CANADA
Pandemic highlights gaps in First Nation health care

The latest wave of COVID-19 is highlighting the gaps First Nations face in health care, pushing forward a conversation advocates have been having for decades.

The past two years have been the most challenging time in Melanie MacKinnon’s 25-year career. She is the lead for the Manitoba First Nations COVID-19 pandemic response co-ordination team, a partnership between the Assembly of Manitoba Chiefs, Manitoba Keewatinowi Okimakinak, First Nations Health and Social Secretariat of Manitoba and Keewatinohk Inniniw Minoayawin.

The fourth wave of the pandemic has been different because the omicron variant of the virus appeared quickly and aggressively.

“It was in a handful of communities to start and then, of course, that grew in more days and in the first couple of weeks,” MacKinnon said.

The pandemic response team has been trying to keep up with increasing volumes of infections, testing for COVID-19 and contact tracing, on top of traditional public health protocols and guidelines that have been actioned in previous waves.

“It was very apparent that the workload burden or the demand given our supply was going to be challenging to manage in those first couple weeks. The ability to pivot was also a pretty significant strength of all the partners,” MacKinnon said.

Omicron was also different because it arrived in nations during the holiday season — a time where staffing levels are already fairly low. Illness and absenteeism throughout the workforce have been additional obstacles.

These experiences create unique challenges in First Nation communities because resources are much more finite and need to be preserved and protected, MacKinnon said.

The pandemic response team was fortunate to deploy rapid molecular tests in several First Nation communities, but keeping up with the increased testing volume proved challenging, she added. While the province has stepped up to provide plenty of supplies, the team continues to advocate and lobby for more rapid tests, she said.

The team was able to access the federal stockpile of rapid tests in the last couple of weeks, securing about 50,000 for Manitoba.

“We’re continuing to work with our federal and provincial partners [and others] for those types of tools and technologies … to kind of pause and pull their existing resources to build that surge support roster so we can help that local finite health resources to ensure there is some sustainability there.”

For decades it has been well documented that First Nations are at higher risk when it comes to maintaining health supports, MacKinnon said, and this has only been further substantiated by the omicron wave.

Factors include overcrowded housing, lack of potable water, poverty, income insecurity and limited access to comprehensive health-care services close to home.

“There’s long-standing health status concerns with respect to long-standing chronic diseases, like hypertension and diabetes. The list goes on as to what puts us at higher risk,” MacKinnon said.

There are going to be long-term effects and consequences from the pandemic from a societal perspective, but there will also be opportunities that emerge during this time of adversity.

The pandemic has highlighted cracks in the health-care system when it comes to care available to First Nations, even if these issues were already known in communities or through advocacy and research for many years.

“This has been a conversation for most of my career and for others, much, much longer. It’s not new, unfortunately, but I do think we would all collectively be remiss if we didn’t take this time and this opportunity to reframe system improvements,” MacKinnon said.

Organizational leads are working to foster positive change, she said, including the Southern Chief’s Organization Federal Health Transformation Program, Manitoba Keewatinowi Okimakanak, the Assembly of Manitoba Chiefs and others.

The team is noticing a fatigued workforce throughout the health-care system across Manitoba and Canada. The recovery stage of the pandemic will require some intensive support, and possibly areas of other investments in regard to other losses the sector has experienced in terms of people leaving the industry.

“None of us have done this work alone in the past 22 to 24 months. It has been a real collaboration between both levels of government, as well as our First Nation leaders and our health system and health-care leaders, to really come together and build the biggest suspension bridge to overcome those jurisdictional gaps that we’ve experienced in the past,” MacKinnon said. “Our hope and our intent [is] for that degree of collaboration to continue well after this pandemic.”

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Chelsea Kemp, Local Journalism Initiative Reporter, Brandon Sun