowknife in March 2021, after working as a reporter and newscaster in Ontario for five years. She can be reached at liny.lamberink@cbc.ca

Distance a barrier to accessing addictions treatment, say communities

Members of B.C.’s most northern communities are saying they need more resources to deal with the impacts of the province’s drug crisis, at a forum in Prince George, B.C., this week.

More than 200 First Nations leaders and health-care workers met to talk about harm reduction, treatment centres, resources, land-based healing and best practices for dealing with addiction, at the three-day First Nations Health Authority’s Northern Addictions and Engagement and Knowledge Exchange Forum.

First Nations people are dying at a rate five times higher than the general B.C. population from illicit drug toxicity, according to the First Nations Health Authority. But communities north of Prince George and south of the Yukon border say it is hard to make progress on the drug crisis when there is little health infrastructure to begin with.

“We need everything,” said Pamela Moon, the wellness director for Dease River First Nation. “We’re just at the bottom of the barrel for B.C. … We have absolutely nothing.”

• Indigenous advocates call for more culturally informed addictions treatment in B.C.

Out of Dease River’s 186 band members about 39 people live in Good Hope Lake, about 700 kilometres northeast of Prince George. Despite the community’s small size and remoteness, Moon said drugs are “rampant” in the area.

Moon, who is Kaska Dena from Liard First Nation, said over the years harder drugs started making it up north, and she now hears of drugs like heroin and meth in small communities. “Absolutely, people are dying from it,” said Moon. Moon said Dease River First Nation has no drug and alcohol workers, no doctors or nurses available, just her team that has to send people hundreds of kilometres to places like Prince George to enter addictions treatment programs.

14-hour drive to services

Richard Jackson, who is Tahltan from Telegraph Creek, said the distance for treatment is a barrier — like a 14-hour drive to the nearest urban centre to access services.

Telegraph Creek has a population of about 400 residents according to the Tahltan Band, and is about 700 kilometres north of Prince George. Jackson said its isolation is no longer protecting it from the illicit drug crisis. “Sometimes you’re kind of forgotten about in a way, because it seems like we’re doing well on our own because we have to,” said Jackson.

Jackson said he would like to see the First Nations Health Authority bring more services to his area so people don’t have to travel as far.

Jennifer Hearn, the wellness manager for the Taku River Tlingit First Nation in Atlin, B.C., said there needs to be support in place for people who leave their community for treatment, such as medical escorts, but also when people return home. “I’m going to leave you at an airport to now fly back to the community alone, fresh out of treatment with 150,000 questions in your head about how this is going to play out,” said Hearn, who is Mohawk.

Atlin has a population of 424 people but has no road connecting the hamlet to any other communities in B.C., only Yukon.

Hearn said the community still faces more challenges with alcohol than drugs but wants more information on harm reduction. She said she thinks the money spent bringing community representatives to the forum in Prince George might have been better spent in communities. “We’re all saying we want to make a difference, then conferences should include like half a day of service work where we’re going into the community and let’s go make a difference,” said Hearn.

Corrections

• A previous version of this story said the population of Telegraph Creek was 51 people. In fact, the population is approximately 400 people. Mar 23, 2023 9:05 PM ET

ABOUT THE AUTHOR

Jackie McKay, Reporter

Jackie McKay is a Métis journalist working for CBC Indigenous covering B.C. She was a reporter for CBC North for more more than five years spending the majority of her time in Nunavut. McKay has also worked in Whitehorse, Thunder Bay, and Yellowknife. Follow her on Twitter @mckayjacqueline.

Recent deaths linked to inadequate medical care include mother of 5 from Manto Sipi Cree Nation, chief says

CBC News: A group of Manitoba chiefs is calling for immediate action from the federal government to address what they call a health-care crisis causing preventable deaths on northern First Nations in the province. That action needs to start with ensuring nursing stations in remote communities are staffed adequately with nurses and have a full-time doctor available, said Michael Yellowback, chief of Manto Sipi Cree Nation (previously known as God’s River).

Right now, the community only has two of the three nurses it’s supposed to, and doctors only visit every two weeks, he said. “Too many of our people are dying. You would not see this in an urban environment,” Yellowback said alongside other chiefs and the federal NDP at a news conference in Ottawa on Monday morning.

• 11 northern Manitoba First Nations declare state of emergency to urge government intervention

The update comes less than two weeks after the Keewatin Tribal Council declared a regional state of emergency to sound the alarm over deaths involving suicide, drugs, violence and inadequate health care in its 11 northern Manitoba communities, including Manto Sipi.

Recent deaths

Yellowback said people in the community are often turned away or given Tylenol and sent home when they try to seek medical attention at the nursing station. He said that’s what happened to a 48-year-old man who died in June after seeking care for two weeks straight. More recently, a 37-year-old mother of five died after seeking medical treatment. Yellowback would not provide additional details, citing privacy reasons.

About 80 per cent of Manto Sipi’s population is on a fixed income, and a round trip from the community to Winnipeg costs more than $1,000 for travel alone — putting that option out of reach for community members who want to access health care or a second medical opinion, he said.

Jordna Hill, chief of Shamattawa First Nation, echoed Yellowback’s calls for more nurses in remote communities like his.He said Shamattawa has also seen people die after failing to get adequate medical attention at the community’s nursing station. He also called for more thorough assessments of patients seeking care in the community and an increased ability to triage patients and determine what care they need.

“This needs to stop,” Hill said at the news conference, which also included Garrison Settee, grand chief of Manitoba Keewatinowi Okimakanak, and Cathy Merrick, grand chief of the Assembly of Manitoba Chiefs. “We can’t go any further like this.”

‘Humanitarian crisis’

Niki Ashton, the NDP’s deputy critic for Indigenous services, said what’s happening in communities like Manto Sipi and Shamattawa amounts to a “humanitarian crisis” that requires urgent action from the government. “These are stories that, for too many Canadians, are out of sight and out of mind,” said Ashton, the MP for Manitoba’s Churchill–Keewatinook Aski riding.

“This is not the time for hollow commitment to reconciliation. This is the time for action to save lives.”

A recently released answer to a Feb. 9 order paper question from Ashton said all remote and isolated nursing stations managed by Indigenous Services Canada in Manitoba and Ontario ran below capacity for at least one day over the past two months.

That was due primarily to staffing shortages and “the rotational nature of this kind of nursing,” the answer said.

