WhatFinger


Health care on reserves and the cost of health care climbing all over Canada

Is there a fix for health care on remote areas of Canada?



Five-year-old Brody Meekis died from strep throat. No, this is not a report from 50 years ago or from a third world country. This happened in Canada, May 2014. He lived in Sandy Lake First Nation, 500 kilometres north of Thunder Bay. Gloria Galloway wrote in the Globe and Mail that his death “casts a critical light” on the inadequacies of health-care delivery on First Nations reserves. Sadly he wasn’t the only child to die from this treatable disease. Five months earlier a four year old from a different reserve had also died from strep. Ms. Galloway wrote “Many things went wrong in the treatment of Brody Meekis, many of them related to a shortage of medical resources in the remote indigenous community where, as with other Canadian reserves, the responsibility for health care lies with the federal government.”
Accessing the nursing station for people on this reserve is difficult. There is only one vehicle to take them to and from the facility. Weather can delay travel. The Brody's family was unable to access the vehicle to get to their follow-up appointment the next day. What if…? There is also a shortage of staff at the station. The facility which was constructed for a reserve of 500 people now has nearly 3,000. The nurses are overworked and some of the nurses do not have the training to give the services required. This lack of training and staff is not specific to Sandy Lake. Galloway reported that “one in 45 nurses working at a sample group of on-reserve nursing stations had completed all of the government’s mandatory training courses; that nurses are being asked to do jobs they are not authorized to do; that the stations had numerous health and safety deficiencies; and that Health Canada does not know whether individual reserve facilities are capable of providing essential services.” Coroner services are also lacking. Coroners are expected to attend the dead, search for causes of death and report on ways to improve the system. But, like the rest of the health care, coroners are in short supply, especially in Northwestern Ontario where emergency and family physicians fill in when a coroner is not available. To attend a death requires that these doctors leave their own practice and patients. This is a difficult balancing act. Michael Wilson, the regional supervising coroner for the area said “Where you have geographically a widely scattered population, it is just logistically and geographically not possible to get people to every scene at the time of the death.” In young Brody’s case, no coroner was able to attend so a member of the Sandy Lake police service sent his observations to the coroner. Brody’s body was then flown to Kenora for an autopsy. There’s no question there are serious stumbling blocks to providing primary healthcare in remote areas. And not just logistics. The health care budget is not unlimited, provincially and federally. According to a report from the Fraser Institute, the average Canadian family is paying $12,000 a year for their “free” health care. The report noted that health care insurance costs are rising 1.6 times faster than the average Canadian income and as “not all Canadians, including children and dependents are taxpayers …. families earning only $13,742 pay as little as $477 per year. The wealthiest families earning $282,206 contribute $37,180 per year.” I think it’s fair to say that many Canadians are not receiving the health care for which we are paying. That is no excuse, of course, for lack of primary care for children. But money will not solve all the problems.

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None of this takes away the feelings of abandonment by these families. Alvin Fiddler, the Grand Chief of the Nishnawbe Aski Nation of which Sandy Lake is a member said “It is difficult for our communities not to perceive that the deaths of their children are somehow of less importance.” I am hoping Grand Chief Fiddler is wrong in his perception. As a Canadian citizen, I believe we value the lives of all our citizens and residents. All of our children should be able to receive timely, good quality health care. I hope this is not a problem specific to First Nations. That would be a travesty. We have a relatively small population for such a vast country. And most of us live in urban areas along the border between Canada and the USA. As much as we like the idea of equal and timely access to health care for all, we don’t have it. It’s very difficult to find a primary physician in many rural areas. Many of us live far from large hospitals. Mental health care is at a premium even in large cities. As we don’t have the money and we don’t have the manpower to provide the same services in remote areas of the country as we do in large cities, what can we do for people who choose to live in remote areas of the province? Are we to force health-care providers to go to these areas and provide care? Or are we to insist that people move closer to populated areas? In the 12th century Maimonides a doctor and philosopher wrote that one should never move into a town where there is no doctor. That was 900 years ago. We all have rights in this country, but those rights are always tempered with responsibilities. Ultimately we all must be held accountable for our own actions because we live in a democracy where free-will is the underpinning of our culture, so different from other cultures. Do these families who live on remote reserves have choices? If they decide that they want to live in areas that provide much better health care, can they move? If not, then we have a bigger problem than providing quality health care.


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Diane Weber Bederman -- Bio and Archives

Diane Weber Bederman is a blogger for ‘Times of Israel’, a contributor to Convivium, a national magazine about faith in our community, and also writes about family issues and mental illness. She is a multi-faith endorsed hospital trained chaplain.


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