A severe nursing shortage has plagued remote Manitoba First Nations for the last three years, forcing two nursing stations to temporarily close and a dozen others to work with a mere fraction of their regular staff.
Data obtained through a federal access-to-information request reveal that the majority of Manitoba's 21 nursing stations were short an average of 45 per cent of their nurses between 2006 and 2009.
Health Canada data show that 13 of all nursing stations on northern Manitoba reserves were short more than half their regular complement of nurses for an entire year. Eight communities were short more than half their nursing staff for multiple calendar years.
For one year, two remote northern communities -- Shamattawa and Pauingassi -- averaged zero staff, and the nursing stations were forced to close for days at a time until relief staff could be flown in.
First Nations leaders say the chronic shortages make it more difficult to recruit nurses to northern communities and result in stressed-out, overworked staff who are more apt to make mistakes.
A recent Free Press investigation into tuberculosis revealed that a 2006 outbreak in Garden Hill went undetected for eight months after infectious patients said they visited the nursing station but were told to go home and take Tylenol. At the time, the nursing station was short five nurses.
"I think the longer we wait, the more lives we're going to lose," said Shamattawa First Nation Chief Jeffrey Napoakesik. "There's only so much this person can do with a stethoscope."
Health Canada refused an interview request from the Free Press. A federal spokeswoman sent an email statement denying that any nursing station in a Manitoba community was temporarily closed due to staff shortages -- even though their own federal data obtained by the Free Press refute that.
"In the past, there have been occasions where nursing stations have been closed due to staff shortages. However, in the last three years this has not occurred," the statement said.
The statement said some nursing stations have been temporarily closed due to "weather conditions."
Napoakesik said the nursing shortage was so bad in Shamattawa in 2007, the nursing station was forced to shut down for days at a time until relief nurses could be flown in.
Things haven't improved much since. Current data from 2009 show Shamattwa has the second-worst shortages in the province and is short 72 per cent of its regular full-time nurses.
"I remember that year that Health Canada (said they) would have no choice but to close the nursing station because there was no staff at that time," Napoakesik said.
About 1,350 people live in Shamattawa, a fly-in community on the north shore of God's River, 750 kilometres north of Winnipeg. Napoakesik said a doctor flies in twice a month, but there are still not enough nurses or doctors to deal with the health needs of a growing community. He said the nursing station is slated for an upgrade, since the medical equipment is so out of date there are no longer parts made to repair a broken X-ray machine.
The fallout, Napoakesik said, is a lack of access to proper medical care. Last week, he said, an elderly man died of a cancer that went undetected at the nursing station for a long time. Napoakesik said the community is upset that the man was not flown out for treatment and was told there was nothing wrong with him.
"This has to stop," said Manitoba Keewatinowi Okimakanak Grand Chief David Harper, the head of the lobby group that represents 30 northern First Nations.
"They (nurses) are not doctors and they're stressed out. We applaud their work and what they're trying to do, but there's going to be times when mistakes happen, and mistakes have happened."
Earlier this year, six-month-old Chace Barkman died of meningitis after his parents were repeatedly sent home from the Garden Hill nursing station with instructions to treat the baby's fever with a cool bath and Tylenol.
By the time he was flown for emergency treatment in Winnipeg, it was too late, and he died eight days later.
Harper said there needs to be a better way to recruit and train nurses from northern communities, because nurses are reluctant to sign up to work under the current high-stress conditions.
He said programs to train licensed practical nurses are underway in Oxford House and St. Theresa Point, but there are no LPN positions available in any nursing station.
"The numbers of nurses per population in First Nations communities is a third of what it is in the Canadian average," Harper said. "We don't have proper medical care."
Will there be extra staff during a pandemic?
Health Canada said in an email statement that the federal government contracts with nursing agencies to fill vacancies in nursing stations.
While they didn't say what that means for a pandemic, a spokeswoman for the Winnipeg Regional Health Authority said there are more than 100 doctors, nurses and medical residents who have signed up to volunteer to help out in northern communities in the event pandemic flu hits a remote First Nation.
The Assembly of Manitoba Chiefs reports that more than 40,000 people on reserves have been vaccinated against H1N1 -- close to half of the population in The stats
Who was the most short-staffed?
Health Canada supplied the Free Press with average nurse-shortage percentages for each calendar year between 2006 and 2009.
2006 -- Pauingassi, short 100 per cent of its nurses
2007 -- Shamattawa, short 100 per cent of its nurses
2008 -- Wasagamack, short 88 per cent of its nurses
2009 -- Pauingassi, short 79 per cent of its nurses
Who had the most staff?
Pukatawagan had a full complement of nurses for 2006, 2007, and 2008 -- the only community that recorded no nursing vacancies during that time. But the community has been short an average of 48 per cent of its nurses in 2009.
In 2009, the lowest vacancy rate in a nursing station was recorded in Garden Hill, which is short 21 per cent of its regular full-time nurses.