Walter Wastesicoot, grand chief of the Keewatin Tribal Council, said Indigenous Services Canada reached out to begin discussions with affected communities after they declared a state of emergency last month, but there have been no substantial measures taken yet to address the ongoing crisis.

• Family doctor shortage creates stress for patients, communities — and physicians

“There are so many cases of neglect that we are currently exploring legal action as an option,” he said, adding that step was a work in progress that he couldn’t provide further details on. Indigenous Services Canada did not provide a response by deadline.

Northern Manitoba First Nations call for immediate action to fix staffing crisis in nursing stations

The Globe and Mail: Another tuberculosis outbreak has been declared in Nunavut, this time in a community near the top of Baffin Island.

Nunavut’s Department of Health announced Friday that five active and 22 latent cases of TB have been identified in Pond Inlet, a hamlet of 1,500 people, since last month. The territorial government had two weeks ago confirmed that a TB outbreak continues to affect Pangnirtung. More than 200 cases, 39 of them active, have been diagnosed there since January, 2021.

TB is caused by airborne bacteria that most often lodge in the lungs, causing fevers, night sweats, weight loss, deep fatigue and a relentless, sometimes bloody, cough. Active cases make patients sick and infectious. Latent infections are asymptomatic and not contagious, but they put people at risk of developing active TB disease in the future.

TB is rare in most of Canada. But that is not the case in Inuit communities, where in some recent years, TB rates have been as much as 300 times higher than those of non-Indigenous people born in Canada. That disparity prompted the federal Liberal government to promise in 2018 to eliminate TB in Inuit lands by 2030 – a goal that has prompted renewed attention by news of another outbreak in Nunavut.

Sean Wachtel, Nunavut’s Chief Public Health Officer, travelled to Pond Inlet to share news of the outbreak with the community directly. He addressed a meeting of the hamlet council on Thursday night. On Friday, he visited Pond Inlet’s health centre and spoke about the outbreak on a local radio show. “People have a lot of questions,” Dr. Wachtel said. “And that’s really why we came up in person to speak to the council and the community, and to engage people at the local level to try to reassure them as much as possible.”

Friday’s outbreak declaration in Pond Inlet marked a departure from the way TB news was handled in Pangnirtung. In the latter case, an outbreak wasn’t publicly declared until November, 2021, nearly a year after the first case was identified.

Even then, the Department of Health initially refused to divulge a case tally. A Globe and Mail investigation later found that front-line nurses in Pangnirtung were desperate for help in the summer of 2021 as the disease spread and as senior health officials dragged their feet on declaring an outbreak.

The Nunavut government finally revealed the Pangnirtung case numbers last May. It has since updated the tally every three months. Last November, the government and the territory’s top Inuit organization, Nunavut Tunngavik, Inc., signed a TB information sharing agreement that included a commitment to greater transparency.

Dr. Wachtel said tackling TB in Nunavut will require “addressing the social determinants of health,” such as overcrowded housing, food insecurity, poverty and high rates of smoking and chronic disease.

“It’s not just a medical treatment and a quick cure,” he added. “The ultimate solution to TB is a political one.”

Kelly Grant, Health reporter – Follow Kelly Grant on Twitter: @kellygrant1

“We’ve known for a long time that Inuit babies have four to eight times the rate of hospital admission due to RSV, compared to the premature babies or the cardiac babies” with RSV, Banerji said.

In the Arctic, the peak is usually February/March to June. One doctor is calling for an expedited review of a single-dose drug for high-risk infants.

Toronto Star: Dr. Nicole Radziminski has seen members of the same family flown out of her community to a hospital because they’d been hit with RSV or other viruses.

The pediatrician, who works in the Northwest Territories and treats patients from the Kitikmeot region in northwest Nunavut, recalls an “unusually large number” of infants and older children being sick during the 2022 viral season — the most she’d ever seen.

“I recall sending at least a couple of kids a week on a medevac to Edmonton ICU, which maybe doesn’t sound like a lot, but it is actually quite a lot for us to do that,” Radziminski said, adding that this doesn’t include the other Nunavut patients that would have been flown to Yellowknife.

Respiratory syncytial virus is a common cause of bronchiolitis, which causes inflammation and congestion in the small airways of the lung. It shot to prominence in recent months in Ontario, as a combination of RSV, COVID-19 and the flu ripped through communities, and left pediatric hospitals overwhelmed.

But in the North, it had exacted a harsher toll for years. In the Arctic, peak RSV season usually occurs in February/March to June.  Radziminski said the “significant RSV activity” last year was between June and October.  “Every day our wards were full of kids with bronchiolitis,” Radziminski said. “We have an eight-bed unit with capacity up to 10 and it’s a shared pediatric-adult unit, but it was basically all full of children for about five months.

Dr. Anna Banerji, a pediatric infectious disease specialist, said that in typical seasons, “the rate of RSV hospitalization for an average baby in Toronto is about one per cent. In the Arctic, it can be up to 30 per cent of the babies or even more in remote communities. Thirty per cent of the babies (with RSV) end up in the hospital.”

The Toronto-based doctor is calling on the federal government to expedite a review of a single-dose drug that she said could help Inuit and other Indigenous infants who are at high risk of severe RSV. 

Sanofi, the company developing the drug with AstraZeneca, said Health Canada has accepted a submission for nirsevimab, sold as Beyfortus, the first investigational long-acting antibody to help protect infants from RSV. Sanofi said it expects a decision in the last three months of the year.

While RSV is a common infection and almost all babies are infected by the age of two, those living in the Arctic and remote communities are at higher risk due to overcrowded housing and exposure at a younger age.

Inuit babies also get sicker and stay in the hospital longer. They also tend to have more complications. “We’ve known for a long time that Inuit babies have four to eight times the rate of hospital admission due to RSV, compared to the premature babies or the cardiac babies” with RSV, Banerji said.

A study that Banerji was involved in compared sick and healthy Inuit babies. It found that overcrowding increases the risk, as does cigarette exposure in pregnancy and at home. The study also found that those sick enough to be hospitalized would need to wait for a medical evacuation team, and that could take a couple of days depending on weather. 

“In the meantime, the baby that needs to be hospitalized gets sicker during that wait,” Banerji said. Banerji added that Nunavut’s Kitikmeot region has an “extremely high rate of RSV admissions,” higher than documented rates in other places including India, Africa and other parts of the Arctic. 

