H1N1 just one epidemic facing Indian Country

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CANADA: Summer is behind us now and the fall flu season is about to begin. The H1N1 flu strain is waiting in the wings and we’re waiting to see how it all works out.

Signs are starting to show already.

Last spring and during the summer, H1N1 had an impact in northern Manitoba. Now it is being felt in such diverse places as the Ahousat band on Vancouver Island and the Dehcho First Nation in the Northwest Territories.

So, can we expect First Nations people to be harder hit than the rest of the country? If history is any indicator, the answer is yes. The 1918 flu pandemic took a terrible toll on our people. The First Nations population of Canada dropped to around 100,000 after that pandemic. Communities that had been hit hard by smallpox and other diseases were greatly reduced and, in some cases, ceased to exist. The early indications are that, once gain, we will bear the brunt of this pandemic.

The reason is simple. Our people live in crowded, unsanitary conditions. Our more remote communities that lack basic infrastructure have been hit the hardest. Ground zero for the pandemic may well be aboriginal communities, not the cities. One theory making the rounds suggests that aboriginal people are more susceptible to diseases that are foreign to Canada. This may have been true in the past, but most aboriginal people today are descendants of those who survived foreign-introduced diseases and our immune systems should be up to the task.

The difference lies with our living conditions. Poverty breeds disease. Overcrowded and poor quality housing, and a lack of proper sewer and water services all combine to provide the H1N1 virus with a welcome environment. The federal government’s response has been hit and miss.

Bone-headed moves such as the refusal to send hand sanitizers to some northern communities because of the alcohol content of these products, and the infamous body bag issue have tried the patience of our leaders and are just plain stupid and bad PR. The federal government so far has spent five times more on ads that promote its economic plan than it has on an H1N1 information program.

These days in Ottawa, it’s all politics, all the time. The recent announcement by the health minister that she’ll work with the Assembly of First Nations and increase communications between the First Nations and the Health ministry is a positive step. Health is among issues that are a jurisdictional minefield for our people. Under the British North America Act, health care is a provincial responsibility, but the same act designates “Indians and lands reserves for Indians” as a federal responsibility.

The result has been that the health care portion has been transferred to provincial medicare programs, but much of the preventive health measures on reserves and health education functions remain with Ottawa. Therefore, if and when the H1N1 flu pandemic hits, the provinces will care for the patients in the hospitals, while the on-reserve response remains up to the federal government.

Too often the jurisdictions are confused, and there is either overlap or a vacuum. The latter is more often the case. The First Nations relationship with Canada is contained in the treaties. In Treaty 6 and subsequent treaties, a clause was negotiated and inserted that calls for a “medicine chest” to be kept on each reserve for “the use and benefit of the Indian people.” This medicine chest clause has been interpreted by our elders as meaning universal medical care.

Today all Canadians receive health care, which is delivered by the provincial medicare programs. However we need the federal government to step up to the plate and deliver the health-care program on reserves. Health care is not just treatment but prevention. However, the federal infrastructure programs have bypassed many of the aboriginal communities that need it the worst. There now is a feeding frenzy elsewhere for the infrastructure dollars. Funds are being dispersed across Canada and the federal government is making as much political hay as it can.

Minority governments are famously short-sighted as they fight for survival and the next election, which may come at any moment. This does not bode well for our communities, which need long-term planning and serious improvements in infrastructure.

In a few months the H1N1 threat will be over, but the diseases of poverty will remain in the First Nations and aboriginal communities. We have other epidemics — with diabetes, AIDS, drug and alcohol abuse running rampant in Indian Country. The rest of the world may move on, but for us the crisis will continue.

Published: Friday, October 02, 2009
Kia ora to Doug Cuthand and The StarPhoenix (Saskatoon)

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