I will call this meeting to order. Welcome to meeting number 10 of the House of Commons Standing Committee on Indigenous and Northern Affairs.
I will start by acknowledging that I am joining you today from the traditional territory of the Haudenosaunee, Anishinabe and Chonnonton nations.
Pursuant to the order of reference of April 20, 2020, the committee is meeting for the purpose of receiving evidence concerning matters related to the government’s response to the COVID-19 pandemic.
Today’s meeting is taking place by video conference, and the proceedings will be made available via the House of Commons website. During the meeting, the webcast will always show the person speaking rather than the entirety of the committee.
In order to facilitate the work of our interpreters and ensure an orderly meeting, I will outline a few rules.
Interpretation in this video conference will work very much like in a regular committee meeting. You have the choice at the bottom of your screen of either floor, English or French. In order to resolve the sound issues raised in recent virtual committee meetings and ensure clear audio transmission, we ask those who wish to speak during meetings to set their interpretation language as follows: if you're speaking in English, please ensure that you are on the English channel; if speaking in French, please ensure that you are on the French channel.
As you are speaking, if you plan to alternate from one language to the other, you will also need to switch the interpretation channel so that it aligns with the language you are speaking. You might want to allow for a short pause when switching languages.
Before speaking, please wait until I recognize you by name. When you are ready to speak, you can either click on the microphone icon to activate your mike or you can hold down the space bar while you are speaking. When you release the bar, the mike will mute itself, just like a walkie-talkie.
As a reminder, all comments by members and witnesses should be addressed through the chair. Should members need to request the floor outside of their designated time for questions, they should activate their mike and state that they have a point of order.
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When speaking, please speak slowly and clearly. When you are not speaking, your mike should be on mute.
The use of headsets is strongly encouraged. If you have earbuds with a microphone, please hold the microphone near your mouth when you are speaking to boost the sound quality for our interpreters. Should any technical challenges arise, such as in relation to interpretation, or if you are accidentally disconnected, please advise the chair or clerk immediately and the technical team will work to resolve the problem. Please note that we might need to suspend during these times, as we need to ensure all members are able to participate fully.
Before we get started, can everyone click on the top right-hand corner of their screen and ensure they are on “gallery view”? With this view, you should be able to see all the participants in a grid. It will ensure that all video participants can see one another.
During the meeting, we will follow the same rules that usually apply to opening statements and the rounds for questioning of witnesses during our regular meetings. Each witness will have up to five minutes for an opening statement, followed by our usual rounds of questions from members.
I will now welcome the witnesses in our first panel.
We have with us today, from the Assembly of First Nations Quebec-Labrador, Chief Ghislain Picard; from the First Nations of Quebec and Labrador Health and Social Services Commission, Marjolaine Siouï, director general; and from the Northern Inter-Tribal Health Authority, Tara Campbell, executive director.
Ms. Siouï and Chief Picard, I'm told you'll be sharing your presentation. I'll be fairly strict on timing. You'll have five minutes, and I'll give you a one-minute warning. Similarly with questions, we'll try to stay very tight because of our time constraints.
Ms. Siouï and Chief Picard, you may now have five minutes for your opening statement. Please go ahead.
Thank you very much, Mr. Chair. My greetings to all the members of the standing committee. Thank you for this opportunity.
We will be making our presentation in French.
I would like to thank the members of the committee for inviting us to present a status report on the situation of the First Nations of Quebec following the government's response to the COVID-19 pandemic.
The COVID-19 pandemic has raised, and continues to raise, major public health issues. Extraordinary measures were put in place. It is important to highlight these collective efforts, but also these results.
We will never stop saying it: First Nations are among the most vulnerable populations, given the risk factors that are prevalent in First Nations populations. For many communities, the preventive measures and preparations required to provide essential services and care have fallen short of what they should have been. The gradual return to what we describe as the “new normal” will be difficult for many of them, and it will be at a different pace than for the Canadian population.
With respect to what we might call the first wave, we recently conducted a new assessment of our relationships with other governments in the context of the pandemic. So this is an assessment...
In terms of assessment, we consulted our chiefs and grand chiefs as well as the heads of our commissions and regional organizations in Quebec.
It goes without saying that we have found that this exceptional context, by putting pressure on the public apparatus, brings out the challenges that existed before the pandemic. In this extraordinary situation, the federal government's response was perceived by our authorities as ordinary, in that the administrations maintained their approaches, whether good or bad. Upgrading the federal bureaucracy's response to First Nations issues is one of the improvements that are required and that must be addressed quickly.
A formal coordination mechanism including all departments and agencies dealing with First Nations would have been most useful. In the absence of such a mechanism, First Nations authorities had to repeat the same steps with numerous federal stakeholders in order to meet the needs of their population.
