For the past month, flights in and out of Garden Hill First Nation have been leaving full and returning empty.
They depart with wheezing, coughing residents and come back with nothing the town can use to combat the severe form of flu sweeping through the remote, 3,400-person community 500 kilometres northeast of Winnipeg.
"We are in a war with no artillery," Chief David Harper said by cellphone as he walked across the fly-in town's tiny airport. "I'm looking at several medevac planes, but still no masks, no hand sanitizer, no new equipment to speak of. I've been asking for this stuff for over a week and nothing has improved. "
On the day the World Health Organization formally declared a A/H1N1 influenza a pandemic, several first nations communities in Manitoba said their continuing flu battles have exposed huge flaws in the country's pandemic preparedness plan and offer a bleak hint of what aboriginal reserves across Canada will face should the pandemic worsen in the winter.
They forget that there are many communities here that are not full of the healthy, wealthy Club Med crowd. Kim Barker, public health physician
"The federal government says it has a plan in place, but that plan doesn't appear to include this part of the country," Mr. Harper said shortly after learning that a pregnant Garden Hill woman with flu symptoms miscarried Thursday. In the past week, 11 Garden Hill residents have been airlifted to urban hospitals, most with severe flu symptoms.
Across the province, 24 people with flu symptoms - two-thirds of them aboriginal - are breathing with ventilators.
Influenza A has long been known to hit first nations communities harder than the rest of the population. Fatality rates during past pandemics have hovered between five and 10 per cent, and entire aboriginal towns were wiped out during the 1918 outbreak.
But Canada's pandemic preparedness plan included specific protocols for first nations communities only two years ago. And they're already in need of revision, some health advocates say.
"It's a guideline, but there's no money attached to it," said Kim Barker, public health physician with the Assembly of First Nations. "There are still a lot of things that need to be worked out."
In Garden Hill, the delivery of basic pandemic supplies appears to be one of those overlooked items. Mr. Harper said the band has already forked over $2,900 for supplies the federal government was supposed to provide and that he is flying to Winnipeg Friday to buy more.
"We can't wait any longer here," he said.
Terry Goertzen, an assistant deputy minister in Manitoba's Health Ministry, said Thursday that the provincial government has sent surgical masks, respirators and antiviral drugs to the federal government for delivery to aboriginal communities, and it's not clear why those supplies haven't reached their destination.
In a news conference, Federal Health Minister Leona Aglukkaq said the flu fight is going according to plan.
"Canada is well prepared for the situation," she said. "We have a national plan that we have been following."
If it's bad now, it could be much worse later. Many flu experts expect the pandemic to intensify this winter, a frightening prospect in first nations communities coast to coast where overcrowded housing and lower health levels prevail.
"We're talking about a hand-full of communities right now," Dr. Barker said. "If they can't shift a few masks onto an airplane right now, what will it be like when we're dealing with dozens and dozens of first nations communities this fall and winter?"
Health officials may have underestimated the outbreak because it initially appeared severe among impoverished Mexican populations but not Canadian travellers to the country, Dr. Barker said.
"They forget that there are many communities here that are not full of the healthy, wealthy Club Med crowd," she said. "We may soon have a Mexico situation on first nations reserves."
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