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Peter Beatty
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Peter Beatty
2017-11-07 11:13
Thank you, Madam Chair and honourable committee members, for the opportunity to speak with you today regarding the impacts of the wildfires on our northern communities.
The Peter Ballantyne Cree Nation, PBCN, is a large multi-community band located in Saskatchewan and has a population of 10,655 members, seven distinct northern communities, and one community located just outside of Prince Albert. The seven northern PBCN communities are spread throughout a vast traditional territory of approximately 51,000 square kilometres.
During the first week of August, 2017, several fires were started due to lightning strikes in the vicinity of a number of PBCN communities. Although the fires began as small and manageable, as they grew daily they came to significantly impact three of the PBCN communities. Poor air quality and direct fire threat led to the evacuation of approximately 2,800 PBCN band members. These evacuated members were displaced for approximately 34 days.
During Wildfire Management's actioning of the fires and the efforts to evacuate, shelter, and repatriate community members, there were several significant issues that surfaced that I would like to bring to your attention at this time. These issues fall under the areas of communication, actioning of fires, and funding.
In the area of communication, clarity is needed in the definition and terminology used by Wildfire Management when describing operations. Differing definitions used throughout the event were confusing and at times misleading. Provincial teleconferences regarding strategy and event management were closed to the PBCN leadership and the emergency operations centre, resulting in a question of transparency of operational communications.
In the area of actioning of fires, the timeliness of actioning fires with manpower and equipment is a major concern. The impacts to the communities would have been minimized if the original small fires had been controlled earlier. Instead, major roads, critical infrastructure, and public safety were compromised significantly. Over 185,000 hectares of traditional lands were impacted, and a community of over 3,500 people was threatened. This led to the general evacuation of Pelican Narrows.
In the area of funding, wildfires have significant financial and human resource costs to the bands and their agencies. Expectations that these costs will be absorbed by the band are unrealistic, based on the current funding practices and models. Both health services and the band are mandated to have emergency response plans in place. However, no funding is allocated to this. During this event, it was clear that having an emergency response coordinator, ERC, in place to provide leadership and coordination through a band-led emergency operations centre had major benefits for all stakeholders.
There are unfunded costs associated with community security, local fire suppression, and maintaining sustenance and supply chain to essential services remaining in the community. It is essential to have health workers and other community agency staff working with community members at evacuation sites to provide support and continuity of care. This is another unfunded cost.
These are only some of the costs associated with community emergencies that are expected to be borne by the band and are not clearly defined in reimbursement models.
I am respectfully requesting the federal government to review the attached information package and to consider the following requests related to forest fire management and response.
Operational terms need to be clearly defined along with current fire actioning policies and made available to first nations stakeholders.
During an emergency event affecting a first nation, it should be deemed standard procedure to have first nations representation at all provincial/federal meetings where decisions will be made regarding event management, strategy, or provision of services affecting the first nation.
Standard operating procedures or guidelines utilized by Wildfire Management to define the actioning threshold for a fire need to be reviewed. In our opinion, the fires could have been managed better to minimize the effects on the communities and the large traditional land area. We are requesting a review of the fire suppression efforts of Wildfire Management by an impartial third party. This should result in improved outcomes in future fires.
Congregate shelters have had ongoing concerns regarding such things as the safety of at-risk populations, maximum length of state, utilization of traditional foods, and activities to name a few. Where congregate shelters are absolutely necessary, a first nations committee should be engaged to advise on standardized shelter management policies and procedures.
The La Ronge 2015 wildfires resulted in INAC giving a verbal indication of funding for the Lac La Ronge Indian Band, LLRIB, health emergency response coordinator position. This should be extended to include the PBCN health ERC position as well.
Standard covered services should be clearly defined by INAC/FNIHB.
INAC and the province should work with first nations to identify locations within first nations communities that could serve as alternate shelter locations, and support them the same as any other shelter facility.
Permanent clean air shelters should be supported to reduce health risks during times of delayed evacuation, when sheltering in place and/or as respite during poor air quality due to high smoke levels.
First nations should be supported through funding and manpower in the areas earlier identified as funding deficiencies. As stated, the recent wildfires of 2017 have had significant impacts on the PBCN northern communities. Two reports that document the Lac La Ronge 2015 and the PBCN 2017 wildfires will be completed by March 31, 2018. These would greatly assist in future planning and policy review.