Radziminski said one of the biggest factors in how RSV affects babies more in the North compared to the South is how long it takes them to get increased care if they need it. The first point of contact is the community health centre, usually staffed by nurses “who are generally very good and adept at dealing with bronchiolitis,” and can provide oxygen, Radziminski said. But kids requiring more care often must go to Yellowknife or Edmonton.

Being transported out of the community is stressful for families, too. Radziminski said often, unless the child is quite unwell, only one parent can travel with the child on the medevac plane. Child care for other kids in the family is another challenge and decisions have to be made “at a moment’s notice.”

Radziminski said depending on the child’s condition they could be away in hospital anywhere from a few days to a month or longer.

Palivizumab — a monoclonal antibody, a protein that is injected externally and wears off over time — is approved by Health Canada and given to babies in monthly doses at the start of RSV season, to reduce complications of RSV. But Banerji says it’s expensive and restricted to higher-risk babies, such as those born premature or with a significant heart or lung issues.

Banerji said several studies have also shown that it’s cheaper to give palivizumab to Inuit babies than to pay for the extra cost of transporting sick babies to regional and children hospitals for further treatment.

In a statement to the Star, Nunavut’s department of health said a recent study in Nunavik in northern Quebec, “which followed the recommendation of universal palivizumab administration, further supports Nunavut’s approach after it found that, amongst healthy term infants, palivizumab was not effective at reducing hospitalizations.”

Banerji said the single-dose nirsevimab could be approved and made available to northern communities, hopefully at a lower cost than palivizumab. She started a petition on Change.org to raise awareness about the issue. 

Radziminski said it’s hard to know what the upcoming season may look like. “Having this past year under our belt definitely makes us a little bit apprehensive and hopeful that the same thing won’t be repeated” this year and next, Radziminski said.

Data provided by Nunavut’s Department of Health shows 223 RSV infections in children two years old and under from August 2021 to July 2022. The department noted there was a spike at that time that was seen across the country after COVID-19 public health measures ended. So far this year, there have been 27 children two or younger diagnosed with RSV.

In a statement, Health Canada said that as with all drug submissions, it will review nirsevimab “based on scientific rigour and medical evidence.” “The timing for the completion of Health Canada’s review depends on many factors, including but not limited to a need for additional data, discussions with the sponsor, and requirements for updates to safety information. Given the ongoing public health considerations, Health Canada is committed to reviewing the nirsevimab submission as quickly as possible without compromising safety.”

Health Canada added that all provinces and territories have programs that make palivizumab available for high-risk infants, including premature Inuit babies and infants with certain medical conditions. 

Nunavut’s department of health said when nirsevimab is approved in Canada, the territorial government will look into how best to use it.

Nirsevimab was approved last fall in the European Union. Before that, the European Medicines Agency recommended that nirsevimab, sold as Beyfortus, be authorized based on advanced research that showed the drug reduced the chances that babies with RSV needed medical attention and appeared to be safe, compared to infants who got a placebo.

Nirsevimab was also recently approved by the U.K. regulator.

In November, Pfizer announced preliminary research showing that a new vaccine given to pregnant women could help protect their babies against RSV, after decades of failure to develop an effective shot. Moderna is also testing an mRNA vaccine and plans to seek approval from regulators this year.

Banerji is also calling on the public to help the cause by signing the petition and by reaching out to their local MP and minister of health as well as the minister of Crown-Indigenous relations, asking them to fast-track approval of nirsevimab and designate Indigenous infants in northern communities as high-risk for RSV.With files from The Associated Press

Kelly Skjerven is a Toronto-based general assignment reporter for the Star. Reach her via email: kskjerven@thestar.ca

Release of Manitoba Advocate for Children and Youth (2020): Safe and Sound: A Special Report on the Unexpected Sleep-Related Deaths of 145 Manitoba Infants” According to population projections, Indigenous infants account for between 20-30% of live births in Manitoba during the study period (Jan. 2009 – Dec. 2018), but represent 57% of sleep-related infant deaths. That translates to 83 First Nations and Métis infants.

Policies articulated in the Indian Act have excluded Indigenous Peoples from participation in economic life for generations, leading to intergenerational poverty. In evidence of ongoing systemic racism, many Indigenous families have unequal access to health services, they lack suitable stable housing, and access to clean drinking water. The health gap between Indigenous and non-Indigenous Manitobans is widening (Katz et al. 2019). Of the 13 recommendations, 7 are directed towards First Nations and Métis governments and various federal and provincial ministries.

https://manitobaadvocate.ca/wp-content/uploads/SafeSleep-Report.pdf

About 20% of ER visits last year to northwestern Ontario hospital related to mental health or addictions

CBC News: The Meno Ya Win Health Centre in Sioux Lookout in northwestern Ontario is undergoing renovations to make space for four safe rooms in its emergency department. The rooms will be designated for patients experiencing acute mental health conditions who are considered at high risk of injuring themselves or others.

The hospital is a hub for 30 fly-in First Nations communities in the region and is one of the first points of contact for people in crisis in northern Ontario. It currently uses two small rooms in the department as mental health rooms. But Dr. Justin Bell, the hospital’s chief of mental health and addictions, said staff felt they weren’t able to adequately meet people’s needs in these spaces.

About 20 per cent of visits to Meno Ya Win’s emergency department were related to mental health or addictions last year, Bell said. That’s up from 12 per cent in 2019, and much higher than the provincial standard of around four per cent. Drug-related deaths and “skyrocketing” suicide rates recently prompted a group called NAN Hope — consisting of First Nations crisis workers and counsellors who support the 49 First Nations that make up the Nishnawbe Aski Nation (NAN) — to call for a state of emergency to be declared.

“Some communities that I know in the past year have had over 30 deaths in the last year, and these are not huge communities that are having these kinds of deaths,” said Tannis Smith, a NAN Hope co-ordinator and counsellor.

• Crisis counsellors call on Nishnawbe Aski Nation to declare mental health, addictions state of emergency

Meno Ya Win is not a Schedule 1 psychiatric facility, which means it does not have in-patient psychiatric beds or a full-time psychiatrist. It relies on the regional hospitals in Thunder Bay and Kenora for these services, which means the rooms in its emergency department serve as temporary holding spaces. “Due to a lot of issues like weather and access to planes, access to hospital beds, individuals have had to stay in those rooms for several days at a time,” Bell said.

