Health & Wellness

AFN Grand Chief & Minister of Health differ on status of health in First Nations

From PHIL FONTAINE - Oct. 13, 2006

Native people wait for promise of better health

The federal Conservative government has clearly indicated that it has little understanding of how to optimize the investments of Canadian taxpayers in the health and social safety net.

Funding cutbacks to health and social programming aimed at the most vulnerable populations in Canada - particularly First Nations - will result in a greater burden to the system, and greater disparities among the health of Canada's richest and poorest populations.

Instead of producing savings to taxpayers, this is going to cost all of us in the short and long term.

Last week, Health Minister Tony Clement gave an address to the Empire Club in Toronto called The Need for Patient Wait Time Guarantees in Canada.

At the same time, the minister is defending the elimination of the First Nations and Inuit Tobacco Control Program even though the smoking rate among First Nations is almost triple the Canadian rate.

Clement has not explained how the patient wait times guarantee will benefit First Nations peoples, who have been excluded from any input into developing a new approach.

Let us remember that Clement is directly responsible for providing health services to First Nations, and there is a well-documented and shameful gap in the health status of First Nations and other Canadians.

Without taking a broader primary care and public health approach to the wait times guarantee, and without ensuring that federal, provincial and territorial governments become more accountable for how they are providing services to First Nations, this new strategy of the minority government will fail in its primary objective: ensuring that all Canadians have the same access to the same standard of care.

Any health professional will agree that access alone does not mean better health status. One must account for quality of service as well as meeting basic needs, like housing and water.

Many First Nations communities are in crisis. One in four First Nations children live in poverty. Overcrowding is double the Canadian average. Mould contaminates half of all First Nations homes.

As of Sept. 8, there are 89 First Nations communities - including 34 in Ontario alone - that have to boil their drinking water. This is why we see Third World diseases like tuberculosis and shigellosis in First Nations communities.

The situation calls for urgent reform of the system and strategic thinking, not simple tinkering with improved measurements of access to hip replacement surgeries.

Next month will mark the 10th anniversary of the Royal Commission on Aboriginal Peoples' final report and the one-year anniversary of the First Ministers Accord on Aboriginal Issues.

The Conservative government committed in its election platform to "accept the targets agreed upon at the recent Meeting of First Ministers and National Aboriginal Leaders, and work with first ministers and national aboriginal leaders on achieving these targets."

No such discussion has taken place.

As a result, the annual cost to Canadians of the government's failure to act will reach $11 billion in 2016.

What is truly unfortunate is the cost of addressing these issues is less than the future cost of being satisfied with doing nothing now. What is impossible to measure is the misery and maladies this do-nothing approach costs.

One of the targets achieved at the first ministers meeting was a comprehensive First Nations health plan.

It included recommendations to ensure that the root causes of poverty and disease were addressed in partnership between federal, provincial, territorial and First Nations governments.

The plan was endorsed by all jurisdictions and investments secured to ensure its implementation and success over the next 10 years.

Instead of proposing a "new approach" that will do nothing to make significant progress in closing the gap between First Nations and Canadians, Clement should look to the First Nations Plan. It is actionable and it has the support of all governments.

Lives are in the balance. Time and money should not be wasted trying to repackage innovative approaches for the sake of political gain.

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Phil Fontaine is National Chief of the Assembly of First Nations

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From http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&c=Article&cid=1160949009607&call_pageid=970599119419

Staff working with First Nations
Oct. 16, 2006. 01:00 AM

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Native people wait for promise of better health - Opinion, Oct. 13.
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I wish to clarify the misleading statements contained in the op ed by Assembly of First Nations' Chief Phil Fontaine.

I met with Fontaine on Sept. 21 specifically to address the problems he cites.

We had a positive and productive discussion about how to improve working relationships and I invited the chief to work directly with me and Health Canada to help solve the native health-care problems that have resulted from 12 years of Liberal mismanagement.

In fact, just last week on Oct. 12, my officials met members of the Assembly of First Nations for further discussions about priority areas on which Fontaine and I will work together.