In closing, I would like to express my appreciation for the opportunity to address the standing committee, and I look forward to any questions you may have.
View Kevin Waugh Profile
You talked about insufficient funding for health equipment and support. What is the funding you get for this and how much more would you think is required when you're dealing with this?
Peter Beatty
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Peter Beatty
2017-11-07 11:31
In the case of Peter Ballantyne Cree Nation health services, the emergency response coordinator was a funded position through the Prince Albert Grand Council. I believe it came from the first nations and Inuit health branch, FNIHB. That funding is coming to a close. I believe that they funded that position at $75,000 a year.
Peter Beatty
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Peter Beatty
2017-11-07 11:32
As I stated in my opening statement, we know that La Ronge had been given verbal confirmation that they would be funded through INAC.
We're asking for the same funding as well. If we were funded it would be at that minimum of $75,000 per year.
Lisa Bourque Bearskin
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Lisa Bourque Bearskin
2016-10-17 15:44
Thank you very much. Tansi. Hello. Bonjour.
[Witness speaks in Cree]
I want to thank the chair and the committee for this invitation to present on behalf of the Canadian Indigenous Nurses Association and to support the families who have lost loved ones.
I'd like to begin by honouring the traditional territory of the Algonquin people, as you've mentioned.
I am from Beaver Lake Cree Nation in Treaty 6 in northern Alberta, and as you mentioned, I am the president of the Canadian Indigenous Nurses Association. I have worked in health care service delivery my entire life, as a nurse. I am now an associate professor at the school of nursing at Thompson Rivers University. Today I have Lindsay Jones with me. She is one of our CINA nursing members and a student here at Thompson Rivers who is studying community health within indigenous communities.
Beyond the symbolic ritual of place, this acknowledgement signals the urgent challenges we face in the era of reconciliation. The struggle for human rights and equitable health care for our indigenous children and youth is a collective and vitally important undertaking, so I come to you today as a survivor. I am reminded of what our elders and traditional knowledge holders continue to tell us. As we continue to reflect on our own philosophy, the spirit of wellness and the struggle for self-determination, we have to know who we are and where we come from, while walking in the footsteps of those who have moved on to the spirit world at the same time of creating footprints for those who come after them.
It is clear that the health of indigenous youth is intimately related to the history of colonization and residential schools, removal of the child from their home and their culture. We know the statistics are grim and that one of the most difficult things to face in life is the reality that somebody close to you has committed suicide. This harsh aspect of life is all too real for first nations, Inuit and Métis families. What we know is that indigenous youth suicide is the most significant public health issue facing our societies.
Our brief presentation today will address how the Canadian Indigenous Nurses Association, CINA, can contribute to addressing the crisis by offering three recommendations for the committee's consideration. These recommendations address the sustainable funding, about which you've heard extensively, to improve access to high-quality culturally responsive and integrated health service delivery by increasing the number of indigenous nurses working with individuals across lifespans, across the nation, and across our northern communities, specifically where the elevated risk of suicide is at alarming levels.
You've heard about the productive factors. You've heard about the risks. We stand united in support of our other indigenous-led organizations and researchers who have undertaken extensive inquiries into this topic.
Our first recommendation is to advocate for sustainable funding for CINA as a national leader on behalf of our front-line nurses and the communities they serve. Firmly rooted in this recommendation is the belief that the Canadian Indigenous Nurses Association can significantly contribute to the overall wellness of our indigenous youth by supporting and fostering the human potential, in creating community capacity to deal with the issues at the local level with front-line workers.
Most do not realize that CINA is the longest standing professional indigenous health organization in the history of Canada. It is a non-profit voluntarily run organization that is governed by 12 indigenous nurses whose vision is to be recognized as a bio-expert advancing the health of indigenous communities, with an end view to improving first nations Inuit, Métis peoples health and well-being.
Our organization began as a political support to Monique Bégin when she started to take this on back in the early 1970s. CINA members are the doorway to the indigenous communities and delivers its core strength from its membership base.
Currently there are approximately 9,000 indigenous nurses in Canada, which represents a huge untapped and underestimated resource. CINA holds real potential to expand its work as nurse members.
Our CINA nurses continue to bring their unique and diverse languages, understandings of culture and healing traditions to their practice. Their roles as stewards of indigenous nursing knowledge informs the ongoing development of local, regional, and national indigenous health policy and service programs around the country.
