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 7 of 7: "I've never seen anything quite like this."

Moosonee, ON Whether Wabano and the other nurse-practitioners will be able to do enough for their patients depends greatly on Moose Factory and Moosonee settling their health-care feud. They were told to merge their operations to save money and make better use of their few doctors.

But federal-provincial tensions that plague so much of Canada quickly came to haunt the two communities.

In 1996, when Weeneebayko gained its autonomy, a new native-run board discovered it was headed for a huge deficit. Some directors blamed Ottawa for miscalculating costs, but that didn't change the reality: Within two years, the native organization was $2-million in the hole, and facing a sharp increase in government-approved wages and pharmaceutical prices.

The hospital's treasurer, George Small, says he wanted to keep the losses going, if that's what it would take to maintain health care. He figured the natives would find the money later. They always do, he maintains.

Like many native leaders in the area, Small cannot imagine cutting health care for his people. Similarly, Moosonee officials cannot imagine merging their work with a money-losing operation, not when they are governed by the strict rules of the provincial hospitals act.

Across the water, Moosonee's non-native health care managers say efficiency, as much as politics, is the issue.

Peter Fabricius, a career administrator from Southern Ontario who runs the James Bay General Hospital in Moosonee, points to some simple examples. When his board of directors gathers, the meetings last three to four hours, with every director allowed to speak for only five minutes on any issue. At Moose Factory, the meetings last three to four days, with directors allowed to speak until they feel they have ex-pressed their views.

The Moose Factory board gets a per diem of $150. The James Bay board gets nothing. The Moose Factory board deals with a litany of patient complaints and concerns, such as a native's application this year for a wheelchair. The James Bay board deals only with organizational issues, with a standard set of performance criteria evaluated at each meeting and a new rule barring directors from bringing up individual complaints.

After a career in the hospital business, and a year in Moosonee, he can only shake his head, and say: "I've never seen anything quite like this."

Any hope of the amalgamation fell apart last winter. On Feb. 15, at a special meeting of the regional health authority, the two sides simply could not agree on where to place a new regional hospital.

Moose Factory threatened to pull out of the authority if it didn't get its way. The Moosonee delegation, feeling the issue was too heated politically, left the meeting, along with its three partner communities from the coast, and a fourth that agreed to abstain from any vote.

The dissidents thought the choice was absurd. Moose Factory is an island without an airport. How could it house a regional hospital?

But the islanders had their own concerns. If a new hospital were built on provincial land in Moosonee, by the airport, wouldn't they as natives lose their special federal status and funding? Besides, the town has been in decline for years, while the island is on the move, economically and demographically. It's even willing to build an airstrip, if that's what is needed.

Moose Factory's arguments seemed to work, as three inland reserves voted alongside its two voting members - the Moose Crees and MoCreeBec - to produce a bare majority. The hospital would go to the island. "For the first time in a long time, it's made everyone uncomfortable," says Beck, Weeneebayko's chief executive.

Afterward, when a lawyer was hired to bring the two sides together, he couldn't get them to sit down in the same room. At one point, Beck says, "it was hard for people to look at each other in the eye."

The Moose Crees believe they can push on despite the tensions. For 330 years, they have struggled with outsiders, and now that they seem to hold the upper hand they are not about to give up. Besides, they consider their special arrangement with Ottawa more than a good deal; it's an inherent right. If others see it as two-tier medicine, well, they as aboriginal people have lived in a two-tier society for much longer.

But the division along the Moose River is more complicated than race. Moosonee, dependent on a provincial government that thinks little about Ontario's Far North, has more natives than non-natives to worry about. Most of them voted for Rheal Cool, thinking he could get a better deal. But the mayor knows he can do little to change how the reserve manages its affairs, and nothing to change how Ottawa and Ontario deal with each other.

Last spring, the local health authorities asked Health Canada and Queen's Park to address the financial troubles at Weeneebayko - in effect, to clear the slate before any amalgamation went ahead. They haven't heard back.

Even those who would like to build a bridge between their separate existences feel they cannot do much now. They cannot change the fundamental reasons for their two solitudes.

And so, Cool must wait, knowing that on the great muskeg, two very old societies - rivals, friends, neighbours, in-laws - will again have to see their fates decided from afar.

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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