The renovated safe rooms will be larger and purpose built, without anything present that could lend to self-injury, he said. Each will have a toilet and sink, so patients don’t have to be escorted down the hall to use the washroom, and security cameras. The rooms will also have televisions behind plexiglass. The bulk of the work should be completed by May, with the rooms operational by the summer, said Bell.

Hospitals need purpose-built safe rooms

More emergency departments in Ontario are looking at creating safe rooms for patients experiencing mental distress, but this isn’t always feasible, said Dr. David Gratzner, a psychiatrist at the Centre for Addiction and Mental Health (CAMH) in Toronto. “Because of societal stigma, because of demands on space in emergency departments, people with mental health problems were often an afterthought,” he said.

He recalled working at a hospital that used two converted storage rooms in the back of the emergency department for patients experiencing mental health crises. “Imagine you’re going through some of the worst moments of your life and you’re sitting on a stretcher in a room under fluorescent lights. There’s no window. It’s not quiet. It’s just a very unpleasant environment,” he said. But dedicating the time, money and resources to constructing and maintaining safe rooms in emergency departments “can be a tall order,” Gratzner admitted.

Since CAMH moved into a new emergency department with more space 2½ years ago, Gratzner said, overall incidents of violence have become lower than those in other emergency departments in the province. “These things matter, they make a difference. But again, the question becomes one of priorities,” he said.

Imagine you’re going through some of the worst moments of your life, and you’re sitting on a stretcher in a room under fluorescent lights.- Dr. David Gratzner, Centre for Addiction and Mental Health

Recent data from the Canadian Institute for Health Information (CIHI) shows emergency department visits are on the rise in Canada, coming closer to pre-pandemic levels. Meanwhile, the health-care system continues to feel the pains of staffing shortages and burnout. Gratzner reminds people that not too long ago, mental illness was often a family secret. A relative would “disappear” for a couple years — sent to a psychiatric facility — and nobody would talk about where they went or why. 

“It’s great that the stigma is fading, but there’s huge unmet need within our population and it’s important for us to keep advocating for resources,” he said.

• KIDS IN CRISISFirst Nations family says culturally sensitive mental health care difficult to find
• ‘We don’t want any more tears’: First Nations urge Ottawa to boost mental health spending

Creating safer, more dignified spaces to meet people’s mental health needs in dedicated safe rooms is an important step, said Gratzner.  “These spaces aren’t an afterthought, but they’re carefully constructed.”

ABOUT THE AUTHOR

Sarah Law, Reporter

Sarah Law is a CBC News reporter based in Thunder Bay, Ont., and has also worked for newspapers and online publications elsewhere in the province. Have a story tip? You can reach her at sarah.law@cbc.ca

Health centres in 1 Baffin community, 3 Kivalliq communities and 2 Kitikmeot communities affected 

Nunatsiaq News: Six of Nunavut’s community health centres are currently offering reduced or emergency services only.

Staff shortages in the territory’s health-care sector are creating a “heavy workload and greater likelihood of burnout,” according to Health Department spokesperson Chris Puglia. “When there is an emergency that keeps numerous health centre staff on the job for extended periods of time, staff are required to have a rest period to ensure the safety and quality of care,” he said Wednesday in an email.

“Reduced services are based on these circumstances.”

According to data provided by the Department of Health, centres operating this month at reduced services — meaning some services are not available depending on staffing levels, and there may be a reduction in operating hours and staff available, especially for walk-ins — are:

• Baker Lake: 11 out of 13 indeterminate positions are vacant but being filled with four casual employees;
• Coral Harbour: five out of 10 indeterminate positions are vacant and being filled by four casual employees, up from one casual employee;
• Kugaaruk: four out of six indeterminate positions are vacant but being filled with four casual employees, up from three.

Also according to health department data, health centres operating at emergency service, meaning only emergency cases are being dealt with although paramedics and medevacs remain available, are:

• Gjoa Haven: seven out of 10 indeterminate positions are vacant but being filled with five casual employees;
• Resolute Bay: two out of four indeterminate positions are vacant;
• Whale Cove: five out of five indeterminate positions are vacant but some vacancies are being filled with two casual employees.

Meanwhile, some services at those centres continue to be offered virtually. In March, 11 community health centres operated on reduced or emergency service.

Last month, Health Minister John Main said his department is working with the Department of Human Resources and Nunavut Employees Union to strengthen staffing and help with employee retention. “We need the staff to have our health centres at full service so that we can provide the full suite of programs that communities need, and that is something that my department understands,” he said March 6 during the winter sitting of the legislative assembly in Iqaluit.

“We’ve brought in one package to improve our staffing at the community level, which includes a number of measures including looking at changing the hours of operation for health centres.”

The Department of Health uses a combination of virtual health and paramedic services to support residents of communities affected by centres offering reduced or emergency services, according to Puglia. This includes support staff who are available by phone to assist with services such as filling prescriptions and medical travel. Physicians also schedule community visits when staffing is most critical and are available to support virtual walk-in clinics.

Core services such as medevac services and medical travel continue to operate as normal across the territory, said Puglia.

By  Meral Jamal, Reporter

Indigenous Services Canada says it’s working to recruit and retain nurses 

CBC News: A shortage of nurses across the country is hitting hard in remote and northern First Nations like Pimicikamak Cree Nation in Manitoba, where nursing stations are typically the only place people can access health care close to home.

Chief David Monias said the nursing station in Pimicikamak was only open to see people on an emergency basis as recently as last week due to nurse availability, which has him concerned about the kind of care community members are getting. “The front line is very key in terms of how they’re receiving our people,” Monias said, noting the situation in his community has since improved. “We have to make sure that we have our people properly diagnosed.”

Indigenous Services Canada runs 21 of 22 nursing stations located in Manitoba. They are places where the majority of care is provided by nurses and they’re in short supply, ISC has said previously.

According to a recent response from the federal department to an order paper question filed by Niki Ashton, NDP MP for Manitoba’s Churchill-Keewatinook Aski riding, 223 nurses are needed each day in ISC-staffed nursing stations across the country. ISC said on average in recent months, those shifts have been filled by 71 public servant nurses. Seventy-nine agency nurses and 30 auxiliary health workers were called on to help fill vacancies while 43 nursing positions were left unfilled.