CINA believes that addressing youth suicide can be achieved by putting the health of its youth back into the trusted hands of its families, communities, nations and nurses. This includes indigenous leadership by promoting the development of practice of indigenous health nursing that is grounded in indigenous knowledge and the expertise that our members hold.
In advancing our mission, CINA engages in activities related to recruitment, retention, member support, and consultation. For the past five decades, CINA has traversed this ever-changing environment.
What we are experiencing is an urgent call for action on reconciliation, decolonization, and incorporation of traditional approaches to health and wellness. We need to apply the metaphor “culture is medicine”.
Unlike any other national aboriginal organization, CINA receives no core funding. Equity funding is an important discussion that has not been explored fully to date. We support Dr. Cindy Blackstock's human rights fight for equity funding for indigenous children. It is currently needed, and we stand strongly beside her.
The greatest potential that CINA has is its ability to deliver primary health care by investing and supporting nurses who work in each of the 655 different communities across the country. What we do know from the Auditor General's report is that one in 45 nurses is adequately trained to work in these northern communities.
As a result of growing requests, we have been working on a collaborative indigenous partnership framework, which I can discuss later, but it really establishes how we are better prepared and situated to work with non-indigenous communities and partners.
Our second recommendation is to support the implementation, as you've heard about...the mental health framework stemmed from the collaborative work together. CINA was a major contributor to that work, and we stand by that report. It really addresses the six continuums of care: community development, early identification, secondary risk, active treatment, specialized treatment, and facilitation of care. That is where nursing is often underestimated. We have the skills, the abilities, and the capabilities to foster that.
Our third recommendation is to support the reorientation of health services to focus on health care closer to home, health care that supports capacity building and health, economic, and environmental sustainability by giving children and youth the skills and capabilities to cope with the impact of intergenerational trauma from dislocation and displacement from their families, so they are much better able to handle that systemic violence that continues to impact the health and well-being of our communities. There is ample evidence to show the point that systemic issues continue to contribute to these inequities.
CINA has been able to develop some much-needed training. We propose that the federal investment in indigenous health and education be used to support the new health accord, which calls for the reorientation of health services. This training can help reduce racism and discrimination, which is found to have a significant impact on people's health. A study with which I am closely involved is examining rural access to health care. It has revealed that people living in these rural settings are even further marginalized by bias-informed care.
With the evidence, it is clear that we need to put in a whole-of-government approach that supports the people and puts the power back in their hands, and while there are new and promising partnership models, such as the First Nations Health Authority here in British Columbia, there is a lot to be done for a comprehensive, holistic approach as services continue to be siloed.
Now I'd like to give Lindsay an opportunity to discuss health care closer to home.
Lisa Bourque Bearskin
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Lisa Bourque Bearskin
2016-10-17 15:56
In summary, we want to advocate for nurses to be perfectly situated on the front lines to provide immediate intervention, to teach about protective factors that stem from our own limited experiences.
I want to leave two words with the committee, kiyam ahkameyimo, which means enough has been said and that we must never give up. These actions are about resiliency and the internal power we each have to eliminate these escalating crises we face as Canadians.
We look forward to taking any questions from you.
Thank you very much for this opportunity.
Calvin Morrisseau
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Calvin Morrisseau
2016-10-17 16:16
I want to address this question a little bit from my experience. I've been doing this for more than 30 years.
I guess one of the things important to know is that you can't fix a system or a community that's broken without investing in the community. I think a lot of people believe that if we take children out of the community, it's going to benefit that community. I think what needs to happen, from my own personal experience, is that we need to invest in those communities.
One of the things I've noticed is that when a crisis happens, everybody is ready with a crisis team to go into the communities and deal with the crisis, but once the crisis is over, everybody leaves. I think there's a real disconnect there.
I think you need to really look at making long-term plans for the children and for the people in the community. I've known suicides to happen with the very young as well as with the very old, so it's not just one specific age group that's affected. It's the whole community sometimes that is suffering from the impacts of what occurred over the course of the last 500 years with our people.
I think it would be an immature thought that there could be one quick fix. There have to be massive investments into these communities. We have to go in there and talk with the children. We have to talk with the adults, the parents. We have to talk with the elders. We have to bring people together and start a discourse on how we're going to do this.
