Sources for the above are from StatsCan,
Calls to Action
There are seven Health Calls to Action. To find out more about each Call to Action, including government responses and progress to date, visit the links below.
|Call to Action #18||Recognize and implement healthcare rights of Indigenous peoples|
|Call to Action #19||Establish measurable goals to identify and close health gaps|
|Call to Action #20||Address distinct needs of Métis, Inuit and off-reserve First Nations|
|Call to Action #21||Provide ongoing funding for existing and new Aboriginal Healing Centres|
|Call to Action #22||Recognize value of Indigenous healing practices and use in health system|
|Call to Action #23||Increase the hiring and retention of Indigenous healthcare workers|
|Call to Action #24||All students to take a course in Indigenous culture and awareness training|
Three of the most alarming health-related problems within the Indigenous world are Suicide, Drinking Water Advisories and Food Insecurity in the north. All three are endemic throughout the country and have devastating effects. Given their profound impact on Indigenous people’s lives, the following sections on National Suicide Prevention, Drinking Water Advisories and Food Insecurity address these issues.
|Suicide Prevention||National strategies and action plans|
|Drinking Water Advisories||What are they? What are the current issues?|
|Food Insecurity||Issues and recommended Inuit solutions|
Call to Action Status Updates
|For an updated summary of the TRC Calls to Action, including all Health Calls to Action, click here (PDF 205 KB).|
Current Problems and Issues in Indigenous Health
Failure of BC Government to respond to multiple requests from BC First Nations for information and resources to protect them from COVID-19
June 24, 2020: Globe and Mail – First Nations are among the most vulnerable populations in B.C., with the most to lose – the loss of an elder represents a loss of language, culture and history. First Nations are still waiting for the BC government to respond to repeated requests for more information and resources to protect communities and fulfill the following four basic measures:
- An information-sharing agreement to ensure early reporting of suspected and confirmed cases in nearby regions to Indigenous governments;
- screening methods to ensure travellers seeking to enter Indigenous territory are not symptomatic or infected with the virus; \
- rapid-testing mechanisms available that can prioritize Indigenous and remote communities – in fact, there are currently just two rapid testing kits for all Indigenous communities in B.C.
And finally, funding for culturally safe contact-tracing that can increase the likelihood of effective tracing in the event of an outbreak, and reduce the risk of racist interactions with the health care system of the sort the government has decried.
We continue to call on the B.C. government to consult and meet with us, on a nation-to-nation basis, to begin implementing the four safety measures on an urgent basis, and to discuss the underlying issue of systemic racism, which appears to be driving the status quo of putting Indigenous lives at risk.
June 25, 2020: News 1130 – The Heiltsuk, Nuu-chah-nulth, and Tsilhqot’in nations say the provincial government didn’t consult them before throwing the doors open to non-essential travel. Their priority, they say, is protecting elders and Indigenous leaders say basic safety measures are not yet in place to be able to welcome travellers to their communities.
Independent investigation into systemic racism within the BC Health Care system
June 19, 2020 – First Nations, Métis and Inuit patients seeking emergency medical services in British Columbia are often assumed to be intoxicated and denied medical assessments, contributing to worsening health conditions resulting in unnecessary harm or death. This is according to information obtained by Métis Nation BC and the BC Association of Aboriginal Friendship Centres. Additionally, the parties have notified the First Nations Health Authority of this concern.
Participants within the San’yas Indigenous Cultural Safety Training program detail thousands of cases of racism in healthcare, resulting in the harm of Indigenous patients. In a recent training session, a program participant disclosed a common game played within B.C. hospital emergency rooms, where physicians, nurses and other staff try to guess the blood alcohol concentration (BAC) of Indigenous patients. The winner of the game guesses closest to the BAC – without going over.
The Province of B.C. has yet to enforce standardized anti-racism training for health service workers
BCAAFC and MNBC, Indigenous leadership are calling upon the Ministry of Health to accept the following four recommendations:
- A public inquiry into Indigenous specific racism in health care in B.C with a focus on hospitals and emergency departments.
- Ensure that all front-line staff are required to take mandatory First Nations, Métis and Inuit training that results in increased health professional personal accountability in the delivery of safe health care.
