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Ecosystem Health in Northern Aboriginal Communities in Manitoba. Shirley Thompson University of Manitoba S_thompson@umanitoba.ca SLESH conference 2006. Question. Are sustainable livelihoods and Ecosystem health approaches appropriate in Canada (for Northern Aboriginal Communities)?. Agenda.
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Ecosystem Health in Northern Aboriginal Communities in Manitoba Shirley Thompson University of Manitoba S_thompson@umanitoba.ca SLESH conference 2006
Question • Are sustainable livelihoods and Ecosystem health approaches appropriate in Canada (for Northern Aboriginal Communities)?
Agenda • Introduction • Health indicators • Ecosystem health • Case study: TB and Housing • Case study: Water quality • Conclusions
Four key challenges for an Ecosystem Approach to Human Health • finding a shared vision; • assuring community access; • gaining credibility; and, • measuring success.
Traditional Knowledge reveals the complexity of traditional approaches to environmental systems. Elder Robin Greene teaches the traditional ways. Photo by: Randy Paishk
Community Food Security “ a condition in which all residents obtain a safe, culturally appropriate, nutritionally sound diet through an economically and environmentally sustainable food system that promotes community self-reliance and social justice!” Hamm & Bellows
Health • Not only the absence of disease but also “the extent to which an individual or group is able to on the one hand to realize aspirations and satisfy needs and on the other to change or cope with the environment.” • “State of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” It is not “an objective for living, but a resource for everyday life.” • WHO
Age-standardized Leading Causes of Death, First Nations (2000) and Canada (1999) • Used to compare rates across groups with different demographic characteristics • Reduces the effects of very old or young population age differences
Potential Years of Life Lost (PYLL) by Cause of Death, First Nations (2000) and Canada (1999) Increased risk of suicide at all ages for First Nations up to 65 years of age; highest for young males and females. Source: Health Status of First Nations in Canada (1999) • Calculates the number of years of life lost assuming an average lifespan of 75 years • Expressed as a rate per 100,000 population (similar to death rates)
Life Expectancy at Birth, by Sex, First Nations and Canada, 1980, 1990 and 2000
Projected Number of People with DiabetesMB First Nations, 1996-2016 Source: http://www.gov.mb.ca/health/publichealth/ epiunit/docs/storm.pdf
Diabetes – Implications for Health Care • Persons with diabetes account for: • 91% of lower limb amputations • 60% of hospitalizations for heart disease • 50% of hospitalizations for stroke • 41% of hospital days • 30% of all hospitalization (Strategy Steering Committee, 1998) • First Nations patients with diabetes in Manitoba have longer hospital stays with an increased intensity of care, and there is an increase in obstetrical admissions (Dow, 1999)
NIHB Expenditures In Manitoba Region by Benefit (FY 2003/2004 $2.8M $48.5M $17.3M $5.6M $53.5M Total: $127.8 M
Case Study: Housing • Shelter: Only 56.9% of homes in FN communities adequate • (not needing major repair or replacement) (1999/2000)
Pukatawagan Remediation The houses condemned and knocked down because of the fuel spill have not been replaced, leaving only 299 residences for 2,600 people, with an average of nearly nine occupants per house.
Rates of Tuberculosis, 1994 to 2004* in Manitoba * 2004 Data is preliminary
Tuberculosis Notification Rates, by Community Housing Density, First Nations, 1997-9
Host Tuberculosis Environment Agent
Determinants of Health –Water and Sanitation • Water Quality: Only 41.4% of FN communities reported at least 90% of homes connected to water treatment plant (1999/20) • Sanitation: Only 33.6% of FN communities had at least 90% of homes connected to community sewage disposal system (1999/2000) Source: A Statistical Profile on the Health of First Nations in Canada, 2003, Statistics Canada 2001 Census
Difficulties with building adequate infrastructure for Safe water on Reserves • technical difficult and costly to develop infrastructure in isolated areas, often having difficult terrain (e.g., permafrost, swamp) and often having drinking water source off-reserve; • limited access to financing and recovery of costs due to poor economic conditions; • lack of qualified personnel in environmental service delivery; • high birth rates in these communities expanding infrastructure needs rapidly; and • unclear technical standards with limited support for standards and enforcement mechanisms.
Why the safety of First Nations drinking water is compromised? • No laws and regulations govern the provision of drinking water in First Nations communities. • INAC and Health Canada implement policies, administrative guidelines, and funding arrangements with First Nations inconsistently and piecemeal. • Action with First Nation communities is not being taken to: • assess the capacity and support that First Nations need to deliver safe drinking water in their communities; • establish the institution or institutions that could consolidate these capacity-building and support functions for all First Nations; and • define the information needed to demonstrate that the drinking water is safe (Gelinas 2005). http://www.oag-bvg.gc.ca/domino/reports.nsf/html/c20050905ce.html
Drinking water at risk in First Nations communities • In 2001, Indian and Northern Affairs (INAC) found a significant risk to the quality or safety of drinking water in three-quarters of the systems (Gelinas 2005). • In Manitoba 5 northern First Nations are on boil-water advisories one with a reported case of E. coli contamination (Water Stewardship Branch 2005) • Assembly of Manitoba Chiefs spokesman, Michael Hutchinson, reported that many as 25 Manitoba First nations have varying degrees of water quality problems (CanWest 2005). • Kashechewan First Nation’s storyhttp://www.cbc.ca/story/canada/national/2005/10/28/kashechewan-evacuation051028.html
Multiple Barrier Approach to Safe Drinking Water (1) source: the best possible raw water quality should be maintained and protected (2) treatment: effective treatment should be designed, operated and maintained (3) distribution: secure storage and distribution of treated water should be provided (4) monitoring: appropriate and effective monitoring should be performed (5) response: appropriate and effective responses to adverse monitoring or adverse circumstances are needed.
Thank you. Questions? • Are sustainable livelihoods and Ecosystem health approaches appropriate in Canada (for Northern Aboriginal Communities)?