To me, this is the thing that's been lacking in a lot of the situations. A crisis team comes in. The crisis is over for a little bit, and then everything goes back to normal. Then another one pops up somewhere else, and the crisis team goes over there. There has to be some long-term planning for this.
The other part to this is that we rely on health directors in the communities, for the most part, to do this—and I'm hoping to speak more about that health director role later on. The health director is only one person in a larger system that's out there. I think that, if we really look to address the long-term needs of the communities in terms of what their social, recreational, and health activities are, then you'll begin to see some changes in terms of how people are acting out.
We have to give people hope. Without hope, these are the things that occur within our communities, and they're occurring far too often. That means we're not doing a very good job of providing that hope across the board. I think we should all be ashamed of ourselves for not doing that.
View Cathy McLeod Profile
Thank you to both of the witnesses.
I want to note that Dr. McCormick is from Thompson Rivers University, which we're both very proud of in the riding of Kamloops—Thompson—Cariboo.
I guess a whole number of things have piqued my interest. To some degree, in response to a crisis that's been very profound lately—I would say it's been a crisis forever—Health Canada created SWAT teams to go in, and what I'm hearing is that probably it won't be all that effective.
How is that going to help in terms of the response, from your knowledge and the research that you've done, versus what some other short-term crisis responses might be?
Rod McCormick
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Rod McCormick
2016-10-05 16:18
I would say you're right. Initially, to contain things is a good idea, but that SWAT team, or whatever, mental crisis team, is going to leave eventually, and that's not going to solve any problems. If there's a suicide, if there's fear of contagion and so on, it might contain that, but it's not a long-term solution.
I know the government has invested heavily just recently in the mental wellness teams, which hold more potential, if there are enough of them. But the idea there is you have a sustainable, community-based team that can provide this ongoing support. The difficulty is we have 600-and-some first nations alone, and then there are the Métis communities and Inuit communities, so one team is never going to have the local knowledge. At best, I think there were about a dozen that were based on already existing sorts of community projects that were pretty successful, based on the evaluation I read. But again, they struggled with human resources, with how to maintain those workers, some of whom didn't have much training; and once they had it they went off and found better jobs, full-time jobs. For others, burnout occurred.
Logistically, I just can't see bringing in outside people. No matter how many teams you have they're never going to have local knowledge because, at best, they're going to be representing 10 different communities, or trying to provide services to 10 or 20, whatever the math is. I just can't see how it's going to work. The needs from community to community vary so much.
View Don Rusnak Profile
Lib. (ON)
I was going to suggest that the analyst grab some of the data from, at least, some of the projects throughout the years that the foundation did the good work that I saw on the ground. I was immensely upset when the previous government cut funding to that foundation because it did such good work.
I'm going to go off on a tangent and agree with my colleague from the NDP in saying that, yes, there are good things that could be done through organizations such as the Aboriginal Healing Foundation. It doesn't always have to come from government. Oftentimes when the federal government does something or one of its departments does something in terms of health, it's well meant but done in stringent boxes. It's not done with the flexibility that's needed in a lot of our first nations communities. And I say our first nations communities because I'm Ontario's only first nations member of Parliament. So I'm well aware of the problems in our communities and in the communities of Hunter Tootoo who is sitting here today. The communities experience amazing rates of suicides and other problems. Michael McLeod from the Northwest Territories just had a rash of suicides over the last couple of weeks in his communities.
I've said this a number of times at this committee: I don't want my successors 10, 20, 100 years from now sitting at another committee studying indigenous youth suicide. We need to do something now, and I believe that the Aboriginal Healing Foundation was doing was amazing work because I saw the work. But again, it's a two-part stage. In my mind, at least, and in the minds of a lot of the people I've talked to, we don't want to create this industry just on the misery in indigenous communities. We want to end that misery somewhere. I know that's what the foundation did so well. They were doing programs built within the communities that were finally putting a stop to the feelings of despair and the problems that lead to other problems in the community and cost all of society so much.
I see it in my community of Thunder Bay where we have a lot of people coming from the north who aren't adjusting well to the city of Thunder Bay. We have colonialist attitudes among institutions. We see it with an investigation of the Thunder Bay police force right now. I really don't want to see this continuing, and the work that the foundation did was a starting point but not an ending point.
Other than restarting an organization like the Aboriginal Healing Foundation, do you have any recommendations on how to help to at least start to end these crises?
