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. 2017;76(1):1320208.
doi: 10.1080/22423982.2017.1320208.

An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario

E J Mew  1 , S D Ritchie  2   3 , D VanderBurgh  4 , J L Beardy  5   6 , J Gordon  7 , M Fortune  8 , S Mamakwa  5 , A M Orkin  1   9
Affiliations

An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario

E J Mew et al. Int J Circumpolar Health. 2017.

Abstract

Background: Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities.

Objective: We aimed to understand emergency response systems, services, and training in remote NAN communities.

Design: We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multi-stakeholder roundtable meeting (n=33) in October 2013.

Results: Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps.

Conclusions: Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed.

Keywords: Indigenous health; Nishnawbe Aski Nation; aboriginal health; community-based participatory research; emergency medical services; environmental scan; health services; remote health.

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Figures

Figure 1.
Figure 1.
Map of Nishnawbe Aski Nation member communities, road access and nearest emergency care services. (Reproduced with permission from Jill E. Sherman).
See this image and copyright information in PMC

References

    1. Office of the Auditor General of Canada Spring 2015 reports of the auditor general of Canada: report 4 access to health services for remote first nations communities. Ministry of Public Works and Government Services; 2015. Available from: http://www.oag-bvg.gc.ca/internet/docs/parl_oag_201504_04_e.pdf (Archived by WebCite® at: http://www.webcitation.org/6Yh1LKH5O)
    1. Health Canada First nations comparable health indicators [Internet] 2005. [cited 2015 May 21]. Available from: http://www.hc-sc.gc.ca/fniah-spnia/diseases-maladies/2005-01_health-sant.... (Archived by WebCite® at: http://www.webcitation.org/6Yh9PL49F)
    1. Nishnawbe Aski Nation First nation leaders declare health and public health emergency [Internet] 2016. February 24 [cited 2016 Nov 18]. Available from: http://www.nan.on.ca/article/health-and-public-health-emergency–2222.asp (Archived by WebCite® at: http://www.webcitation.org/6m7l1ugxQ)
    1. Nishnawbe Aski Nation About us [Internet] 2016. [cited 2016 November 18]. Available from: http://www.nan.on.ca/article/about-us-3.asp (Archived by WebCite® at: http://www.webcitation.org/6m7ah5XKL)
    1. Orkin A, VanderBurgh D, Ritchie S, et al. Community-based emergency care: an open report for Nishnawbe Aski Nation. Thunder Bay: Northern Ontario School of Medicine; 2014. Available from: www.nosm.ca/cbec.

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