Cancer patients who need intravenous chemotherapy on the British Columbia archipelago of Haida Gwaii will now have to take an eight-hour ferry trip to the northern mainland, highlighting the challenges of delivering health care in remote communities.
Dr. Jaco Fourie, Northern Health’s medical lead for cancer care, says the health authority has been unable to recruit a new pharmacy technician to mix the drugs, so about eight patients will have to seek treatment elsewhere as of June 21.
Haida Gwaii isn’t unique in its staffing challenges, Dr. Fourie said in an interview.
“It does raise a concern about the future of delivering complex and often dangerous care in small, isolated communities and how sustainable that will be in the long term, especially as we get more efficient newer drugs that are also more complex to deliver.”
Haida Gwaii is one of the most remote regions in B.C. that offers cancer care. Patients will still have access to other treatments, including oral or injectable chemotherapies, but the specialized role of the pharmacy technician requires particular training.
Northern Health has offered “substantial” incentives to fill the position. It has previously filled vacancies by employees elsewhere in the province who volunteer to travel, but Dr. Fourie said the novelty typically wears off after a few visits.
The health authority is working with existing patients to develop care plans that would minimize travel. There are demonstrated health benefits to remaining in the community, connected with family and the land, especially for First Nations, he said.
“To disrupt people from that supportive framework has profound consequences,” Dr. Fourie said.
“We do know that people who are not stressed are more likely to stay on their treatment and have better quality of life. It’s not just about treating the cancer, it’s about treating the person.”
Northern Health is accustomed to finding ways to deliver service across dispersed landscapes and it won’t give up on this or future problems that come with increasingly complex care, Dr. Fourie said.
“We are going to work very hard to find solutions and sustain this.”
Sarah Dutheil said she was disappointed to hear that other families will now have to go through what she did with her father.
Dutes Dutheil died at 71 last February, more than a year after being diagnosed with pancreatic cancer.
Sarah left her home in Vancouver to help care for him. While there were cancer services on Haida Gwaii at the time, she said they still had to make about 20 trips to Prince Rupert, on the northern B.C. mainland, or Vancouver because the chemotherapy nurse only worked part time and was flown in periodically – a gap that Dr. Fourie said has since been filled.
The ferry was free but the family still had to pay for hotels, food and other costs on each trip. High winds in the fall sometimes meant they couldn’t get back to Haida Gwaii for up to two weeks, she said.
“It totally sucks, it’s the worst ever. It’s really hard on the patient. You just want to be home after getting this treatment,” Ms. Dutheil said.
“It’s too bad it’s coming up again as an issue,” she said. “There’s a lot of stress involved and the older you are, the harder it is.”
Kris Olsen, mayor of Haida Gwaii’s largest village of Queen Charlotte, said Haida Gwaii has had cancer services for about 10 years.
“It’s been wonderful. We have an amazing group of doctors and nurses, we have a brand new hospital in Haida Gwaii,” he said.
The community will have to go back to fundraising for each another to support off-island travel expenses if no one moves to fill the position, he said.
“There’s got to be someone in Canada who has this skill set and would be willing to move here,” he said. “We live in a beautiful part of the world.”