Michael DeGagné
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Michael DeGagné
2016-10-05 16:36
I think the work of Michael Chandler and Lalonde, in B.C., has probably come to this committee already. If not, it will.
It's the notion that any community that develops more and more self-efficacy or self-government, has its own agreements, has its own police force, all the way up to true self-governance.... The higher you get on that sort of scale, the more resilient you become, and the youth in that community become more resilient to suicide.
The idea, then, is that if we can't create structures—and that's fine—then what we can do is make sure that we act within at least a policy framework. That means, if we're going to act, we have to engender more empowerment. We have to engender more authority for people over their own lives. That's even if it's small things, small agreements, or opportunities for youth to meet and speak peer to peer and support each other. As long as it's supportive of empowerment, I think anything we do will be better than what we're doing.
Rod McCormick
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Rod McCormick
2016-10-05 16:37
I would add that in terms of empowerment, I don't know that necessarily governance...when I look at the experience of the Nisga'a in B.C., one of the first, at the Government of Nunavut....
I think it was Natan Obed who said that governance in Greenland and in Canada hasn't necessarily lowered our suicide rates. If what is reproduced in terms of governance is similar to the old government, people get pretty disappointed and disillusioned when they had high expectations. That's one variable.
We still have to deal with a lot of unresolved grief and unresolved trauma, and I think that we need to address that. What's being offered currently by FNIH just isn't doing it. It hasn't worked.
Gwen K. Healey
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Gwen K. Healey
2016-10-05 16:43
Thank you to the chair for the invitation to address the committee today.
I'm Dr. Gwen Healey, and I was born and raised in Iqaluit, Nunavut. It's in this community that I continue to live and work. I'm the executive and scientific director of the Qaujigiartiit Health Research Centre. I co-founded Qaujigiartiit in 2006 with the late Andrew Tagak, Sr. I am also an assistant professor of human sciences at the Northern Ontario School of Medicine. My formal training is in epidemiology and public health.
Our centre is an independent, non-profit community research centre. We exist to answer the health questions of our communities. This may take the form of community-based research, territorial and systems-level research, or circumpolar international projects across the Arctic. We develop evidence-based interventions, conduct surveys, collect narratives, and explore community-identified health questions. We are contributing to scholarship and academia by sharing our evidence nationally and internationally, and by developing and sharing health research approaches that are developed from an Inuit epistemology.
Health research studies are usually developed from a deficit-based model. There is an issue, a medicine or treatment is created and applied, and then presumably an individual gets better. However, this is not the only way to examine a topic. This method often treats contextual information as confounding or biased. Occasionally it is ignored altogether. However, sometimes the contextual information can be the essence of the issue.
We know that the context of Nunavut's suicide crisis is extremely important but rarely openly discussed. There is a marked difference between Canada and Nunavut when it comes to such social determinants of health as poverty, housing, and education. From the Nunavut portion of the Inuit health survey, we know that 11% of adult respondents were verbally abused as children; 31% of adults reported experiencing severe physical abuse in childhood; 52% of women and 22% of men reported experiencing severe sexual abuse in childhood; 43% reported feeling depressed some or little of the time, and 9% all or most of the time; feelings of depression were more commonly reported among women and youth; 48% of respondents reported having thought seriously about suicide; and 29% of respondents reported a non-fatal suicide attempt in their lives.
These are heartbreaking statistics, and the context of this information is extremely important. Nunavut settlement history is relatively new compared with other indigenous communities in Canada. The federal settlement program, the tuberculosis outbreak, the dog slaughter, and the residential school system events all occurred in roughly the same time period, in the 1950s and 1960s.
At this time, families were severed, children were taken away from their parents, and a complex series of events unfolded that had an immediate and long-lasting impact on Inuit society. What is particularly damaging about this series of events is the fact that Inuit society is relational, founded on a system of kinship relations. These relations form the basis of a unique attachment philosophy. When parents were separated from their children during the settlement and separation events, the development of family attachments was disrupted, threatening the foundation of Inuit kinship society, ways of knowing, language, transfer of skills, and knowledge about wellness and what one needs to be well. It severed the very threads that wove the fabric of many families together.
The deficits are important to understand, but so are the strengths. Rather than a purely deficit-based model, at Qaujigiartiit we often apply a strengths-based model to our work. We know that we have certain strengths in our communities and our way of life. We know that certain aspects of our lives are very good as a result of celebrating and building on these strengths. How can we help others to tap into their strengths and ensure that our communities are well, now and for future generations?