- Commit to structural and systemic changes to dismantle indigenous specific racism to ensure culturally safe health care experiences for Indigenous people.
- Ensure that Indigenous governments play a stronger role in the development and implementation of anti-racism programs and training throughout BC.
July 9, 2020 – An independent investigation into Indigenous-specific racism in British Columbia’s health care system was launched today by former judge and provincial child advocate Mary Ellen Turpel-Lafond. Appointed by Health Minister Adrian Dix on June 19 after highly disturbing allegations of racism in B.C. Emergency rooms came to light, Turpel-Lafond has now assembled her team for the “Addressing Racism” investigation, established her terms of reference and launched a survey to collect and assess the experiences of First Nations, Métis and Inuit people when they access health care. “Our task is to address the specific incidents that have been reported, as well as to gauge the levels of systemic and individual racism that Indigenous people face when using the health care system in general,” Turpel-Lafond said. After examining the systemic racism that occurs in the health system, the investigation will make a number of recommendations designed to prompt necessary improvements.
Government of Quebec infringing on First Nations Aboriginal treaty rights by their failure to consult with First Nations on Bill 62’s impact on their health
June 5, 2020 – Bill 61, an omnibus bill (An Act to stimulate the economy of Quebec and mitigate the consequences of the state of health emergency), declared on March 13, 2020 due to the COVID-19 pandemic and tabled earlier this week by the CAQ government cannot be misused by the Quebec government to minimize its duty to consult First Nations and reduce the application of already low environmental standards to a minimum. It cannot take advantage of the current context to put the health of our populations on the back burner, nor can it more openly infringe First Nations’ Aboriginal and treaty rights,” said AFNQL Chief Ghislain Picard.
There is an opportunity here for the provincial government to put its words into action and listen to First Nations who are looking for a balance between their own economic recovery and the protection of their territories. In any case, as we have decades of experience of being excluded from the decisions that affect our communities, we will continue to do what it takes to ensure that our governments have a voice when it comes to the development of our non-ceded territories and resources,” concluded the Chief of the AFNQL.
First Nations protest against Manitoba Hydro Keeyask project due to COVID-19 health concerns.
Northern Manitoba First Nations had the highest rates of hospitalizations of all First Nations in Canada during the last H1N1 pandemic. MacLean’s July 16, 2009
May 21, 2020: CBC – Members of the four First Nation community partners of Manitoba Hydro’s Keeyask project (Tataskweyak, Fox Lake, War Lake and York Factory) have launched protests to protect their communities from COVID-19. Hydro is switching out the current 600 on-site employees with an outside group of 1000 some of whom are from outside Manitoba. The Manitoba Court of Queen’s Bench issued an injunction on Monday, ordering the blockade be removed and Hydro be granted access to the construction site. The injunction was served on Wednesday by members of the RCMP.
Chief Doreen Spence “ripped that injunction [and] put it on the ground,” Tataskweyak band Coun. Nathan Neckoway said Thursday morning.
A number of Tataskweyak Cree Nation community members who are concerned about the possible spread of COVID-19 started blocking Provincial Road 280 and the north access road to the Manitoba Hydro Keeyask work site on the weekend, in an attempt to stop a worker shift change scheduled for Tuesday. After the injunction was delivered, Fox Lake First Nation put up their own blockade on the Keeyask south access road.
May 20, 2020 – CBC We were not included in the discussion of the plan for the shift change,” said Robert Wavey, a band member and spokesperson for Fox Lake Cree Nation. “It was given to [First Nations] after Hydro came up with their plan.” “Our First Nations leaders do not want to see a repeat of what is happening in La Loche, Sask.,” Settee said in the letter, referencing a COVID-19 outbreak in the northern and largely Indigenous town, which affected more than 100 people.
Discrepancy in COVID-19 health data on Indigenous people from federal, provincial and territory government health sources
May 12, 2020: Yellowhead Institute release of Policy Brief: “Colonialism of the Curve: Indigenous Communities and Bad Covid Data”. There is wide discrepancy on COVID-19 related health data from Indigenous Services Canada (ISC) and provincial health authorities:
- There is no agency or organization in Canada reliably recording and releasing Covid-19 data that indicates whether or not a person is Indigenous.