I'd like to talk about reconciliation and the current state of affairs. While the commitments of the to reconciliation are clear, the results are a little less clear. We must commend the fact that several landmark pieces of legislation and policies have been or are in the process of being implemented. The implementation of the United Nations Declaration on the Rights of Indigenous Peoples is more than ever a priority, and the federal machinery will have to comply with it even though the challenges are considerable.
It is also important to highlight another major component of reconciliation in the Canadian political system, namely the involvement and commitment of the provinces, which involvement and commitment are essential conditions for any progress in relations with first nations. The provinces, particularly Quebec, will have to go beyond their traditional reflex of systematically redirecting their responsibility to the federal government as soon as an issue that concerns first nations arises.
In conclusion, a clear plan is an excellent goal, but it also requires an excellent starting point. We do request that this plan be co-developed with first nations governments and institutions. It will be essential that the means be in place to support First Nations in the development and implementation of measures that will enable them to adequately prepare for a second wave, to strengthen their self-determination, to address the problems that persist and to build on their strengths and on the lessons learned since the beginning of the pandemic.
In Quebec, as of May 20, there were 45,495 confirmed cases of COVID-19 and 3,800 deaths. You all know that the province of Quebec has been the hardest hit in terms of deaths.
Of course, this has implications for first nations communities. To date, the communities have been very well organized and have all put in place an emergency measures plan, which has made it possible to limit, in the case of Quebec, the number of cases to 35 and the number of deaths to two.
Monitoring health status and its determinants is one of the major challenges in public health. Currently, there are no formal protocols. Normally, this is the responsibility of the province, but this has not been solidified by concrete agreements so that first nations communities can have accurate caseload and surveillance data, particularly in their care homes. We know that there are still a lot of people—
, good afternoon, Mr. Chair, and committee members.
Thank you for the opportunity to participate in this process. I would like to begin by acknowledging that I am presenting today from Treaty Six territory, the traditional territory of the Cree and homelands of the Métis.
My name is Tara Campbell. I am Swampy Cree from Treaty Five territory in Manitoba. I am the executive director of the Northern Inter-Tribal Health Authority, often referred to as NITHA.
Since 1998 NITHA has provided third-level support functions that serve to strengthen the first nations health service delivery model and contribute to the improved health status of first nations communities.
NITHA is governed by a board of chiefs representing the Cree, Dene and Dakota of our four partners: the Prince Albert Grand Council, Meadow Lake Tribal Council, Peter Ballantyne Cree Nation and the Lac La Ronge Indian Band. Combined, they represent 33 first nations communities in northern Saskatchewan, with a population exceeding 55,000. Thirteen communities provide primary care services, and the remaining provide community health. The four partners have functioned under their own respective health transfer agreements for over 20 years.
NITHA services include medical health officer, disease surveillance and health status monitoring, communicable disease control, infection prevention, research, policy development and training. We also provide specialized program support in areas including mental health, environmental health and nursing.
Over the years communities have been impacted by wildfires, floods and interruptions to critical infrastructure such as potable water. Such events remind us that increased adequate support is crucial to our communities as emergency management efforts often sustain major financial and personnel limitations.
Due to remoteness and single-road access, our communities are at an increased level of vulnerability and inability to respond. Given factors such as overcrowding and limited access to quality health care, food security and potable drinking water, our communities are more susceptible to COVID-19.
One impact during this pandemic has been a lack of consultation with first nations in provincial planning and response, specifically in regard to reopening. The province is moving forward with reopening plans despite the number of cases rising in the north. We are often overlooked or are an afterthought in planning.
Food security issues result from travel restrictions, road closures and/or remoteness.
Communication issues are linked to language barriers. Adequate resources are needed to support translations.
There is a shortage of supplies, including PPE for health care workers and cleaning supplies. There continues to be a demand for access to thermometers for clients for the purpose of isolating and screening.
Testing supplies are not readily available. We continue to experience difficulties in obtaining testing swabs through the province, despite having 16 designated testing sites throughout the NITHA communities.
We have delays in accessing PPE. On-reserve populations' PPE in Saskatchewan are distributed by the province, and unfulfilled requests are then forwarded to the national emergency stockpile.
Nursing capacity continues to remain a critical issue, as does medical transportation. Workers and clients who are transporting for out-of-community appointments are put at risk of exposure to COVID-19.
Regarding mental health and addictions, ensuring services are available for those in need is an issue.
We have mitigated some impacts. Partners have distributed essential supplies to their on- and off-reserve members, and are supporting their communities with surge capacity and food security.
NITHA provides translation of public health orders in both Cree and Dene.
Good afternoon, everybody.
I want to thank our witnesses for coming today, for sharing their information with us and for being willing to participate in this committee proceeding.
Most of my questions are going to be for Ms. Campbell. As probably most of you are aware, she comes from northern Saskatchewan, as she identified, which is actually my riding as well, so I'm gong to focus most of my questions in this round on Ms. Campbell.
