The 2009 H1N1 Health Sector Pandemic Response in Remote and Isolated First Nation Communities of Sub-Arctic Ontario, Canada
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On June 11, 2009, the World Health Organization declared a global influenza pandemic due to a novel influenza A virus subtype of H1N1. Public health emergencies, such as an influenza pandemic, can potentially impact disadvantaged populations disproportionately due to underlying social factors. Canada’s First Nation population was severely impacted by the 2009 H1N1 influenza pandemic. Most First Nation communities suffer from poor living conditions, impoverished lifestyles, lack of access to adequate health care, and uncoordinated health care delivery. Also, there are vulnerable populations who suffer from co-morbidities who are at a greater risk of falling ill. Moreover, First Nation communities that are geographically remote (nearest service center with year-round road access is located over 350 kilometers away) and isolated (only accessible by planes year-round) face additional challenges. For example, transportation of supplies and resources may be limited, especially during extreme weather conditions. Therefore, remote and isolated First Nation communities face unique challenges which must be addressed by policy planners in order to mitigate the injustice that may occur during a public health emergency. The Assembly of First Nations noted that there has been very little inclusion of First Nations’ input into current federal and provincial pandemic plans. Disadvantaged groups know best how they will be affected by a public health emergency and are able to identify barriers and solutions. Therefore, the objective of my research was to gain retrospective insight into the barriers faced by three remote and isolated First Nation communities of sub-arctic Ontario (i.e., Fort Albany, Attawapiskat, and Kashechewan) during their 2009 H1N1 pandemic response. Culturally-appropriate community-based suggestions for improvement of existing community-level pandemic plans were also elicited. Collected data informed modifications to community-level pandemic plans, thereby directly applying research findings. Being a qualitative community-based participatory study, First Nation community members were involved in many aspects of this research. Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants representing the three main sectors responsible for health care services (i.e., federal health centers, provincial hospitals, and Band Councils). Data were manually transcribed and coded using deductive and inductive thematic analysis to reveal similarities and differences experienced within and between each community (and government body) regarding their respective pandemic response. Another round of semi-directed interviews (n=4) and community pandemic committee meetings were conducted to collect additional information to guide the modifications to the community-level pandemic plans. Reported barriers due to being geographically remote and isolated included the following: overcrowding in houses, insufficient human resources, and inadequate community awareness. Primary barriers faced by government bodies responsible for health care delivery were reported as follows: receiving contradicting governmental guidelines and direction from many sources, lack of health information sharing, and insufficient details in community-level pandemic plans. Suggested areas for improvement included increasing human resources (i.e., nurses and trained health care professionals), funding for supplies, and community awareness. Additionally, participants recommended that complementary communication plans should be developed. As suggested by participants, community-specific information was added to update community-level pandemic plans. Remote and isolated First Nation communities faced some barriers during their 2009 H1N1 health sector pandemic response. Government bodies should focus efforts to provide more support in terms of human resources, monies, and education. In addition, various government organizations should collaborate to improve housing conditions, timely access to resources, and the level of coordination regarding health care delivery. Furthermore, as pandemic plans are dynamic, government bodies should continue to aide First Nation communities with updating their community-level pandemic plans to satisfy their evolving needs. These recommendations should be addressed so that remote and isolated western James Bay First Nation communities and other similar communities can be better prepared for the next public health emergency.
Cite this version of the work
Nadia A. Charania (2011). The 2009 H1N1 Health Sector Pandemic Response in Remote and Isolated First Nation Communities of Sub-Arctic Ontario, Canada. UWSpace. http://hdl.handle.net/10012/5984