- The division of powers between provincial and federal government has gradually displaced and disrupted Indigenous governance over time.
- ISC only gathers on-reserve data which eliminates over 50% of the Indigenous population who live off-reserve
- Canadian federalism was established to serve Canadians and consequently maintains discrimination and sub-standard service delivery in on-reserve communities.
- This jurisdictional fight between provinces and the federal government, where both claim the other is responsible for services, more often than not leaves Indigenous people without any services.
Through publicly available data—media reports, Band Council updates to members, local reports and obituaries—a team of researchers supported by Yellowhead has compiled and verified many more cases.
- ISC: COVID-19 cases = 175; Deaths = 2
- Yellowhead: COVID-19 cases = 465; Deaths = 7
The same gaps in data collection exist in child welfare and were a primary reason why the National Inquiry on Missing and Murdered Indigenous Women and Girls were unable to definitively identify the number of Indigenous women who have been murdered or are missing.
Publicly accessible data makes it easier for Indigenous people to seek accountability from leaders, and to independently evaluate and measure the efficacy of interventions by all levels of government, including our own Indigenous leadership. In fact, this is probably one of the reasons why we don’t have it.
Protecting the health of oilsands workers is more important than protecting the health of Indigenous people as evidenced by the suspension of environmental monitoring by Alberta Energy Regulator
May 8, 2020 – Clean Tech Canada (anadian Manufacturing) – The leader of a Fort McKay First Nation surrounded by oilsands development is frustrated by the Alberta Energy Regulator’s decision to suspend a wide array of environmental reporting requirements for oil sands companies over public-health concerns raised by the COVID-19 pandemic by the Imperial Oil, Suncor, Syncrude and Canadian Natural Resources Ltd. don’t have to perform much of the testing and monitoring originally required in their licences. The regulator says some programs are to resume by the end of September, but most have no restart date. The latest exemptions specifically relieve operators of the following:
- Monitoring most ground and surface water, unless it enters the environmental
- most all wildlife and bird monitoring is suspended
- Air-quality programs, including one for the First Nations community of Fort McKay, have been reduced, along with many other conditions of the companies’ licences
- Testing for leaks of methane, a powerful greenhouse gas, has been suspended
- Wetlands monitoring and research is gone until further notice
- Water that escapes from storm ponds no longer must be tested
The decisions to suspend environmental monitoring were made unilaterally. We were not notified—in fact, we would have had no idea this had occurred if it had not been revealed in the press,” stated Mel Grandjamb, Chief of Fort McKay First Nation. Consultation would have enabled us to inform the regulator how its monitoring decisions impact our Nations. Both we and the industry would have been better served by the clarity that consultation would have contributed to these decisions.”
In the days leading up to these decisions, our representatives sat AER, government and industry representatives to provide oversight to environmental monitoring programs under the Oil Sands Monitoring Program. The fact AER did not mention once it was considering suspending monitoring, some of which may overlap with program work, is very disappointing. This neglect does not encourage reconciliation. In March, the Canadian Association of Petroleum Producers requested that the federal government relax several regulatory and policy activities, including an indefinite suspension of all consultation with industry to develop new environmental policies. At the same time, industry has lobbied the provincial government to resume consultation with Indigenous communities to advance projects despite the closure of our communities due to COVID-19 pandemic responses.
June 23. 2020 – All temporarily suspended reporting and monitoring requirements will come back into effect on July 15, 2020. The Alberta Energy Regulator’s (AER) decision to end its temporary suspensions follows steps taken by the Government of Alberta, including the repeal of Ministerial Order 219/2020 and Ministerial Order 17/2020.http://nationtalk.ca/story/aer-temporarily-suspended-requirements-to-resume-july-15
Among youth aged 10-17 suicide is the # 1 leading cause of death on Manitoba
May 7, 2020 – On national Youth Mental Health Day, the Manitoba Advocate for Children and Youth released “Stop Giving Me a Number and Start Giving Me a Person: How 22 Girls Illuminate the Cracks in the Manitoba Youth Mental Health and Addiction System”. The report focuses on the suicide of 22 girls aged 11-17 from mostly rural and norther communities between 2013 -2019. 20 of the victims were either First Nations or Métis.