Ms. Campbell, you talked about the data collection right at the end of your remarks. You talked about sharing data and data collection. This has been an issue that we have been talking about for a few weeks. We were able to talk about it with the national chief—I think it was a couple of weeks ago—and with some of the national leaders of the Métis people and whatnot. I understand that there's been some progress, and I heard that from your comments as well.
Can you maybe elaborate a little on the importance of improving that data collection and the need for that sharing of data so that the decisions are being made with accurate information? Some of those silos and some of those challenges that we find jurisdictionally are overcome a little bit when the data is shared, and you can better make decisions on structuring supports and staging that support appropriately.
No, that's totally fine. Thank you.
I was just getting at the idea that ISC focuses on the data just on reserve and that this idea of having data and numbers for indigenous people both on and off reserve in order to structure supports appropriately seems to be a bit of a challenge. That's totally fair.
Here's a little bit of a shout-out to your organization. We've looked at some of the work that you've done, and you've done an excellent job of promoting healthy and positive health outcomes for children through some different contests and activities. I think you did a physically active bingo campaign, and there are some initiatives that you've done that look like they were very effective—and maybe a lot of fun at the same time—as you reached out to children and whatnot.
One of the discussions that we've had over the last few weeks in talking to leadership, especially in northwest Saskatchewan, is the fact of getting the message across to certain groups of people that it's so important to follow the advice of the public health officials on washing hands, social distancing and taking this seriously so that we don't increase the risk to elders and vulnerable people in our communities in these areas where there is a higher risk.
Can you speak to any plans that you've had within your organization that are helping to get the message out to the people that it's so important to take this seriously to protect our elders and the vulnerable people in these communities?
That's a good question.
Right now we're in the process of starting to do it. We have communities that do promote, for instance, elders saying “We are vulnerable, and think about us when you go out” and whatnot, so we are hoping to do the same for all of the partnership to be able to provide that type of messaging together.
As you mentioned, we have been trying to target youth to try to let them know this is a serious issue. What happens if those with health issues contract COVID-19? I guess it's following public health measures, and just by doing that, we can reduce the transmission altogether.
Thank you, Mr. Chair. I want to welcome all the witnesses. My question is for Mr. Picard.
Mr. Picard, this week, on Facebook, I saw an interesting image shared by a first nations activist. It was an embroidery piece on which one could read that the coronavirus had not broken the system, but rather revealed a broken system. That pretty much sums up the problem. In terms of housing, we are facing a systematic problem that can be very dangerous in terms of the transmission of the virus.
Can you tell us about the housing needs of the first nations of Quebec, the epidemiological challenges posed by the lack of housing, and what can be done by the federal government to correct this situation?
Thank you very much for your question.
That has always been the case. It's not the first time we've talked about it. Let us say that the crisis has amplified the situation and the problems that communities are experiencing. We hear almost contradictory messages. On the one hand, they are promoting guidelines, such as physical distance and washing your hands for 20 seconds, and on the other hand, there is overcrowding. It is therefore extremely difficult to take the guidelines into account and apply them in the circumstances we are aware of.
Simply put, tomorrow morning, 8,000 new housing units would have to be built in Quebec alone to make the situation comparable to that elsewhere. We have been talking about this for 20 years. Since 2000, the communities in our region have been saying that the housing situation is in crisis, and we have been advocating for change for 20 years. In the context of the current crisis, the determinants of health become even more important and, indeed, access to shelter or housing is at the heart of these conditions.
I'll be splitting my time with my colleague, Niki Ashton.
Just a quick shout-out to the IT team and the translators. I know trying to keep up with everything that's going on is a lot of work.
Thank you so much, of course, to all the witnesses for sharing your wonderful knowledge and your perspectives.
Ms. Campbell, can you speak more on the availability of testing and care in the communities that you support? I know there is some concern about how data is being collected in some communities.
How much testing is being done? Could you talk to some of these concerns and on how discrimination seems to play a significant part in these decisions?
One of the things we have learned is that testing is key. Testing is key to determining, obviously, the cases that are out in the community. By being able to test and get results sooner, we are able to isolate individuals to make sure that the transmission is minimal.
We do a lot of testing with respect to the outbreak that was in the La Loche-Clearwater area. We had a total of 30 cases there, and right now we only have nine active cases. We've tested 147 people there, again going door to door and testing individuals.
We aren't able to do this in every community, obviously, because testing supplies are limited. We do have a hard time getting these supplies from the province, as I mentioned earlier. The number of tests that we've done doesn't give an accurate reflection of the number of tests that have been done on our people in total, just because some of the testing is done off reserve, so again there is that gap with data sharing that we often come across, as well as in notifying individuals of their test results. We've come into snags with that as well, with negative results not being submitted back to either us or to the communities in a timely manner, so we're working to address that issue as well.
