Canadians are becoming increasingly aware of how past injustices continue to have a devastating impact on the health and wellbeing of First Nations people. The severe and ongoing health inequities faced by these communities have rightfully risen to prominence in our national media and public discourse in recent months.
In February, Nishnawbe Aski Nation (NAN) Grand Chief Alvin Fiddler and representatives of the Sioux Lookout Area Chiefs Committee on Health (CCOH) declared a health and public health emergency for First Nations in the Sioux Lookout region and across NAN territory.
Aboriginal people in Canada experience higher rates of illness, specifically 3 to 5 times higher rates of type 2 diabetes, with cases peaking at 40-49 years of age compared with the national average of 70+ years. Preventable diabetes complications in Northwestern Ontario have led to an amputation rate that is almost three times the national average. The Auditor General of Canada’s Spring 2015 Report found that First Nation people living in remote communities in Northern Ontario and Manitoba did not have comparable access to health care services as other provincial residents living in similar geographic locations.
As a Canadian health organization working with First Nation communities in Northern Ontario, Dignitas International has expressed solidarity with First Nations leaders in calling on the Federal and Provincial governments to take meaningful action in addressing the urgent and long-standing health issues caused by the inequality of health and health care services.
Along with our partner, the Sioux Lookout First Nations Health Authority (SLFNHA), Dignitas is working to support the development of First Nations-led solutions to close this unacceptable gap. Our joint Aboriginal Health Partners Program was launched in the Sioux Lookout Zone of Northern Ontario – home to some of Canada’s most remote and underserved communities.
Together, we are working with Community Health Workers (CHWs) to pilot a model of community-based care to address diabetes. With generous support from the RBC Foundation and the Ministry of Health and Long-Term Care, the program supports CHWs to improve the quality of diabetes care in collaboration with other health care providers.
“There is a huge opportunity to strengthen the role of CHWs in ensuring continuity of diabetes care and delivering culturally safe and appropriate health services,” says Emmay Mah, Director of Programs and Policy for Dignitas International.
Dignitas is currently training and mentoring CHWs in disease management and treatment skills with customized training tools. In doing so, we are building the capacity of CHWs to provide critical care, carry out support tasks, and work through the gaps in community-level care that put people living with diabetes at risk of serious complications. The pilot program is taking place in four communities: Kingfisher Lake, Kitchenuhmaykoosib Inninuwug (KI), Slate Falls and Kasabonika Lake.
Based on the results of our pilot, Dignitas will work with SLFNHA to train CHWs in all 33 communities supported by the organization in the coming years. There are over 30,000 people living in these communities, of which we estimate more than 25% suffer from diabetes. Perhaps most importantly, our program aims to develop a sustainable model of First Nations-led community care that can be adapted in other First Nations communities across Canada.
Dignitas encourages the governments of Ontario and Canada to support immediate, intermediate and long-term action to address the health crisis facing First Nation communities.
“It is critical for our governments to work together with First Nations on a nation-to-nation basis to build an equitable health system that genuinely serves the needs and priorities of First Nation communities,” says Emmay.
On April 1st, 2016, following meetings with Ontario First Nations leaders, Minister Jane Philpott and Minister Eric Hoskins, who serve as the federal and provincial Ministers of Health respectively, issued a joint statement:
“As Ministers of Health, we are deeply troubled by the states of emergency declared in northern Ontario First Nations communities. These communities face many serious health challenges, ones that cannot be solved alone or in isolation, but must be met with collective action.”
According to the statement, government officials have been directed to work with the Nishnawbe Aski Nation leadership to assemble a joint action table and begin working immediately on the issues raised during the meetings.