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La Loche Mayor Kevin Janvier, left to right, Saskatchewan Premier Brad Wall, federal Public Safety Minister Ralph Goodale and MLA Georgina Jolibois lay flowers at a makeshift memorial at La Loche, Sask., on Sunday. January 24, 2016.JASON FRANSON/The Canadian Press

Saskatchewan Premier Brad Wall has been talking about the state of an X-ray machine in a remote village for a year now.

He first brought it up during his visit to La Loche last January, after a shooting rampage left four dead, seven wounded and a community traumatized. The crisis was magnified as residents poured out stories about surviving residential schools, struggling with substance abuse, losing family to suicide and searching for help. Mr. Wall, speaking to reporters, promised to help the indigenous community in the immediate aftermath of the alleged murders and in the long run. He addressed everything from counsellors to diagnostic equipment.

"I was told the X-ray machine was working that day, thank God," he said two days after the shootings in La Loche, a remote community about 600 kilometres north of Saskatoon. "[It was] working well. But that's not always the case. So we can take that back with us and find out what's happening with respect to health-care funding."

Saskatchewan has since pledged to chip in for a new X-ray machine for La Loche, as part of its support package in the wake of the shootings. But La Loche's health officials had been trying to secure funding for the new machine since 2015. As with many of the problems familiar to Canada's remote indigenous communities, action came after a crisis made national news. The X-ray machine hasn't been purchased yet.

A year ago this weekend, a 17-year-old killed Drayden and Dayne Fontaine with a shotgun around lunchtime at a home near the high school in La Loche, a Dene and Métis community neighbouring the Clearwater River Dene Nation.

The half-brothers, 13 and 17, knew the shooter well. That person cannot be named under the Youth Criminal Justice Act. The gunman then went to the school where he killed Adam Wood, a 35-year-old teacher from Ontario, and Marie Janvier, a 21-year-old teacher's aide from the community. Seven more were injured.

The accused pleaded guilty last fall to two counts of first-degree murder, two counts of second-degree murder and seven counts of attempted murder. His sentencing will come this spring.

On Friday, as the community prepared to face the Jan. 22 anniversary of the shooting, classes at La Loche Community School and at the neighbouring reserve were cancelled after RCMP received a threat of a potential shooting.

"We're still struggling. I think we need a lot of support. I think we have a long road ahead of us," Mayor Robert St. Pierre told reporters earlier this month.

Prime Minister Justin Trudeau visited La Loche days after the shootings, promising to support the surrounding community but offering little in the way of specifics. Mr. Wall similarly pledged to stand by the community, focusing his remarks on providing mental-health support in the school and community in the immediate aftermath and beyond.

Officials emphasized supporting the La Loche Community School, where much of the violence occurred. Greg Hatch, the school's acting principal, says Regina and Ottawa have not fulfilled their commitments to be there when the community most needs them.

"We feel alone," Mr. Hatch told reporters earlier this month, noting extra support as the anniversary date approached was not forthcoming. "We feel abandoned."

After the shooting, the high school and the elementary school each received two additional social workers, bringing the total to three per school. They are not mental-health therapists, he noted this week. Another social worker was added, but that person does not live in La Loche and tours the entire school division, Mr. Hatch explained. That brings the total to seven.

"There was no healing plan to go along with them," he said this week. The heath region hired a psychiatric nurse to serve the roughly 3,000 people who live in the area.

Fulfilling funding promises is a slow process plaguing not just La Loche but struggling communities across the country. Local Health Canada officials, for example, recommended deploying $1.8-million over three years around La Loche for mental-health services and other programs. But this has not yet been finalized by Ottawa. Health Canada, however, noted it has, so far, "provided or committed to" $613,000 in response to the crisis.

Further, the province did not dramatically alter the region's health-care budget after the shootings, which shone a light on several community struggles, ranging from a lack of affordable housing to addiction services in the zone. Saskatchewan allotted $27.36-million to the Keewatin Yatthé Regional Health Authority, which encompasses La Loche, for the 2016-17 fiscal year, up 1.6 per cent from the previous year's $26.91-million budget. Spending across all regional health authorities rose 3.6 per cent, according to the government's 2016-17 budget documents.

Comprehensive information about each of the province's 12 health regions – data contained in their respective annual reports and including detailed budgets, demographics, summaries of each zones' needs, successes and health problems – may soon be obsolete. Saskatchewan earlier this month announced plans to amalgamate the province's 12 health regions into a single authority.

Meanwhile, Saskatchewan earmarked an additional $480,000 to deal with "priority projects" in La Loche, including funding for the new X-ray machine, equipping the hospital with WiFi to strengthen its electronic health services and improve cell coverage, and adding security. This, too, is a slow process. Local officials are still examining bids for X-ray equipment, and the province has allocated cash for the machine that will come out of this year's budget for the health region. The province expects it to cost about $500,000.

"The timeline is being determined as Keewatin Yatthé [Regional Health Authority] works to award the contract," Kathy Young, one of Mr. Wall's spokeswomen, said in an e-mail.

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