First Nations push for their own numbers to solve health inequalities

Federal Health Minister Tony Clement was in Whitehorse on Wednesday to talk sports. He looked the part, wearing a white and red Team Canada sweater…

Federal Health Minister Tony Clement was in Whitehorse on Wednesday to talk sports.

He looked the part, wearing a white and red Team Canada sweater in anticipation of the television cameras at the sports conference he was to address at the Westmark Hotel over lunch.

But during a hastily scheduled talk with First Nations leaders at the Council of First Nations early Wednesday morning, Clement and several chiefs quickly hashed out a plan to start fixing problems with aboriginal healthcare in the territory.

It was the first time the two sides had met and First Nation leaders didn’t waste their opportunity: Clement emerged looking a bit overwhelmed mere moments before his date with the cameras.

“Usually there are a few issues that are still outstanding, and that was certainly the case here,” said Clement, flanked by CYFN grand chief Andy Carvill and Assembly of First Nations regional chief Rick O’Brien.

“I can tell you we’re sincere and we want to move forward (on First Nation healthcare),” he said.

Clement, Carvill and O’Brien have agreed to create a group tasked with finding mutual solutions to healthcare problems in the Yukon.

While the Conservative government wants more accountability for the health dollars it sends North, Yukon First Nations want the capacity to collect information themselves to clearly tell Ottawa what the pressing health issues are in their communities.

The group will try to please both sides, and Clement has pledged to meet with Yukon First Nation chiefs in several months to check up on the team’s progress.

“I think we’ve agreed we want to work on that issue in particular and other issues,” said Clement, though he made no funding commitments for the group.

“We’re a government that has been acting quite fulsomely in changing the way things are done in terms of the delivery of services, and, specifically, health services.”

Carvill and O’Brien were joined by Tr’ondek Hwech’in chief Darren Taylor, Liard First Nation chief Liard McMillan and others, and welcomed the opportunity to speak with Clement.

“The meeting was a good, first original meeting,” said Carvill. “We’re on the way to having a good relationship and an understanding that’s going to be beneficial to all Yukoners with respect to the health issues we have in the North.”

But in spite of increased funding and interest from Ottawa, continued healthcare problems faced by Yukon First Nation communities is pushing some to speak up about problems with the system itself.

As reporters waited for Clement and First Nation officials to emerge from the negotiation table, an impassioned Liz Walker appeared and explained what’s happening on the ground and what needs to change.

Walker is the director of health partnerships with CYFN. She provided a blunt appraisal of services aboriginal people receive.

“We really react a lot to crises,” she said. “When we’re constantly reacting to crises that other governments — by their decision making — are creating in our communities, how do we have the capacity to plan, to look at what research needs to occur, to identify which data needs collecting?”

The lack of a clear picture of health problems in Yukon communities and what money is needed to address them is the biggest roadblock to progress, she explained.

Yukon First Nations have always applied a Band-Aid to this reality, by trying to fit their myriad health problems into specific boxes created far away in Ottawa, said Walker.

“We’re never at the forefront with our priorities because we never really have any evidence of what they are,” she said.

“So we’re always reacting and trying to fit our programming into their funding criteria, and it’s a very poor fit and creates a lot of labour in terms of accountabilities.”

While First Nations governments know injuries and addictions are problems in the communities, health workers are often dedicated to writing grant proposals to get more funding or account for its spending, rather than doing research to understanding the issues.

We have no ability to track where we’re at,” said Walker. “How do we know our programs are going to make a difference in these areas?”

The real solution is to give First Nations governments the ability to do their own research about health, she said.

But CYFN doesn’t want the Yukon government collecting information on First Nations health problems.

Indeed, the last health-indicators survey carried out by the Yukon Bureau of Statistics was in 1996.

Instead, CYFN is pushing for a central body that has the money and ability to carry out its own research and control how its results are released, said Walker.

She provided an old life-expectancy study by the Yukon government to make her point: the study found average male Yukoners live to be about 70 years old and females live to about 76 years old; aboriginal male and females in the Yukon, however, were found to live only 61 and 69 years, respectively.

What the study didn’t explain is why those disparities exist, creating false perceptions and stereotypes, said Walker.

“We want to be able to have the context on numbers that mean something to the people and the communities they’re describing,” she said.

“We had Indian residential schools operating in the Yukon for 85 years — that has had an tremendous influence on our health status, and you will not see that in a health status report from Yukon government.”

There has been a commitment to the central research body proposal by all 14 Yukon First Nations, not only the 11 that CYFN represents, said Walker.

The healthcare topography in the Yukon is a complicated one for Ottawa and First Nations to navigate.

The territorial government, the feds, self-governing First Nations and First Nations that haven’t settled a land claim all play a role.

Some of the First Nations are represented regionally by CYFN; others such as the Kaska Nation and the Kwanlin Dun aren’t.

“There’s not a lot of clarity in some areas,” said Walker.

Making the patchwork function and actually help those in communities is the next step that needs to be taken, she said.

Clement acknowledged the difficulties.

“It seems that when you’ve got 15 different groups of funds and 15 different sets of accountability mechanisms, at the end of the day, when you actually get the money that gets out of that whole process, it’s less than desirable,” he said.

“Quite frankly, I don’t think that 15 years ago, the government of Canada knew how to do these things (self-government agreements), and had the expertise that have do now.

“It’s all about arriving at these solutions rather than Ottawa flying in and delivering them,” said Clement.

Clement committed to creating the working group instead of just talking about it and that left O’Brien impressed.

“Of course, you’d love to have the minister come up and meet directly with you, but we appreciate he’s very busy and has a tight schedule,” he said. “We appreciate any little time we get to spend with him.”

But wariness still exists because the Conservatives have trashed the $5 billion Kelowna accord, created by the former Liberal government, to address First Nation inequalities.

 “Some of us leaders are still fighting for it; we still bring it up with ministers and we will continue to do so,” said Carvill.

The follow-up meeting between Clement and Yukon First Nation officials about the progress of the working group has not been scheduled and may take place in the Yukon or in Ottawa.