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Alberta preparing for the return of H1N1 flu
Susan Thompson
for Smoky River Express
Aboriginal leaders are asking for help from Canada’s premiers as the country braces for more outbreaks of swine flu.
There are major concerns that First Nations and Inuit communities may be hit hardest by the H1N1 virus. Memories of the 1918 Spanish flu epidemic, which was also due to a form of the H1N1 virus and hit First Nations particularly hard, haunt some reserves.
In early August, Shawn Atleo, newly elected Grand Chief of the Assembly of First Nations, met the country’s premiers in Regina to discuss how to prepare in case the H1N1 flu virus returns with a vengeance this fall during the regular flu season.
After the closed door meeting, Atleo said H1N1 preparedness is of particular concern to remote and northern communities.
“While there are some good examples of First Nations having good plans in place, having the resources, using the resources that may be available to produce those plans, much more needs to be done,” Atleo told media.
But Dr. Gerry Predy, Medical Officer of Health for Alberta Health Services, says that it’s too early to know if Alberta’s First Nations will be hit harder if the swine flu comes back.
“Based upon our experiences in Alberta, we have had some First Nations people fall seriously ill, but we haven’t had enough cases to say whether it affects them more,” Dr. Predy says. “Based upon what’s happened in Manitoba, they do seem to be more vulnerable, but whether that’s risk factors due to chronic disease or socioeconomic factors, it’s hard to separate out.”
Alberta Health Services is still working with First Nations health authorities to prepare.
“Given what’s happened we have to work closely with First Nations,” Dr. Predy says.
Children, the elderly, and pregnant women are believed to be more likely to contract the H1N1 flu. According to Predy people with chronic diseases like diabetes, which is more common among First Nations, are also more susceptible.
A study published in the medical journal the Lancet in July found socioeconomic conditions may make First Nations and Inuit people more prone to flu outbreaks.
“First Nations and Inuit communities, especially northern, remote, and isolated communities, are particularly vulnerable,” says Dr. Malcolm King, a health researcher at the University of Alberta who co-authored the study. “It’s not just isolation although it’s an important factor. It’s housing conditions.”
Poor housing and inadequate ventilation in housing tend to predispose people to respiratory diseases of various kinds. The swine flu also attacks the respiratory system. Overcrowding in houses is another important factor since close contact makes it easier for disease to spread.
Poor nutrition is another problem.
“People in northern and remote communities would tend to make what people in the south would call poor food choices, but there’s really not much choice,” Dr. King explains.
Fruit, vegetables, and milk may not be as easily available in remote and northern areas and are often much more expensive than chips and pop. That means people in those areas don’t get enough vitamins and their health is not as good in general.
“It’s not rocket science,” Dr. King says.
Also, while hand washing has been one of the primary ways officials have been encouraging Canadians to prevent the spread of the virus, in First Nations communities where clean water isn’t available hand washing is not a good way to prevent disease. Hand sanitisers are an alternative for communities without access to clean running water, but in Manitoba, First Nations leaders recently slammed federal health officials for delaying delivery of hand sanitisers to communities there because the sanitisers contained alcohol.
Dr. Predy acknowledges the problems in Manitoba, but says Alberta has learned from what happened there.
“I think that’s been addressed. In places with a lack of running water, hand sanitisers will be available,” he says.
Vaccinations are another important part of the preparations for a new flu outbreak. On August 6 Health Minister Leona Aglukkaq announced that Canada was ordering 50.4 million doses of swine flu vaccine at a total cost of about $400 million, enough to vaccinate every Canadian who wants to be inoculated against the virus. The vaccine will be manufactured in Ste-Foy, Quebec by GlaxoSmithKline and is expected to be ready in October or November.
“It’s the most important preventative measure we can take,” says Dr. Predy.
Alberta has already announced that it will offer free flu shots for the first time this fall to protect people against three strains of the virus, and will offer a second round of flu shots against the H1N1 strain when that vaccine becomes available.
While some have suggested that First Nations and Inuit receive vaccinations first, that decision hasn’t been made.
“We don’t know the vaccination priorities yet, because those will be determined by the federal government in consultation with the provinces,” Dr. Predy says.
Besides vaccinations, surveillance and testing are key to getting ready, since they can help pinpoint when and if the flu returns. Preparing to transport sick people out of remote communities and getting ready for the potential hospitalization of large numbers of people are also important.
Overall, Dr, Predy says that Alberta is prepared for a swine flu outbreak.
“In some ways the fact that it hit in spring has given us some more time to prepare,” Dr. Predy says.
Typically what happens with pandemics is that they come in waves, which is why a second wave of the flu pandemic is expected to return in fall.
Dr. Predy says, “I think we are getting to the stage where we are as prepared as we can be.”
David Drummond, the Administrator for the Gift Lake Métis Settlement, agrees the community feels more ready for a possible fall outbreak after learning a lot about the swine flu already this spring. The first swine flu related death in Canada involved a woman who was living in High Prairie but also maintained a residence on the Gift Lake Métis Settlement.
“In many respects we may be better prepared than most communities to deal with a new outbreak,” Drummond says. “Been there, done that.”
However, researcher Dr. King warns the social issues that affect First Nations and other indigenous peoples won’t be fixed by short-term planning.
“We always ignore the long-term and deal with crises. It’s time to stop just dealing with crises. We need to deal with running water and nutrition,” Dr. King says.
“I think when you look at who has been affected, it definitely happens to be a high percentage of aboriginal people,” says Lewis Cardinal, an educator and community advocate who is also running for the federal NDP in Edmonton in the next election. Cardinal is a Treaty 8 Cree originally from Sucker Creek near High Prairie.
“It largely points to issues of poverty, but also the quality of health care,” Cardinal says. “Aboriginal health care is not up to the same standard of care, even on regular health issues.”
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