Whole system has to change: advocate

Dr. Barry Lavallee, executive director of a northern health and wellness advocacy agency called Keewatinohk Inniniw Minoayawin Inc., characterized the situation in some communities as “emergencies.” “If you have no nurse, there’s nothing available,” Lavallee said. “In the communities it’s life or death in many cases, so we need somebody there.”

• Northern Manitoba chiefs call for immediate federal action on health-care crisis
• Manitoba nursing stations face ‘extreme shortage of nurses’ over holidays

For that reason, Lavallee said nursing shortages in southern Manitoba communities can’t be compared to those l ocated in the north.   “The whole system has to change,” Lavallee said.”The nurses that we have, they’re doing a hell of a job in a poor situation to try and provide good care when I think the system is just a little bit backwards in trying to find ways to support them effectively.”

He said more needs to be done to attract nurses back to the public service, and mixed models of primary care need to be looked at to make it less dependent on nurses. “We have all kinds of people, pharmacists, we have all kinds of people that could deliver care,” Lavallee said.

• Manitoba nurses quitting amidst mandated overtime, high vacancy rates, no home-life balance
• Manitoba regulator introduces faster pathway for nurses coming through Philippines recruitment drive

Jennifer Carr, president of the Professional Institute of the Public Service of Canada which represents nurses working in remote and isolated communities, said insufficient staffing levels are taking a toll on front-line providers and communities. “Their primary role is to provide primary care to these locations,” Carr said.

“With the staffing levels that we have right now, that is in jeopardy … so much so that a lot of these communities are on emergency care only, which is not delivering the needed health care that these communities need and are promised on behalf of the federal government.”

Ripple effects of nursing shortages

ISC told CBC last week it contracts agency nurses to help fill vacancies when required and calls on other health-care workers, such as paramedics, to help provide care. “As there are critical nursing shortages that are having an effect on health care across the country, this is also affecting nursing staffing levels at ISC-run nursing stations in remote and isolated Indigenous communities in Manitoba,” ISC said in an email.

Carr said some may find agency work more appealing because people have more choice over when and where they work. She suggested the government needs to do more to bolster staffing levels among publicly-employed nurses. “It’s not just about pay,” Carr said, who added fixing up nursing stations, adding security and making sure nurses aren’t required to deal with other tasks — such as dealing with information technology or maintenance work — are also key concerns.

Carr said her members typically work rotational shifts of two weeks on, two weeks off in the same community, which allows them to build stronger relationships.

• Man’s death at Pukatawagan nursing station, 3 days after calling for help, sparks federal review
• Health-care partnership bolsters emergency response, transportation in northern Manitoba First Nations

Darlene Jackson, president of the Manitoba Nurses Union, said while her members don’t typically work in nursing stations, she knows the work can be difficult.  “You have to have a lot of skills and experience to work in those nursing stations,” Jackson said. “You’re basically on your own.”

ISC announced in August 2022 it would triple recruitment and retention bonuses through 2025 to help address critical nursing shortages, and said it has a longer-term strategy to increase staffing levels in remote and isolated First Nations. Since September the department has hired 111 full-time community health nurses and two full-time general duty nurses.

Monias said Pimicikamak, which has an on-reserve population of nearly 5,000 people, is trying to take matters into its own hands. A new health centre is expected to open soon and the community wants a bigger role in staffing it. “We know what we want. We know what we need. We know how to take care of our people,” Monias said. “If you give us a chance to take care of our people, we’ll make it happen.”

ABOUT THE AUTHOR

Josh Crabb,Reporter

Josh Crabb is a reporter with CBC Manitoba. He started reporting in 2005 at CKX-TV in Brandon, Man. After spending three years working in television in Red Deer, Alta., Josh returned to Manitoba in 2010 and has been covering stories across the province and in Winnipeg ever since.

With files from Bryce Hoye

Globe & Mail: Tanya Talaga – Over the past week, a Thunder Bay hotel’s conference room has become home to a land-based healing and recovery program. There, 17 women from one northern First Nation about two hours down the highway – women who are addicted to opioids, alcohol, crystal methamphetamine (jib) and/or methadone, which is itself used to treat the horrific, widespread disease of addiction that plagues First Nations communities – are participating.

Around Lake Superior’s northern shores, the devastation of drugs created to treat extreme pain – oxycodone, fentanyl, methadone, morphine and heroin – is there for all to see, including in the yellow needle disposal units affixed to the walls of many public washrooms. The Thunder Bay District Health Unit reports that from April, 2021, to March of this year, the opioid death rate was 82.1 per 100,000 people – four times Ontario’s rate of 18.7 per 100,000. There has been a 50-per-cent increase in deaths between 2020 and 2021 in that district – or about two people dying every five days, according to the CBC. 

As a northern hub city, Thunder Bay is where many First Nations people come to access health services for addiction, even though the city’s hospital and shelter system is already beyond stretched. The stories of addiction I’ve heard are heartbreaking: of homes being stripped of furniture and electronics just to afford the next hit; of essentially parentless children who are at daily risk of violence; of mothers so desperate for drugs that they sell their daughters to get high.

And so the awful news about the alleged actions of two brothers who reportedly lived and grew up in this cycle of addiction and abuse fell over the people gathered in that hotel room with muted sadness and deep understanding.

We do not yet know exactly what happened around the tragedy that took place in Saskatchewan over the Labour Day long weekend. But here is what we do know: 10 people are dead and 18 others were injured after a series of stabbing attacks on James Smith Cree Nation and in the nearby community of Weldon. Damien Sanderson, one of the suspects, was also found dead outside a house on that First Nation, just east of Prince Albert. The other suspect, his brother Myles – whose lengthy 20-year parole records say he began to drink and use weed at 12, cocaine by 14, and crystal meth in his 20s, while noting that he had a long history with gangs and grew up surrounded by domestic violence and substance abuse – was arrested on Wednesday, but died after going into what the RCMP called “medical distress.”

From the start, news reports quoted James Smith Cree community members blaming the attacks on addiction. “The battle we’re fighting here is not with each other. … The battle we’re fighting here is with alcoholism and drug use,” Darryl Burns, whose sister Gloria was killed, told Global News.

Myles Sanderson’s parole records bear that out, citing “intergenerational impacts of residential schools.” It was effectively a case study in what can emerge after decades of genocide and after institutions fail to account for the human cost of historical colonial policies.