Between 2006 and 2008, we held a series of public engagement sessions across Nunavut to identify health priorities from the perspective of community members. Mental health and wellness of our communities was the most important priority. Our board focused on the mental health and wellness of children and youth in particular after these consultations. At that time, we knew there was a dearth of programs or supports for children or youth or their parents in Nunavut. We knew what our strengths were. Our relationship with the land, our connections and relationships with each other, our willingness and readiness to help each other, our arts and music and stories, our absolute undying love for our children—all are our collective strengths and core societal values.
From this place, we set out to design a program to help young people realize these strengths in themselves. Our belief was that from this position, we could, as a community, contribute to the building of such strengths in our youth to help them be well, especially if their home environment included trauma or neglect, or if for any other reason they were not learning about these strengths at home.
Through this pathway, we believe we can prevent death by suicide. This program would be something that any community member could deliver if they also saw these strengths in themselves. We worked with elders, youth, parents, youth workers, and community members from across Nunavut to develop the content for the program that one of the parents named Makimautiksat, which means “building a foundation within oneself.” The program was designed to take place on the land and in the community. We spent the next four years piloting and evaluating the program in Nunavut.
The model for Makimautiksat comes from Inuit perspectives on what it means for a young person to be well, as well as the western scientific literature. For example, we know from neuroscience literature that in an adolescent's developing brain, a very important time to develop coping skills is between the ages of nine and twelve years. By focusing on this age group, there is a greater likelihood of retention; hopefully, these skills can be retained during tough life events and transitions that lie ahead in the teen and early adulthood years.
The model for Makimautiksat is developed around eight core concepts or foundational pillars. We envision them as rocks in a tent ring, which provides the stabilization for a tent or qammaq. The first concept is the strengthening of coping skills. The second is Inuuqatigiitiarniq, which is being respectful of others and building healthy and supportive relationships. The third is Timiga, my body, promoting awareness of the body, movement and nutrition. The fourth is Sananiq, which is crafting and exploring creativity. The fifth is Nunalivut, which is our community, and is about fostering personal and community wellness. Saqqatujuqis the sixth concept, which is the distant horizon and it's about self-discovery and future planning. The seventh is understanding informed choices, substance use and peer pressure. The eight concept is Avatittinik Kamatsiarniq, stewards of the land and connecting knowledge and skills with experience on the land.
From our research findings, as we evaluated the program, we found that activities fostered physical, mental, emotional, and spiritual wellness and supported a holistic perspective among youth. Campers reported feeling more happy, cheerful, and energetic, with a decrease in feeling sad or miserable, and felt more comfortable expressing themselves. Lessons that they were glad to have learned included being physically active, to have respect for themselves, the importance of going on the land to Inuit culture and values, self-empowerment skills, and healthy relationships.
Six months after the program, one youth was reported saying, “I am smart”, and others reported feelings of confidence in their ability to complete tasks, like going to school on time, and were more aware of problems that they now had control over. They reported realizing that they were capable of helping others and offering advice.
Facilitators felt youth were more confident after attending Makimautiksat and that the land component was vital for skill building and for revitalizing the importance of stewardship for the land among youth. Parents also described that their children had more confidence.
After the conclusion of the funding we had received to develop Makimautiksat, we tried for two years to find more funding to sustain ongoing delivery and expansion. We submitted a number of proposals, to the territorial government in particular, and nothing came through, so the project stagnated. This year, we have received six months of funding from the Government of Nunavut, to train new facilitators and support the delivery of Makimautiksat as an after-school program, which will culminate in a land camp in the late winter and early spring. We continue to struggle to find opportunities for sustainability and scale-up.
Inuit societal values and pathways to wellness are key to moving forward. Rebuilding and strengthening the relational aspects of society, fostering the relationships between youth, their families, their communities, the land and the spirit world and the ancestors, will take time but is essential. We are thinking about the seven generations to come.
Seven people in my life have died by suicide. This issue affects all of us. I have young children, and when I look at them I think it's unacceptable that our children should have to grieve the way we grieve for the loss of our peers, our loved ones, and our fellow community members. Our generation must do something about this. It's imperative that we act. I believe we know many of the pathways forward, and what we need are sustained support, leadership, and opportunities to act on them.
