Cree woman plans to get medical treatment she needs in Nicaragua

APTN News: Sherri Caudron is planning to travel more than 6,000 km to South America from her home in Hay River, Northwest Territories to get the medical attention she needs.

The Cree woman, who says she has lived with chronic pain and mobility issues for three years, expects to meet with a specialist in Nicaragua after being unable to connect with one in Canada.

“I couldn’t feel my legs from the waist down,” Caudron told APTN News. “There was something wrong and the chiropractor wouldn’t even touch me because he said my spine was twisting my nerves.”

Caudron is paying thousands of dollars out of pocket for the therapies she needs and, hopefully, a diagnosis after lengthy wait times and disappointment in the N.W.T.

“The doctors in the (emergency room) consulted with the neurologist in Edmonton, who wanted me to see that neurologist,” said Caudron. “The neurologist phoned me and it’s like you’re in, but I called medical travel, and they wouldn’t approve it.”

In 2021

Caudron says she first began experiencing problems with her knee in 2021.

She says the condition worsened while she waited a year-and-a-half for medical transportation to Edmonton for an MRI. By February 2023, she ended up in a Yellowknife emergency room.

She says she learned because the referral was not issued by a physician working in the N.W.T., it did not meet the criteria for medical travel to the south (Edmonton).

She was told to wait for a neurologist to come to the N.W.T.

Caudron says she finally saw a neurologist in Yellowknife in June 2023 and was told she needed to get used to walking with a cane for life.

Throughout the entire ordeal she says she has only been referred to physiotherapy once.

“With how many times I’ve been to an emergency (room), and how many times I’ve been medevacced out, well, they just throw me on a plane, but I can’t imagine the costs,” said Caudron, who is eligible for non-insured health benefits (NHIB) status for First Nations and Inuit.

“Treaty (the federal government) is getting billed for this but yet Treaty people have no control over it.”

NWT Health declined to speak to APTN about issues regarding medical travel.

Medical records

In 2023, Caudron requested a copy of her medical records and discovered she was referred to a waitlist for other specialists, which she didn’t know.

In December 2023, she finally had knee surgery.

“The damage was so bad, but I was happy because I could walk with an aide,” she said. “I’m going to Nicaragua where I will have access to doctors any time of the day and will hopefully get a diagnosis for neurological issues.”

Recently, she’s met with a lawyer to discuss her experiences with the NWT medical system.

“I wanted to copy my medical file, contacted the lawyer, paid a lawyer retainer because I wanted to know the difference between my treaty rights and (territorial government) workers, because, under the treaty, you can’t deny me health care,” she said.

Caudron believes the outcome would have been different if she had met with the specialist in Edmonton immediately.

However, she wasn’t prepared to spend up to $4,000 for the round trip flight to Edmonton from Hay River, five hours south of Yellowknife, on short notice.

By comparison, she says her journey to Nicaragua will cost $1,200 for airfare and $850 per month for accommodations.

Create barriers

N.W.T. politicians have long acknowledged how certain medical travel policies and processes create barriers that affect patient experiences and outcomes.

“As long as it’s going to be case-by-case, and as long as we have non-medical personnel being the final decision-makers, I think you’re always going to be in this situation,” said Kieron Testart, MLA for Range Lake.

“How can we improve things? Because, right now, it feels much more arbitrary than I think you intended to be.”

Testart was speaking as part of the committee on social development, which met with representatives from the Department of Health and Social Services and the Health Authority of the Northwest Territories on July 3.

From the moment a referral is made to when a patient travels for care, the committee heard communication breakdowns can occur.

There are guidelines on who can travel with a non-medical escort, the approved accommodations, the per diem amount, referral procedures, and the scheduled flight dates for receiving medical care.

Like a stroke

Even a life-threatening emergency like a stroke does not automatically activate medical travel benefits for the patient to receive support from a non-medical escort during their medical journey away from their home community.

“We can’t put escorts on the actual air ambulance,” said Tim Van Overliw with the health authority. “It’s only very rare cases where there’ll be eligibility for an individual on the air ambulance.”

Jane Weyallon Armstrong, MLA for Monfwi, recalled from her constituents’ experiences that even when a doctor approves an escort for medical travel, the approval from Ottawa doesn’t come in time for travel.

“Maybe it’s due to the bureaucracy, or the time difference with the Ottawa office,” she said. “Sometimes the medical escort does not arrive at the other end.”

NHIB is run by the federal government, and approvals are made in Ottawa during regular business hours. This can be tricky for requests that come in after hours or on weekends.

“One of the fundamental challenges in the Northwest Territories is the complexity of the medical travel benefits and the number of different insurance plans that are accessed by residents,” Health Minister Lesa Semmler told the committee meeting.

During a standing committee meeting, health authority representatives said if an airline ticket cost $2,000, the territory pays $1,600 and NHIB covers $400.

Last year, the government reported paying $7 million out of pocket for these expenses.

New agreement

They representatives mentioned if a new agreement is not reached by the end of August, they may end up doubling that amount this year.

“We have heard Indigenous governments express that they are interested in administering NHIB, but only if it’s fully funded and the policy issues are addressed,” said Semmler.

She said her department would hand over that responsibility once the program wasn’t in deficit.