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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
CPC (SK)
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
CPC (BC)
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
View Rod McCormick Profile
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
NDP (BC)
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
NDP (BC)
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
CPC (AB)
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
CPC (AB)
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
CPC (AB)
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
CPC (AB)
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?
View Carolyn Bennett Profile
Lib. (ON)
What it looks like will be determined with the first nation.
I think you know that sometimes it's the great hockey coach or the great teacher. There are other people, we know, in communities. We can build their mental health capacities so that they can do the most they can for these kids. As opposed to a health care problem, we get these kids feeling good about themselves by creating health.
View Charlie Angus Profile
NDP (ON)
This is really helpful because I did get a Facebook message from a young woman in one of our northern communities. She said, “I hear there's an emergency response team going to Attawapiskat. Could you drop a couple of workers off in our community because we don't have any?”
I want to go to ground. In 2009, we had a horrific suicide crisis in the James Bay region and Chief Jonathan Solomon spoke eloquently of that. At that time, the provincial workers were laying off staff at Payukotayno because they had spent their budget, because they were working around the clock trying to keep children alive.
Then there was a big outcry, so the provincial government augmented its efforts, and said they would hire new workers. In 2012, when nobody was paying attention, they laid them all off.
In 2014, I was in the communities and we had children on suicide watch because there were no mental health workers and the only tool they had was to take the children into custody and put them into child welfare and foster care, as they had no other tools to help these children. The children were going to ground.
In 2016, we have another huge blow-up of a suicide crisis and everybody was wringing their hands and saying, “How did this happen?”
It seems to me that if we don't have the ongoing support on the ground to respond to young people when they need it, what we're seeing in northern Manitoba, Attawapiskat, Pikangikum is the result. You have the experience.
What do we need to make sure that we don't have to respond in the middle of a crisis, but are preventing a crisis?
Isadore Day
View Isadore Day Profile
Isadore Day
2016-06-09 17:02
That's a good question, Mr. Angus, and I want to refer back to what just took place in the Ontario region.
Premier Kathleen Wynne has been a champion of a number of issues as they pertain to the aboriginal community and has a very direct relationship with first nations in Ontario. As such, as seen with the issues in Attawapiskat and in the north, it was the provincial government that stepped up first in most cases.
Recently, with the announcement of a $220-million health investment in Ontario, focused on the north where it's needed, one of the things we need to be clear on here at the committee in terms of sending this back to the federal government is that the Ontario government is saying that it will put in six new treatment centres in the province of Ontario for first nations, but it needs the federal government to finally come to bat. This is going to be required immediately. What we want to be able to do is make use of those investments in the Ontario region, for example, but we need the federal government to work with us on the capital side now.
I think it's safe to say that a lot of people are doing a lot of work, and I think the federal government has said a lot of good things. They've made some promises and created high expectations. The provincial government has come to bat now, and I think we need the federal government to move on some of the other issues, such as capital for treatment centres.
View Charlie Angus Profile
NDP (ON)
I want to close out on that, because the fact is that the provincial government stepped up in an area of federal jurisdiction with $220 million on the table. We need to get a comprehensive plan for treatment centres. The fact is that we have no place to send young people out for treatment. We were told by Health Canada that it would be “utopian” to meet the need for mental health wellness teams. They have, what, 10 mental wellness teams now? We asked them if they didn't need 80, and they said, well, it would be “utopian” to get there. They didn't seem to have a plan.
What do you think we need to do to close that gap? If the province is stepping up in regions where we have serious mental health and health problems, what does the federal government have to do?
Isadore Day
View Isadore Day Profile
Isadore Day
2016-06-09 17:04
I think we need to make the determination that action is needed now. We can't fall into this cyclical phenomenon of proactive disengagement. We can't keep talking to see no results. We definitely need the federal government to move. We need commitments now. We need to be able to see what the government is prepared to put forward in terms of those investments in dollar values, and within this quarter, within the next fiscal year. We need action today.
Tom Wong
View Tom Wong Profile
Tom Wong
2016-05-31 15:34
To begin, I would like to acknowledge that we are on the traditional territory of the Algonquin people. Thank you for gathering us here today and inviting us to speak on this very important issue of suicide in indigenous communities in Canada.
