OTTAWA — Nurses are still circling in and out of Manitoba reserves every two weeks even as a directive halts doctors’ visits to the communities to contain the spread of COVID-19.
"We just feel abandoned. We feel like First Nations communities are always put last," said Sandra Cook, a nurse at Berens River First Nation, which sits 275 kilometres north of Winnipeg.
The conflicting guidelines highlight the disparity in health services for First Nations, which make it hard to follow officials’ advice to self-isolate and limit travel.
Berens River is among a dozen reserves served by Ongomiizwin Health Services, a University of Manitoba group that co-ordinates health care with the federal and provincial governments.
In a March 19 letter, Ongomiizwin informed the community it was indefinitely cancelling visits by all doctors and specialists like pediatricians, and shifting to phone services.
"We will be moving to an offsite virtual-care model," reads the letter, which says it will send doctors to contain an outbreak if one occurs.
"We want to do everything we can to minimize the risk of introducing COVID-19 into the communities that we serve."
Head nurse Brenda Frogg said the decision was made without consulting the community. Three of her fellow nurses visit the community on two-week rotations, otherwise working elsewhere in Manitoba or in Regina.
"We’re trying to keep ourselves safe," Frogg said. "We can’t step back anymore and just allow this to happen."
Berens River is served by a road, making its 2,200 residents more exposed to outsiders than fly-in communities. Though it is not on the federal list of boil-water advisories, the community gets its drinking water from just one water truck. The 2016 census found a third of homes were overcrowded, and 54 per cent needed repairs.
Band councillor Glen Boulanger said he doesn’t want to force nurses to stay put, but doesn’t know how to avoid the risk of an outbreak.
"Our hands are tied," he said. "We are lucky our nurses love our community. They want to help."
Ongomiizwin, known for decades as NMU, did not respond to a request for comment.
Indigenous Services Canada, which oversees health care on reserve, said staff are monitoring First Nations’ pandemic preparedness in daily calls, and is trying to hire more nurses for reserves while assessing the need for paramedics.
"This is an ongoing discussion that is happening in real time," ISC Minister Marc Miller told the Free Press on Wednesday.
"Looking at what that capacity gap is, and how to fill it in the most expeditious manner, is part of that conversation."
Northern Manitoba MP Niki Ashton said Ottawa needs to ensure doctors are available, and should compel Ongomiizwin to consult with its communities before changing services.
"We are seeing the rolling out of second-class health-care services to the communities who are most vulnerable to COVID-19," Ashton said.
"Communities are being told it’s not until a potential tragedy strikes that they will get the attention that any Canadian deserves."
Berens River declared a state of emergency Tuesday. Last Saturday, a protest convinced a bar outside the reserve to reluctantly shift to only allowing a beer vendor.
Officials have expressed concerns about Mounties being shifted around detachments; Manitoba RCMP were not able to respond by deadline.
This month, federal officials testified that the H1N1 swine flu spread into reserves in 2009 in part because so many patients have to visit cities for essential medical services. Manitoba’s northern reserves had an infection rate five times the national average.