UNICEF Report: First Nations Especially Vulnerable To Swine Flu

By Lloyd Dolha

On June 24th UNICEF Canada marked the 20th anniversary of the Convention on the Rights of the Child with the release of a report called Aboriginal Children’s Health: Leaving No Child Behind. “The health of Canada’s Aboriginal children is a bellwether of the health of our nation,” said Margo Greenwood, Academic Leader of the National Collaborating Centre on Aboriginal Health (NCCAH). “Their health status is not a product of biological determinants, but of social conditions and access to societal resources.” UNICEF Canada partnered with the NCCAH to produce the report, which examines the health of Aboriginal children in Canada through the perspectives of national experts and analysis of existing data. The report concludes that health disparities between First Nations, Inuit, and Métis children relative to national averages is one of the most significant children’s rights challenges facing Canada.

The virus affects a disproportionate number of Aboriginal people. Roughly half of all confirmed cases are First Nations residents and two-thirds of patients on respirators are of First Nations descent. Cramped living conditions, lack of running water, and high incidence of chronic illness are thought to be factors in the spread of disease on reserves. In St. Theresa Point, Manitoba, hundreds of people began showing flu-like symptoms in May 2009. The first confirmed case of swine flu on the reserve was detected in June, and it soon spread to neighbouring Garden Hill First Nation. Both are remote fly-in communities about 600 kilometres northeast of Winnipeg. While the majority of H1N1 cases have so far been mild, the World Health Organization has warned that H1N1 could reappear in the fall and cause more severe illness.

Manitoba’s First Nations chiefs have declared a state of emergency and are urging the provincial and federal governments to do the same—a move intended to speed up efforts to stop the spread of the virus on reserves. Assembly of Manitoba Chiefs Grand Chief Ron Evans said he and his fellow chiefs want to ensure government officials are fully aware of the devastating impact of the H1N1 virus in their communities. “The governments need to step up,” Evans said at a news conference in Winnipeg. “There is no plan in place. Nobody wants to accept responsibility for First Nations. There is very little combating the H1N1 pandemic. Our people are sick.” The call for action came as the province announced an additional 163 confirmed swine-flu cases in Manitoba, bringing the total to 458. The assembly said there is a “rising sense of worry” about the looming fall flu season.

Assembly of First Nations (AFN) National Chief Phil Fontaine said the UNICEF report provides further evidence that First Nations are especially vulnerable to viruses like H1N1 (swine flu). “Today’s report by UNICEF demonstrates that the inequities in health services for First Nations, compounded by the poor social conditions found in too many of our communities, contributes to our poorer health status even in the best of times,” he said. “This is why First Nations are particularly vulnerable to H1N1. The World Health Organization already has pointed out that there is a link between the severity of H1N1 cases and poor living conditions, over-crowded housing, poor-quality drinking water, pre-existing chronic diseases, and sub-standard healthcare. It is time for action to improve the conditions that make us the most vulnerable segment of the population.”

The AFN has called on governments to take urgent measures to improve the response to pandemic outbreaks of H1N1 in First Nations communities. Suggested improvements include an independent study of recent outbreaks in Ontario and Manitoba, recommendations to develop national guidelines for service to First Nations, and providing investments that will allow every First Nation to develop a pandemic plan. “It should be clear to all Canadians at this point that the problem is not simply confined to the current H1N1 crisis,” said AFN Manitoba Regional Chief Bill Traverse. “We do need immediate action on that front, but even with that our communities will still be vulnerable and our people will still be living in conditions that would not be tolerated elsewhere in Canada. We need a government-wide response that involves working with First Nations to create a real, coordinated plan that will foster healthier communities and healthier citizens. We should all support this goal because strong First Nations make a stronger Canada.”

The UNICEF Canada report found that Aboriginal children suffer from a much greater burden of poor health. Specifically, Aboriginal children fare at least two or more times worse than the national averages for non-Aboriginal children in almost all health status indicators (measures of child health, such as diabetes and suicide rates) and in the determinants of health and well-being (influences such as poverty and access to clean water). Despite improvements in recent years, inequalities persist in higher infant mortality rates, lower child immunization rates, poorer nutritional status, and endemic rates of obesity, diabetes, and other chronic diseases.

The report also revealed that federal investments in First Nations health services have not mirrored population growth, and that a number of services routinely provided to other Canadians are under-funded or denied. Experts suggest that the root of health problems experienced by Canada’s Aboriginal children stems from the legacy of policies such as residential schooling, which severed the last few generations of families from their children and resulted in family and community breakdown. “The chronic under-investment in health is unacceptable, but it is not unique,” said AFN Ontario Regional Chief Angus Toulouse. “In fact, as we have seen in report after report and study after study, First Nations are under-funded across the board, and this is reflected in the poverty and poor conditions in too many of our communities. First Nations want to build their economies and ensure their people and communities are healthy, but making this a reality means putting an end to this fiscal discrimination.”

Hundreds of Aboriginal children are caught in government disagreements about where responsibility lies, with the survival and best interests of the child a distant consideration. The report calls for funding the same level of services for all children in Canada and passing both federal and provincial legislation to implement “Jordan’s Principle” that no Aboriginal child languishes during disputes about who will provide or pay for services that other Canadian children receive without question.

Recently, the Canadian Imperial Bank of Canada has donated $10,000 to the Assembly of Manitoba Chiefs to support current efforts related to controlling the virus in First Nations communities in Manitoba. “The H1N1 virus is hitting the Aboriginal community in Manitoba especially hard,” said Rob Bennett, CIBC’s market vice-president of retail markets in the prairies. “We hope that this donation will help reduce the impact of the virus in First Nations communities.”