It appears that Fontaine was drafting his op ed saying the First Nations "have been excluded from any input into developing a new approach" at precisely the same time his staff were meeting with mine to develop the new approach.

I trust that the coincidence of Fontaine's confusing comments and the meeting of our staff was an unfortunate misunderstanding and not an indication that he no longer wishes to work co-operatively with Canada's new government to get things done for the families he represents and who trust him to act in good faith to deliver improved services for them.

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Tony Clement,
Minister of Health,
Ottawa

KO team joins other health providers at region Public Health delivery workshop

Donna Williams, KO Telehealth Program Manager and Penny Carpenter, K-Net Business Manager joined other health service providers from across the region in a two day workshop (Sept 27-28) in Sioux Lookout. The workshop was hosted by the Northwestern Ontario Health unit (http://www.nwhu.on.ca/). 

Discussions centred around the delivery of public health services in First Nation communities across the region.

Representatives from the tribal councils, the Assembly of First Nations (Sagatay Williams), Northern Ontario School of Medicine (Orpah McKenzie), Ontario Telehealth Network,(Stewart Stein), Health Canada and the NWHU spent the two days exploring strategies to ensure equitable access to services in the remote First Nations across the region.

NurseOne portal gets millions for recruiting and retaining nurses in FNs

Health Canada press release

Health Canada announces $8.1 million for NurseOne Portal: Cutting edge tool another step to improving health care

OTTAWA, Sept. 28 /CNW Telbec/ - The Honourable Tony Clement, Minister of Health, today announced federal funding of $8.1 million over six years to launch and maintain the NurseOne web Portal, a tool of particular importance for the recruitment and retention of nurses in First Nations and Inuit communities. Minister Clement made this announcement following a meeting with the Board of Directors of the Canadian Nurses Association (CNA), in Ottawa.

NurseOne (www.nurseone.ca) is a bilingual Portal that has been in development by the CNA since 2002 and contains a wealth of health information for the Canadian public and for all nurses across Canada. This Portal allows nurses to obtain timely, easily accessible information on all aspects of health care - from public health alerts, to consultations with experts and health specialists, to best practices. In short, it gives nurses many new tools to better treat their patients and improve their professional skills.

"NurseOne will certainly empower nurses everywhere in Canada, but particularly those working in rural, isolated and First Nations and Inuit communities. This Portal will provide nurses with quick access to reliable resources, enable them to improve quality of care and will assist in reducing wait-times," Minister Clement stated. "This investment will serve as an important contributor to the advancement of the professional practice and development of Canada's front line health providers - our nurses," he added.

"NurseOne is a significant tool which will provide access to quality, up-to-date health information to support the 250,000 plus nurses working in urban, rural and remote parts of the country to deliver effective, evidence-based care," says Marlene Smadu, President of the Canadian Nurses Association. "This investment supports nurses in caring for their patients, families and communities, managing their careers and connecting with colleagues and experts with the click of a mouse. In addition, NurseOne supports employers in recruiting and retaining nurses."

Health Canada had previously contributed $3.98 million to the Canadian Nurses Association to develop this Portal which was introduced at the Canadian Nurses Association Biennial Convention in Saskatoon on June 19, 2006.

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/For further information: Media Enquiries: Carole Saindon, Health Canada, (613) 957-1588; Erik Waddell, Office of the Honourable Tony Clement, Federal Minister of Health, (613) 957-0200; Tina Grznar, Communications Specialist, Canadian Nurses Association, (613) 240-7830, Public Enquiries: (613) 957-2991, 1-866-225-0709; Health Canada news releases are available on the Internet at www.healthcanada.gc.ca/media/

Smart Systems for Health Agency moves on developing electronic health records

From Toronto Star at http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&c=Article&cid=1158961811221&call_pageid=968256289824&col=968342212737

$125M needed to speed e-health

  • Electronic record keeping could be in place next year, agency says
  • Would build on success of Child Health Network's computerized files

Sep. 23, 2006 - TYLER HAMILTON, STAFF REPORTER

Most Ontarians could have a basic electronic health record by the end of next year if the province expanded a system that already exists for young patients, according to the agency overseeing electronic health infrastructure.