As a physician and as a father, I know the death of a child is heartbreaking. A death of a 10-year-old child by suicide compounds that heartbreak as the profound impacts spread across families and communities. The circumstances are tragic and difficult to comprehend. When we ask ourselves why, we must acknowledge the impacts of colonization, which continue to affect indigenous peoples today. The Truth and Reconciliation Commission has offered Canada the knowledge and recognition that policies of forced assimilation have assaulted and suppressed indigenous culture for as long as Canada has existed as a nation.
As a nation, we now have an opportunity to recognize that the introduction of the reserve era in the 19th century, the residential school experience in the 20th century, and the forced adoption policies of the sixties and the seventies are just examples of policy that led to eradication of culture, loss of language, erosion of traditional values, and the disintegration of traditional family structures. These impacts have been passed down through the generations and these effects are often referred to as intergenerational trauma and have led to the tragedies that we collectively face today.
Health Canada, through the first nations and Inuit health branch, recognizes the need to reset its relationship with indigenous partners, and through these relationships, support community-led, comprehensive, culturally founded, and culturally safe services that are integrated into a broader continuum of wellness programming.
My role and the work of the branch is guided by inclusive and participatory policy engagement approaches with first nations and Inuit organizations, as seen through several key frameworks developed in partnership with indigenous organizations.
In fulfilling the mandate to promote the health of indigenous peoples, I advocate for equitable programming to address social determinants of health, and to strengthen prevention, diagnosis, treatment, support, surveillance, and data for public health actions.
In Canada, the rates of indigenous suicide are much higher than the general population. The overall Canadian rate has declined, while in some aboriginal communities rates have continued to rise. In general, risk factors for suicide include depression, hopelessness, low self-esteem, substance use, suicide of a family member or friend, a history of physical or sexual abuse, family violence, intergenerational trauma, poor peer relationships, social isolation, poor performance in school, and unemployment, to name just a few.
Protective factors that contribute to resilience include family cohesion, good communication, feeling understood by one's family, involvement in family and community activities, indigenous language, cultural knowledge, activities with elders and traditional healers, community self-determination, good peer relations, and school successes.
Suicide is just one indicator of distress in communities. For every suicide there may be many more people suffering from depression, anxiety, and despair.
There are five key elements funded by Health Canada to support first nations and Inuit health: health promotion, health protection, primary care services, supplemental health benefits, and health infrastructure support. Health Canada spends $300 million a year in community-based programming and services guided by mental wellness frameworks. Through a variety of targeted programs, organizations and communities deliver mental health promotion, addictions and suicide prevention, crisis response services, treatment and aftercare, including prescription drug abuse and supports for eligible former students of Indian residential schools and their families.
Mental wellness teams are community-led teams that provide a comprehensive suite of culturally appropriate services, which include but are not limited to capacity-building, trauma-informed care, land-based activities, early intervention and screening, aftercare, and care coordination with provincial and territorial services. Each mental wellness team serves between two and 10 communities, depending on community size, location, and need. Health Canada has allocated funding to regions for 10 mental wellness teams. The B.C. First Nations Health Authority also funds a team in B.C. However, flexible funding allows regions to maximize the number and reach of teams to address regional needs.
The brighter futures, building healthy communities program, available to all first nations and Inuit communities, supports improved mental health, child development, parenting skills, healthy babies, injury prevention, and response to mental health crisis, depending on community needs.
The IRS resolution health support program provides cultural, paraprofessional, and professional supports to eligible former students, their families, and communities.
The national native alcohol and drug abuse program and the national youth solvent abuse program include funding for 43 first nations addiction treatment centres and community-based prevention programs that respond to substance abuse.
The national aboriginal youth suicide prevention strategy supports over 130 community-based suicide prevention projects in first nations and Inuit communities across Canada. Strategy funding was used to train over 800 community-based front-line workers to provide culturally appropriate information about suicide prevention. We have seen positive results.
For example, the Taiga Adventure Camp is a camp for girls aged 11 to 17 and is open to all 33 Northwest Territories communities. The goal of the camp is to increase self-esteem and promote healthy living, relationships, and mental wellness to protect against youth suicide. The camp uses outdoor skills development to provide leadership opportunities and develop confidence and respect for others. Outcomes have shown improvements in confidence, initiative, leadership, and optimism, an increased ability to address conflict, and improved knowledge of protective factors.
The department is also supporting the development of a web-based first nations “wise practices” resource that will allow communities to access and implement proven and promising youth suicide prevention strategies.