When the last Indian Residential School closed in Canada in 1996, there was nothing to support the survivors as they struggled to rebuild their tattered lives. Most returned to First Nations in free fall, to families ripped apart by federal policies enacted by religious orders that in many cases resorted to abuse. And instead of admitting to genocide, Canada turned away, dismissing these as Indigenous peoples’ problems.

Instead of setting up mental-health clinics, traditional healing centres, or places to care for wounded and destroyed spirits, successive governments in Canada provided little more than child-welfare and prison systems that effectively swept up many of the kids of survivors and took them away from their homes and communities, leaving children without any sense of belonging.

That’s how violence can manifest: through trauma, left unchecked.

We have seen what happens when we fail to deal with the social fallout of residential schools and racist policies such as the Indian Act. There have been countless reports warning against continued inaction by Canada – from the Royal Commission on Aboriginal Peoples, to the Truth and Reconciliation Commission’s four volumes, to the National Inquiry on Murdered and Missing Indigenous Women and Girls.

So it is time for Canada to take responsibility and enact a giant Marshall Plan of change. Come together with our communities. Listen to Indigenous peoples and leaders. Bring true reconciliation to that cold, empty word that has left us in a state of seemingly inevitable, violent flux.

Myles Sanderson’s story is all too familiar. But it doesn’t have to be.

• Timing of elimination of the hepatitis C virus (HCV) in Canada’s provinces indicates 70% of provinces could reach the World Health Organization’s (WHO) HCV elimination target of 2030, however three of Canada’sprovinces — two of them the most populous in the country — are off track to achieve this hepatitis C elimination goal.¹
• Timely elimination would save 170 lives and $122.6 million in direct medical costs in these three provinces by 2030.¹
• The Progress Report developed by Action Hepatitis Canada outlines key metrics on which to evaluate HCV elimination progress in Canada, specific to each province.²
• In Canada, there are five priority populations and one age-cohort that carry the largest burden of HCV and are recognized as being affected the most by the virus.

NationTalk: MONTREAL – AbbVie (NYSE: ABBV) supports a wide range of efforts to help elevate and prioritize hepatitis C virus (HCV) elimination. With a recent publication indicating 70% of Canada’s provinces are on track to reach HCV elimination by the World Health Organization’s (WHO) initial proposed target of 20301, it is important to turn our attention on those affected by the virus and acknowledge that infection with chronic HCV is a global public health concern.

In 2016, Canada was one of the 194 countries that committed to support the World Health Organization’s (WHO) goal of eliminating viral hepatitis as a public health threat by 2030. With the remarkable progress in HCV therapy, offering the ability to cure patients, this goal seemed possible.

“With the decline in treatment across Canada, it is particularly critical we continue to monitor treatment levels to assess Canada’s progress to HCV elimination,” said Jordan J Feld, MD MPH, Interim Director, Toronto Centre for Liver Disease, University Health Network, University of Toronto. “We need to continue to pursue novel approaches to case finding and linkage to care, as well as work closely with identified priority populations to ensure that they are able to seek prevention and treatment services without facing stigma and other barriers in the health care system. At the policy level, we need to improve our data sharing abilities across the country to ensure we can track our progress toward elimination.”

Populations Most Affected by HCV in Canada3

• Indigenous people
• People with experience in the prison system
• People born between 1945 and 1975
• Immigrants and newcomers
• Gay, bisexual, men who have sex with men (gbMSM)
• People who inject or use drugs

“Canada has made great strides toward the elimination of hepatitis C. However, there is a lot more work to be done, and the tactics that got us to this point will not necessarily get us to elimination,” said Jennifer van Gennip, Executive Director, Action Hepatitis Canada. “Our mandate is to hold the federal and provincial governments accountable to provide the policies and resourced plans to achieve our goal, with focused efforts on priority populations within Canada.”

A look at national treatment data from January 2019 to November 20204 confirmed the decreasing trend in treatment levels nationally – a year-over-year decline of 31% in total treatment levels between 2019 and 2020. The report notes that this drop could be due to the disruptions to the healthcare system caused by the COVID-19 pandemic but could also reflect the saturation of treatment among those already linked to care and the difficulties with finding and engaging with individuals and populations not well served by our various healthcare systems.1

“Everyone has a part to play in eliminating viral hepatitis as it will take more than medicine to achieve this goal,” said Tracey Ramsay, Vice-president and General Manager, AbbVie Canada. “AbbVie is committed to partnering with stakeholders to implement sustainable solutions that allow more patients to be screened, linked to care, and treated in a timely manner, especially for those vulnerable patient populations that have lost access to our healthcare system as a result of the pandemic.”

Given the available evidence, Canada’s momentum towards timely HCV elimination may be jeopardized if diagnosis and treatment are not maintained at appropriate levels. Improved HCV surveillance to build frameworks and innovative approaches to prevention, testing, linkage to care and treatment to achieve this goal is required.

About Hepatitis C

An estimated 250,000 people in Canada are living with chronic hepatitis C but as many as 44% are not aware that they have the disease.5 Left undiagnosed and untreated, chronic hepatitis C can lead to cirrhosis, liver cancer or liver failure. Currently, hepatitis C is the leading indication for liver transplant in Canada.6 AbbVie supports a range of efforts to help elevate and prioritize HCV elimination because we know achieving the shared goal of elimination by 2030 will take more than medicine. It will take transparent and collaborative partnerships with all stakeholders – industry, healthcare providers, healthcare systems, patient groups and their support networks. Joint efforts and maximizing the time we have left will enable us to reach this goal.

About AbbVie

AbbVie’s mission is to discover and deliver innovative medicines that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people’s lives across several key therapeutic areas: immunology, oncology, neuroscience, eye care, virology, women’s health and gastroenterology, in addition to products and services across its Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at www.abbvie.ca. Follow AbbVie Canada on Twitter, Instagram and LinkedIn.

1 Timing of elimination of hepatitis C virus in Canada’s provinces.https://canlivj.utpjournals.press/doi/full/10.3138/canlivj-2022-0003. Accessed November 2022.

2 Action Hepatitis Canada. Progress Toward Viral Hepatitis Elimination in Canada. 2021 Report. https://www.actionhepatitiscanada.ca/uploads/8/3/3/9/83398604/ahc_progress_report_2021.pdf. Accessed November 2022.