The price tag for getting the ball rolling: $125 million.

Electronic health records have been touted for years as a way to reduce costs in the health-care sector and improve patient care, and their creation was a key recommendation in the Romanow report on the future of Medicare four years ago.

The Smart Systems for Health Agency, charged with electronically linking 150,000 health-care providers across Ontario, has proposed that the Ministry of Health fast-track the move toward a province-wide e-health record by building on the success of the electronic Child Health Network, which already gives 36 hospitals and health centres across the province shared access to a secure database containing medical records of patients under 19 years old.

More than 5,300 pediatric physicians and health-care workers are now using the provincially funded network, which was spearheaded by the Hospital for Sick Children and has been in operation since 1999.

"It's a neat application," Smart Systems chairman Michael Lauber said in an interview with the Toronto Star. "It gives the doctors a lot of good information to work with."

Records include everything from personal information and doctor's notes to X-ray and laboratory results. Authorized doctors are able to see the records and add to them over a patient's lifetime. As the system evolves, it's expected that patients would be able to securely view their own e-health records online.

Andrew Szende, chief executive officer of the children's health network, said a system expansion would require some tweaking and more data storage to accommodate adult records. He emphasized that the network was secure, pointing to a seven-year track record of no privacy or security breaches.

"It's been looked at by the Smart Systems people, the government and the privacy commissioner and everybody is satisfied that it not only meets but exceeds the security needs and confidentially requirements," said Szende. "So far, we haven't heard anybody say that this was not a good idea."

Lauber said it makes more sense to build on what already works "rather than reinvent the wheel," and Smart Systems appears keen to move forward after being criticized for not acting quickly enough.

A Star investigation last November revealed that the little-known agency, established four years ago, has burned through more than $260 million since 2001 on e-health infrastructure projects that have been riddled with delays and so far have failed to demonstrate value — including a standardized e-health record — for taxpayers.

Following the report, Smart Systems' board of directors was overhauled and the agency is now the focus of a ministry-led operational review, which is expected to be complete within the next five to seven weeks.

Lauber, who was brought on to lead the restructuring of Smart Systems, said he's committed to making the agency more transparent. He said a privacy audit will soon take place and a national search has begun for a new chief executive officer after the recent resignation of current CEO Michael Connolly.

"There's still some housekeeping to do," said Lauber, former CEO of the Ombudsman for Banking Services and Investments. "This organization is transitioning from an infrastructure and build mode to client services and delivery."

He said Smart Systems has taken its e-health record plan to the government and is optimistic the ministry will accept the proposal before year's end.

Patient files today are largely collected in folders and stored in cabinets. Referrals and lab results are relayed mostly by fax machine, while lab images and hospital reports are most often received through mail and courier. Health-care experts say it's an inefficient system prone to error — sometimes with deadly consequences.

According to a draft of the proposal obtained by the Star, Smart System's first step would be to combine data from the province's existing laboratory and drug-profile databases with the child health network.

"The implementation of phase 1 of the (electronic health record) strategy will immediately provide a significant amount of data on a significant number of patients to a significant number of (health-care) providers," the document states.

Lauber said establishing an e-health record is top of mind for the provincial government and that he expects a major push over the next five years to get a province-wide system in place. "The issue is not technology. It's really a management issue."

Timing could be key. The next provincial election is just over a year away and the Liberal government is eager to show progress on a number of files, including health care.

But getting the job done will require another big injection of funds. Smart Systems, according to its draft proposal, said phase 1 of the plan requires a $125 million one-time investment in 2006-07 and an "annual increment of $40 million for ongoing deployment and operations."

Each health record would gradually contain more information over time. "The question is how much of it could be populated with information and how quickly," said Szende.

"With every field of data you add, you're going to attract more and more doctors, nurses and therapists," Szende added.

