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Int J Circumpolar Health. 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.

Author information

1
a Dalla Lana School of Public Health , University of Toronto , Toronto , Canada.
2
b School of Human Kinetics , Sudbury , Canada.
3
c Centre for Rural and Northern Health Research , Laurentian University , Sudbury , Canada.
4
d Division of Clinical Sciences , Northern Ontario School of Medicine , Thunder Bay , Canada.
5
e Nishnawbe Aski Nation , Thunder Bay , Canada.
6
f Northern Ontario School of Medicine , Thunder Bay , Canada.
7
g Sioux Lookout First Nations Health Authority , Sioux Lookout , Canada.
8
h Michael G. DeGroote School of Medicine , McMaster University , Hamilton , Canada.
9
i Schwartz/Reisman Emergency Medicine Institute , Sinai Health System , Toronto , Canada.

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

PMID:
28494638
PMCID:
PMC5497541
DOI:
10.1080/22423982.2017.1320208
[Indexed for MEDLINE]
Free PMC Article

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