Thank you for your time. That's the end of my statement.
View Don Davies Profile
Thank you all for being here today.
By the end of the year, 800 British Columbians are expected to die from opioid overdoses. That's one by noon today, and one by midnight. Dr. Perry Kendall, the provincial health officer for British Columbia, has declared a public health emergency in British Columbia. Hundreds more will die in Alberta, and about the same number are expected to die in Ontario as in British Columbia by the end of this year. Across our country this year, 2,000 Canadians are expected to die from overdoses. That's a Canadian dying about every four hours.
The RCMP reports that the fentanyl market is expected to grow in the next 18 months, which means that even more Canadians will die. Two grains of fentanyl the size of a salt crystal, or one grain in the case of carfentanil, are capable of killing drug users, including young people who don't even know they're ingesting it. This puts our first responders and our police at risk. These are our neighbours, our friends, our families dying; as Ms. Geller said, no one is immune.
Ms. Geller, my question for you is this: Is the national opioid overdose crisis a national public health emergency?
Hilary Geller
View Hilary Geller Profile
Hilary Geller
2016-10-04 9:49
Certainly B.C. has declared it a public health emergency in B.C. If you look at the definition of an epidemic as set out by the World Health Organization, it has to do with levels of death or disease above an average level. By that definition, certainly in British Columbia, as declared by the government, it is indeed an emergency. If you go with that strict definition, I can honestly say, because of some of the data limitations unfortunately, it's impossible to tell you if that definition would be met in every other province, but certainly we see growth in Alberta as you said and signs that it is moving eastward. We've heard from police in Ontario indicating that.
I think from our point of view we are treating it as an emergency to help jurisdictions across the country have what they need in order to be able to respond. We as the federal health department are putting everything in place within our areas of authority and encouraging others to do the same, so that not only can we respond in B.C., but we're ready for when it emerges elsewhere.
View Don Davies Profile
Okay. I don't mean to interrupt, but I have limited time.
Doesn't the Public Health Agency of Canada have the ability to actually declare a national public health emergency?
Hilary Geller
View Hilary Geller Profile
Hilary Geller
2016-10-04 9:51
I apologize. I'm not familiar with their legislation.
View David Yurdiga Profile
During our visit to the north, it was mentioned that the community is always in a mode of crisis. How is this going to affect them in the long term, when it becomes normalized for individuals to commit suicide and the shock factor isn't there anymore? What can be done to address that in the short term and long term?
Christopher Lalonde
View Christopher Lalonde Profile
Dr. Christopher Lalonde
2016-09-26 16:24
I think the short-term answer regarding crisis is to provide immediate on-the-ground support. What form that takes depends on what the crisis is and what the community needs. The longer-term problem is that we imagine that, if we just bring in some support workers for a week to talk to the youth, and then they go away, we haven't really done anything at all. We've calmed the waters momentarily, but the underlying issues are still going to be there. For the longer term, I think it's the need to find ways to support the communities over the long term.
For example, when I was talking about elder and youth interaction, the community can decide what form that takes, but the resources to do that can't be another one-off program; that people come in, they kick up the dust, and then they're gone. There needs to be more long-term funding support for the things that communities want to do to be able to help their youth.
I think the problem with particular programs is that they tend to be focused on particular things, like suicide prevention, for a particular period of time, three months or maybe a year. Even the research programs that Michael and I tried to put together, which are aimed not just at extracting data from the communities, but helping them find ways to support themselves and their youth, at most are two or three years long. Then once again we're gone. I think there needs to be a way to get around that somehow. I don't know what it is, but I think there needs to be a way to provide those long-term resources.
View Don Rusnak Profile
Lib. (ON)
Thank you for appearing before the committee today. It's a pleasure to hear from you, and to hear your perspective from the west coast.
We have our member from Nunavut here today, a friend of mine, Hunter Tootoo. I'd like to acknowledge his presence here today.
You just echoed my frustration—in terms of previous governments' responses to suicide crises and epidemics across this country in indigenous and northern communities—with doing one-off programs, where people make a big stink about a crisis that's happening. In the moment the government reacts, it sends in health care workers for a finite amount of time. There are good or mixed results, and then everything washes up and it's ignored, and then it cycles back into the norm.
