Housing ‘critical ingredient’ to curbing diseases like TB: Hajdu

Indigenous Services Minister Patty Hajdu sidestepped questions last week about her department’s plan to tackle tuberculosis across First Nations communities, calling housing a “critical ingredient” to doing so but offering little detail about any forthcoming plan.

Speaking to the Indigenous affairs committee, which is studying the effects of the housing shortage in FN communities, Hajdu was pressed on the matter by Conservative MP Gary Vidal, whose Saskatchewan riding folds in Black Lake, Fond du Lac and Pelican Narrows — all of which have been hit hard with tuberculosis in recent months.

Pelican Narrows became the third to declare a TB outbreak in February, with the other two highlighting their situations in October.

“We’re talking about dozens of outbreaks and over 100 cases, and that’s nearly double what it was a few years ago and much higher than it’s been in over a decade,” said Vidal.

He pressed the minister why “in a developed country like Canada,” there remain outbreaks of a disease that has largely been eradicated in western countries, questioning when an action plan will be released and if it will fold in “targets.” He also asked whether the blueprint would address steps to limit overcrowded housing in the communities.

Hajdu trumpeted a recent visit to the province where she met with the Federation of Sovereign Indigenous Nations, which represents 74 communities in Saskatchewan, noting “a lot” of the discussion was about housing.

She said many leaders highlighted the “exclusion they felt from appropriate medical care from the government of Saskatchewan and about the need for urgency in the developed health legislation” that aims to offer care “closer to home.”

While Hajdu pointed to 2021 budget promises like $6 billion for “shovel-ready projects and operations and maintenance costs” and $5 billion aimed at beefing up “health outcomes” for those in the province, she did not directly answer Vidal’s question.

“You point out that housing is a critical ingredient to defeating infectious diseases like tuberculosis and I would agree,” she said. “We have to work more quickly on supporting culturally appropriate medical care and access.”

Vidal had referenced Indigenous Services Canada’s 2020-21 departmental plan, which appeared to “admit” that the development of a TB reduction action plan aimed at First Nations was not finished. But “what’s more concerning,” he said, is the 2022-23 plan does not contain “any mention” of steps to curb outbreaks declared in recent months.

The former blueprint vowed that Ottawa would work with the Inuit Tapiriit Kanatami and other groups to help it be the “lead on the elimination of tuberculosis in Inuit Nunangat by 2030,” a region that folds in what’s known today as Nunavut, northern Quebec, northern Labrador and the Northwest Territories.

The following year’s plan cited the pandemic as creating “additional challenges in the work towards” eliminating TB but vowed to work to “enhanced planning for communicable disease outbreaks… that can support TB elimination post-pandemic.”

The most recent plan, shared this month, referenced that Ottawa’s goal is to keep active TB incidence rates among on-reserve First Nations to a three-year average of 22 cases per 100,000 population. That goal, introduced in 2019-20, is one Ottawa hopes to hit by March 2028, though Hajdu declined to wade into specifics when offered the chance by Vidal.

According to the updated blueprint, there has been some progress toward that target, with the figure hovering in the 26-case range in 2019-20 and sitting at 24.3 the following year.

But the latest wave of outbreaks has reignited concern that the disease is creeping back up in cases involving the younger generation.

That prompted one Saskatoon pediatrician to issue reminders that it is a sneaky disease able to emerge in vulnerable communities despite available treatments and cures, with symptoms like a cough and night sweats commonly confused with more common sicknesses. In children, symptoms can appear faster and risk causing permanent damage to the brain and other development.

Dr. Nnamdi Ndubuka, Northern Inter-Tribal Health Authority’s medical health officer, noted children six and younger were testing positive, marking a “shift in the pattern of the outbreak” as past cases were “mainly” found in adults.

Vidal said his northern Saskatchewan area makes up 3.6 per cent of the province’s overall population, but a study last fall pegged the area as responsible for half the province’s cases.

Incidence rates in Saskatchewan typically sit 1.5 times above the national average, the MP noted, at 7.9 active cases per 100,000 people in 2016. That year, the total provincial figure was 91, more than one-third of which were sourced back to First Nations communities in northern Saskatchewan.