On the very first episode of White Coat, Black Art, we explored the growing problem of physicians who cherry pick the easiest patients, and leave the complex ones as 'orphan' patients. No where is the problem of orphan patients more acute than in Canada's far north.
For our final original episode of the current season, we've gone full circle. A couple of weeks ago, producer Lara Hindle and I visited Sioux Lookout, population 5600, located 1700 km northwest of Toronto. I was the guest of Sioux Lookout Family Practice Zone (SLFPZ) a group of dedicated health professionals who care for 25 remote Ojibway, Cree and Oji-Cree First Nations communities as far north as Hudson Bay, in an area the size of France.
These communities have populations in the hundreds. And, they are isolated, many with access by plane or by ice road. Some have described the challenges of providing health care to these communities as roughly equivalent to working in a developing country.
Everyone who works there has a slightly different story, but all of them have come out of a desire to make a difference.
Harriet Lennox, a classmate of mine, did an elective rotation at Sioux Lookout, met her husband, a commercial pilot who owns and operates an air transport company in the region, and has been living there ever since.
It's a cliche to talk about intractable health problems among First Nations people...things like obesity, high blood pressure, diabetes and substance abuse. There's no question these problems are getting worse. It's sobering to realize that putting more doctors in the region will not stem these growing health problems.
Several things really struck me while I was there. In Toronto, where I ride the subway to and from work each day, you're considered strange if you make eye contact with strangers. Not so in Sioux Lookout, where everyone knows everyone else, and considers each other part of their support system.
Nowhere was the connectedness more apparent than in Frenchman's Head, a community of the Lac Seul First Nation a 45 minute drive from Sioux Lookout. There, I met Louise Chisel, the coordinator of home care services in the region. She told me that no effort is spared to keep people in their homes instead of admitting them to long term care facilities.
She gave me an astonishing example: an elder who had many health problems. Had he lived in any medium to large city in Canada, he would surely have been hospitalized for the rest of his life. But Louise Chisel was able to keep the man at home for 5 years by marshalling an amazing 5 hours of home care a day! Where I work, at best, people are eligible to receive 2 hours a day, but usually receive much less.
So, how was she able to accomplish this feat? Chisel says everyone went the extra mile to provide the man home care services from personal support workers, nurses and other health care providers because everyone involved was in some way related to the man. In other words, what kept the man at home was a sense of family that you seldom see anywhere else.
I'd like to take this opportunity to thank Clifford Bull, Lac Seul First Nation Chief, for smoothing the way to allowing us to visit Frenchman's Head. And, I'd also like to thank Cindy Hunt, SLFPZ's whiz administrator, and all of the people at the clinic who welcomed us with open arms.