Another thing I wanted to touch on is what I see as the solution, or one of the solutions, perhaps the ultimate solution.... You mentioned a side benefit of the positive things that self-government brings, but self-government that is truly realized. I believe you mentioned self-determination hitting a glass ceiling. I'd like you to explain what you meant by that, and then perhaps comment on any of the numerous comments I made.
Michael Chandler
View Michael Chandler Profile
Michael Chandler
2016-09-26 16:27
Maybe I should at least start to answer this question. I think that governments better understand how to deal with individual problems than they understand how to deal with cultural problems. It's common in British Columbia and across Canada for communities to declare themselves in some kind of suicide-crisis circumstance. As a result, we parachute in a bunch of people who are trained counsellors, but it's a puzzle. If you were parachuted in, having spent all the time you have looking at this problem, what could you or would you do?
I think we have this individual focus where we're going to go in and solve the problems of a series of individuals who are inclined to commit suicide while ignoring the real cultural devastation that underlies this sense of loss and impotence, and lack of control of one's own destiny.
Here's a thought about how you might more coherently intervene. If it's the case that you can identify—certainly as we can identify here in B.C.—bands or communities that have never had a youth suicide, I think we have to presume that they know something about how to raise children who believe that life is worth living.
There is indigenous knowledge sedimented in those communities that have few or no suicides. Intervention programs that try to pair up communities with high and low suicide rates respectively would be a novel solution, a solution different than just bringing in some kind of platoon of counsellors who, themselves, don't know what results in suicide.
View Arnold Viersen Profile
Thank you, Mr. Chair.
Thank you, Minister Bennett, for being here today. I appreciate the opportunity to ask you a few questions.
I see in the estimates that a lot more mental wellness teams are being brought in. As you probably know, we're currently studying the state of suicide in indigenous communities across the country. I hope that you're following our study as well.
I see you've increased the number of these mental wellness teams from 11 to 43. We've heard from different people that it is difficult to come up with some of the professionals, or even finding professionals to work on these committees. I'm just wondering how finding people is going, and who you are finding.
View Carolyn Bennett Profile
Lib. (ON)
It's a great question.
When we met with the NAN youth on Monday morning, it was quite shocking to realize that this young man, at 23 years old, has been a mental health worker for four years with no training. When a crisis breaks, it's very hard if the people who are there in a community really don't have the training.
The formal health teams will be able to move into a crisis area as fully trained organizations, and then we will endeavour to get the mental health capacity built up in each of the communities, with two specifically for Attawapiskat because of what they're going through right now.
View Arnold Viersen Profile
You're definitely leading in the direction I was looking for. They said it's very difficult to find appropriate people to work on these teams. Chief Isadore Day said that often it takes years to build up the trust to even have the ability to do anything.
Are these teams being made up of local people? I guess that's the question. Is that an avenue you're looking at to some degree? He said that often spiritual leaders are the people who are doing these jobs anyway and, as you mentioned, often without training.
Are these the people you're looking to to perhaps give the training and to build the team around, say, three or four individuals from the local area?
View Carolyn Bennett Profile
Lib. (ON)
There are a couple of things.
The teams that are mobile will be set in regions and then will go in during a crisis. We are learning a lot, as you say, in terms of how we build capacity. We heard from the kids when we were in some of these remote communities that trust in speaking to somebody locally is not there. They're worried about confidentiality, worried about telling their stories, so sometimes having somebody come from outside feels safer to people.
I've been very interested in looking at Peggy Shaughnessy's program, RedPath. They go in, but then they stay in touch online and are able to stay in touch with people they've made that primary relationship with.
We're exploring all of these. Obviously, it's in Dr. Philpott's department. My job is to make sure that these kids have hope and are getting what they know they need in language, culture, land-based programs, housing, and water, the things that the kids are really worried about, as well as the recreation centres that weren't previously on the agenda.
View Carolyn Bennett Profile
Lib. (ON)
That's being negotiated, but I think the moving teams are of four people. I would sort it out, but it's in the backgrounder to the press release that came from Dr. Philpott.
View Carolyn Bennett Profile
Lib. (ON)
Those 43 teams are in communities that have been deemed as high risk. There are the four moving teams, and then the 43 teams will be.... In ramping up, there will be a priority-setting as to the people who really have been struggling and need it most.
View Arnold Viersen Profile
It's the 43 teams I'm talking about. What is the composition of those looking like? Is it going to be two or three local people giving training?
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