The Mental Health Commission of Canada has been provided with $1.2 million from FNIHB to support first nations and Inuit adaptation of its mental health first aid training.
Health Canada, the Assembly of First Nations, and community mental health leaders jointly developed a first nations mental wellness continuum framework, grounded in culture as its foundation.
Application of the framework is supported by an implementation team with members across regions and communities, as well as the department.
FNIHB is also supporting ITK in their work to develop Inuit mental wellness teamwork and an Inuit suicide prevention strategy. Both the strategy and the framework are anticipated to be finalized later on in 2016.
View Don Rusnak Profile
Lib. (ON)
I'll be as brief as possible.
We know this is an absolutely complex issue, and there are many layers and ideas for solutions. I look at this as a short-term problem where we're reacting to the immediate crises that are absolutely horrible in these communities. That will form one of my questions.
Ultimately we're going to have to look at long-term solutions to make sure the first nations communities and the indigenous populations aren't facing these horrible issues. I'm familiar with them because of my work. For the benefit of committee members who've heard me talk many times, I've worked with first nations organizations. Over the years I've worked in first nations communities in different capacities and with different governments.
I have one question for INAC and one for Health Canada. What have you come up with in terms of immediate solutions and immediate programs to deal with the immediate crises? Are you working ad hoc, or are there crisis teams on standby? We know the problems are entrenched in the communities. We need that immediate response to the crises to make sure the communities get the support they need right away. Is there a plan in place?
The first question will go to Health Canada.
Tom Wong
View Tom Wong Profile
Tom Wong
2016-05-31 16:08
Thank you very much for the question.
Yes, crisis needs to be dealt with in the context of needing to deal with the long-term issues. Regarding the immediate crisis, there are a number of things already in place. I spoke about the small number of mental wellness teams across Canada that have been mobilized and can be mobilized to help deal with emergencies. Within that context it has to be working together at the invitation of the first nations communities and also in collaboration with the involved province. Most recently, with Attawapiskat, there was an invitation by the province and the invitation from the community to assist. It's a collaborative effort.
The reason why I mentioned the number is small is so you can do the math. Canada is a big country. Ten mental wellness teams are a good start, but we need more to do a better job.
As far as what to do in emergencies, before dealing with emergencies one should think about whether there is a way to prevent emergencies. Some of those elements are social determinants of health, reconciliation around Indian residential schools, and the TRC recommendations. All those things need to be in place.
I will turn to my colleague, Paula, regarding some of the social determinants of health work her department has been actively working on with the communities.
Paula Isaak
View Paula Isaak Profile
Paula Isaak
2016-05-31 16:10
As Dr. Wong was talking about, the long-term solution is around ensuring those basic underpinnings are solid. That means ensuring education supports, labour market supports, and income supports are there to prevent these from happening in the future. Those are long-term solutions that need to be done with the communities, jointly and collectively. There is not one strategy for all communities writ large, but there are strategies that need to be developed with those communities.
That's the commitment our department has with our Health Canada partners. Health Canada is there at the front lines when some of these crises happen, but we're right there with our Health Canada partners working with the communities to see what key underpinnings need to be strengthened.
View Don Rusnak Profile
Lib. (ON)
Immediately, is INAC working with these crisis teams through their contacts within the communities to make sure they're localized? This is probably a two-part question. What are the outcomes or successes of these crisis teams going in? What has been the reception in the community, and what's been the result?
Tom Wong
View Tom Wong Profile
Tom Wong
2016-05-31 16:11
INAC and Health Canada work hand in glove with some of the activities in response to a crisis. For example, with a crisis we know there are some long-term issues that need to be addressed, but there are some short-term approaches that can be quickly instituted. For example, when we hear from youth that there's a need for more books, better schools, a place to play sports, and programs to actually link up with elders, some of those activities and some of the linkages do not need to wait two, three, or four years. Those are some of the things, like building a centre, that can be done very quickly.
Those are some of the practical linkages and activities that we at Health Canada have been working with communities to try to facilitate. To me nothing is as important as linking a youth who sees no hope, no meaning in life, and is disconnected from their culture to a connection with the elders and with their culture.
View Cathy McLeod Profile
CPC (BC)
Thank you.
