Health care in northern Ontario First Nation now managed close to home

A remote First Nation in Ontario's far north will now have a much larger say over how health care is delivered in the community.

The Keewaytinook Okimakanak chiefs council now manages the nursing station in Deer Lake, a fly-in First Nation located about 650 kilometres northwest of Thunder Bay, Ont., near the Manitoba border. That means the organization is in charge of the community's health-care facility and its nursing staff, instead of Health Canada, although federal health regulations remain in place.

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"Today is like giving birth," said Tina Kakepetum-Schultz, the health director for Keewaytinook Okimakanak. "We've gone through the nine months of pain and waiting .. and when you give birth, it's like pure joy."

Using Kakepetum-Schultz's analogy, the labour was more like three years. The chiefs council hired a nursing director in 2015 to begin exploring the process of transferring control of local health care services more directly to its communities. Keewaytinook Okimakanak also has five other member First Nations, all in the far north.

The chiefs council provides a number of services to its member communities, including in the health and education fields, as well as public works and telecommunications.

A feast in Deer Lake on Friday celebrated the achievement, and also showed appreciation to all parties involved, including federal officials.

"The overall [goal] is to listen to the people first," Kakepetum-Schultz said. "The belief has to come from the roots, not from outside, whereas before, the government, they came in and tried to go to the roots but it didn't work."

New nursing positions

One immediate change in the community under the new system is the addition of two additional nursing positions, bringing the number to six. The community has a population of about 1,100.

Staffing was at the core of the community's decision to pursue more autonomy in the local health care system, said Roy Dale Meekis, Deer Lake's chief.

"When we'd go to the nursing station, our nurses were tired. We see them and we know they're human, they can't work 24 hours," he said. "We started asking for more nurses and when this opportunity came up, we jumped to it and said 'OK, this is a good program for us.'"

"It's important that we look after our own nurses ... as they look after us."

Other First Nations eyeing similar move

Meekis said the transfer also signifies the community's move to longer-term planning to improve its whole medical system.

Two other northern Ontario First Nations who are also members of Keewaytinook Okimakanak are also contemplating similar nursing transfers and federal officials say the idea is becoming more popular.

"There's a resurgence of energy from communities, visionaries, leaders, health professionals, saying 'it's time to assert the rightful role in terms of management and control,'" said Keith Conn, an acting assistant deputy minister with Indigenous Services Canada and the federal representative at Deer Lake's celebration on Friday.

Conn said there had been a number of health-care transfers to more local Indigenous authorities about 15 or 20 years ago but there was a "pause" after that.

According to Conn, among the chiefs council communities, North Spirit Lake and Keewaywin have also shown some "general interest."

Long-time nurse 'couldn't imagine leaving'

For Linda Fardy, a nurse who has spent almost a decade in Deer Lake working formerly for Health Canada and now for Keewaytinook Okimakanak, the management change is something she said she's excited about, calling it "the best of both worlds."

"This community just embraced me when I came here and I just fell in love with the people, with the community and couldn't imagine leaving," she said. "So when the transition happened ... there wasn't a question about whether I could leave."

Fardy said, with additional nurses on staff, they now have some time to focus on public health.

"Because we were so busy in the clinic, we really didn't have as much time to devote to public health and prevention as ordinarily we would really have liked to do," she said. "I think now with the extra staff here, that's one of the really positive things that's going to be obvious right from the very beginning."

Another benefit to the move, Fardy said, is the opportunity to work more closely with other community-based health-care workers like mental health teams and mother-and-baby clinic staff.

"It's not just the nurses, right? There's a whole team of people that are actually behind that."