Thank you very much, and welcome, everybody.
I am looking forward to later on in this meeting discussing an important motion that is looking at how procurement is taking place for indigenous communities. I'm very concerned that a community here in our region, Mathias Colomb Cree Nation, was told that it would be receiving tents that nobody ever asked for. I think this motion is critical in terms of getting to the bottom of what happened. We know that this has already led to a resignation from the procurement council. It's clear to me that people in the community that I represent deserve answers and that all communities across the country, as we've heard today, require access to much-needed infrastructure that they are asking for right now.
I'd like to shift my question and direct it to both Ms. Campbell and Monsieur Picard.
You were both talking about vulnerable northern regions, and we know that a number of our regions also involve work camps. We know that the outbreak in La Loche started from somebody who came back from the Kearl Lake work camp.
Here in our region, there are four first nations that are standing up against the ramping up of production at the Keeyask Manitoba Hydro work camp. They've done everything possible to keep COVID-19 out, but knowing what's happened elsewhere, we know work camps can be a vector in the spread of COVID-19 to the most vulnerable communities.
Do you share the concerns coming out of first nations that work camps can continue to put first nations at risk during this pandemic?
In a way, we are guided in part by public health authorities in Quebec. As for the chiefs, they have been extremely proactive and they have come up with their own directives.
At the height of the crisis two weeks ago, at least 30 communities out of 43 really controlled access to the community, if not completely closed off access to the community. That is what's working, that is what's preventing the spread of the virus. In fact, anyone who has followed the news knows that the community of Kanesatake, located about 40 minutes from Montreal, has taken the same action in Oka Provincial Park and that the objectives in relation to vulnerable populations were the same.
At the risk of repeating myself, I think that we have a reality that is not the same as that of other Quebeckers or other Canadians.
Mr. Battiste, Ms. Campbell and I understand each other in this regard. We're familiar with these situations.
I think that in this case the chiefs found themselves in situations where they had no choice but to make extremely radical decisions to control access to their community in order to prevent the spread of the virus.
Ms. Siouï gave us some numbers earlier. With about 30 cases and two deaths in Quebec, if we compare our situation to the situation elsewhere in Quebec, proportionally speaking, we get much better results, with extremely limited means. Imagine what we could do if we had both the structural and financial means.
So far, things are going fairly well, I would say, although we did see two murders over the most recent weeks, unfortunately, and a couple of suicides as well. That is always unfortunate.
I would say that most communities have access to mental wellness teams and to intervenors and workers. We do have a network in support of those resources. Of course, everybody is tired right now, because it's been going on for quite a while, but the work is about keeping an eye on that and making sure there is a safety net for communities.
In terms of violence, many people said that we could expect an increase, but we don't necessarily have the numbers right now—
Thank you for the opportunity to speak to you today.
We will provide a brief summary of the document we have provided which will give you greater context. We are, of course, very interested in questions.
One of the things I want to focus on is that our response to the pandemic is characterized by our partnership with both the federal government and provincial government. Further, there are additional partnerships that exist with each of the five regional health authorities within the province of B.C. This, I would say, is a unique situation in Canada for first nations, and our response and our ability to respond have benefited from those partnerships and relationships.
One of the things I would use as an illustration is that as we have moved into the COVID response, one of the innovations that has been developed is the first nations virtual doctor of the day. This was done by working with the rural and remote coordinating committee, which is a subcommittee of physicians in B.C., with our First Nations Health Authority staff in partnership, and then working with the Ministry of Health in terms of using primary care resources to carry out this important innovation.
This has enabled us to provide primary care services in contexts where no longer have physicians been able to travel into rural and remote communities. This is an example of how we've pivoted our services in the midst of COVID response. Similarly, we are doing mental health services, even including traditional healers and other cultural supports through this mechanism.
I would use as a further example that we have developed partnerships with groups, like the Red Cross, which are also part of our readiness and ability to deploy resources such as volunteers to meet our anticipated surges.
These are some of our partners.
One of the challenges we have worked through in our tripartite approach are the PPE issues. Obviously, this is a global issue, but we've been able to address and develop mechanisms for distribution so that we are covering some of the basic needs. However, I would say that there is much to do on that.
There is point-of-care testing, which is evolving under the first nations context, again to make sure we're covering the gaps.
There are also discussions with emergency management. Our response is based also on the relationship to overall emergency management, with a specialization in pandemic response on our part.
I just wanted to make some of those general comments and then pass it over to Shannon to talk about our circumstances and our data.
We've been really lucky in our relationship with the provincial health officer in being a full participant in the B.C. response to COVID. Our province is sitting at 2,467 cases, as of yesterday, and 149 deaths.