We have a myriad of programs, and I am glad to see that CIHR is starting to really focus, because I think that is going to be critical. Aboriginal head start has been around forever, as well as the NNADAP program. Programs have been around, and if they are not working, I think we need to start to refocus support. Obviously, the biggest issue is the upstream.
Again, hopefully my next question is a quick one. In the headlines this morning, in the Ottawa Citizen, was a young indigenous person who was clearly having challenges. The doctor was so horrified that she felt she had to speak out. You talked about the mandate of working with the provinces and territories. When those sorts of things happen, do you ever take an incident like this and give that doctor a call to say, what the heck is going on? Do you have a system in place with the provinces where you can use a case study like that to improve things? Did you pick up the phone, or did anyone in your department pick up the phone? Apparently, it sounded very horrific in terms of a local case.
Tom Wong
View Tom Wong Profile
Tom Wong
2016-05-31 16:18
Yes. In a situation like that, what our department does is liaise with the province and have discussions about that. That particular example is something that can be of major concern to all Canadians, if all the facts that are described in the newspapers are there. The reason is that we need to think about the circumstances where an aboriginal youth who is very scared ends up in a facility. What is the most welcoming way to help this youth? Of course, we don't know the circumstances, and we don't want to comment on the individual circumstance.
View Cathy McLeod Profile
CPC (BC)
I understand that.
I know, as well as many, that not everything reported has all the facts. Is there a system in place where you can immediately take action?
Keith Conn
View Keith Conn Profile
Keith Conn
2016-05-31 16:20
I will try to support my colleague. It's Keith Conn.
To answer your question, yes, the phone is picked up. I am not sure about this particular case, but for example, when there are disturbing prescription patterns for an individual client—we do have a tracking system—there is a call from our head office to that prescriber or pharmacist. We work closely with the various provinces and territories. I wouldn't say a hotline, but we have a direct line to senior officials to say that we have an issue, for example, “This person is in Toronto, they are stranded, and they are going through a crisis. How do we work co-operatively together?” We have navigators as well, who are out in the field working for first nation communities to champion or to help clients who are in a distressing situation that could be leading to some high-risk situation. Yes, we pick up the phone. We call pharmacists, doctors, or our connections within various ministries of health to resolve the issue.
View Charlie Angus Profile
NDP (ON)
One of the key recommendations from Dr. Bert Lauwers, who did the Pikangikum report—and it strikes me as something to be learned in Attawapiskat—was to establish a steering committee with health professionals, law enforcement, and government in the community so that we could actually move forward. That doesn't seem to have taken place. It seems to have been a bit ad hoc. But a coherent steering committee.... This is what we're hearing in Attawapiskat as well with the youth, about giving them something.
We see that there are partners stepping up. In Pikangikum, Project Journey with the OPP is doing incredible work with young people. When Mr. Conn and I walked into Attawapiskat we were met by the Canadian Rangers, who were on the ground. We have an enormous amount of goodwill. We have an enormous amount of expertise in providing services, but in some of these communities we need a framework. We need to have, especially in troubled communities of crisis, the federal government or the provincial partner playing a role to support the efforts of organizations that want to help.
Mr. Conn, the clock is ticking on the EMAT team in Attawapiskat. People in our community have seen this movie before, where once all the attention is gone, one by one so are all the workers, and we're back to square one. What's the post 30-day plan with EMAT and making sure that we can get the best out of all these organizations that want to help?
Keith Conn
View Keith Conn Profile
Keith Conn
2016-05-31 17:00
Thank you for the question.
The EMAT team along with some of the federal resources—we have a senior executive from Health Canada as well as representatives from the North East LHIN, Local Health Integration Network—have been working with the community itself. The EMAT has been doing some knowledge transfer and training within the community, including for the health director and other staff, to develop a transition plan so that as the EMAT dissipates, there will be a plan in place in terms of medium-term supports, coordination.
They've been doing some community mapping of all the agencies, the workers that are in place on a continual basis but also what is going to be augmented shortly between the collaboration and input of the North East LHIN and the WAHA hospital, so those are being solidified. We're going to have some discussion hopefully with the chief on Thursday. I think there's a reasonable plan. It's been a lot of hard work, but I think there's some light.
View Cathy McLeod Profile
CPC (BC)
Sorry, I think we'll probably have to take this offline.
