Do outsiders realize that Canada’s remote Indigenous communities are weighed down with a lot of public health crises and other challenges?

By Suhail Hashim

May/June 2023

The dawn of Covid-19 vaccines opened new challenges. Countries had to decide how to distribute it equitably among their various populations. The need to recruit more skilled health care workers became more relevant than ever, as they were needed to administer the vaccines. 

Canada swiftly prioritized its vulnerable populations — the elderly and health care workers. There was also a push to prioritize First Nations communities.

For one who has always been inquisitive about the diverse communities of places where I have lived and visited, as well as their histories and cultures, being a health care professional enabled me to learn so much about them from my clients and patients. 

During summer 2022, I worked with the Covid-19 Vaccine Resource Team of Weeneebayko Area Health Authority (WAHA), which provides health care services to remote communities in northern Ontario living along the eastern James Bay and Hudson Bay coasts. Most of these regions’ residents share the Cree lineage.

The “First Nations,” which is preferred over “Indian” in Canada, is used interchangeably with “Aboriginal,” “Indigenous” and “Native.” Prior to contact with Europeans, estimates suggest that North America contained 1.2 to 2.6 million First Nations’ people. The Europeans not only reaped riches by establishing trading posts like the Hudson Bay Company, but also by stealing tribal lands via deceptive treaties. They also tried to erase Indigenous traditions and cultures by coercing Indigenous children to become Catholics by setting up brutal residential schools and other systems. Regardless of this dark history, I was excited about my upcoming firsthand experience with the First Nations. 

My first stop from Toronto Airport is in Timmins, a city that meets nature. Like all small Ontario cities, it has a proper infrastructure, roads and other amenities. Multiple Indigenous reserves are located around Timmins, and some notice boards are in their native language — Cree. 

From Timmins, the first stop made by aircraft is Moosonee. Small airports in these remote towns just have the essentials like a runway, a check-in counter and a toilet. There are no security checks to board flights, and sometimes no boarding passes are given to passengers. Adjacent to Moosonee, across the Moose River, is a tiny island called Moose Factory. These are the last towns where one can still connect via the mobile networks available to us in Southern Ontario. To access networks in remote northern towns, one has to purchase a SIM card from the local operators, which are usually hard to find and expensive. 

There are daily weekday flights from Moosonee Airport to even remoter towns along the James Bay coast: Fort Albany First Nation, Kashechewan First Nation, Attawapiskat First Nation and Peawanuck First Nation. One flight usually takes passengers to all these locations and returns the same day. 

The Indigenous reserves in these remote parts have no roads, which means that only trucks, vans, SUVs and similar heavy vehicles are found there. Some of the residents use buggies. Most of them speak English, but there are elders who only understand Cree. The Northern College has branches in each town. I visited and spent some time at the branch in Moosonee, whose college magazine is appropriately titled “The Feather.” This prominent symbol in Indigenous culture represents power, wisdom, high honor, trust, strength and freedom. It’s often seen in this region’s administrative offices and people’s houses, as well as on bracelets and other art forms. 

For Indigenous communities, land and animals are very important. There are land-based healing programs like walking together — a symbol of the holistic approach to healing in Cree culture. Otherwise known as “Pimi Pici Wak,” this 10-day program seeks to help those with substance abuse and other mental health challenges by encouraging them to find power in the sense of community and connect with nature’s resources. 

One main grocery store, Northern, serves as these towns’ main market. Prices are at least two or three times higher than they are in the Greater Toronto Area. One can also see how less healthy options like chips and cookies are priced lower than natural produce. Surprisingly, prices of alcoholic beverages at the government-run Liquor Control Board of Ontario outlet in Moosonee are more affordable than fresh produce. 

A resident of a senior living home told me of how before the colonizers came, the Indigenous tradition was to help those in need. “One has to share what they have with others and that’s how you keep yourself mentally sane. When the settlers came to this land, they not only stole our resources, but took away more priced traditions like these,” he said. There are stories of continuing drug abuse and addictions, and parents of children who complain about the individuals who supply illegal drugs, but no respite has been provided. 

The Nishnawbe Aski Police Service, which serves this region’s First Nation communities, cannot act against such drug offenders due to the bureaucracy’s politics and lack of strong evidence. 

The roughly 2,000-member Attawapiskat First Nation has recently been in the news for their mountain of troubles. In 2016, the Attawapiskat Council declared a state of emergency due to the increase in suicides attempts. In 2012, then-chief Theresa Spence went on a six-week-long hunger strike to call attention to Canada’s treatment of the First Nations.

Attawapiskat is also known for its housing and water crises and the government’s ongoing neglect of establishing safe educational facilities for its students. A house contains up to 10 family members. After Covid hit, it became extremely difficult for the public health team to ask residents to self-isolate when an individual showed symptoms or tested positive. 

When my team visited in July 2022, we were asked not to drink tap water (even after boiling) or to bathe or shower for more than 10 minutes, for the water was contaminated with harmful chemicals like trihalomethanes (THMs). The town had only two water plants, from which we were expected to collect water for drinking and cooking. 

In 2007, the young local activist Shannen Koostachin launched an “Education is a Human Right” campaign to lobby the government for better educational facilities for First Nation youth. Shannen died in a car accident in 2010, but her dream lives on — in 2014 a new elementary school opened.

To the north of Attawapiskat, close to Polar Bear Provincial Park, is the Peawanuck First Nation; the northernmost town served by WAHA. With a population of close to 300, it doesn’t have a hospital, only a nursing station/health center run by two community nurses who can arrange teleconferencing with doctors or airlifting if needed. 

This community had to relocate due to a flood. There is a sense of pride and determination among its residents — which I felt was missing in the other communities. Also, relative to other remote communities, addictions and substance abuse are significantly lower. The distant northern location and sense of determination might have contributed to this.

While flying between Indigenous reserves, usually at a lower altitude than commercial planes, I pondered on these small communities living among the wildlife and wilderness, on the river meeting the sea or the lake meeting the river. I thought about how they thrived and are still thriving with their attachment to the nature and animals of these lands. 

Every time my flight prepares to land in Toronto and I see how blessed we are with well-developed roads, tall structures and other amenities, I am reminded of these remote Indigenous communities weighed down with a lot of public health crises and other challenges. There is a heightened need to teach our younger generations to learn and connect with this land’s First Nations. Mere recognition of the Indigenous communities and land acknowledgments before an official program is nothing but a meager effort.

Suhail Hashim, a Registered Nurse currently working at Toronto Western Hospital, is also a public health professional. He has worked with various public health projects in Ontario, Canada and Southern California.

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