Vaccines won’t be enough to fix crisis in Kashechewan, says Indigenous health authority

By Alan S. Hale June 16, 2021

Help is on the way to Kashechewan First Nation to ensure vaccination uptake among youth, per Premier Doug Ford, as the community copes with a growing Covid outbreak disproportionately impacting young people.

The community of 1,800 people on the James Bay Coast had 216 active cases as of Tuesday, up about 100 cases since the end of last week, when more than half were among youth under age 17. Meanwhile, the other nearby First Nations communities all have fewer than 20 active cases each.

“We are going to be flying in … to get the 12- to 17-year-olds and anyone else who needs to be vaccinated,” said Ford on Tuesday.

Like other Indigenous communities in Ontario, Kashechewan was prioritized to receive vaccine doses since the early days of the rollout, as the province recognized that poverty and overcrowding issues in housing put Indigenous people at greater risk.

In Kashechewan, people have resorted to sleeping in tents outside the local high school to avoid close contact with family members at their homes, some of which house up to 18 people, according to Chief Leo Friday.

“How can people self-isolate in these conditions?” Friday said in a statement.

Because vaccines were not approved for children 12 and up until late May, youth were left out of the first vaccination efforts in Kashechewan. Weeneebayko Area Health Authority (WAHA) president Lynne Innes said this initially caused vaccine hesitancy within the community.

“A lot of the elders and knowledge keepers felt that it wasn’t appropriate for them to take the vaccine when there were healthy children that didn’t even have the opportunity to take it,” Innes told Queen’s Park Today.

Around 1,000 12- to 17-year-olds in the James Bay communities had been vaccinated as of last week, as part of Operation Remote Immunity 2.0.

But Innes said the crisis in Kashechewan cannot be solved with more vaccines alone, as the community is hampered by an under-resourced and understaffed health-care system. The chief is calling for mobile isolation centres and additional nurses ASAP.

“There have been multiple requests from the First Nations for additional support and resources, with respect to a mobile isolation centre or mobile isolation village,” Innes said. “Having additional support … to make sure there are enough nurses to be able to conduct contact tracing and health promotion — that’s what’s going to get us out of this crisis.”

As a remote fly-in community that floods almost annually, requiring many of its residents to be evacuated, Kashechewan leaders have been asking for years to relocate the community somewhere else.

Innes said the province needs to see related housing problems as part of the public health response.

“Basic social determinants of health, such as housing, infrastructure and clean water, are three huge components of a healthy community,” she said. “Even if we have enough manpower, space is always an issue.”

Indigenous leaders tout province’s rollout for First Nations
Despite the outbreak in Kashechewan, Health Minister Christine Elliott defended the government’s vaccine rollout for First Nations in recent months as “very successful.”

That assessment is shared by prominent Indigenous leaders, including Nishnawbe Aski Nation Grand Chief Alvin Fiddler, who was involved in implementing the rollout at the nation’s 49 member communities, some of which are only accessible by air.

“I’m not sure that it could have gone any better,” Fiddler told Queen’s Park Today. “It was almost flawless, like a ‘well-oiled machine,’ as one of the paramedics put it.”

Innes also praised Operation Remote Immunity as a successful partnership in WAHA’s communities.

Former Ontario Regional Chief RoseAnne Archibald, the only Indigenous member of the province’s vaccine task force, was the driving force behind Ontario’s vaccination efforts for Indigenous people

From her first day on the task force, Archibald said she and her team recognized Indigenous people were at a greater threat for “tragic outcomes” from the virus because of their social determinants of health.

“How do you take care of your health when you can’t even drink the water out of your tap,” she asked. “[It] also covers things like overcrowded housing, high rates of poverty, and more pre-existing conditions like diabetes. We knew that we had to take stronger action in First Nations to save lives.”

Archibald and a team of researchers and Indigenous leaders later pushed to prioritize vaccinations for off-reserve Indigenous people as well, noting they often faced the same issues even if they lived in urban centres.

Fiddler called the collaboration a high point for relations between Indigenous people and the provincial government, and a precedent he hopes can be built upon.

“It was a true partnership,” the grand chief said.

“We hope to see the momentum of the original operation carry forward into other relationships and partnerships. It showed us all that we can accomplish when we come together in a good way, building these relationships based on respect and trust.”

Concerns over ‘colonialist oppression’ remain
But some say credit for that success belongs elsewhere.

NDP MPP Sol Mamakwa noted that making Indigenous people a priority during the vaccination rollout was mandated by the federal government.

He said accusations he faced from Ford of “jumping the line” in March when he got vaccinated outside his home community (but still within his treaty area), shows the PCs haven’t changed their underlying disregard for Indigenous people.

“It was like that old pass system where Indians had to get a pass to leave their reserve,” Mamakwa said. “It’s all part of colonialism, and colonialist oppression is racism. It’s what I see in [the legislature] on a daily basis.”

The fact that First Nations communities like Kashechewan have under-resourced and deteriorating health care and housing systems is no accident, he argued.

“These systems were never built for our people,” he said. “These systems are not broken; they are working exactly the way they were designed to.”