Measures to stop spread of COVID-19 in First Nations limited by lack of infrastructure: report

Suggested measures to limit the spread of COVID-19 won't be effective in remote Manitoba First Nations unless housing conditions and access to clean water are improved, says a new report.

"Asking people to wash their hands and isolate in overcrowded homes without running water is like asking people unable to afford bread to eat cake," reads the report, released Wednesday by the Canadian Centre for Policy Alternatives (CCPA).

The research examines housing, water infrastructure and access to emergency services in northern Manitoba First Nations including Wasagamack and Garden Hill First Nations. There are no known cases of COVID-19 in the area.

Drawing on water infrastructure studies from 2003 to 2018, the report outlines the history of limited access to clean water on reserves across Canada, and highlights the frequency of water shortages in Wasagamack, including a shutdown of the community's water treatment system earlier this month. 

In 2018, just over half of the homes on the Garden Hill reserve had piped water delivery, with 27 per cent using cisterns or holding tanks, and 21 per cent using bottled or pails of water in their homes, according to data in the report. 

"It's been really hard. I don't have water in my cistern right now," said Nora Whiteway of Wasagamack First Nation.

Whiteway lives with seven family members in a three-bedroom home. Their cistern, which sits next to an unreliable septic tank, she said, frequently runs dry because of how many people use the water for showers and to rinse the toilet bowl.

"It's hard to teach the youth about this, too," she said.

"You can't tell them not to take a shower or clean themselves because there's no water. Some of them aren't [physical] distancing, because they don't think it's serious. It's really hard." 

Problems with housing conditions that limit personal hygiene and physical distancing because of overcrowding are another major issue, the report says.

In 2016, Statistics Canada found that 37 per cent of First Nations people on reserve were living in housing that did not have enough bedrooms for the size and composition of the household, and in Wasagamack and Garden Hill First Nations, the person-per-room rates were respectively 24 and 22 times higher than the national average.

Whiteway said she's also worried Wasagamack doesn't have the health care facilities to treat people if they become ill. 

"We get scared here ...  we don't have a hospital nearby," she said.

"The problem we have here is that the nurses rotate [from other parts of the province], and they are still rotating. We're worried they might bring that virus to us."

H1N1 was 'more than a warning'

Addressing the infrastructure problems is a matter of life and death, said Shirley Thompson, co-author of the report and associate professor at the University of Manitoba's Natural Resources Institute.

Thompson said the communities are in "triple jeopardy," because of water problems, housing problems and the fact that Canadian service providers and resource extraction workers are still being allowed to travel to the area, without respecting the First Nations' travel restrictions and lockdowns. 

"They are sitting ducks," she said. 

"We've had deaths from pandemics in the past. This has to be the one that makes the change." 

In 2009 H1N1 influenza killed 11 people in the province, three of whom were from Garden Hill First Nation. Hundreds of people from the Island Lake area became ill and some were admitted to a Winnipeg hospital in critical condition.

After the H1N1 outbreak, the federal government paid for water and sewage cisterns and indoor plumbing for some of the home in the communities, but she said irregular service and maintenance problems have been common for the last decade.

"The H1N1 crisis [was] more than a warning. People died, hundreds of people were ill ... and an inadequate, low cost solution was given," said Thompson.

Indigenous Services Canada has said its approach to COVID-19 is different than for H1N1 in 2009.

Recommendations

The report's recommendations include:

• Policies to ensure decisions by First Nations leaders to lock down or restrict travel to and from their communities are respected and supported by federal departments.
• Collaborations between Canadian service providers, like health care workers and law enforcement, that continue services while respecting the restrictions to community access. 
• Classifying resource extraction workers as non-essential, which would prohibit their entry to communities.
• Special funding to deal with the lack of infrastructure, through Indigenous-led organizations. 
• Sustained programs to ensure food security, access to hunting and fishing gear, delivery of clean water and extra fuel for water deliveries.

The recommendations should be carried out by or done in partnership with First Nations organizations to "build capacity, social enterprise and support self-determination," the report reads.