These girls did not have appropriate access to mental health and addictions services where they lived. And as we know from past reports, like The Slow Disappearance of Matthew (February 2020), demand for these provincial services in Winnipeg already outpaces supply,” Penrose said. All of the girls in this report also experienced early childhood traumas, but only three were offered some type of professional trauma-related interventions in their early and middle years.
Similar to the findings of our 22 child death investigations, the Virgo Report repeatedly noted that the availability of, and accessibility to, services in the mental health and addictions systems vary greatly across our province by region. Rural and remote communities throughout Manitoba, for example, experience limited access to services and supports due to their location and the availability of service providers. Of course, these rural. and remote locations, where services are limited or non-existent are also the locations populated by Indigenous Peoples. This leads to unequal access to provincial services, which is a children’s rights issue. This current investigation found that many of the Virgo Report’s criticisms of Manitoba’s youth mental health and addictions system remain true today and are certainly reflected in the stories of the 22 girls which informed this report. These include a lack of access to locally available services, a lack of follow-up support after crisis, service providers not communicating and collaborating to carry out plans, a lack of access to culturally appropriate services, and services that do not match the needs of youth.
- Conduct a gap analysis – The province must see what services are available in youth mental health and addictions and release a public framework and its strategic plan for system overhaul.
- Demonstrate equitable access to services – The province must spread youth mental health and addictions services throughout Manitoba in any future frameworks or strategic plans.
- Train workers on trauma and its effects – The province must provide early childhood trauma education to all government service providers working with children and youth.
- Help families learn where the right resources are – The province must conduct and publicize an annual inventory of what therapeutic trauma interventions are available to children and youth in Manitoba, describing whether services require referrals and what their eligibility criteria are.
- Create more youth hubs – In keeping with recommendation 4.8 of the Virgo Report, the province must establish more youth hubs outside of Winnipeg, providing access to community-based services like counselling, tutoring and extracurricular activities.
- Create “focal points” outside of Winnipeg – In keeping with recommendation 2.11 of the Virgo Report, the province must develop “focal points” outside Winnipeg, so that all Manitobans can have access to urgent and acute mental health and addictions clinicians and other professionals and services closer to their homes.
- Create long-term treatment for youth with the highest needs – The province must develop an inpatient or community-based long-term treatment facility that offers stabilization, assessment, treatment and aftercare for youth at the top tier of mental health and addiction service needs.
Reducing risk to Indigenous inmates of becoming infected by COVID-19
April 20, 2020 – First Nations leadership across BC is united in calling for immediate action to protect incarcerated peoples amidst the COVID-19 pandemic. The COVID-19 outbreak at the Mission Institution is now the third largest outbreak in the Province of BC, with the first inmate tragically passing away on April 15, 2020. Senior health and corrections officials have verified that almost 40% of the confirmed cases of COVID-19 at Mission Institution are among Indigenous inmates despite Indigenous people making up just 5% of the population in BC.
April 23, 2020: The Indigenous Bar Association (IBA) Calls Upon Federal, Provincial and Territorial Justice Ministers and Attorneys General to Immediately Release low-risk Indigenous Inmates over COVID-19.Specifically, we call for the immediate release of incarcerated Indigenous people and the following actions:
- Immediately and minimally, carry-out the release of Indigenous inmates that are low-risk, non-violent, nearly eligible for parole, nearing sentence end, over 50 years of age, pregnant women, those offenders who are able to be adequately supervised in the community, and those at heightened risk due to pre-existing medical and chronic health conditions;
- The release of inmates described above to apply to federal and provincial correctional facilities, including all remand, youth and short-term detentions centres;
- For those that absolutely cannot be released, ensure:
- Full access to medical and mental health care;
- Full and equitable access to personal protective equipment, medical grade sanitizer and cleaning agents, personal hygiene products, and other critical supplies, with invariable availability of these supplies to all inmates and correction workers (including officers, administrators, and all other employees and contractors);
- Access to enhanced cultural supports during heightened safety measures, ensuring any quarantine of those incarcerated is carried out in the least traumatic way, in an attempt to mitigate resurgence of traumatic experiences or intergenerational effects of the legacy of colonialism;
- In accordance with domestic and international laws and conventions, ensure that institutions do not use isolation methods that are akin to segregation punishment for infected inmates, specifically:
- Individuals should not serve longer than 15 days in segregation, isolation, solitary confinement, medical removal or administrative removal;
- Those who are segregated within the 15-day limit are given access to daily use of shower, telephone, and recreational facilities;
- Those who are segregated are given daily access to mental health professionals in attempt to mitigate the lasting damage done by isolation;
- Implement the short and long-term measures identified recently by the Union of British Columbia Indian Chiefs in their open letter dated March 24, 2020; and
- Correctional Services Canada and all provincial correctional jurisdictions implement the recommendations of the Correctional Investigator of Canada, Dr. Ivan Zinger and take notice of specific requests by Indigenous organizations and communities.
