Northern Ontario Guest Lecture Flashcards
Facts about the Doctors
- Family doctors in Owen Sound
- Relatively new in practice
- Family practice, ER, obstetrical care, addiction medicine clinics
- Both interested in working with vulnerable populations
“Locum Year”- Sioux Lookout
- Population: 5272
- Demographics: about 50/50 Caucasian/Indigenous
- “Hub of the North” services 31 First Nation communities with a total catchment area of about 32000 people
- Healthcare, tourism (fishing in summer), forestry
Meno-Ya-Win Health Center
- Opened in 2010
- “Health, wellness, wellbeing”
- 60 bed hospital
- Emergency department, OR, obstetrical programs, dialysis, chemo
- Mostly Family Physician run, also general surgeons, anesthetists, and an infectious diseases specialist
- Hostel- 100 beds
Northern Health Centres
- “Nursing Stations”: nurse and NP run, physicians available by phone
- Physicians on site to run clinic generally 1-2 weeks per month, more in larger communities
- Access to good preventative health care (well baby, paps, diabetes care)
- EKG
- Most have no x-rays or labs
Neskantaga (Lansdowne House)
- Oji-Cree First Nation
- Population 265
- Accessible by flight year round
- Accessible by road during winter only
- Services: Northern Store, K-9 school, health centre, community center, arena
Wapakeka
- Oji-Cree Community
- 465 km NE of Sioux Lookout
- Population: 375
- Accessible by flight year round
- Accessible by road in winter only
Historical Aspects of Healthcare in Sioux
- 1922: Sioux Lookout General Hospital Opens
- 1949: Sanatorium for TB patients from remote first nations opens
- Becomes the “Indian Hospital” and later the “Sioux Lookout Zone Hospital” in 1970s
- Amalgamation into Meno Ya Win Health Centre in 2010 (plans to do so had begum much sooner)
2 Physician Groups
Northern Group (larger) & Town Group
Mental Illness
-Indigenous youth have five to six times higher suicide
rate than non-Indigenous youth in Canada
-Nishnawbe Aski Nation reported 38 suicides in 2017 alone, and around 600 suicides since the mid-1080s (with about 90% of those deaths age 10-14)
-several northern Ontario Indigenous communities have declared a state of emergency due to high you suicide rates
-> Wapakeka 2017: 3 12-year old girls in a row as part of a sucide pact- at the time 10% of the reserve’s population considered “at risk” for suicide
Substance Use
- very high rate of substance use disorders
- eg. Cat lake; estimated at one time that 250/700 residents suffered from addiction
- eg. Neskantaga chief estimated that more than 1/2 of the community’s adults were addicted to opiod painkillers
- e.g. Fort Hope health director estimated that 70-80% of the adults in the community were suffering from addiction in 2010
- eg. Bearskin Lake- estimated that 80% of residents addicted to oxycodone in 2011
Infectious Diseases
- One of the highest rates of MRSA in Canada
- Eg rates of infection with MRSA about 20 times higher than in Calgary
- Rate of rheumatic fever (a complication of Streptococcus infections) in remote First Nations communities 75 times higher than the rest of Canada
- Heavy burden of MSK infections, skin and soft tissue infections, hepatitis C, respiratory infections including TB
- Biggest contributors probably inadequate housing, unsafe water, and inferior health care access
Diabetes
-Three to five times higher rate of diabetes
-Diabetes
the national average
related amputation rate approx three times
-On the reserves covered by Sioux Lookout approx 25% of the population has diabetes
-Food security lacking; First Nations families in Northern Ontario spending more than half of their income on food just to meet basic nutritional needs
Social Determinants of Health
- Unsafe water/no running water
- Inadequate housing, overcrowding
- Poverty
- Lack of social supports/health care/allied health professionals/home care etc
- Geographic isolation
- Food insecurity
- Lack of educational and employment opportunities
- Loss of hope
- Intergenerational trauma, PTSD, lost generation, residential schools
