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From the Ministerial Advisory Council on Rural Health at http://www.phac-aspc.gc.ca/rh-sr/advis_e.html

Up to one-third of Canadians live in rural, remote, isolated or northern areas of the country ...

The report "Rural Health in Rural Hands: Strategic Directions for Rural, Remote, Northern and Aboriginal Communities" at - http://www.phac-aspc.gc.ca/rh-sr/rural_hands-mains_rurales_e.html

An important letter to the editor in the Sioux Bulletin, July 5 ...

Mismatch in healthcare needs

By Pete Sarsfield, MD, FRCP©, Medical Officer of Health and Chief Executive Officer Northwestern Health Unit

Health Canada’s Ministerial Advisory Council on Rural Health recently stated, "There is a fundamental mismatch between the health care needs of people living in rural Canada and the availability of health care providers and health services." (Rural Health in Rural Hands: Strategic Directions for Rural, Remote, Northern and Aboriginal Communities, p.2).

This astute and accurate statement regarding a key " fundamental mismatch" includes public health (prevention, promotion/protection) services and providers, by both implication and reality. For example, the availability of public health practitioners and public health services and programs in the Kenora and Rainy River Districts of Northwestern Ontario does not match the need for disease prevention, health promotion and health protection. We are experiencing a fundamental mismatch, especially our smaller communities, the region’s First Nation (Reserve) communities, and the residents of the unincorporated areas.

Of these three - the small communities, the unincorporated areas and the Reserves - the public health service/program situation facing First Nation communities exemplifies the greatest mismatch between need and service. I have lived, worked, and travelled in this region for over 12 years, and during that time have made the following observations:

• Public health programs and services are not symbolic but do have an impact on the prevention of disease, the protection of health, and the promotion of well-being;
• Public health programs and services for First Nation communities (Reserves) in this region lag behind those available to regional municipalities, in both number and intensity;
• Epidemiological evidence regarding the burden of preventable disease facing First Nation communities and Aboriginal peoples in this region is unequivocal and indicates a huge problem as well as a significant gap between the First Nation communities and the municipalities;
• No level of government is willing to assume responsibility for full and adequate public health services to and for First Nation communities (Reserves);
• No service providing agency has been able to obtain adequate funding and/or clarify their mandate in order to permit provision of adequate and full public health services to and for First Nation communities. This includes (but is not limited to) representative Aboriginal organizations, the federal and provincial governments, and the regional health units.

The present fundamental mismatch facing rural and remote residents is destructive and dangerous for both rural/remote and urban residents. The present situation should not continue to be tolerated, not by us or the organizations we represent, and not by our representative governments. I propose that we find remedies for this harmful mismatch of need and service, and that we do so in 2006.