I am a Canadian nurse. I realized that our health is socially determined while working with children from northern communities in a pediatrics ward.
A baby was admitted to pediatrics during my night shift a few years ago. The memory has blurred a bit with time, but I recall this little patient’s full head of dark hair, and her worried mom and auntie. I can still see the panic on their faces, the concerned lines on their foreheads, how they wouldn’t let their precious little one out of sight. It was breathing problems. Her family took her from their northern reserve community to the closest hospital, then to the nearest city for treatment.
"Zoey" was about three months old and had a two year old brother at home with the rest of their family. It’s common for our pediatric ward to treat patients from northern communities, so I’m used to seeing parents and loved ones enduring the stresses of being far from home in an unfamiliar place. The ongoing challenge of being present for one’s sick child is worsened by worry for the other family members back at home, hours away.
As baby Zoey settled in safe and sound with oxygen and monitors, the doctor talked to her mom. Zoey’s breathing problems were consistent with pertussis (whooping cough). It’s highly contagious, so the doctor asked who else Zoey had been in contact with, and about her vaccination history.
Zoey had not received her pertussis vaccination yet, and it seemed her brother "Zeke"'s vaccinations were behind as well. Zoey’s breathing problems had started a day or two after her brother caught a cold. The doctor raised concerns about the brother’s sickness being more than a cold, and instructed that he needed to be watched closely for signs of whooping cough. Baby Zoey was resting and peaceful, but her mom was unsettled by the doctor’s words. The next day she returned home to her toddler Zeke.
"No child in Canada should be dying from an illness which we can vaccinate against."
When I returned for my next shift, I learned that Zeke had died from whooping cough. Looking into her room and seeing that full head of hair, that perfect baby, I could feel the disconnect between her peaceful breaths and the tragedy that her family was now immersed in. It seemed surreal. Frustration crept up. Pertussis is a nasty bacterium, but we have a way of preventing it. No child in Canada should be dying from an illness that we can vaccinate against.
I thought of Zoey's family. How could they not get their little boy immunized? But as my frustration turned toward them, I remembered the faces of Zoey's mom and auntie. Their love for Zoey was obvious in how they held her, nurtured her, spoke to her. I couldn’t believe such loving and attentive family members would deliberately choose to not prevent an illness if they were given the opportunity.
I began wondering about this northern family’s access to vaccinations. How far do they have to travel each time an immunization is due? Are they contacted, taught about the vaccination schedule, about the illnesses being vaccinated against? What do we do to make easy for them? What don’t we do?
"I think we can do better."
On January 26th the Canadian Human Rights Tribunal ruled that the Canadian Government is racially discriminating against First Nations children and their families in providing inadequate child welfare services to children on-reserve. This ruling is not specific to vaccination access on-reserve, but systemic discrimination shows itself in a variety of ways.
I hope that this ruling, fought so hard for by Cindy Blackstock and others, can open our eyes to the inequality with which the people of Canada's North are treated, so we can do better. Canadians must demand improved access to health, education and support the North, and I believe that health care providers can and should lead by demanding these improvements in a visible way.
I think we can do better. Large scale changes like this take time. Fortunately, such work has already been underway for years. If you want to support a strong movement calling for improvements in access for First Nations children, check out Jordan’s Principle here.
If you're in the Ottawa area in early April, don't miss Cindy Blackstock at Closing the Gap Canada: Action for Health Equity.
Sharissa Hantke is a registered nurse who works in pediatrics and in community health. She imagines a healthier, more equitable version of Canada, and works on bringing that version into being. Sharissa loves being part of a variety of communities in Saskatoon, especially swing dancing and social justice communities. She wishes that all Canadian communities could access what they need to make them healthy.