September 19, 2020

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Rural communities uniquely challenged by pandemic

On August 25, Dr. Brent Roussin announced that 236 of Manitoba's 993 reported COVID-19 cases to date were individuals living in communal living communities. One hundred and forty-eight of those cases were active. (Mikaela macKenzie Winnipeg Free Press files)

On August 25, Dr. Brent Roussin announced that 236 of Manitoba's 993 reported COVID-19 cases to date were individuals living in communal living communities. One hundred and forty-eight of those cases were active. (Mikaela macKenzie Winnipeg Free Press files)

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As Manitoba’s countryside becomes one of Canada’s COVID-19 hotspots, experts in rural health say the pandemic will test officials’ trust with local communities, including Hutterite colonies.

"The answer is simple in a way, you just have to keep everyone six feet away from everyone else. But it's complicated, because how in practice can you do that?" asked Dr. Margaret Tromp, the recent head of the Society of Rural Physicians of Canada.

"Most remote communities are just locking down, and most have been successful. But if a case gets in, it's very bad," said Tromp, in a call from Moose Factory, Ont.

That’s because many rural people work in jobs that require close contact with others, like farm work and machinery repair.

Communities across Canada have implemented social-distancing measures in shops, but not all of them can provide delivery services or curbside pick-up.

Spotty Internet service can prevent people from working and socializing at home, noted Paul Peters, a Carleton University health-science professor.

He noted that other countries have seen outbreaks linked to long school-bus trips for students in rural areas.

"One might expect there would be, at some point, outbreak in rural communities, with lots of community transition," he said. "Those of us who do rural health aren’t very surprised."

Physical distancing itself can be particular hard in what the province calls "communal-living communities", which includes many Hutterite colonies.

Calls to several of those communities went unreturned Tuesday afternoon.

Don’t stigmatize Hutterites: prof

 

A University of Winnipeg professor who has long researched Hutterite settlements urged people not to vilify their fellow Manitobans.

A University of Winnipeg professor who has long researched Hutterite settlements urged people not to vilify their fellow Manitobans.

Retired professor Jock Lehr said colonies are like other communities; most people follow physical-distancing rules, but not every single person.

"They’re just people like you and me, they just happens to live communally," he said.

He suspects the colonies are uncomfortable under the public's gaze during this pandemic, and public-health officials have warned that stigmatizing any community dealing with COVID-19 will only make it harder to trace.

Most Hutterite families arrived in Canada after persecution in the United States in the First World War, when members of the pacifist religion refused military drafts and war bonds. They were stigmatized in the Second World War for speaking German and faced restrictions in owning land until the 1970s.

"They're very sensitive about the fact that the outside world can get some crazy opinions about them."

—Dylan Robertson

Jock Lehr, a retired University of Winnipeg geography professor, has researched Hutterite settlements extensively. He said physical distancing within a colony would be extremely difficult.

"It would be a lot easier for a Hutterite colony to physically isolate itself as a whole, than it would be for a settlement of similar population in a small town in Manitoba,"

"But within the communities it's very difficult, because previously everything was done communally: you eat with the other, you work together, you worship together."

A typical colony has 60 to 170 people and about six to 12 families, with housing and furniture owned or paid for by the colony, Lehr said. Many Hutterite homes might have a microwave or toaster oven, but often lack stoves because all three meals are generally eaten in a communal hall.

Workers might be paid a few dollars a month for personal expenses, but otherwise share their possessions. Many people are working the fields together in the late summer.

Some colony workers interact with agricultural retailers to sell the colony's hogs and vegetables, but generally socialize with other Hutterites. The outbreak in some colonies in the Prairies has been linked to guests returning from a funeral at a colony in Alberta.

Peters said that doctors across the Prairies have long tried to form trust with remote areas, particularly religious minorities and First Nations reserves.

In part, it’s because they know some communities have limited access to medical supplies, mental-health supports and even clean drinking water.

"Public health has worked long to develop those relationships, and I do think they have good relationships, overall, within those communities that are traditionally a little more isolated."

Canada’s Chief Public Health Officer cited the importance of those relationship for rural areas, given that they often have lower incomes and less access to health care, and some struggle with drugs like opioids.

"Responding to COVID-19 is quite complex," Dr. Theresa Tam told the Free Press.

"You actually have to understand the community, the culture and be able to leverage the on-the-ground leadership to get buy-in and trust, in order for a lot of the public health measures to work."

Tam said an uptick in cases can be a positive indication that needed testing is now underway. She noted that numerous Indigenous communities have accessed funding and come up with their own plans to keep COVID-19 at bay.

"As long as they’re empowered to do what is needed to protect the communities, that can be done, and they’ve shown that to be the case," said Tam.

"Some communities live in a very congregate manner as their everyday life. And so, having those kinds of changes is a big deal and requires a lot of buy-in."

It can also require money.

Tromp noted that Alberta and Ontario outbreaks have been linked to meat-packing plants with crowded, wet working conditions where the virus thrives. Cramped migrant farmworkers’ bunkhouses have been vectors for COVID-19.

Wealthier small towns instead had a few cases, but had the space and resources to resolve them quickly.

Meanwhile, Tromp said a spring outbreak in northern Saskatchewan was only mitigated when the community got access to isolation trailers, and a delivery service for people with an alcohol dependence who otherwise could not stay home.

"Most rural communities know what the answers are, and what will work best in their community— but can't always put it into place, because of funding issues," Tromp said.

"Often we need support from urban centres, not to tell us what to do but to assist us to put things into place."

dylan.robertson@freepress.mb.ca

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