Aboriginal health survey in Quebec highlights the results of poverty & poor living conditions

From http://www.cbc.ca/canada/montreal/story/2006/09/13/qc-nativehealthstudy.html

Leaders demand urgent action to improve Quebec aboriginal health
Last Updated: Wednesday, September 13, 2006

First Nations leaders in Quebec are calling for urgent action to improve living standards on reserves, in light of a new health study that reveals the majority of the province's 80,000 aboriginal people smoke, and are overweight or obese.

'With those numbers, I'm ashamed to be Canadian. Our health is the same as people in Third World countries.'
- Dr. Stanley Vollant, aboriginal surgeon and former president of the Quebec Medical Association

The study, which was based on interviews with 4,000 Quebec aboriginal people living on and off reserves, found the obesity and overweight rates among adults and seniors were two and three times higher than the national average.

The study also found that more than 50 per cent of people participating in the study smoked cigarettes.

The situation is scandalous, said Dr. Stanley Vollant, an aboriginal surgeon and former president of Quebec's Medical Association.

"With those numbers, I'm ashamed to be Canadian," said Vollant, a member of the Montagnais community of Betsiamites. "Our health is the same as people in Third World countries."

The study found the following obesity and overweight rates within aboriginal communities:

  • 52 per cent of aboriginal children.
  • 42 per cent of adolescents.
  • 67 per cent of adults.
  • 71 per cent of elders over age 55.

Aboriginal communities could face an alarming number of cases of diabetes and respiratory disease in the near future if nothing is done to address the situation right now, said Vollant.

"You can expect in 10-15 years, an epidemic in diabetes. The rates will increase two, three, four times," he warned.

Economic and social conditions on both reserves and in urban settings exacerbate the problems, said Ghislain Picard, chief of the Assembly of First Nations for Quebec and Labrador. The combination of underemployment and poor access to healthy foods makes it hard for people to make the right choices.

It's time all three levels of government — band councils, the province and Ottawa — act fast and act together to stem the tide, said Picard.

"Maybe the investment we have so far from the governments hasn't been properly placed," he said Tuesday.

The study was carried out by the First Nations of Quebec and Labrador Health and Social Services Committee in 2002. Aboriginal people living on 23 reserves and in Montreal, Quebec City and Val d'Or took part in the investigation. The study excluded northern Quebec Crees, the Mohawk community of Kahnawake and the Inuit.

FOR ADDITIONAL INFORMATION:

Regional LHIN draft plan online for review and feedback

The North West Local Health Integration Network (LHIN) is a new organization designed to plan, integrate and fund health services in Northwestern Ontario, including hospitals, community care access centres, home care, long-term care, community health centres, community support services and mental health and addiction services.

The North West LHIN has been working with health service providers, communities and the public to develop an Integrated Health Services Plan (IHSP) for Northwestern Ontario. This plan will set out broad health care priorities and strategies for our area for the three year period beginning in April 2007.

The Integrated Health Services Plan will be submitted to the Minister of Health and Long-Term Care by October 31, 2006 and will include:

  • An assessment of health needs, services, issues and challenges across Northwestern Ontario;
  • The North West LHIN’s vision, values and principles;
  • Priorities for health system improvements; and
  • Action plans to address priority health care issues during the three-year period.

A draft plan is now available and the North West LHIN is
seeking public input on this document.

You can access the draft plan and the accompanying feedback survey on the Northwest LHIN web site at www.lhins.on.ca, or you can contact the North West LHIN for a copy.

Contact: Maria Harding
Administrative Assistant
Toll-free: 1-866-907-5446, ext. 2009
Tel.: 807-684-9533, ext. 2009
E-mail: maria.harding@lhins.on.ca

The North West LHIN will receive feedback on the plan until October 10, 2006.

HealthyOntario.com online space for health information, services and advice

http://healthyontario.com provides Ontarians with a world-leading web destination for trusted health information, services and advice for healthier living. HealthyOntario.com annually receives over 2 million visits and is increasing as more people feel empowered to manage their health, discover their options, and connect to services and people that can help them on their path to wellness.

HealthyOntario.com provides quick and easy access to health information. The Ontario Ministry of Health Promotion created HealthyOntario.com, which launched in October 2002, as way to demonstrate the ministry's commitment to providing trusted health information to help the people of Ontario to live healthier lives.

