ISLAND LAKE, MANITOBA – A deadly outbreak of H1N1 flu swept through a First Nation on this picturesque lake in northeastern Manitoba’s boreal forest during the first wave of the pandemic. ’ A year later, whooping cough broke out in the sister community across the lake, where two people in their 30s also died in quick succession last fall after catching seasonal flu. Kids in all three communities around the lake suffer from skin sores that won’t heal, many are colonized by antibiotic-resistant superbugs, and diarrhea is common, especially in the spring. Even compared to other remote First Nations with similarly overcrowded housing, the health situation in Island Lake seems extreme.
Crimean War nurse Florence Nightingale could probably have figured out a solution in about five minutes: get these people running water.
Hard as it is to believe, about half the 10,000 people living along the shores of Island Lake and nearby Red Sucker Lake have no plumbing. Those who can’t afford a vehicle haul water home from communal outdoor taps by hand or on sleds, and they either use indoor latrine buckets – sometimes dumped in the yard – or brave 30 below trips to the outhouse.
“You can freeze your ass in there,” Sam Harper, 69, said of his family’s outhouse as he carried plastic pails of water up a slippery bank from a hole in the frozen lake. “I find myself, once in a while, lying down on the snow because I’m so tired.” As an elder, Harper sometimes gets treated water delivered by the band – as long as the truck doesn’t break down or get stuck in the snow.
An investigation by the Winnipeg Free Press revealed that it’s common for Island Lake families with young children to struggle on less than the 50 litres of water per person a day recommended by the United Nations for basic needs. Some use less than the 15 litres aid agencies try to distribute during natural disasters. The average Winnipeg resident uses 180 litres of treated water a day.
Jacob Flett’s mother Valene worried about how she was going to follow a nurse’s instructions to bathe her child and wash his clothes regularly after the baby developed itchy sores. “I only have one pail,” she said. Meanwhile, Bernard Flett waited a decade after a doctor “prescribed” running water to help prevent diabetes-related infections before the band found enough money to install a water holding tank in his home. By the time he got plumbing, Flett’s toes had been amputated and he and one of his grandchildren were colonized by the MRSA superbug that spreads easily in homes without proper sanitation. “We try to keep the kids clean,” Flett said, as a child pulled out a small red plastic tub used for baths. His daughter sometimes puts a wooden yoke carved by her grandfather over her shoulders to lug heavy water buckets home.
Too long to wait
Few Canadians have heard about the situation in Island Lake, but when confronted with the reality, many leap to fictional conclusions. Surely the First Nations must have squandered government cash set aside for plumbing. And what about those overpaid chiefs we keep hearing about from the Canadian Taxpayers Federation? The Federation’s own numbers show the average Manitoba band council member earns about $63,000. Water and sewer projects can cost $10 million for larger First Nations like those in Island Lake, so no amount of salary scrimping by the chiefs would make a significant dent.
The simple truth is that the federal government – responsible for water and sewer services on reserves – has never gotten around to funding plumbing for half the homes in Island Lake. Indian and Northern Affairs Canada has a tentative plan to extend water and sewer services to more – but not all – Island Lake homes between about 2013 and 2017. That’s a long time to wait for people like Mary Jane Harper, who nearly died from flu that spread rapidly in homes without enough water for hand-washing, or elder Moyer Taylor, who can no longer walk to an outhouse. “My dad, he’s sitting in a wheelchair and he … just has a pail to go to the toilet,” said his frustrated son Chris Taylor.
Clear links between clean water and health, so why is nothing happening?
The link between running water and health was demonstrated most clearly by Dr. Thomas Hennessy in a study published in the American Journal of Public Health in 2008. He found Alaskans 65 and older were twice as likely to be hospitalized for pneumonia or influenza in areas where a lower proportion of homes have tap water and flush toilets. Infants in under-serviced villages had a five times higher rate of hospitalization for lower-respiratory-tract infections and respiratory syncytial virus, and were 11 times more likely to be hospitalized for pneumonia compared to the overall US population.