For first nations in B.C., the story is actually better. So far we have had a total of 81 first nations cases in the province. Of those cases, 41 are residents on reserve, and a significant number of those 41 have occurred in two cases of wide community transmission. We have had only nine of over 200 first nations communities that have had a positive case of COVID in the community.
We are also able to monitor the non-resident first nations people through a first nations client file. The first nations client file was created initially in 2010 and allows us to combine the Indian registry plus the provincial registration and premium billing system so that we have a dataset that identifies all resident first nations people in B.C. and links them to their provincial health number. We can use that dataset to link to a number of provincial datasets that we have. However, in this case, we were able to link to the dataset from the Provincial Health Services Authority that registers all the positive COVID cases in the province.
My name is Charlene Belleau. I'm chair of the First Nations Health Council. The Health Council is a representative body with 15 appointed members from the five health regions throughout the province. Our mandate is to advocate on behalf of B.C. first nations in the area of health and to make progress on the social determinants of health.
The First Nations Health Council supports the first nations health authority in this work through advocacy with partners. We've established tables with federal and provincial deputy ministers. As chair, I advocate through direct phone calls and meetings with the Premier of B.C., various ministers, and the regional director general of Indigenous Services Canada. We also have coordinated our respective COVID-19 efforts with the First Nations Leadership Council in B.C.
Through our advocacy work, we've elevated several issues to the attention of B.C. and Canada. These include the following challenges that leaders identified.
There were challenges around engaging and informing chiefs of positive cases in their community so that they could mitigate and manage further spread of COVID-19 impacting elders and citizens. One example of this is that of a federal inmate who was released, tested positive and made contact with families and communities.
As the First Nations Health Council representatives and chair, we successfully advocated for the First Nations Health Authority to work with key provincial partners, such as the provincial health officer Dr. Bonnie Henry, for changes relating to COVID-19 processes of notification to include chief health director and regional First Nations Health Authority officials. The First Nations Health Authority, Correctional Services Canada and the Province of B.C. developed a notification pathway after this incident. We need to ensure that first nations' interests are addressed in the development of these agreements.
First nations and their communities do not have access to adequate Indigenous Services Canada financial resources for security costs associated with mitigating the spread of COVID-19. First nations have been referred back and forth between ISC and Emergency Management BC. It hasn't been clear who is responsible for these additional costs. ISC cannot rely on first nations to use their own resource revenue as a means of protecting their communities. The federal and provincial governments need to address issues and concerns identified following the 2017 wildfires and previous flooding incidents so that we are not constantly responding from a position of crisis.
During the pandemic, when communication and connection are so critical, many of our first nations do not have connectivity. This issue must be addressed as a priority.
A key principle is that no one is left behind, especially during this time of crisis. We have been strong advocates for our family members living off reserve. We have advocated that any available off-reserve resources be provided directly to our nations. We know where our members are and can support them.
The Health Council made a presentation to the National Inquiry Into Missing and Murdered Indigenous Women and Girls and provided recommendations that would greatly assist during this pandemic. Violence against indigenous women is on the rise, and women continue to go missing during the pandemic. Our communities already suffer from a lack of resources for those fleeing violence and we need infrastructure to provide support. We especially need second-stage transition houses near our communities where women can stay for as long as they need to in a safe and permanent place. Transition housing will save lives.
Our indigenous children and youth are impacted by COVID-19. Timely and definite access to funding under Jordan's principle is critical.
COVID-19 has had devastating impacts on the mental health of our youth, families and communities. We have initiated and provided culturally appropriate funeral protocols, traditional wellness and many return-to-the-land activities to address these mental health needs. It's crucial to have adequate supports in place in the event of a second wave.
In 2018, the Health Council signed a tripartite MOU on mental health. The MOU pilots a new community-driven nation-based model of funding mental health services. It supports a broad range of measures to improve mental health and clinical support. The MOU on mental health and the social determinants of health focuses on more than short-term improvements. It commits Canada and B.C. to develop a 10-year strategy on the social determinants of health. It also sets the foundation for a more transformative conversation on nation building and empowering B.C. first nations to design and deliver services that work for them.
Throughout our work, we have noted that self-determination is a critical determinant of the overall health of our people. When our people have their authority and autonomy recognized and supported with adequate resources by Canada and B.C., our health improves.
The knowledge exists within our communities. Supporting nation-based health governance will improve the resilience of B.C. first nations, support an empowered response to COVID-19 and better health outcomes for all.
Thank you again for the opportunity to speak today. I am happy to answer any questions.
Thank you, everybody, for coming on the call today.
Chief Belleau, I was through your community just this week. I drove to Vancouver. I had some very important meetings down there. I always like going through Williams Lake. I have family there still. It's a great city.
My role is critic, or shadow minister, for northern affairs and the Canadian Northern Economic Development Agency, so my questions are going to be posed around the economic side of where we are with COVID and the situation we're in.