This is from a media release from Ontario's Health Promotion Minister Jim Watson ....

http://ogov.newswire.ca/ontario/GPOE/2006/09/15/c6514.html?lmatch=&lang=_e.html

Ontarians can now access information on nutrition and healthy eating through a new, province-wide online service called EatRight Ontario, part of the existing, highly-acclaimed website, http://HealthyOntario.com. EatRight Ontario includes an online resource which will allow people to ask specific nutrition related questions and receive feedback.

"Access to reliable nutrition information is key to promoting good health," said Minister Watson. "In addition to programs such as the Northern Fruit and Vegetable Pilot Program, which has a strong educational component, we are also developing additional information resources for Ontarians who are seeking to improve their health and quality of life through healthy, nutritious eating."

"This pilot project supports our local agri-food industry by promoting the consumption of fresh, high quality Ontario produce," said Leona Dombrowsky, Minister of Agriculture, Food and Rural Affairs. "It also gives schoolchildren the opportunity to choose healthier snacks."

"Fruit and vegetable consumption is associated with better health. Research indicates that it's important to develop healthy eating habits early in life," said Dianne Oickle, Chair, Ontario Society of Nutrition Professionals in Public Health. According to the recent Canadian Community Health Survey, the 59 per cent of Canadian children and youth aged 2 to 17 who reported consuming fruit and vegetables less than five times a day were significantly more likely to be overweight or obese than those who ate fruit and vegetables more frequently."

The Northern Fruit and Vegetable Pilot Program is one of the new programs that has come out of Ontario's Action Plan for Healthy Eating and Active Living, launched by the government in June. The Action Plan responds to key findings in the Chief Medical Officer of Health's report entitled Healthy Weights, Healthy Lives, which called for a broad, province-wide effort across sectors and communities to combat obesity. The government's $10 million action plan offers new programs and strategies, and builds on existing ones to support healthy eating and active living in Ontario.

Cultural Awareness & Sensitivity for non-aboriginal caregivers

Equay-wuk (Women's Group) has developed their latest resource, "A Guide for Professional Caregivers:  Self-Advocation for First Nations Clients" and is hosting a workshop on Cultural Awareness and Self-Advocation Training in September 2006.

The Menonakachihewaywin Natamakewin (Better Caregiving Project) is a cultural awareness and sensitivity project, intended for non-aboriginal front-line caregivers employed to provide care for Anishnaabe clients from remote First Nation communities in Northwestern Ontario.

Workshop:  "Cultural Awareness and Self-Advocation Training Workshop"

Sunset Inn, Sioux Lookout, Ontario

September 19-21

Facilitator:  Bill Constant

Major components of the workshop include:

  • Priming for cultural competence
  • Understanding the historical Anishinaabe worldview

For more information, contact:

Darlene A. or Felicia Waboose
Equay-wuk (Women's Group)
Tel: (807) 737-2214 or toll free: (800) 261-8294
Fax: (807) 737-2699
email: equaywuk@nwconx.net

Workshop Information available on website: www.equaywuk.ca

NAHO's Journal - Call for Abstracts - Aboriginal women's health fall issue

The Journal of Aboriginal Health
Published by the
National Aboriginal Health Organization

*NEW* Journal of Aboriginal Health Call for Abstracts

View poster: Call for Abstracts - Aboriginal women's health (pdf)

Deadline for receipt of abstracts is October 15, 2006. Direct inquiries to dsoucy@naho.ca  

The Journal of Aboriginal Health will share traditional knowledge, success stories, issues, new information, and the latest research results. It will publish in-depth analysis of health research and issues with full citation of sources; facilitate informed discussions of new research, recent publications and projects; and explore health determinants with Aboriginal approaches.

The Journal is published by the National Aboriginal Health Organization. The goal of the Journal is to cultivate a dynamic community of those concerned with Aboriginal health matters through information exchange, networks and partnerships while contributing to the critical thinking and learning process. Ultimately, the Journal will lead to improved health and increased capacity and participation of Aboriginal People in health care fields.