How many of the communities, the 600 and some, have reasonable broadband access available? To what degree is telemedicine and also things like...? There are some very good preventative mental health programs that are quite catchy for young adults in terms of these online supports, like WalkAlong, for example. Are we scaled up across the country for broadband? Are we scaled up across the country in terms of the ability in the majority of the communities, 50% of the communities, to deliver both telemedicine and to have capacity to administer some programs that are perhaps effective?
Tom Wong
View Tom Wong Profile
Tom Wong
2016-05-31 17:14
The short answer is not enough. We really would like in the future to have enough bandwidth and broadband so that those services can be actually brought to the most remote fly-in communities, but at the moment, unfortunately—
Tom Wong
View Tom Wong Profile
Tom Wong
2016-05-31 17:15
It's less than that, yes. In many of the communities remember it is dial-up, so doing any kind of download is extremely slow.
Alain Beaudet
View Alain Beaudet Profile
Alain Beaudet
2016-05-31 17:15
If I may add, scaling up is not easy. We are realizing it is a problem we are facing worldwide. The World Bank is coming to us to ask how to scale up projects in western Africa, and how to deal with different cultural backgrounds and the scale of a project. We're dealing with a science that is a new science, the science of scaling up. How does it work? How do you do it? How do you do it efficiently? We are just seeing the beginning of that and we'll be way more effective in scaling up in the near future.
View Todd Doherty Profile
CPC (BC)
Mr. Perron, I want to deal with the emergencies that we have in La Loche and Attawapiskat. Can you tell me why there is a delay in getting these communities the critical help they need? La Loche is still waiting for some critical support. Even to this point, our honourable colleague was taking it easy on the panel today. Clearly he had an opportunity to ask these questions. We have a crisis. We've all talked about it. There's been a considerable amount of media attention. This is not new. These are crises we're seeing in many first nations communities, not just these two that we've mentioned. Specifically, why is there a delay in getting that critical help to these communities?
Sony Perron
View Sony Perron Profile
Sony Perron
2016-05-10 16:11
I'm going to share my time with my colleague, Keith, who can talk about the situation at Attawapiskat. He just visited the community, and is quite familiar with the file. I will talk about the La Loche situation.
There is a reserve nearby, the Clearwater River Dene First Nation. This is where Health Canada's first nations and Inuit health branch mandate is. We have worked with the community and with the Meadow Lake Tribal Council. They have a mental wellness team to provides additional support to the first nation Dene community. Two weeks ago, I had my regional executive reaching the chief to make sure that what we have done and the services that were provided by the Meadow Lake Tribal Council were satisfactory. We got the signal that things were working well, and they were working with the province.
If you're referring to the La Loche community, this is not a place where our mandate is operating. We were on reserve in the first nation Dene community. I would say that for that portion, the assessment is that we have been responsive. Now we are looking at the long-term needs of this community. Fortunately, the Meadow Lake Tribal Council, which is the authority that provides service to the first nations in this area, has one mental wellness team, which we referred to earlier today. It has been the instrument that has been used to leverage some capacity. There was also help from other first nation organizations in Saskatchewan that were directed toward the community to assist with that tragic situation.
Maybe I will ask Keith to talk a bit about the situation at Attawapiskat.
Keith Conn
View Keith Conn Profile
Keith Conn
2016-05-10 16:12
In terms of Attawapiskat, we did have a sense from our communications with the chief and council and the community members that there were issues percolating, so we were able to deploy some mental health resources through the Nishnawbe Aski Nation organization, which has a crisis response. Even before the declaration, some surge capacity was deployed to the community with our assistance.
Once the declaration of emergency was made, about two and a half days later a crisis response team was deployed to the community through our NAN partnership. That included mental health crisis counsellors and a youth coordinator.
This is a crisis kind of environment, so there's a bit of a rotation. I think we need to look, at as the Chief has said, the more medium- and long-term work in terms of a transition from crisis to stability to mental health supports for youth in the community writ large.
I think we were responsive. We now have our provincial partners. I won't speak for them, but I know I can say they are physically there at present. That's the emergency medical assistance team who were deployed I think a week after the call. Minister Hoskins was responsive in terms of making that happen.
They are there. They are continuing. They have nurse practitioners, mental health workers, and psychologists who were hired through NAN who are in and out on rotation. There are people who need some respite care, of course, given the volumes of work and the intensity of the work in that community.
