First Nations are exerting more control over their borders. Health care could be next

Pimicikamak is among the First Nations that have exerted more control over their borders during the pandemic. COVID-19 has turned a spotlight on the substandard state of health care in remote communities — and First Nations' desire to improve it by assuming more control of it.

COVID-19 has turned a spotlight on the substandard state of health care in remote communities

Pimicikamak Cree Nation - also known as Cross Lake - is one dozens of Manitoba First Nations that restrict access to mitigate the spread of COVID-19. (Bartley Kives/CBC)

On the only road connecting Pimicikamak Cree Nation to the rest of Manitoba, there's a checkpoint designed to staunch the spread of COVID-19.

Anyone driving in and out of what's also known as Cross Lake must stop at the row of pylons and disclose contact-tracing information, including their name, phone number, point of origin and intended destination.

They're given temperature checks, asked if they've been tested for COVID-19 and if they have any symptoms. If they intend to stay in the community and interact with anyone, they may be required to spend days inside a school converted into a makeshift isolation centre.

For all intents and purposes, Pimicikamak has exerted control of its borders in a manner befitting a sovereign nation.

All it took was a global pandemic and the mortal threat it poses to isolated, remote communities with substandard health care and overcrowded housing.

"We had to be ready for the virus," said Donnie McKay, the Pimicikamak councillor responsible for health care, who helped oversee the creation of the checkpoint during the early months of the pandemic. "They said it would never get here. Bullshit." 

Pimicikamak Coun. Donnie McKay says southern Manitoba residents would not tolerate the quality of health services available in his community, also known as Cross Lake. (Tyson Koschik/CBC)

Officially, Pimicikamak has 89 active COVID-19 cases, though that number is presumed to be smaller due to the lag time in designating patients as recovered. McKay said he believes the checkpoint has helped prevent more illness — and he's not alone.

"If it wasn't for those checkstops, our communities would be in even more dire situations," said Grand Chief Garrison Settee of Manitoba Keewatinowi Okimakanak, an organization representing 26 northern Manitoba First Nations.

Indigenous communities bearing brunt of pandemic

In recent weeks, remote Indigenous communities have borne the brunt of the pandemic in Manitoba. 

As daily case counts and infection rates started to subside in the southern half of the province, home to all but about 100,000 of Manitoba's 1,379,000 people, remote First Nations across the north — as well as on the isolated east side of Lake Winnipeg — became the new front in the pandemic fight.

Some, like Shamattawa, are recovering from outbreak. Others, like the four Island Lake communities, are trying to contain active infections.

There are also new crises underway, most recently in Pauingassi, where the entire Family Lake community was placed under code-red restrictions on Tuesday.

Everyone entering and exiting Pimicikamak must clear a checkpoint where contact-tracing information is collected, including their name, phone number, point of origin and destination. They are also checked for temperature and asked about symptoms. (Tyson Koschik/CBC)

What is now a largely Indigenous and remote pandemic in this province is once again exposing the dangerous state of health care and housing on remote and isolated First Nations.

"It seems like we don't have a listening ear out there unless there is a real crisis and everyone's up on their hind legs," said McKay.

'It's frustrating'

His community, situated three hours south of Thompson by road, claims a population of 7,200 people.

Pimicikamak converted a school to an isolation centre because it has few empty structures of any sort. And while a hospital is under construction, the community's health-care needs are met for now by a nursing station that resembles a provincial park campground office.

Ground has broken for a hospital that will replace the nursing station, but McKay said the band continually has to press Indigenous Services Canada for additional resources such as isolation accommodations or rapid COVID-testing equipment.

"It's frustrating. It's silly sometimes, the responses we get regarding things that we ask for," he said.

An Indigenous man sits wearing a beaded medallion and a suit.
MKO Grand Chief Garrison Settee, sitting in his Thompson boardroom, says the pandemic has exposed the lack of access to health care in remote Indigenous communities. (Tyson Koschik/CBC)

Like all First Nations, Pimicikamak must deal with multiple levels of government to fulfil its health-care needs. Ottawa has a treaty obligation to provide health care on reserve. Manitoba's Northern health region provides care for members living elsewhere in the north.

The Winnipeg Regional Health Authority, meanwhile, cares for members who must travel south for serious ailments, including serious cases of COVID-19.

Settee said bureaucracy could be reduced if First Nations like Pimicikamak delivered their own health care.

"This is not new. We've been talking about it for decades," he said.

Cots are set up in a Pimicikamak school to allow people returning to the community to isolate. (Tyson Koschik/CBC)

Helga Bryant, the CEO of Northern Health, suggested she supports a future where Indigenous health care is led by Indigenous people.

"They are sovereign nations. They have a right to govern themselves," Bryant said in Thompson. "They know those needs in their communities and I fully support efforts that they can make and hopefully will continue to make in the future."

Back at Pimicikamak, McKay speaks of the need to "repatriate" health care from Ottawa. 

"It's very, very different than what people have in the south," he said. "They have facilities there we don't have."

The Chief of Pimicikamak (Cross Lake) says staffing his community of 8500 with just three nurses is "dangerous."
Only 3 of 16 nurses are working this week in Cross Lake's nursing station. (Tyson Koschik/CBC)


Bartley Kives

Senior reporter, CBC Manitoba

Bartley Kives joined CBC Manitoba in 2016. Prior to that, he spent three years at the Winnipeg Sun and 18 at the Winnipeg Free Press, writing about politics, music, food and outdoor recreation. He's the author of the Canadian bestseller A Daytripper's Guide to Manitoba: Exploring Canada's Undiscovered Province and co-author of both Stuck in the Middle: Dissenting Views of Winnipeg and Stuck In The Middle 2: Defining Views of Manitoba.

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