First Nations infant deaths by sudden infant death syndrome (SIDS) were 4.5 times higher in Manitoba than non-First Nations infants
Mar. 13, 2020 – 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.
Failure of all governments to protect Indigenous people from H1N1 pandemic (27.8% of all infections in Canada in 2009 were Indigenous)
Mar. 17, 2020: Globe and Mail – Despite accounting for just under 5 per cent of the Canadian population, Indigenous people were 25 per cent of those admitted to ICUs during the first wave of H1N1. First Nations children were 21 per cent of the paediatric patients admitted to ICUs during both waves. This led to sad and tragic outcomes. Indigenous peoples represented 17.6 per cent of the reported deaths in the first wave and 8.9 per cent of reported deaths in the second.
These figures likely reflect the lack of timely interventions and diagnoses that plague communities who depend on understaffed nursing stations for their health-care needs, as well as jurisdictional squabbling about roles and responsibilities.
John Borrows is Canada Research Chair in Indigenous Law at the University of Victoria Law School writing with Constance MacIntosh, Viscount Bennett Professor of Law at Schulich School of Law at Dalhousie University
Timmins Police Service, Timmins and District Hospital, Cochrane District Social Services Administration Board for discrimination against Indigenous people
Feb. 5, 2020 – Timmins The Daily Press – On the second anniversary of the deaths of Joey Knapaysweet and Agnes Sutherland, the Ontario Human Rights Commission (OHRC) announced it has filed an application with the Human Rights Tribunal of Ontario (HRTO) alleging discrimination based on Indigenous ancestry by public service providers in Timmins, Ontario.
The February 2018 deaths of Joey Knapaysweet and Agnes Sutherland highlight the serious and sometimes tragic result of systemic discrimination against First Nations peoples in Northern Ontario. Both Joey Knapaysweet and Agnes Sutherland traveled to Timmins from Fort Albany First Nation, more than 400 km away, to access health services that were not available in their community. These circumstances left them particularly vulnerable to discrimination.
The OHRC acts in the public interest and is committed to ensuring that Indigenous peoples receive equal access to essential services consistent with their unique cultural and language needs, pursuant to the Ontario Human Rights Code and consistent with the UN Declaration on the Rights of Indigenous Peoples. The OHRC is seeking a variety of public interest remedies, including requiring the respondents to:
- Engage with Indigenous communities to understand their concerns and needs
- Develop policies and provide training to ensure that their services are delivered in a culturally competent and safe manner, free of discrimination
- Develop a human resources plan to promote and expand the hiring and promotion of Indigenous staff
- Collect human rights-based data to identify problems and monitor solutions.
Health Canada, Government of Canada and Government of Alberta’s refusal to conduct a baseline health survey as recommended by provincial health organizations
Dec. 17, 2019: Canada’s National Observer – Repeated failure by government authorities to conduct a comprehensive baseline health study as recommended by the Alberta Cancer Board (supported by the province’s governing health authority, Alberta Health Services) in 2009. In Fort Chipewyan a community of roughly 1,200 people, the study found, you would expect to see 39 cases of cancer. Instead, it found 51 cases, a difference of 30.7 per cent. The Athabaska River flows through Canada’s oil patch, giving rise to the theory that the oil-and-gas industry is responsible for the illnesses, having poisoned people for years by contaminating the environment. Government bodies and researchers have challenged that theory, leading to a call for a new more conclusive health study that could provide real answers.
