ISC responds to doctors’ calls on improving healthcare in northern Indigenous communities

Reeti Meenakshi Rohilla - Staff Writer 

A call on the federal government in January to urgently increase funding for nursing, support staff, and housing in northwestern Ontario Indigenous communities, by 47 northern physicians, has yielded some results. 

“I just wish we were seeing more immediate results,” said Dr. Claudette Chase, who works in remote Indigenous communities and is one of the doctors who signed the letter. She said that all the problems that existed pre-COVID have become emergent with the staff being stretched even more thinly during the pandemic. She hopes for acknowledgement that this problem exists and is fixable. “So many things that are wrong in this world, to me, feel far too complex to be fixed. But these are fixable problems.”

Indigenous Services Canada spokesperson Leslie Michelson shared with The Bulletin that Indigenous Services Canada (ISC) acknowledges the gaps that still exist in the supports for, and delivery of, primary health care services in remote and isolated First Nation communities. Michelson added, “ISC is working with Health Directors and Band Councils to improve accommodations for healthcare professionals in communities. For instance, two 10-unit apartment-style residences for nursing staff were recently completed at Sandy Lake First Nation. These residences were among 42 new residences in five northern communities, totaling 73 bedrooms for nurses and other healthcare professionals that the Department provided funding for since 2016-2017.” 

Michelson shared that to address the urgent healthcare needs, ISC surged support that brought in 332 contracted resources, including registered nurses, paramedics, registered practical nurses, as well as 54 reassigned departmental nurses to provide additional capacity.

Chase said, “We had hoped for bringing in some kind of modular housing this winter, to be able to step it up, that certainly hasn’t happened.” She further stressed the fact that lack of adequate housing has been a long-standing issue. “It would have been great if the work had begun sooner. But, I’m certainly very happy that it started and I am excited to hear for Sandy Lake, which is the largest community, and one of the busiest, that, that was, to me, an appropriate place to start.”

While healthcare professionals are already shouldering the burden of the largest vaccination campaign in Canada’s history, the press release issued by the group of physicians states that mental health emergencies have been increasing due to prolonged community isolation, while preventive care has been further de-prioritized. 

“It’s having a long-term vision of what a true responsive health care system would look like, and I think, the physicians I work with in the northern practice, I am so in awe of them as we are all trying to be better allies,” said Chase. She added that she believes a medium-term goal should be to build housing and offer training courses to staff. Chase shared that there should have been emergent efforts made sooner to provide quarantine housing to not just some, but all remote northern communities, that could later be repurposed as housing for the nurses. 

Chase said, “This has been such a long-standing issue. I was a northern nurse in the 80’s in this area, and it was a problem then.” She added that one of the major reasons for a recent shortage of northern nurses is the relatively low salary they receive as compared to agency nurses. “You could apply for agency, work whenever it suited you, and make more money. Or, you could have a job where your vacation is a bit more mandated, and things are a bit more structured, and you make less money.”

While trying to bring back nurses with prior experience in this area, Chase shared some responses that she received, “I won’t come back there because I can’t do my course work without the Internet.” “I won’t come back here because I’m too old to be sharing housing with two other people.” “I won’t come back because the basement keeps flooding.” 

The obligation to share accommodation eliminates the ability of the healthcare staff to properly self-isolate when traveling from “red zones,” putting these front-line workers and the communities they serve at an unacceptable risk, explained the press release. It added that Indigenous Services Canada’s neglect of such chronic issues has created an evolving crisis on the ground.

In order to improve recruitment and retention rates in remote and isolated First Nation communities, ISC Spokesperson William Olscamp shared that ISC has also strengthened their Nurse Recruitment and Retention Strategy. This includes a student outreach program, an on-boarding program that aims to orient and familiarize nursing candidates, a nursing development program and a nurse recruitment promotion plan. ISC has also extended existing nursing relief contracts to surge capacity in an effort to ensure staffing coverage, and signed additional contracts to make the alternative resources of Registered Practical Nurses and Paramedics available with a focus on remote and isolated community surge.

Olscamp shared that ISC is in close contact, and communicates regularly with Chiefs and others in communities to share information and ensure needed supports are in place.  

In addition, Olscamp shared that in order to reduce risks of COVID-19 entering communities; ISC has been using charter flights to ensure remote fly-in communities have continued access to primary care. These flights provide access to personnel critical to community health, such as nurses and paramedics, professionals needed to maintain or repair critical infrastructure, and to move cargo, such as supplies, equipment and food.

Olscamp concluded, “The department continues to take steps to enhance care in remote communities by investing in innovative health delivery models such as interdisciplinary teams, integrated services, tele-health and e-health that support primary care service delivery with Indigenous-led organization like Sioux Lookout First Nations Health Authority, which has shown exceptional leadership throughout this pandemic.”