In failing health

Hey there, time traveller!
This article was published 28/10/2016 (3291 days ago), so information in it may no longer be current.

OTTAWA — By the time four baby boys were switched at birth at a northern Manitoba hospital 40 years ago, federal officials were already aware the facility needed a major overhaul — the building was run-down, staff turnover was high and patients lacked confidence in the quality of care.

According to more than 250 pages of documents about the Norway House Indian Hospital held by the Library and Archives Canada, federal and regional bureaucrats responsible for the hospital were well aware there was a serious level of distrust between First Nations people and the mostly non-First Nations doctors and nurses who worked at the hospital in 1975 — the year two cases of switching babies have been confirmed.

“The interviews quickly lead one to the conclusion that there is widespread lack of confidence in the treatment people get at the hospital,” reads a report on a survey of residents of the nine communities the hospital was supposed to serve.

The survey found more than half the people served by the hospital had such little faith in the treatment it provided they would rather be treated elsewhere.

At least three different reviews were carried out between 1971 and 1975 that examined the physical building, administration and medical services. While each review drew some differing conclusions, the overriding theme was of a facility that had outlived its lifespan and had serious issues with mechanical, plumbing and fire safety systems.

“The building is now obsolescent in terms of effectiveness, efficiency and safety,” says the report.

These records will likely form part of the review process Indigenous and Northern Affairs Canada is about to undertake to determine how it was that two sets of babies were sent home with the wrong mothers, within six months of each other, after being born at the hospital in 1975.

The hospital had inpatient wards, an emergency room, and an outpatient clinic, and provided general medical, surgical, obstetrics and pediatrics. Together obstetrics and newborns accounted for about one-third of hospital admissions. Statistics in the documents also suggest an extremely high birth rate — 26 per cent of women of child-bearing age delivered a baby at the hospital in 1974 — and a very high rate of obstetrical complications with 60 per cent of births experiencing some sort of difficulty. The report suggests this was largely due to poor prenatal care, as fewer than one in five pregnant women saw a doctor or nurse at least once a month during their pregnancy.

It has been almost a year since DNA tests first proved Luke Monias was actually the biological son of Rebecca and Daniel Barkman, and not Rosamund and Isaiah Monias, who had raised him as their son. Not long after, another test proved his good friend Norman Barkman, who he had grown up with in Garden Hill First Nation, was the Monias’s biological son, yet had been raised by the Barkmans.

The two had battled rumours about their heritage their entire lives, and the tests showed they had in fact been switched after being born June 19, 1975, at the Norway House Indian Hospital.

Expectations that this was a single, unusual incident went out the window when additional DNA testing proved in August it had happened at least once more less than six months before the Barkman/Monias switch. Leon Swanson and David Tait Jr., of Norway House Cree Nation, discovered they were raised by each other’s biological parents. They were born within a few days of each other at the hospital in late January and early February 1975.

After the first case was discovered, federal Health Minister Jane Philpott indicated she would conduct an internal review. After the second case was revealed in late August, she said she would hire an outside investigator to look at hospital records and procedures and make the report public. The department is also offering DNA testing to any other people born at the hospital in 1975 if they are concerned about their heritage. Health officials will not say if anyone else has requested the testing.

Now, two months later, a departmental spokesman said “highly qualified individuals” have been identified to do the review but the team is not yet actually in place. Still he said the review will take just a few months, with a completion date of February 2017.

Former Manitoba Aboriginal Affairs Minister Eric Robinson said this week the families are growing increasingly frustrated. He has been helping the men and their families navigate the bureaucracy since the DNA tests were completed. A few weeks ago, he was told in a meeting with Health Canada officials that Philpott would meet personally with the men by the end of this month.

While her office says she will have such a meeting as soon as her schedule allows, it won’t happen by the end of October nor is there a date yet set for that meeting.

“I have no idea what is going on,” said Robinson. “We’re trying to be patient.”

The Norway House Indian Hospital was built in 1952 to serve nine First Nations — Norway House, Cross Lake, Oxford House, Gods Lake Narrows, God’s River, Garden Hill, St. Theresa Point, Wasagamack, and Red Sucker Lake. The two-story wooden structure was originally built as a 50-bed hospital but, by 1975, that had been cut to 28 beds, only half of which were filled on a regular basis.

There were supposed to be four doctors, 11 registered nurses and five licensed practical nurses on staff, although turnover was high. Finding Canadian-trained doctors was virtually impossible and in 1975 all of the doctors currently working there had been recruited from Britain.

According to one of the documents, the average length of stay for a nurse or X-ray and lab technician was just over one year between 1972 and 1975, and 20 to 30 per cent of those positions were usually vacant.

Patients were well aware of the issue, complaining about inexperienced new doctors and nurses trying to get some practice before moving on to bigger centres.

“They send rookies up here,” one person told a survey team. “People here aren’t to be practised on,” said another.

Many of the complaints echo to those made in many First Nations today about nursing stations that turn patients away until they are extremely ill. Several people talked about one incident when a child was sent home from the hospital only to return the next day and die. One woman said her daughter was pregnant with twins but was refused treatment at the hospital and both of the twins died.

The trust in the hospital was so poor, 56 per cent of those surveyed “were unable to think of anything at all that they liked about the hospital.”

The building itself was in sad shape by the mid-1970s. As early as 1971, a review of the building by Winnipeg architects Libling, Michener and Associates found it did “not meet national building code requirements for construction, fire separation, means of egress etc.”

A report in 1973 talks about numerous physical deficiencies including exposed insulation. Four years later, a review ordered by the federal government found while maintenance and renovations were at a “good level”, it was not enough to “correct the basic structural or location defects of the sanitation, fire security or mechanical inadequacies.”

In 1975, federal officials were trying to decide whether to build a new, smaller hospital, renovate it to a smaller hospital to treat only Norway House residents, build a new community health centre with just a handful of inpatient beds or leave it as is. The decision began to take shape in 1976, when Health Canada contracted with the Northern Medical Unit in Manitoba to help operate a much smaller hospital.

Today the Norway House Indian Hospital serves the 7,000 residents of Norway House Cree Nation and the adjacent non-reserve community, with emergency service, diagnostic and X-ray, dialysis, a clinic, and a laboratory. There are seven inpatient beds, and it is staffed by nurses and doctors who are provided through the Northern Medical Unit of the University of Manitoba. Babies are not delivered there except on an emergency basis.

mia.rabson@freepress.mb.ca