H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 Hali za dharura za afya ya umma, kama vile janga la homa, zinaweza kuathiri idadi ya watu walio katika hali mbaya kwa sababu ya sababu za kijamii. Idadi ya watu wa Canada waliokumbwa na janga la homa ya H1N1 mwaka 2009 ni kubwa. Jamii nyingi za Taifa la Kwanza zinateseka kutokana na hali mbaya za maisha, mtindo wa maisha wa umaskini, ukosefu wa upatikanaji wa huduma ya afya ya kutosha, na utoaji wa huduma ya afya usio na uratibu. Pia, kuna idadi ya watu walio hatarini ambao wanateseka kutokana na magonjwa yanayoambatana na magonjwa ambayo yana hatari kubwa ya kuugua. Zaidi ya hayo, jamii za First Nation ambazo ni mbali kijiografia (kituo cha huduma cha karibu zaidi na upatikanaji wa barabara ya mwaka mzima iko zaidi ya kilomita 350 mbali) na kutengwa (inaweza kupatikana tu kwa ndege mwaka mzima) inakabiliwa na changamoto za ziada. Kwa mfano, usafirishaji wa vifaa na rasilimali huenda ukawa mdogo, hasa wakati wa hali mbaya ya hewa. Kwa hivyo, jamii za mbali na za kutengwa za Taifa la Kwanza zinakabiliwa na changamoto za kipekee ambazo lazima zishughulikiwe na wapangaji wa sera ili kupunguza ukosefu wa haki ambao unaweza kutokea wakati wa dharura ya afya ya umma. Mkutano wa Mataifa ya Kwanza ulibainisha kuwa kumekuwa na ujumuishaji mdogo sana wa pembejeo ya Mataifa ya Kwanza katika mipango ya sasa ya janga la shirikisho na mkoa. Watu walio katika hali mbaya wanajua zaidi jinsi watakavyoathiriwa na hali ya dharura ya afya ya umma na wanaweza kutambua vizuizi na suluhisho. Kwa hivyo, lengo la utafiti wangu lilikuwa kupata ufahamu wa nyuma juu ya vizuizi vilivyokabiliwa na jamii tatu za mbali na zilizojitenga za Taifa la Kwanza la Ontario (yaani, Fort Albany, Attawapiskat, na Kashechewan) wakati wa majibu yao ya janga la H1N1 la 2009. Mapendekezo ya msingi ya jamii yenye kufaa kitamaduni kwa ajili ya uboreshaji wa mipango ya janga ya kiwango cha jamii iliyopo pia ilichukuliwa. Takwimu zilizokusanywa zilielekeza marekebisho kwa mipango ya janga la kiwango cha jamii, na hivyo kutumia moja kwa moja matokeo ya utafiti. Kuwa utafiti wa ushiriki wa ubora wa jamii, wanachama wa jamii ya Taifa la Kwanza walishiriki katika nyanja nyingi za utafiti huu. Mahojiano ya nusu-kuelekezwa yalifanywa na watu wazima wa msingi (n = 13) kwa kutumia sampuli ya kusudi la washiriki wanaowakilisha sekta tatu kuu zinazohusika na huduma za huduma za afya (yaani, vituo vya afya vya shirikisho, hospitali za mkoa, na Halmashauri za Band). Takwimu zilirekodiwa na kuandikwa kwa mkono kwa kutumia uchambuzi wa mada ya deductive na inductive ili kufunua kufanana na tofauti zilizopatikana ndani na kati ya kila jamii (na chombo cha serikali) kuhusu majibu yao ya janga. Mzunguko mwingine wa mahojiano ya nusu-kuelekezwa (n = 4) na mikutano ya kamati ya janga la jamii ilifanywa ili kukusanya habari ya ziada ili kuongoza marekebisho ya mipango ya janga la kiwango cha jamii. Vizuizi vilivyoripotiwa kutokana na kuwa mbali kijiografia na kutengwa vilijumuisha yafuatayo: msongamano katika nyumba, rasilimali za binadamu zisizofaa, na ufahamu wa kutosha wa jamii. Vizuizi vikuu vinavyokabiliwa na vyombo vya serikali vinavyohusika katika utoaji wa huduma za afya ni: kupokea miongozo na mwelekeo wa serikali unaopingana kutoka vyanzo vingi, ukosefu wa kushiriki habari za afya, na maelezo ya kutosha katika mipango ya janga la kiwango cha jamii. Maeneo yaliyopendekezwa kwa ajili ya uboreshaji ni pamoja na kuongeza rasilimali za binadamu (yaani, wauguzi na wataalamu wa huduma za afya waliozoezwa), ufadhili kwa vifaa, na ufahamu wa jamii. Kwa kuongezea, washiriki walipendekeza kwamba mipango ya mawasiliano ya ziada inapaswa kuundwa. Kama ilivyopendekezwa na washiriki, habari maalum ya jamii iliongezwa ili kusasisha mipango ya janga la kiwango cha jamii. Jamii za watu wa kwanza za mbali na zilizojitenga zilikabiliwa na vizuizi wakati wa majibu yao ya janga la afya la H1N1 la 2009. Mashirika ya serikali yanapaswa kuzingatia juhudi za kutoa msaada zaidi katika suala la rasilimali za kibinadamu, fedha, na elimu. Kwa kuongezea, mashirika mbalimbali ya serikali yanapaswa kushirikiana ili kuboresha hali za makazi, upatikanaji wa rasilimali kwa wakati, na kiwango cha uratibu kuhusu utoaji wa huduma za afya. Kwa kuongezea, kwa kuwa mipango ya janga ni ya nguvu, mashirika ya serikali yanapaswa kuendelea kusaidia jamii za Taifa la Kwanza na kusasisha mipango yao ya janga la kiwango cha jamii ili kukidhi mahitaji yao yanayobadilika. """Tunaomba mapendekezo haya yatimizwe ili jamii za mbali na za kujitenga za James Bay First Nation na jamii zingine zinazofanana ziweze kuwa tayari zaidi kwa dharura ya afya ya umma inayofuata." Nakala hii ni sehemu ya kitabu cha Nadia A. Charania (2011). H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1N1 H1 N1 N1 N1 H1 N1 H1 N1 H1 H1 H1 H1 H1 H1 H1 H1 H1 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H2 H3 H3 H3 H4 H4 H4 UWSpace Hd.html: http: www.hdl.html http: hdl.html http: hdl.html http: hdl.html http: hdl.html http: hdl.html