In the 2009 H1N1 pandemic (pH1N1) Canada's Aboriginal population was affected much worse than the general population (Kermode-Scott, 2009). In one remote First Nations community in Manitoba 576 of the 3200 residents visited the local nursing station with flu-like symptoms over a period of just 10 days (Barker, 2010). Many social determinants of health were responsible for the disproportionate infection rates. To correct the health disparities between the Aboriginal population and the general Canadian population will require major changes in infrastructure. However, simple, relatively cheap solutions like access to sufficient infection prevention and control supplies could significantly mitigate the impact of an epidemic/pandemic in a disadvantaged population.

Almost a quarter (23%) of FN households have an inadequate water supply in terms of volume and/or health requirements (Health Canada, 2009). Inadequate water supply is a huge barrier to infection prevention and control as people are unable to wash their hands frequently enough to prevent the spread of germs. To make matters worse, during the early stages of the pH1N1 outbreak the federal government delayed sending hand sanitizers to remote reserves in Manitoba, reportedly because they feared that individuals would ingest the high alcohol based gel (Spence & White, 2010).

In addition to having an inadequate water supply, 10.3% of Aboriginals living on reserves live in households below the suitability standard (without enough bedrooms for the residents), compared to just 1.9% of Canadians living off reserves. Overcrowded housing conditions increased the frequency of exposure to pH1N1 and resulted in larger doses of the infecting virus (Spence & White, 2010). A larger virus dose can overwhelm the immune system before it has a chance to mount a defence leading to an increase in illness severity and infection rate.

Please ask the Deputy Minister of Aboriginal Affairs and Northern Development, Mike Wernick, to allocate some funds towards creating an emergency stock of standard infection prevention and control supplies to be located on each remote and isolated reserve in Canada. 

These supplies should include hand sanitizers, clean gloves, masks (surgical masks and N95 masks), googles/face shields, disposable gowns, and disinfectants. A greater amount of hand sanitizer and disinfectants will be required for communities without an adequate water supply. The purpose of this emergency stock is to allow health care professionals in the community to respond to any type of outbreak in a timely manner while they wait for support from the government.

Barker, K. (2010). Canadian First Nations experience with H1N1: new lessons or perennial issues? [Editorial]. International Journal of Tuberculosis and Lung Disease, 14(1), 1-4

Health Canada. (2009). A statistical profile on the health of First Nations in Canada: Determinants of Health, 1999 to 2003. Retrieved from: http://www.hc-sc.gc.ca/fniah-spnia/pubs/aborig- autoch/index-eng.php

Kermode-Scott, B. (2009, July 6). Canada has world's highest rate of confirmed cases of A/H1N1, with Aboriginal people hardest hit. British Medical Journal. doi:http://dx.doi.org.myaccess.library.utoronto.ca/10.1136/bmj.b2746

Spence, N., & White, J. P. (2010). Scientific certainty in a time of uncertainty: Predicting vulnerability of Canada's First Nations to pandemic H1N1/09. The International Indigenous Policy Journal, 1(1), 1-36. Retrieved from:http://ir.lib.uwo.ca/iipj/vol1/iss1/1

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