Athabasca Chipewyan First Nation and Mikisew Cree First Nation pooled their resources to fund research. With some additional funding from Health Canada, a three-year, $1-million study was led by Stephane McLachlan, a professor at the University of Manitoba. His findings released in 2014 measured contaminants not only in water but also in beavers, ducks, fish, moose and muskrats — animals consumed as part of a traditional diet for those who continue to live off the land in the Peace-Athabasca Delta. He concluded that the animals contained high concentrations of pollutants such as carcinogenic polycyclic aromatic hydrocarbons and heavy metals such as arsenic, mercury, cadmium and selenium. All of these are by-products of extracting and upgrading bitumen. Arsenic in particular has been linked to increased risk of biliary tract cancer.
Accepted practice of Thunder Bay Regional Hospital security escorting Indigenous patients in need of medical care off of hospital property
Nov. 9, 2019: Toronto Star – A 19-year old First Nations man taken to the hospital by ambulance in obvious distress was escorted off the hospital property three hours later by security staff. Apparently, escorting Indigenous people who are seeking medical care off of hospital property is common practice. The would be patient ultimately committed suicide at a remote part of nearby Lakehead University.
An internal review of the case by the hospital “concluded that appropriate actions were taken and that the right decisions were made by clinical staff based on the information provided to them and the patient’s presentation.”
Tanya Talaga, Toronto Star
An investigation is currently underway by Ontario’s chief coroner, Dirk Huyer. He told me it will look for any “potential systemic issues that may have played a role in contributing to the death — policies, procedures, steps taken.” It will also examine whether this death is part of a pattern — and make any recommendations necessary to break that pattern.
Federal Government and Government of Ontario for ongoing failure to address access to health issues in Nishnawbe Aski Nation who have declared a Public Health Emergency across NAN territory
Oct. 23, 2019 – Nishnawbe Aski Nation (NAN) Resolution 16/04 Call for Declaration of Public Health Emergency. The Sioux Lookout Chiefs Committee on Health and the NAN Executive declared a Health and Public Health Emergency for First Nations across NAN territory. This Declaration was not made lightly. It was forced into existence by decades of perpetual crisis and persistent health care inequities at the NAN community level. The Declaration is an assertion of the inherent Treaty rights of NAN members to equal opportunities for health, including access to appropriate, timely, high-quality health care, regardless of where they live, what they have or who they are.
In order to exercise our self-determination over health we need to bring back accountability, responsibility and resource allocation to our communities. This involves changing the current colonial system to a new system that is based on the needs and priorities of our communities. This led to the execution of a trilateral commitment document: The Charter of Relationship Principles Governing Health System Transformation in NAN Territory (the Charter) which was mandated by NAN Resolution 17/21. The Charter was signed by the Parties (Grand Chief Alvin Fiddler, Minister Jane Philpott and Minister Eric Hoskins) on July 24, 2017.
In order to support the NAN Health Transformation process, the governments agreed to several actions, including:
- Developing new approaches to improve the health and health access, including access at the community level.
- Supporting the ability of First Nations communities and organizations to deliver their own services.
- Proposing policy reform and exploring legislative changes to design a new health system for NAN territory, including sustainable funding models and decision-making structures.
- Removing barriers caused by jurisdiction, funding, policy, culture and structures so that First Nations can deliver better plan, design and manage their own services
NAN is a political territorial organization representing 49 First Nation communities within northern Ontario with the total population of membership (on and off reserve) around 45,000 people. http://www.nan.on.ca/upload/documents/mushkikiw-wiichihiitiiwin-gathering-fina.pdf
July 9, 2020 – Minister of Indigenous Services, announced $2,657,560 to support the Nishnawbe Aski Nation (NAN) Mental Health and Addictions Pandemic Response Program, a unique First Nation-led initiative responding to the specific health needs of community members in northern Ontario. It will identify the mental health and wellness services that are already available, and bridge the existing gaps so that every individual can have access to culturally safe and community based mental health services when needed. Keewaytinook Okimakanak (KO) eHealth and Sioux Lookout First Nations Health Authority (SLFNHA) will run the program, which is designed to provide community members with equal access to high-quality, culturally safe substance use treatment and mental health services with direct input from communities. The services will be coordinated, delivered and promoted by the Regional Health Authorities, Tribal Councils, and community organizations within the NAN region, and will offer access to 24/7 culturally appropriate crisis supports, triage and live service navigation, improved usage of tele-mental health supports, and will help eliminate duplication in existing mental health and problematic substance use services.
