Ecosystem Health in Northern Aboriginal Communities in Manitoba

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Ecosystem Health in Northern Aboriginal
Communities in Manitoba
Shirley Thompson University of Manitoba S_thompson
_at_umanitoba.ca SLESH conference 2006
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Question

• Are sustainable livelihoods and Ecosystem health
  approaches appropriate in Canada (for Northern
  Aboriginal Communities)?

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Agenda

• Introduction
• Health indicators
• Ecosystem health
• Case study TB and Housing
• Case study Water quality
• Conclusions

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Four key challenges for an Ecosystem Approach to
Human Health

• finding a shared vision
• assuring community access
• gaining credibility and,
• measuring success.

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Traditional Knowledge reveals the complexity of
traditional approaches to environmental systems.
Elder Robin Greene teaches the traditional ways.
Photo by Randy Paishk
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Medicine Wheel
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TO BE REPLACED BY UPDATED SLIDE
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Community Food Security

• a condition in which all residents obtain a
  safe, culturally appropriate, nutritionally sound
  diet through an economically and environmentally
  sustainable food system that promotes community
  self-reliance and social justice!
• Hamm Bellows

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Health

• Not only the absence of disease but also the
  extent to which an individual or group is able to
  on the one hand to realize aspirations and
  satisfy needs and on the other to change or cope
  with the environment.
• State of complete physical, mental and social
  well-being and not merely the absence of disease
  or infirmity. It is not an objective for
  living, but a resource for everyday life.
• WHO

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Source Millenium Ecosystem Assessment
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Age-standardized Leading Causes of Death, First
Nations (2000) and Canada (1999)

• Used to compare rates across groups with
  different demographic characteristics
• Reduces the effects of very old or young
  population age differences

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Potential Years of Life Lost (PYLL) by Cause of
Death, First Nations (2000) and Canada (1999)
Increased risk of suicide at all ages for First
Nations up to 65 years of age highest for young
males and females. Source Health Status of
First Nations in Canada (1999)

• Calculates the number of years of life lost
  assuming an average lifespan of 75 years
• Expressed as a rate per 100,000 population
  (similar to death rates)

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Infant Mortality Rates, Manitoba, 1991 to 2001
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Life Expectancy at Birth, by Sex, First Nations
and Canada, 1980, 1990 and 2000
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Projected Number of People with DiabetesMB First
Nations, 1996-2016
Source http//www.gov.mb.ca/health/publichealth/
epiunit/docs/storm.pdf

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Diabetes Implications for Health Care

• Persons with diabetes account for
• 91 of lower limb amputations
• 60 of hospitalizations for heart disease
• 50 of hospitalizations for stroke
• 41 of hospital days
• 30 of all hospitalization
• (Strategy Steering Committee, 1998)
• First Nations patients with diabetes in Manitoba
  have longer hospital stays with an increased
  intensity of care, and there is an increase in
  obstetrical admissions (Dow, 1999)

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Health Facilities and Hospitals
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NIHB Expenditures In Manitoba Region by Benefit
(FY 2003/2004
2.8M
48.5M
17.3M
5.6M
53.5M
Total 127.8 M
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Environmental Change drivers
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Case Study Housing

• Shelter Only 56.9 of homes in FN communities
  adequate
• (not needing major repair or replacement)
  (1999/2000)

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Pukatawagan Remediation
The houses condemned and knocked down because of
the fuel spill have not been replaced, leaving
only 299 residences for 2,600 people, with an
average of nearly nine occupants per house.
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Rates of Tuberculosis, 1994 to 2004 in Manitoba
2004 Data is preliminary
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Tuberculosis Notification Rates, by Community
Housing Density, First Nations, 1997-9
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Host
Tuberculosis
Environment
Agent
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Inadequate housing
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Case study water quality
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Determinants of Health Water and Sanitation

• Water Quality Only 41.4 of FN communities
  reported at least 90 of homes connected to water
  treatment plant (1999/20)
• Sanitation Only 33.6 of FN communities had at
  least 90 of homes connected to community sewage
  disposal system (1999/2000)
• Source A Statistical Profile on the Health of
  First Nations in Canada, 2003, Statistics Canada
  2001 Census

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Difficulties with building adequate
infrastructure for Safe water on Reserves

• technical difficult and costly to develop
  infrastructure in isolated areas, often having
  difficult terrain (e.g., permafrost, swamp) and
  often having drinking water source off-reserve
• limited access to financing and recovery of costs
  due to poor economic conditions
• lack of qualified personnel in environmental
  service delivery
• high birth rates in these communities expanding
  infrastructure needs rapidly and
• unclear technical standards with limited support
  for standards and enforcement mechanisms.

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Why the safety of First Nations drinking water is
compromised?

• No laws and regulations govern the provision of
  drinking water in First Nations communities.
• INAC and Health Canada implement policies,
  administrative guidelines, and funding
  arrangements with First Nations inconsistently
  and piecemeal.
• Action with First Nation communities is not being
  taken to
• assess the capacity and support that
  First Nations need to deliver safe drinking water
  in their communities
• establish the institution or institutions that
  could consolidate these capacity-building and
  support functions for all First Nations and
• define the information needed to demonstrate that
  the drinking water is safe (Gelinas 2005).

http//www.oag-bvg.gc.ca/domino/reports.nsf/html/c
20050905ce.html
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Drinking water at risk in First Nations
communities

• In 2001, Indian and Northern Affairs (INAC) found
  a significant risk to the quality or safety of
  drinking water in three-quarters of the systems
  (Gelinas 2005).
• In Manitoba 5 northern First Nations are on
  boil-water advisories one with a reported case of
  E. coli contamination (Water Stewardship Branch
  2005)
• Assembly of Manitoba Chiefs spokesman, Michael
  Hutchinson, reported that many as 25 Manitoba
  First nations have varying degrees of water
  quality problems (CanWest 2005).
• Kashechewan First Nations story
  http//www.cbc.ca/story/canada/national/2005/10/28
  /kashechewan-evacuation051028.html

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Multiple Barrier Approach to Safe Drinking Water

• (1) source the best possible raw water quality
  should be maintained and protected
• (2) treatment effective treatment should be
  designed, operated and maintained
• (3) distribution secure storage and distribution
  of treated water should be provided
• (4) monitoring appropriate and effective
  monitoring should be performed
• (5) response appropriate and effective responses
  to adverse monitoring or adverse circumstances
  are needed.

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Thank you. Questions?

• Are sustainable livelihoods and Ecosystem health
  approaches appropriate in Canada (for Northern
  Aboriginal Communities)?