The primary audience will be Aboriginal community members including traditional healers; Aboriginal health care practitioners and practitioners in health care for Aboriginal People; and Aboriginal health organizations. Other readers will include Aboriginal community, tribal, treaty, and national political organizations; Aboriginal health scholars and researchers; people who influence and determine Aboriginal health research and policy including politicians, public servants, consultants, think tanks, and foundations; and those outside of Canada who are interested in Aboriginal health issues.

Each issue of the Journal of Aboriginal Health will feature a theme. A Guest Editor will solicit appropriate papers from a variety of perspectives. Each Guest Editor is an expert in the subject area and has an established network of contacts in the field. They are responsible for acquiring and evaluating submissions before papers are sent to peer review.

The Journal of Aboriginal Health will be available online on the National Aboriginal Health Organization's Web site at www.naho.ca.  For more information, contact naho@naho.ca.

Journal of Aboriginal Health, January 2004, Volume 1, Issue 1

Journal of Aboriginal Health, March 2005, Volume 2, Issue 1

NAHO Journal Guidelines

Plain Language Guidelines

Writing Style Guidelines

Terminology Guidelines

HIV and AIDS infections among Aboriginal people at highest rates in Canada

Stories coming from the International AIDS conference being held in Toronto will hopefully increase awareness and support further prevention programs for the Aboriginal population. But the news about the increased number of HIV/AIDS victims that are Aboriginal is very troubling. Increased knowledge and education are important components of the work that is necessary to make inroads in the battle against the spread of this horrible disease.

From the NAN Health web site ...

Please click on the link to access the NAN AIDS & Healthy Lifestyles website http://aids.nan.on.ca

For information and news or to be added to a mailing list for up to date information on HIV/AIDS please click on the following links.  http://hivandhepatitis.com or http://cdcnpin.org

Contact Gwen Medicine (gmedicin@nan.on.ca) if have any questions, comments or ideas on what you would like to see posted!

Gwen Medicine, HIV / AIDS Coordinator
Tel: (807) 623 8228 or Toll Free: (800) 465 9952, ext 4940
E-mail: gmedicin@nan.on.ca
710 Victoria Avenue East
Thunder Bay, ON P7C 5P7 
Fax: (807) 623 7730

The 2006 World AIDS Conference is being held August 14 - 17, 2006 in Toronto!  For more information please visist www.aids2006.org

from CBC online News at http://www.cbc.ca/news/background/aids/aboriginals.html

Aboriginals: Canada's most vulnerable population - Last Updated August 15, 2006

Canada's First Nations people are disproportionately becoming infected with HIV and AIDS.

"Aboriginal people now total 16.4 per cent of all AIDS cases," said Chief Angus Toulouse, Ontario Regional Chief-Chair of the Assembly of First Nations, during a news conference at the 16th International AIDS Conference in Toronto.

"This is a 500-per-cent increase over the past 20 years, compared to a 24 per cent decrease in the general Canadian-born population."

Aboriginals make up just three per cent of the country's population, but the infection rate for First Nations people is nine per cent, according to the Public Health Agency of Canada.

And the numbers have been rising rapidly.

 Kevin Barlow, executive director of the Canadian Aboriginal AIDS Network, tells the AIDS conference about the unique challenges facing Canada's aboriginals in the fight against the disease. (Robin Rowland/CBC)

"I've had a lot of friends die (from AIDS)," says Kevin Barlow, executive director of the Canadian Aboriginal AIDS Network and a speaker at the Toronto AIDS conference.

"I've seen so many die that in some ways, there are times when I have to numb myself to that kind of loss. But I also draw upon their strength because every person that has touched my life who has been HIV-positive, their spirit teaches me that I must do more."

It's hard to analyze the figures for aboriginal people exclusively, because ethnicity isn't always reported when cases or test results are recorded. But, looking at the cases where the cultural background of the infected person is known reveals some unsettling patterns.

In 2005, aboriginals represented an estimated 200 to 400 new HIV infections that year, according to Canada's public health agency. At the end of 2005, there was an estimated 3,600 to 5,100 First Nations People living with the disease.

