With the world now officially facing a flu pandemic, the deplorable situation in the country's northern native reserves is exposing flaws in the country's pandemic preparedness plan.
In northern Manitoba, many communities are struggling with a severe flu outbreak. Across the province, 24 people with flu symptoms are breathing with ventilators and two-thirds of them are aboriginal.
In the past week, 11 residents of the Garden Hill First Nation alone have been airlifted to hospitals back in the city, most with severe flu symptoms. Garden Hill Chief David Harper says the equipment at the nursing station on his reserve is old or broken and nurses don't have the support of a full medical team as they would have in an urban clinic.
Phil Fontaine, national chief of the Assembly of First Nations, says one cluster of northern Manitoba reserves is home to about 10,000 people and doesn't have a single hospital.
Health Canada has put out a tender for nurses to work in 24 isolated reserves but says it's struggling to find enough nurses to keep medical stations in northern Manitoba open.
"Health Canada is having great difficulty recruiting and retaining employed nurses in the nursing stations and two federal hospitals located in northern Manitoba on reserves," the tender states. "Without adequate service, the nursing stations and hospitals may have to close for periods of time which could result in severe medical liability."
Public health officials are saying that while Canada's pandemic preparedness plan includes specific protocols for First Nations communities, there's been no money attached to it.
In Garden Hill, Harper says the band has already spent $2,900 so it can go and buy its own pandemic supplies, such as masks - supplies that the federal government was supposed to provide.
Jim Wolfe, the regional director for Health Canada's aboriginal branch, says the government is working closely with the province and aboriginal leaders to address the issue. Manitoba's chief public health officer, Dr. Joel Kettner, says the response to swine flu has not been perfect, but has been better than in previous disease outbreaks.
The virus's spread among Canada's aboriginals caught the attention of the World Health Organization earlier this week, though the agency also noted that disease can take a harsher toll on people facing poverty, substandard housing and underlying health problems.
Canadian officials say there is no evidence to support suggestions the virus's impact varies between ethnic groups.
"To make conclusions based on a couple of communities that this is somehow a disease that is worse in a particular ethnic group -- it's much too early to make any of those kinds of conclusions or presumptions," Dr. David Butler-Jones, Canada's chief public health officer, said at a news conference Thursday.
"We may find that in the future, but at the moment, evidence is it doesn't matter who you are; everyone is susceptible," said Butler-Jones.
While the situation in northern native communities is severe, for the rest of Canada, the virus has not been causing much serious illness. Canada has had 2,978 confirmed cases of the H1N1 flu, and about five per cent of those have required hospitalization for treatment. While there have been four deaths from the strain, all of the victims were suffering other health problems.
Infectious disease expert Neil Rau says he believe that many more Canadians have gotten the virus than what the officials numbers indicate.
"The serious cases are only the tip of the iceberg. The rest of people who have this virus get mild disease or don't even go to the doctor," he told Canada AM Friday.
"Granted there have been some cases of otherwise healthy people getting it and that's what drew the initial alarm. But in Mexico, perhaps millions of people had seen this virus before those deaths were described."
Canada's health minister says the Thursday's decision by the WHO to declare H1N1 a flu pandemic will do little to change Canada's response.
"I want to reassure Canada... we were prepared for this decision and this decision does not change our approach in Canada," Health Minister Leona Aglukkaq said at a Thursday afternoon news conference.
"It is primarily a technical decision (by the WHO)," Aglukkaq said. "Thankfully, the vast majority of illnesses remain mild."
Canada's chief public health officer said the WHO move was "based on the spread of the virus, not the severity noting that within Canada, "the virus continues to behave like the seasonal flu."
"We will continue to tailor our domestic responses and public health measure to our own situation and to the evolving needs of Canadians," Butler-Jones said Thursday.
Rau says he believe that even globally, nothing has changed, and the WHO's decision was a technical one based on geographic spread alone.
"The virus has not changed since we've been observing this story. What has changed is the geographic spread," he said. "Spread alone is not cause for alarm. It's if you have a virulent or serious virus that is also spreading."
"So I'm not sure that I'm more excited about this than seasonal flu. Every year, seasonal flu also spreads all over the world and we don't call it a pandemic because it would get to be a kind of a tiring story. So I hope we're dealing with something a little different here, but it's not playing itself out to be that different so far."
H1N1 has been reported in 74 countries, has caused 145 confirmed deaths and almost 30,000 cases of illnesses.
