First Nation leaders from Northern Ontario declared a public-health emergency on Wednesday and are calling on the federal and provincial governments to intervene quickly before the crisis escalates.
Leaders from the Nishnawbe Aski Nation and the Sioux Lookout First Nations Health Authority, which together serve about 75,000 people, say unequal access to health care means treatable and preventable diseases are killing people in remote northern communities.
"It's putting lives at risk, and in some cases it may be contributing to needless deaths," NAN Grand Chief Alvin Fiddler said. "That's why we're here today: to issue that call."
Diseases such as diabetes, hepatitis C, rheumatic fever and other bacterial infections can have dire consequences when doctors are few and far between, the leaders said. In 2014, a five-year-old boy named Brody Meekis from Sandy Lake First Nation died from strep throat; two four-year-olds – one from Sandy Lake, the other from Pikangikum – died from rheumatic fever.
Cramped housing and dirty water only aggravates the situation. The communities are also struggling to deal with a youth suicide crisis and intergenerational trauma caused by the residential school system.
Wednesday's declaration calls on governments to respond within 90 days by, among other things, meeting with First Nation leaders and coming up with a detailed intervention plan that includes more mental-health and addiction services and ensures that communities have access to safe, clean drinking water.
The aboriginal leaders are also demanding that Health Canada meet the recommendations tabled in a 2015 Auditor-General's report that highlighted the discrepancy between health care provided to First Nation communities relative to other Ontario residents and called for better infrastructure, among other things.
"The fact is that people in the communities don't have a health-care system," said James Morris, executive director of the Sioux Lookout First Nations Health Authority. "Not one of our communities has a hospital, not one has a full-time doctor living in it, a dentist or a pharmacist. What they have instead are services provided by Health Canada, the federal government, which usually consists of a nursing station staffed by nurses."
The substandard level of care would never be tolerated in the rest of Canada, the leaders said.
"We're talking about discrimination" Ontario Regional Chief Isadore Day said. "We're talking about institutional racism in Canada's and Ontario's health-care system."
In the House of Commons, Prime Minister Justin Trudeau said he was well aware of a "tragedy" that extends beyond Northern Ontario to across the country.
"We need to fix a relationship that has broken over the past decade, and indeed centuries, between Canada and indigenous peoples," Mr. Trudeau said in response to questions from NDP Leader Tom Mulcair.
"This government has pledged a new relationship: putting real money forward to build support on infrastructure, on health, on a broad range of things, and creating a true nation-to-nation relationship."
Ontario Aboriginal Affairs Minister David Zimmer said he hopes to talk to provincial and federal health ministers as well as to Chief Fiddler about what he called the serious problems.
"Improving access to health and social services and improving outcomes for First Nations, especially in remote communities, are key issues that we all have to tackle together. Whether they be health-care services, education outcomes or over-representation in child welfare, we need to rethink how we support, resource and empower indigenous communities," he said.
With a report from the Canadian Press