Before 1993, aboriginals represented about two per cent of AIDS cases Canada reported to the Centre for Infectious Disease Prevention and Control (CIDPC) where ethnicity was known. By 2003, the number had climbed to 14.4 per cent.

Barlow told CBC News he believes that the problem is much larger than the numbers suggest.

"We also know that aboriginal people are not getting tested," he said. "They're not getting the information as much as we would like them to. Given those kind of dynamics, and the marginalization of some of our people, that creates the formula for the virus to be spreading a little more rapidly than we would like."

That's why he is pushing to create an international HIV/AIDS secretariat to bring a higher profile to the issues of aboriginals and other indigenous people.

"So that in these future conferences, there will be a bigger indigenous presence. It's sad that at this conference there was only one workshop that was indigenous-led."

Epidemic hits women, children and intravenous drug users hardest

Injection drug use is the most common way aboriginals in Canada come in contact with the HIV virus.

It's a trend that has been getting worse over time. Before 1993, 11 per cent of all aboriginal AIDS cases stemmed from injection drug use. By 2003, this rose to 51.7 per cent.

The pattern is even more apparent when looking at HIV infections for the period between 1998 and 2004: 59.4 per cent of aboriginal HIV infections stemmed from injection drug use, compared with 27.5 per cent of cases for the non-aboriginal population.

And the proportion of women with HIV and AIDS is greater when comparing the aboriginal and general Canadian populations. Women represent nearly half (45 per cent) of all positive HIV reports in the aboriginal population, while for the non-aboriginal population the figure is about 20 per cent.

Root causes

The HIV virus and AIDS is a relatively new phenomenon for aboriginals in Canada, speeding the pace at which it has been spreading in the community, Barlow says.

While most AIDS organizations have been around for more about 25 years, he says most aboriginal AIDS agencies have been in existence for just 10 or 12 years years — and as little as four in some cases.

"When we finally mobilized around HIV/AIDS we hit a lot of roadblocks," he said. "One, we didn't have the data that we needed. Second, the dollars were pretty much committed. There were no new dollars for aboriginal people to get into the sectors and start doing some work."

As the frontline response tried to catch up to the AIDS epidemic, he says, the disease kept shifting its spreading pattern within the aboriginal community. From homosexual men, to women, to sex trade workers and the prison population — its changing shape made it hard for AIDS workers to focus their response, he says.

"We have had to do more work in the last 10 years than many of these other groups because our population shifted so quickly … and that has created pressures in itself because the resources haven't grown the way we would have liked," says Barlow.

Plus, poverty, lower education levels, poor housing, and the leftover scars from the residential school years have resulted in more high-risk activities, such as higher intravenous drug use in the aboriginal community, he says.

"These types of lifelong traumas don't just go away. And sadly, some people turn to negative coping patterns, which include addiction," he says.

Mounting a response

The Canadian government hasn't responded adequately, Toulouse says.

"A $5.1 billion commitment was made at the First Ministers Meeting in Kelowna last November to eliminate poverty among the First Nations over the next 10 years," he says. "This included $1.3 billion in new health investments. So far none of this has been approved by the Conservative government."

The Assembly of First Nations estimates that the health-funding shortfall will reach close to $2 billion over the next five years, he says, most likely resulting in cutbacks to HIV/AIDS prevention and promotion programs.

"I would say there would still be a stigma (about HIV and AIDS) in the aboriginal community, because of the lack of resources that aren't there to provide the education and awareness to the youth, and also to the general First Nations population as a whole," Toulouse says.

To stop the rising numbers of HIV-infected aboriginal people, more resources need to be directed towards the front lines, says Barlow.

"Since the Conservative government took (office), four aboriginal AIDS organizations have closed their doors. Two of them have reopened, because the funding finaly started flowing. But two of them remain closed in Manitoba. So here we are listed in the federal initiative as a target population, but yet our service agencies are closing down."

He says even the existing organizations are overwhelmed — some have just two or three workers to serve an entire province.