We were looking at a more sustainable model in terms of medium-term planning. We'll be deploying some federal presence at an executive level this week to look at the more medium- and long-term planning processes.
View Todd Doherty Profile
CPC (BC)
I really appreciate your comments, but I think if you asked our honourable colleagues from both La Loche and Timmins—James Bay, they might have a different opinion on what is really happening and the critical need in the medium to long term. There are challenges we face today. The suicide epidemic is still taking place. We have children who are still choosing to take that avenue or seeing that as the only way out.
I'm going to switch. Hopefully, my colleague from Timmins—James Bay will follow up on that.
Thank you for your time.
View Kevin Sorenson Profile
CPC (AB)
I'm not a regular on this committee, but I certainly appreciated your testimony today. I'm a member of Parliament from Alberta. Right now, obviously, we are watching our north very closely. In Alberta, we're watching the Fort McMurray area. We've talked about emergencies in Attawapiskat. That's obviously a massive issue and emergency that we need to deal with—and also at La Loche.
I'm just wondering how Health Canada is involved in the evacuation, if they are. In previous years, when there were fires at La Ronge in northern Saskatchewan, I was at an evacuation site in Saskatoon and I was impressed by the way it was set up. I think it was Health Canada that was there, diagnosing and looking at people, especially aboriginal and first nations people, making certain they were in good health and checking for other health issues as well.
Are you involved in this Alberta evacuation?
Sony Perron
View Sony Perron Profile
Sony Perron
2016-05-10 16:21
We are working on this with partners, including first nations. This is a tragic situation, and we have a responsibility in that context. As soon as first nations living on reserves are impacted, we have a role. I mentioned initially that we have a role in terms of providing health benefit services, health protection services, and nursing services. Our team in the Alberta region have been working with Alberta Health and the emergency authorities to try to organize services. We have provided some surge capacity to our regional office with additional nurses. We have reached out to other regions to bring additional environmental health officers. We have also organized services for people who have to move from their place of living. For example, when you leave your community to go into a different place, you may have left your medications behind, so Scott's team have issued communications to pharmacists, to clients, to facilitate them in refilling their drugs. We have sent more staff there. So in various fashions we are working with first nations. We are working provincial and federal partners to respond and support first nations communities that are affected by this.
The environmental health issue is a challenge, so we will have our HO inspecting if there are concerns for first nations to make sure that their place of living is safe. We are doing these things.
There was one thing I wanted mention, and it's just slipped out of my mind. It was very important.
Sorry, it was about Fort McMurray. Several first nation communities get their services from Fort McMurray. Community members leave their communities to go to Fort McMurray to see a doctor, to go to the hospital, to get the needed services. One thing we did in the first few hours of this crisis was to start working with all these first nation communities to redirect clients toward other points of service. Therefore, they will still be able to see a physician, they will still get access to care, but not in Fort McMurray. Because we manage medical transportation, there were some logistics involved. But this was probably one of the first tasks that our Alberta regional office started to work on, to redirect clients toward other points of service.
View Andy Fillmore Profile
Lib. (NS)
View Andy Fillmore Profile
2016-04-14 15:31
We'll come to order.
I want to thank everyone for joining us today, and I'd like to welcome our guests, who have travelled to Ottawa to be with us for this meeting. On behalf of the committee, please accept my warm welcome and sincere thanks for making time for us today.
With us today are Alvin Fiddler, Grand Chief of the Nishnawbe Aski Nation; Jonathan Solomon, Grand Chief of the Mushkegowuk Council; Isadore Day, Ontario Regional Chief; and John Cutfeet, Board Chair of the Sioux Lookout First Nations Health Authority. Also joining us is Dr. Mike Kirlew. I am going to ask the committee's indulgence in adding Dr. Kirlew as a fifth speaker. The speakers have agreed to share the time equally among the five, so we won't add any additional speaking time, if that suits the committee.
Some hon. members: Agreed.
The Chair: Okay, wonderful.
We want to make sure that we make the most of your time, so I will ask you each to speak for no more than eight minutes, cumulatively 40 minutes for five speakers. I will indicate seven minutes and eight minutes, and please do your best to make your closing sentence. I will hold our committee members to the same standard when they ask their questions. That way we can ensure fairness and give everyone a chance to be heard and to ask questions.
Let's move speedily along. I would like to begin with Grand Chief Jonathan Solomon.
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