Many have asked—and I'll even speak to my local community here where the Blueberry River First Nations are. They were struck with a few cases of COVID with a huge lack of PPE during that crisis. They were left scrambling to places like Walmart to find hand sanitizer, masks and all kinds of supplies to address those cases in their community. It goes against what has been said about the availability of PPE for our indigenous communities.
Chief Belleau, has PPE been readily available for your communities, broadly speaking, in the Williams Lake area and in the indigenous communities that you know of?
Chief Belleau, you were saying there are issues for PPE for your front-line workers especially and other members of the community who are part of the infrastructure. These are folks who have to deal with the public and also are lacking PPE.
We've heard from members in this very committee who have said that all PPE is readily available to indigenous communities. We have seen the opposite.
Chief, we had also heard concerns from the previous panel about what this is going to look like in the future. Until today, we have had what's behind us, and we can only correct what's in front of us.
As I stated, my concern is about the economic effects and how we can come out of this whereby communities are getting back to work but doing it safely. For community members who are working at the administrative building and band council workers and all the community members who need this PPE, how does that look going forward? How can we get to where we need to be?
Where do you think we need to be to get our economy going again?
I think there are several things that we can do where I feel that our communities may be more prepared. I
am grateful that in the province of B.C. we have at least 145 band offices that were closed during the pandemic and there are 90 first nations emergency operations centres operating. We have 53 local states of emergency. We have 87 communities that self-isolated and went into lockdown. To me, the communities are well aware of what COVID-19 is and how it could impact our communities. It hasn't, thank goodness, and Dr. McDonald's report helps us to prepare for the next round, I think, through lifting it to open to help the economy.
Of course, we're a little afraid for the safety and wellness of our communities, but again, I think the First Nations Health Authority has done what it needs to do to make sure that we have the PPE, that equipment, available to our communities.
Great. Thank you for that, Chief.
I'd like to go to Mr. Jock from the First Nations Health Authority.
I have a question that is similar to what I asked the chief about the PPE and the access to it. Are you seeing access to the needed and available PPE? We hear about this provincial-federal jurisdiction and who's in charge of what. It's a federal responsibility to provide PPE to the indigenous communities. It was supposed to be established that way. We're seeing and hearing of shortages across the board across Canada.
Have you seen that shortage? We don't need to get into the politics of it, I guess, but if there is one, what needs to be done to re-establish this? I think there's a national emergency strategic stockpile that's supposed to provide access to this equipment across Canada. What needs to be done in the future to make that accessibility to the PPE better?
Thank you for your question. I would say two things.
One, as Charlene has said, is that we have made sure there's a few weeks' supply of PPE. What we've done is develop a system of distribution and we make sure that we can replenish those supplies, but I would not want to say that there's a stockpile or an accumulated surplus. I think part of what does need to happen is that each region needs to stockpile.
In our case, what we're saying is that each of our sub-regions within B.C. also has to have its stockpiles and, as you pointed out, that it is available to provide supplies to schools, commercial ventures and other aspects of the everyday operation of communities. We are developing that, but I think there's a long way to go, no question.
Hi, everybody. Thank you so much for your testimony, your words of wisdom and your contributions today. We really appreciate it. It enables us to do our work so much better.
I have a general question, and I'll allow you, Mr. Jock, Dr. McDonald and Chief Belleau, to answer as you see fit.
Chief Belleau, you've already touched on the subject a bit, so if you'd like to elaborate a bit, that's fine. Perhaps your colleagues will go first so that you can hear their take on it as well.
My question is specific to women, children and mental health. I'm hoping that you can identify specifically what factors are negatively impacting women and kids and putting them in an incrementally vulnerable position.
I applaud and support your advocacy for nation-based health and education, governance and self-determination. I think the evidence is very clear that we get better results from the delivery of these programs. I'd like to hear more about culturally appropriate delivery and maybe identify some partnerships. I know about the indigenous guardians program. I've seen what they do, and I think they do an incredible job of ensuring that our relationship with the land is strong.
Basically, what can we do better for these vulnerable populations? How can we mitigate the impacts specifically on women and kids in the context of mental health, but certainly in terms of any other health, economic or sociological concern that your communities or any communities within your jurisdictions might have?
I'll ask Mr. Jock to start.
One of the things we observed and identified early on was that there was an important gap, particularly in terms of youth. I would say that as we look at adolescents and young adults, there's a real area of challenge, especially in a context where social distancing is important. We've observed that this is a really challenging group within our target audience and we've heard that from communities.
What we have done is pivot our mental health programs into virtual approaches. We have cultural supports and other kinds of supports that are provided now over Zoom and telephone platforms, but there is much more to do. Part of what our physician group has been focused on has been tips and comments on parenting and some guidance on how to work with children while they're being home-schooled. We have done a lot of social marketing, but I'll turn to Shannon for some additional comment.