It's only been recently that the federal government has allotted money to deal with AIDS, of which portions are earmarked for aboriginals, he says. Despite losing loved ones to the disease himself, Barlow says he's optimistic about the future.

"I must continue to make sure there are more people in our communities that don't get infected.

"And when there are people living [with] HIV, that we support them and we stand by them. That's the aboriginal way. We don't have the luxury of throwing away any of our people because we've had so much loss."

Aboriginal prevention strategies needed to curb AIDS epidemic - Last Updated Tue, 15 Aug 2006

Indigenous people worldwide are so disproportionately affected by the HIV epidemic that their survival is at risk, the International AIDS Conference in Toronto heard Tuesday.

Yvonne Davis (Robin Rowland/CBC) Yvonne Davis (Robin Rowland/CBC)

To suggest the possibility of a population collapse is not being alarmist, said Clive Aspin of the National Institute of Research Excellence in Maori Research and Development at the University of Auckland in New Zealand.

In New Zealand and Canada, indigenous people are over-represented in the HIV epidemic. Although men who have sex with men are the main group affected among non-aboriginals, heterosexual transmission is higher among indigenous people in both countries. 

In Canada, aboriginals accounted for an estimated 7.5 per cent of HIV infections at the end of 2005, and 9 per cent of all new HIV infections in 2005 — an estimated overall infection rate that is three times higher than for non-aboriginals.

The problem is likely more alarming than the estimates suggest, given that Ontario does not collect data on ethnicity, Aspin noted.

Indigenous prevention strategies

Before the arrival of colonizers, indigenous people in New Zealand were healthier and had longer life expectancies than Europeans, Aspin said.

In the past, Western textbooks have portrayed indigenous people as weak and uncivilized, and when researchers saw differences they didn't understand, they would make up an explanation without considering indigenous perspectives.

Today, indigenous people "want research that produces benefits for us," he said to applause from the audience.

Kevin Barlow (Robin Rowland/CBC) Kevin Barlow (Robin Rowland/CBC)

The research must include people infected by HIV, and prevention strategies should widen their focus from the individual to the community of family and friends who support those who are HIV positive.

Reducing the HIV epidemic among indigenous people needs research into indigenous prevention methods, said Yvonne Davis, president of the board of directors at the National Native American AIDS Prevention Center and a consultant to the University of New Mexico's Center for Health Promotion and Disease Prevention.

"Indigenous people have shown remarkable resiliency in the face of extreme adversity and dispossession of land," Aspin told a symposium at the conference.

"If our ancestors could do it, so can we."

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AIDS hidden among the Inuit, says health worker - Last Updated: Monday, August 14, 2006

A woman who works for better sexual health among the Inuit says AIDS is more prevalent in Nunavut's scattered communities than people know.

A new report by the Public Health Agency of Canada shows that aboriginal people account for nearly a quarter of new HIV cases in Canada.

"There's a hidden epidemic among Inuit communities, for sure," said Aideen Reynolds of the Pauktuutit Inuit Women of Canada.

The numbers, released in a report titled HIV and AIDS in Canada, show 22.7 per cent of positive HIV tests done in Canada last year came from aboriginal Canadians.

However, it shows no reported cases coming from Nunavut.

While the numbers don't distinguish between First Nations, Inuit and Métis groups, Reynolds says she's certain the disease is spreading among Inuit.
 
She believes many don't get tested because of the lack of anonymity in small communities. Some may go to Montreal or Ottawa for a test, but she never gets to see those numbers.

"But at some point, if people start being tested and testing positive we do think there will be an explosion," she said.

Reynolds hopes this week's international AIDS conference in Toronto will open the eyes of all governments to a problem that remains hidden in many northern communities.

"The more education we have, the more awareness we have, if we can nip it in the bud, that's a lot better than having to deal with something coming at us with full force as it is going on in other countries," said Pitsyulala Layta, who co-ordinates HIV programs in the North for Pauktuutit.

Reynolds says right now strategies don't appear to be working, and she calls them short-term and poorly funded.

She said what really needs to happen is a change of attitude about sexual health among the Inuit.