Health Canada refuses to release an epidemiological report on the H1N1 flu outbreak in Island Lake that might shed some light on the situation there. The Winnipeg Free Press has filed a complaint with the federal information commissioner. People living in areas with less water service also end up in hospital with skin infections more often than those with an adequate water supply, according to the Alaska study.
Meanwhile, a University of Manitoba master’s student in community health sciences went door-to-door in Island Lake in 2006 and 2007 collecting stool samples from 142 people with acute diarrhea. The study found people who did not have running water, drank lake water or did not have access to an outhouse were more likely to have diarrhea-causing germs.
The Canadian Pediatric Society says lack of quality running water is one of the reasons methicillin-resistant Staphylococcus aureus is spreading on First Nations. It often causes nasty skin boils that are hard to treat, and can be fatal if it moves deeper into the body. A four-year-old Nunavut boy was killed by MRSA in 2007. Health researchers have been debating for decades whether there’s any point collecting more data that proves what Florence Nightingale knew 150 years ago – poor hygiene means poor health. Frontline health workers in Island Lake are furious about the amount of time they are forced to spend helping people bathe and tending wounds that patients can’t keep clean at home. “We would like to spend more time on education, heart disease, diabetes prevention, maternal-child issues. But we can’t because we’ve got to take care of what needs attention right now,” said a medical professional. Many would like to give politicians a piece of their mind, but are afraid of losing their jobs if they speak out.
Build the road, bring the water
Manitoba Grand Chief Ron Evans is pushing the Canadian government to help build a $1.4-billion all-weather road into Island Lake and neighbouring communities, now accessible only by air or by ice road for a month each winter. A permanent road would make it much cheaper to haul in plumbing supplies, but could take a decade to complete, even if the federal government agrees to help the Manitoba government fund it. In the meantime, St. Theresa Point Chief David McDougall has started work on an emergency plan to protect the health of his people until multimillion-dollar piping can be installed. He estimates that 364 outhouses need to be built on concrete pads in his community alone, and 314 water containers installed that hold at least the 350 litres per family per day needed to meet United Nations minimum health standards. Trucks would need to be bought and drivers hired to suck out sewage from the outhouses and deliver clean water. McDougall said some homes likely don’t have driveways usable by delivery trucks, so road access work would also be required.
None of that can be done within existing budgets, the chief said. Island Lake’s four First Nations receive about $105 million a year between them in federal government funding, but most is allocated to specific things like operating schools and health centres and can’t just be diverted to water projects.
Governments spend less than half as much per capita on First Nations residents as they do on other Canadians, according to a 2004 report by the Assembly of First Nations. The Manitoba regional director general for Indian Affairs, Anna Fontaine, is by all accounts a sincere advocate for First Nations in her region, but she’s competing with other regions for Minister John Duncan’s attention. He’s in turn competing with other departments that are a higher priority for the Harper Conservatives.
The Canadian government has spent a whopping $3.5 billion between 1995 and 2008 on improving previously neglected water and sewer systems on First Nations. Hundreds of millions more have been committed since. But communities with limited plumbing have been mysteriously left off the government’s high-risk priority list. It focuses on fixing treatment plants and ignores whether water from those plants is actually distributed to homes!
A national survey just wrapping up on First Nation water and sewer infrastructure is in danger of repeating that glaring omission. An early draft of a report on one of the Island Lake communities overlooked the fact that most homes don’t have flush toilets.
Meanwhile, a proposed law to regulate drinking water on First Nations – for the first time ever – puts the cart before the horse. Bill S-11, now before the Senate, would make First Nations liable for not meeting drinking water quality standards, without allocating the money to bring their infrastructure up to snuff!
When details of this situation were first published in the Winnipeg Free Press, many of its readers questioned why people living in Island Lake don’t just pack up and move to the city, where even those living on social assistance have running water. “The racism that my children and I endure is not worth it and we can hardly wait to go back,” responded an Island Lake mother studying in Winnipeg.
Former Winnipeg Free Press assistant city editor Helen Fallding was recently appointed manager of the University of Manitoba’s new Centre for Human Rights Research Initiative.
This article appeared in the March/April 2011 issue of Canadian Dimension (Indian Country and Climate Change).