Government of Nunavut’s repeated failure to implement Canadian Paediatric Society recommendations to administer Palivizumab to all Inuit babies with respiratory issues
Oct. 20, 2019 : 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.
Government of Manitoba for worsening health outcomes of First Nations people comparing data from 2015 – 17 vs 2002.
Sept. 17, 2019 – University of Manitoba Today – Joint study by the First Nations Health and Social Secretariat of Manitoba (FNHSSM) and the Manitoba Centre for Health Policy (MCHP) in the Rady Faculty of Health Sciences at the University of Manitoba, “The Health Status of and Access to Healthcare by Registered First Nation Peoples in Manitoba” compares health data collected in 2015-2017 with the results of a study the MCHP published in 2002.
“When we look at health status and health-care access, the inequities between First Nation people and all other Manitobans have gotten worse, according to many indicators,” said Leona Star, a Cree woman who is director of research at FNHSSM and co-led the study. For example, the First Nations life expectancy from birth in 2002 was 7 years lower than for the non-Indigenous population; in 2019 First Nations life expectancy from birth is now 11 years lower.
Other disturbing trends:
- First Nation people’s rate of premature mortality (death before age 75): 2002 = 2x other Manitobans; 2019 =now 3x
- Suicide rates for First Nations people = 5 x higher
- Suicide attempts by First Nations people = 6x higher
As we have now documented that health inequities have increased since 2002, we propose the following specific actions:
- Annual reporting on progress in addressing gaps in health and access to healthcare;
- Development of strategic initiatives for equitable access to intervention and prevention measures (including addressing racism in the health system through mandatory cultural safety training for all staff, hiring of First Nation providers, new human resource policies for safe reporting of racist incidents);
- Development of short- and long-term plans for the training and hiring of First Nation healthcare professionals;
- Further development of research partnerships among MCHP, MHSAL, FNHSSM and Manitoba First Nations;
- Setting First Nations on the path to borderless healthcare delivery by improving access to primary care healthcare that is designed and delivered through First Nations-led partnerships.
Government of Ontario for failure to consult First Nations on Bill C-74 “The People’s Health Care Act, 2019“
Feb. 28, 2019 – Bill-74 “The People’s Health Care Act, 2019” does not contain recognition of First Nations jurisdiction in health area and specifically Articles 18 and 23, of the United Nations Declaration on the Rights of Indigenous Peoples, have not been recognized, as there has been no consultation with First Nations in developing this legislation. (Chiefs of Ontario)
This legislation is set to create a new Agency called Ontario Health, which will be formed by dissolving the province’s 14 Local Health Integration Networks (LHINs) and merging their duties with those of six other health agencies, including Cancer Care Ontario and eHealth Ontario. First Nations must be involved in the conversation if we are to improve the overall health of First Nations in Ontario,” said Ontario Regional Chief RoseAnne Archibald. “We hope for a continued collaboration between First Nations and the Government of Ontario, so First Nations can provide a recommended approach that will lead to overall healthcare improvement and address the gap within First Nations healthcare. “
Government of Manitoba for failing to address the overwhelming need for access to mental health and addiction services by Indigenous people
March 31, 2018 – 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.
Federal, Provincial, Territory Governments for failure to include Indigenous health within the Canadian Health Act
Sept. 21, 2017: Healthy Debates – “Indigenous health services often hampered by legislative confusion“. The federal and provincial governments negotiate health transfers based on the Canada Health Act, which specifies the conditions and criteria required of provincial health insurance programs. It doesn’t mention First Nations and Inuit peoples, Métis and non-status or off-reserve Indigenous peoples who are covered by the Indian Act.
This lack of clarity – and lack of policies for providing Indigenous health services – has historically been used by both the federal government and provinces to narrowly define their responsibilities toward Indigenous health. It’s created bureaucratic delays that leave Indigenous peoples waiting for care or medications readily available to non-Indigenous Canadians. And it’s created gaps in care between Indigenous and non-status and First Nations people living off-reserve.