3 Action Hepatitis Canada. Priority Populations. https://www.actionhepatitiscanada.ca/priority-populations.html. Accessed November 2022.

4 IQVIA GPM National Audit for HCV/Direct Acting Antivirals Market, January 2019–November 2020.

5 Canadian Liver Foundation. https://www.liver.ca/hepatitis-c-warning/. Accessed November 2022.

6 Canadian Liver Foundation. https://www.liver.ca/how-you-help/advocate/. Accessed November 2022.

For further information:

Media:

Muriel Haraoui, AbbVie Canada, 514-717-3764, muriel.haraoui@abbvie.com

373 First Nations people died from illicit toxic drugs in B.C. in 2022: Toxic Drug Data report 

CBC News: First Nations people are disproportionately represented in toxic drug poisoning deaths in British Columbia, according to new data from the First Nations Health Authority.

First Nations members represented 16.4 per cent of toxic drug deaths in B.C. in 2022, despite making up only 3.3 percent of the province’s population, according to the FNHA’s Toxic Drug Data report.

It shows that 373 First Nations people lost their lives to drug toxicity last year, meaning First Nations people are dying from toxic drugs at 5.9 times the rate of the general population.

At a news conference in Vancouver on Friday, FNHA acting chief medical officer Dr. Nel Wieman described 2022 as “the most devastating year for First Nations people.” 

“We’ve lost too many loved ones to the toxic drug supply,” Wieman said.

• Nearly 600 people died from toxic drugs in B.C. in first 3 months of the year: coroners’ service

The report comes on the heels of preliminary data released by the B.C. Coroners Service that showed almost 600 people in B.C. died in the first three months of 2023 because of the toxic drug supply. 

At least 11,807 lives have been claimed by toxic drugs since a public health emergency was declared over the issue seven years ago.

Wieman said more than a third of the First Nations victims in 2022 — 36.5 per cent —  were women, meaning First Nations women are dying at 11.2 times the rate of female B.C. residents as a whole. Less than a quarter of all toxic-drug deaths in B.C. in the first three months of 2023 were women.

‘This is the ugly truth’

But men, at 63.5 per cent, still make up most of the toxic-drug deaths among First Nations.

One of those taken was Darius Smallboy, a 23-year-old Cree youth living in Vancouver. 

“My son had such a loving and caring spirit,” said Rex Smallboy, who is originally from Maskwacis, Alta.

Darius left behind three sisters, a mom and a community in East Vancouver that thought the world of him, according to several online posts in his memory. He was a powwow drummer, a singer and a young man known for his big heart.

“[He] showed me that you could be strong and still be taken away,” Smallboy said through tears, while talking to CBC before the news conference.

During a trip home from a visit with his maternal family when he was 21, Darius slipped on some ice and broke his collarbone. “And that’s when everything changed,” said Smallboy. After his surgery, he became addicted to painkillers.

Smallboy said he was unaware of how deeply entrenched his son was in substance use, even though he noticed small changes over the years. “As a parent, I was in denial. I didn’t want to see my son in that light. And his death, he showed me this is the ugly truth.” 

Addiction among First Nations linked to colonialism

Now Smallboy wants to open up conversations about addiction among Indigenous people, men in particular, and make them feel safe to express emotions like grief. “That whole side of colonialism taught us how to be tough and not express our feelings and not to have needs,” he said.

The FNHA says intergenerational trauma from surviving “the residential school system and other racist federal government and provincial government policies, including the Sixties Scoop, are for many a deeply rooted cause of harmful substance use.” “My son showed me that the most beautiful person is not safe. It is a part of being hurt,” said Smallboy. 

Not enough being done

During the news conference, Wieman said the drug-poisoning crisis is the worst it has ever been. “We have to treat this as it is — a public health emergency,” she said. “It’s sad, and it actually makes me angry,” said Chris Livingstone, interim executive director of the Aboriginal Front Door Society, a safe place for Indigenous people in Vancouver’s Downtown Eastside. 

• Indigenous advocates call for more culturally informed addictions treatment in B.C.

Livingstone started the Western Aboriginal Harm Reduction Society in 2002 when he says he was living on the street and a drug user.  “As an Indigenous person and someone that is down here, I can recognize the disconnection,” said Livingstone, who is Nisga’a from Laxgalts’ap.

• Northern B.C. First Nations say they need more resources to deal with the illicit drug crisis

“You’re disconnected from your family and your culture. There’s no access to housing, and the supports out there are not enough to help people make changes in their lives,” he said. 

‘Real safe supply’ needed: Livingstone

He also says in the bigger picture, policy changes are still needed to address the crisis.  “There’s a certain amount of drugs making their way into this country, so there should be a way for us to find out where they are coming from and stop that part of it,” Livingstone said.  “Even before that, doctors, nurses and health-care professionals need to get a real safe supply to the people.”

He says people in the Downtown Eastside access safe supply through the Rapid Access Addiction Clinic at St. Paul’s Hospital. But he says he doesn’t know anyone who has succeeded in addressing their addiction through the program. He thinks the program needs to be expanded to serve a diversity of needs. He also believes that Indigenous people could benefit from land-based programs to help them reconnect with their culture, people and land.

ABOUT THE AUTHOR

Angela Sterritt, CBC Reporter

Angela Sterritt is an ​award-winning investigative journalist. She is the host of Land Back, a six-part CBC British Columbia original podcast that uncovers land theft and land reclamation in Canada. Sterritt is known for her impactful journalism on the tensions between Indigenous people and institutions in Canada. She is a proud member of the Gitxsan Nation.

Nunavut mother says some Inuit who leave territory for health care don’t return

CBC News: Medical travel between the remote community of Clyde River, Nunavut, and Ottawa has been an essential, but difficult journey for Tina Kuniliusie and her 14-year-old daughter Tijay.

The toll has been high and after almost a decade and a half of navigating the medical travel system, Tina says her family may have to move to Ottawa permanently. “Ten years is a long time to fight the system. I cannot continue another 10 years. That is too much on one’s well-being. So whether I like it or not, it looks like it’s going to have to happen,” she said.

Ottawa is a major hub for essential medical services for the hundreds of Nunavut children that have to leave the territory for care. The long and repeated journeys are costly and can be exhausting for the families and bringing care closer to home is difficult.

For Tina and her partner James Sangoya, Tijay’s father, it can involve several long trips a year — disruptions that take them away from obligations at home, their respective families and culture. “It is painful because we have to leave our community and go to a totally different culture to access these medical places that are not available in Nunavut,” Tina Kunilisie said.