I think what we have to recognize in any discussion about issues with women and children and family violence is that these didn't start with COVID-19. Many of the circumstances, the social determinants of health—issues of poverty, problematic substance use, lack of opportunity—have all gathered together, and just as the rest of the country is coming to the point of experiencing things like isolation and lack of services and financial challenges, those are situations that our communities have been experiencing for a long time. When the stress of COVID-19 is added on top of those, it's not surprising—it's sad but not surprising—that some of those behaviours have come to the fore.
It's very challenging, of course, in this circumstance to have staff travel to communities to provide supports. The virtual supports that are made available have had a really positive response from community. We also encourage communities to do the work themselves and to use their time on the land and their traditional practices to support individuals, families and the community in moving forward in a time of crisis.
Communities have had pandemic plans for some time. Since H1N1, communities, as part of their contribution agreements, were expected to have a plan to respond to a communicable disease emergency. Unfortunately, because there hasn't been urgency over the last few years, that was often not followed up on and communities were found with an empty basket. Things they had stored away to stockpile had been utilized in other ways. Individuals who had skills or knowledge had moved on or gotten older. It has been an exercise in building in-community capacity and supporting community-led nursing staff, for example, health directors, leadership and others, to better understand what they were up against, what the battle was and the decisions they had to make.
They're self-determining nations. My job is to give them the best clinical information to support those decisions and, in my partnership with provincial and regional staff, to make sure there were supports available from the clinical community to make sure that if there was a need, it could be satisfied. We have a very unique situation with our tripartite agreements, which have been in place for some time now, and having the First Nations Health Authority to centralize those resources has been very important.
This is another shout-out to the IT team and translation. I know it can be difficult to get us all back on the same page, so a shout-out to everyone.
Thank you to all the witnesses for coming and sharing your wonderful knowledge and participating.
Mr. Chair, like everyone else on the committee, I'm very eager to hear from our witnesses today and very thankful. However, we do have one item that I would like to talk to, which I think would be appropriate for us to consider today.
During our last meeting I gave a notice of motion, which I'm hoping to move and vote on today. With the permission of the committee, I'd like to move my motion for debate and ask that we have a quick vote so that we can move along with our questions. Because I didn't have the opportunity to finish stating my motion at the last meeting, Mr. Chair, I would like to do that before we proceed.
I think we could always want more transparency. We should especially have transparency during a crisis, because the uncertainty creates a lot of challenges for our leaders.
In terms of federal resources, I know that currently, at least in British Columbia, we've heard from our chiefs that because we've been really proactive to protect our communities and our elders, resources around security have not been available or we didn't have the resources needed to properly protect our communities.
Food security for sure is another issue. I think again we could do a lot more with federal government support around food security.
There is also an issue of connectivity. Our communities need access to timely and accurate information during COVID-19. A lot of our communities don't even have access to the Internet to allow them to have access the benefits available to them.
I think the federal government could improve on a lot of different things so that our communities are not at risk. That includes the recent release of a federal inmate without a proper process in place to protect the communities and our elders.
I appreciate the testimony from our witnesses today.
I can open up to whoever wants to respond. A few weeks ago, we had AFN National Chief Bellegarde at this committee. He mentioned that right now, having policing services on indigenous communities isn't essential. I think he was referring to a 2019 report by the Council of Canadian Academics, which stated that “Jurisdictional ambiguity between federal, provincial/territorial and Indigenous governments has resulted in the development of a “programming and funding” approach to policing that neglects to treat policing as an essential service on reserves as it is in non-Indigenous communities across Canada.”
My first question is with respect to protecting indigenous communities and enforcing public health measures. From a lesson-learned perspective, what value would a local policing authority have on preventing the spread of COVID-19, if any?
The RCMP or any police service is really important for our communities during COVID-19, but we've also seen the challenges they face and the lack of their ability to respond to keep our communities safe.
Jurisdiction is another issue. Through our chiefs and front-line workers we have been able to set up security checkpoints within our province to keep our community safe.
The RCMP will come around and be a part of what's happening, but that's not good enough. We know they could play a bigger role. Again, we need to work on this issue going forward. It's not just the security issues; we also need them to respond to the ongoing issue of violence against women.
Again, I'm almost afraid that the RCMP is going to pull off our first nations officers to other duties instead of responding to our communities. We definitely could do with an improved service from the RCMP or from police services within our respective provinces. It would be really helpful for us.
I'd like to share my time with Pam Damoff, because we might be running out of time.
First of all, I'd like to say thank you so much to all of the witnesses. It has been very, very interesting testimony.
I'd like to ask Chief Belleau a question.
I would like to acknowledge your important advocacy work for residential school survivors. Here in Nova Scotia, in the land of the Mi'kmaq, it has been a big problem, as you probably know. I want to say thank you, Wela'lin, from the bottom of my heart for all your work on that terrible issue.