“The move to a new fiscal relationship is significant,” Grand Chief Doug Kelly, chair of the First Nations Health Authority of BC says. Leaving Indigenous people out of health care discussions and program design hasn’t worked. Instead, he says, First Nations communities should be empowered to identify their priorities and develop a plan. Once costs are attached, communities would negotiate with the government for transfer payments. Groups like the First Nations Health Managers Association that Marion Crowe, Executive Director represents, have been working to prepare communities for the eventual transfer of responsibility, focusing on developing health human resource and health administrative capacity within First Nations communities.
Government of Manitoba for refusing to conduct a public inquiry into the death of an Indigenous man, Brian Sinclair, who died as a direct result of institutional racism at the Winnipeg Health Sciences Centre
Sept. 15, 2017: CBC – Brian Sinclair was killed by racism on Sept. 21, 2008. He was ignored for 34 hours, despite his need for urgent medical care, because medical professionals made negative assumptions about him based solely on his appearance. Anti-Indigenous bias is an endemic problem in Canadian health care:
- The hospital authority denied that stereotyping had anything to do with Mr. Sinclair’s death.
- The government of Manitoba refused to hold a public inquiry.
- The inquest into Mr. Sinclair’s death sidelined issues of race and social marginalization.
- Regulatory bodies have been slow to implement any changes, if at all, and
- no one has been held accountable for professional misconduct or criminal neglect.
The findings of the Manitoba Ombudsman rely on the government’s health and justice departments “appraising their own progress.” http://s3.documentcloud.org/documents/5782400/Brian-Sinclair-Final-Report-En.pdf.
The Brian Sinclair Working group was formed to examine the role of racism in the death of Brian Sinclair and in the inquest that followed, in order to highlight ongoing structural and systemic anti-Indigenous racism in our contemporary health and legal systems. The Sinclair family and the Sinclair Working Group have called for a public inquiry to explore the underlying systemic racism in the delivery of Health services to Indigenous populations. The Working Group aims to release a final report in 2018. The interim report “Ignored to Death” was issued Sept. 2017
Sept, 2017 – “Out of Sight: A summary of the events leading up to Brian Sinclair’s death and the inquest that examined it and the Interim Recommendations of the Brian Sinclair Working Group”. Over-all recommendation:
We recommend that all stakeholders in the healthcare system (including the federal government, the provincial government, Regional Health Authorities, unions, professional organizations, and post-secondary institutions involved in the delivery of professional programs) adopt anti-racist policies and implementation strategies that include committing resources to providing anti-racist training and supporting independent investigations when complaints are filed.
Saskatoon Health Region for forcing Indigenous women to undergo tubal ligations while in labour
July 22, 2017 -Indigenous women were coerced into having a tubal ligation in Saskatoon hospitals while still in labour. A class action lawsuit was initiated on October 5, 2017 by two affected women in the Saskatoon Health Region. (CBC). Now about 60 women are part of the lawsuit. Authorities should very carefully read Article 2 of the Convention on the Prevention and Punishment of the Crime of Genocide adopted by the UN in 1948”, Romeo Saganash, an NDP MP said. “It says that “genocide” includes any acts committed with the intent to destroy, in whole or in part, a national, ethnic, racial or religious group, such as by “imposing measures intended to prevent births within the group.”
Dec. 10, 2018 – 72 organizations endorse the joint statement from Amnesty International Canada, the Native Women’s Association of Canada, and Action Canada for Sexual Health and Rights, calling for government action to #DefendConsent and end #ForcedSterilization of Indigenous women in Canada
All the women interviewed felt that the health system had not served their needs, and they had felt powerless to do anything about it. Aboriginal women who have had such an experience that prevents them from accessing health care are aware that they are higher risk for negative consequences of health problems that are preventable or treatable if diagnosed early; they still cannot get past their distrust. In its submission to the UN committee, the law firm said there has been no effort at a comprehensive review to understand the scale of the problem or the conditions that make forced sterilizations possible. (Canadian Press)
Nov. 22, 2018 – Senator Murray Sinclair, former Chair of the TRC, says Canada needs a national investigation to find out how common coerced sterilizations are among Indigenous women and how they’ve been allowed to continue for so long.