Tijay’s first trips by plane to a hospital in Iqaluit were related to respiratory infections. Before she turned one, her family had to take her to CHEO, the children’s hospital in Ottawa, because her medical needs became more complex.

A trip this fall was supposed to last four days, but stretched to four weeks as more appointments were added on. Some stays last months, Tina said.

The two-flight journey — from Clyde River to Iqaluit, and then from the territorial capital to Ottawa — typically takes 12 hours.

Hundreds face medical travel

CHEO has seen a steady annual increase in inpatient admissions and clinic visits from Nunavut over the last decade, which only temporarily slowed during the first two years of the pandemic when travel restrictions were strict.

At the 2019 peak, there were 544 Nunavut patients at CHEO’s clinics and 191 hospital admissions. In the first 11 months of 2022, there were 456 clinical patients and 163 hospital admissions.

Stephanie Mikki Adams, executive director of Inuuqatigiit Centre for Inuit Children, Youth and Families, said families struggle when they’re told they need to travel south for care. “At that instant, they have a million questions. They’re scared,” Adams said. “Who is going to watch my children? Who is going to go down and escort [the] child? Am I going to be able to go on leave with pay?”

While Nunavut and Indigenous Services Canada cover medical travel expenses for children and one escort, a second escort or siblings are assessed separately. Families still may face financial hardship because of work interruption or bills at home. 

Adams had to travel south for her own care and, at one point, send her teenage daughter away for concussion treatments. “We are placed in a southern environment where we have no connections to our culture and our language,” she said.

“When you’re moving from an isolated community of about 300 to 1,000 people to a bigger city, there is a great risk of culture shock and losing your culture.”

Adams’ organization Inuuqatigiit provides interpretation, cultural and logistical support for Inuit families during medical travel in Ottawa.

• Larga Baffin to fight zoning appeal of Inuit health-care facility
• Ottawa medical school partnership aims to train more Inuit

Families that are travelling also have access to the Nunavut-funded Ottawa Health Services Network Inc. (OHSNI), which co-ordinates medical travel, access to services, and secures funding through the federal Inuit Child First Initiative.

Adams said the strain caused by medical travel will continue as long as there aren’t enough medical services in the territory. “Nunavut, in a sense … is a third-world country within a first-world country.”

In a statement this summer, Nunavut’s Ministry of Health said it’s collaborating with CHEO and OSHNI to expand the territory’s pediatric programs with a “care closer to home mentality.”

There are more specialist consultations happening in the territory and medical devices are made available in the community to help children with acute respiratory conditions, according to the ministry. 

Hard choices

For some families the disruption of repeated medical travel becomes too much and they face the difficult decision of placing their children in medical foster care.

Those parents still have all rights to their children and are kept connected and informed, according to a statement from OHSNI. 

The Nunavut Department of Family Services says 68 children were in medical foster care in 2020-21. OHSNI said instances of medical fostering have “declined to become a true rarity in recent years.”

Tijay’s father James Sangoya said the family had thought about medical fostering but decided against it. Even a respite stay for Tijay in Ottawa was “unbearable,” according to Tina.

Advocates in the system

Canada’s colonial history has contributed to Inuit mistrust toward the medical community. It’s something Dr. Radha Jetty, medical lead at CHEO’s Aakuluk clinic, saw during her time working as a pediatrician in Nunavut.

• Trudeau apologizes for ‘colonial’ mistreatment of Inuit with tuberculosis relocation

“That’s a conversation that we’re having now: that racism is alive and well in the health-care system,” Jetty said in an interview prior to her parental leave earlier this year.

CHEO opened the Aakuluk clinic in 2019 to provide culturally-relevant care and support for children coming from Nunavut and their families as they face the disruption and strain.

“We work very hard to try to provide support to the family to stay here and stay together, or whenever possible repatriate the family. Even under circumstances that care providers wouldn’t normally consider,” Jetty said.

Jetty said medical fostering is among the last options when a child has serious medical needs and their family can no longer cope. 

She is concerned about repeating the mistakes of colonial policies as a result of unequal access to care, even if it isn’t the intention of any individual practitioner. “Although we don’t have the exact same system in place, we have elements of this kind of institutionalization, separation of families, separation of children from their culture and their language, their families and their land,” Jetty said.

That’s partly why experts advocate for more specialized equipment in Nunavut and collaborate with northern pediatricians so they can provide complex care closer to home, Jetty said.

Solutions in the territory

Dr. Amber Miners, a pediatrician in Iqaluit, said her team at Qikiqtaniq General Hospital is constantly pushing to provide more care. 

In one case, she said, they were trained and equipped to perform a blood procedure so a child could travel to Iqaluit once a month instead of having to live in Ottawa for years.  “It’s not completely perfect, but it’s much better for the family,” Miners said.

There will always be some need for medical travel in more specialized treatments given the sparse population of the territory, she said. “My hope for the future is that we could build more capacity within the territory and I’d love to see more Inuit practitioners in the territory. We will never not need our southern partners,” she said.

Miners said telehealth has always been important in Nunavut, but her team was involved in more remote consultations with specialists during the pandemic. 

Aluki Kotierk, president of Nunavut Tunngavik Incorporated, said the COVID-19 pandemic showed medical resources can be mobilized when there’s political will. “A family should not have to choose between being with extended family and culture and language, and making sure someone gets health-care needs that they require,” Kotierk said. “That it happens is already wrong.”

Kotierk said there needs to be more recognition of Inuit medical knowledge in domains such as midwifery and mobilization of family kinship networks to support delivering services in Nunavut.

‘Some don’t return’

When asked on whether services that keep children in communities are prioritized through the Inuit Child First Initiative, Indigenous Services Canada said funding is based on a child’s needs as assessed by professionals, and not the services provided.

Tina wants to see more medical services available in Nunavut, in communities like hers. 

She said while programs like the Inuit Child First Initiative made it possible for her to get medical and mobility devices for Tijay, she qualifies for other services she can’t get at home.

“If they work now in regards to providing these services in Nunavut, we could eventually see it in 10 to 20 years,” Tina said. 

“But at least it would give us a start, instead of watching our Inuit go south,” she said. “Some don’t return, just like how they would with [tuberculosis] relocation or residential schools.”