Also mentioning that domestic violence against women is rising is so important. I don't have time to ask about it, but I do want to ask about addictions and substance abuse. We know they aren't going to disappear overnight just because COVID-19 has come on our horizon. It's a problem for many Canadians, not just first nations people.
What is the First Nations Health Council doing in conjunction with the Government of British Columbia to address this issue during COVID-19?
I know that through our tripartite agreement, our mental health MOU agreement, we have joint partnerships with the Province of B.C. to do work on addiction and mental health issues. Richard would have more detail on the administration of it and implementation of that agreement for some of the specific programs and services.
For sure, the issue of addiction and substance abuse, separate from what happens in the urban areas and away-from-home community members, has been a challenge for our community members as we've gone into lockdown. You heard me say earlier that at least 87 of our communities went into lockdown. In those communities, if there are alcohol problems or drug addiction, there have been some withdrawals. Richard is familiar with some communities where doctors worked closely with the communities to help with safe withdrawals.
I think all of those are important while we go through COVID-19. It's something we've learned and something that we need to continue to build on before there is a second wave.
Again, thank you for the acknowledgement on the residential school work. There is that background in history, the lack of trust, but it's also knowing that we've been able to come together through a settlement agreement to truth and reconciliation. It's that hope for reconciliation that brings us to today. It makes it easier for us to have a level of trust that together we'll get through COVID-19.
Thank you. I can start, and then I would offer the other witnesses the opportunity to comment as well.
I think part of the opportunity is to make sure that first nations aren't caught in the jurisdictional gaps. I would say that's a big change. Actually, we're fully ingrained in both the federal and provincial processes. I was on daily calls with the CEOs and DMs. Shannon was on the calls with the PHO and on the federal calls. Sonia Isaac-Mann was on the daily ISC calls.
Part of the benefit is that we don't get caught in the same sorts of gaps that exist. We've been able to leverage our opportunities to create new services, such as primary care and some of the mental health support I talked about, and also land-based treatment, with significant investment from the province. In the midst of all of this, we're in an opioid crisis and have been in a mental health crisis, I would say, for many years.
There are many benefits to this agreement and to our approach. I just wanted to summarize them and give our other witnesses a chance to comment.
Mr. Jock, I'll allow you to carry on with that thought, because I think Ms. Damoff stole my thunder with that question. Early on in your presentation, I picked up on the tripartite partnerships as the successful model that you talked about, and about how it's resulted in collaboration and data sharing.
To change the direction of the question a little bit from where you just went in response to Ms. Damoff, maybe you could talk a bit about how this tripartite agreement came about. You're ending up with great results, by the sounds of it. What could other jurisdictions learn to address the things you talked about by tearing down some of those jurisdictional silos and whatnot? What was successful in getting you there?
Yes. I think one of the approaches would be much more regionalized support for pandemic planning, getting closer to communities and having this as a continuous focus.
The other thing that's really important is that pandemic planning is also based on effective emergency planning; it's not independent from it. Having an effective emergency plan, with then the layering of pandemic plans, is really key to success. I would say that we would need to develop capacity, as we mentioned before, in stockpiling and preparation and in making sure that we're ready for whatever comes, because these seem to come about every nine to 10 years.
I would say that generally every one of our communities, through their agreements, has some form of plan, but obviously every pandemic and every circumstance is different, and even if you have the plan, you have to adjust it.
I want to add to Richard's comment around the pandemic planing. It's been really good over the past few months—and certainly over the period of time since we've taken over health—for our leaders to make health a priority. In the province of B.C., where our leaders are engaged and really involved in health, it's been really important to this COVID-19 response by the health authority. They know the needs, they express their concerns and they work closely with the health authorities so that their community concerns are addressed.
Again, I think it's about our leaders making health a priority, but that comes from a lot of previous work in dealing with residential schools and being willing to be in charge of our own lives; it's self-determination and how we want to be healthier. It's been really important, I think, for our leaders to be front and centre in a lot of that work and to have the First Nations Health Authority working closely with the provincial health authorities, in conjunction with our communities and our leaders, for those plans to be successful.
Within the different regions that the health authority is working in, I think we do have a lot of success stories from the pandemic that we can share with one another, as well as the challenges.
Thank you, Chief, and thanks, Dr. McDonald and Mr. Jock.
I can't finish this meeting without telling you this in regard to your comment on how good emergency planning is good planning. When 9/11 happened in New York, the hospitals in Hamilton had been preparing, by pre-arranged agreement, to take burn victims. Sadly, there weren't that many, because so many perished on the site, but this can be done.
I'm very impressed with all of our witnesses today and with our committee. I think we gave a lot of good information for our analysts to analyze and put into a report.
With that, I'll tell you that our next meeting is on Tuesday, May 26, from 5 to 7 p.m., and this meeting is adjourned.