stats Making the Business of Life Easier

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Canada's Apartheid, by John Stackhouse
  Nov. 3

Welcome to Harlem on the Prairies
  Nov. 3 (Saskatoon, SK)

Crystal's choice: The best of both worlds
  Nov. 5 (Mississauga, ON)

How the Mi'kmaq profit from fear
  Nov. 6 (Cape Breton, NS)

The healing power of hockey
  Nov. 7 (The Pas, MB)

Norma Rae of the Okanagan
  Nov. 8 (Westbank, BC)

Comic genius or 'niggers in red face'?
  Nov. 9 (Regina, SK)

Praying for a miracle
  Nov. 10 (Lac Ste. Anne, AB)

To have and to have not
  Nov. 12 (Moosonee, ON)

Trouble in paradise
  Nov. 19 (Tofino, BC)

A cut of the action
  Nov. 26 (Wabigoon, ON)

The young and the restless
  Dec. 3 (Ashern, MB)

The wireless warrior's digital dream
  Dec. 10 (Ottawa,ON)

'Everyone thought we were stupid'
  Dec. 14 (Salluit, QC)

First step: End the segregation
  Dec. 15 (Last in the series)


To have and to have not

Story by John Stackhouse. Photos by Patti Gower.
The Globe and Mail, November 12, 2001

Part 3 of 7: The region's health care schism

Lac St. Anne locator The island's gumption helped to produce Jonathan Cheechoo, a young hockey prospect for the San Jose Sharks. It also has peppered the pleasant dirt cul-de-sacs with fast-food shacks selling ribs, burgers and French fries from private kitchens. Even the band-run gas station now has a Pizza Hut outlet.

But nothing pleases the island Crees more than their hospital, an old sanitorium erected in 1950 during a tuberculosis outbreak. Shaped like a Cross of Lorraine - the symbol of TB treatment - the hospital retains its secluded air, built at a remove from the community and brightened by sunshine cascading through tall windows on all sides. Down each corridor, there are long, empty spaces, the remains of a 200-bed facility that has been whittled down over the decades to 38 beds.

Outside, a helipad to one side allows patients to be whisked to the mainland airport, and from there to some of the world's best medical care in Southern Ontario.

At the moment of Canada's creation, the British North America Act of 1867 set out provincial responsibility for health care, except in the case of natives, who became a federal responsibility. Since the native population at the time was largely remote and scattered, Ottawa assigned its burden to private agencies, notably the churches.

In Ontario's muskeg, church-run hospitals, as well as residential schools, became part of a regional race for converts. The Anglican Church gained a toehold on Moose Factory, but in Moosonee and several coastal communities, health care went to the Catholic Hospitals of James Bay.

A schism in health care grew and resulted in a sharp turn in 1969, when the Catholic-run Assumption Hospital in Moosonee burned down. The church asked the province to take over the hospital, as well as nursing stations in Fort Albany and Attawapiskat on the James Bay coast.

Those three communities have since enjoyed provincially run health-care services, although for native patients Ottawa pays the bills. In Moose Factory, and the remote communities of Kashechewan and Peawanuck, the federal government resumed direct control of health care.

But in 1989, another change in direction occurred, as Ottawa began to transfer control of health care to native communities. Some of the experiments were disasters, with doctors quitting en masse from native-run hospitals that couldn't pay their wages. A few fell prey to corruption, such as Manitoba's Virginia Fontaine Memorial Centre, which was closed this year for financial mismanagement.

The Moose Factory hospital, which has a long-standing partnership with Queen's University, became a success. In 1996, management was handed over to a local native authority, and the hospital was renamed Weeneebayko, meaning "of the two bays."

Some locals thought it would mean a return to traditional native medicine, at least until they learned the burning of sweetgrass in a hospital was against fire regulations. Others thought it would be a free-for-all in which the slightest ailment would lead to a round-trip ticket down south, at least until the hospital's new management cracked down on unnecessary travel. No longer were coastal residents, for example, allowed to refer themselves for a psychiatric appointment, which had become a common cover for weekend shopping junkets.

THIS STORY AT A GLANCE (Parts 1 to 7):

Photo Essay
Gateway to the arctic

1. 'The first nations get much better health care'
A two-tier health-care system for two communities

2. A blessed Cree community
An island reserve with its own luxury hotel, cable TV company, shopping mall and elders home

3. The region's health care schism
Provincially run hospitals where Ottawa pays the bills for natives

4. Patching up the wounds of an afflicted society
"I'm not going to march down to the council chamber and say, `You have a problem with drugs' "

5. Health care in isolated communities
The only hope seems to lie in a MoCreeBec nurse-practitioner

6. Moose Factory's epidemic
Persuading her patients to modify a lifestyle that is killing the Crees of Canada's North

7. "I've never seen anything quite like this."
Cutting costs, merging two hospitals



photo essays
Two worlds - photo essay

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