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Homegrown nurses build NWT health care NWT News/North - Monday, June 20, 2011
Graduating 10 to 14 nurses each year, the program's results are easily visible in the territorial capital. Nursing vacancies are low in Yellowknife as new grads enter the workforce, bolstering the expertise at both the Stanton Territorial Hospital and Yellowknife Health and Social Services.
As the ranks of nurses swell and fewer position become available in Yellowknife, however, the health department must find creative ways to ensure that success remains a boon to the North.
The goal is to entice them to remain in the NWT rather than go south.
News/North has previously called for improving working and housing conditions as well as retention policies. While those privileges are essential to keeping nurses in Northern communities, solutions are needed to find ways to get new grads working outside of Yellowknife.
Understandably, new graduates don't necessarily have the expertise to fly solo at a community health station, which is why mentorship programs exist to prepare them with the needed skills.
The challenge is the lack of mentors in small communities. It's asking a lot to mentor a new grad while performing regular duties.
One solution would be to utilize the wealth of experienced nurses in Yellowknife. As capacity builds in the capital, seasoned nurses could become community mentors on a rotating basis, spending a couple months in the communities helping to bring new grads up to speed until they are ready to work on their own.
According to the Department of Health and Social Services, it takes about 18 months - depending on ability - to train a new grad for a community health nurse position. It may be unappealing to some nurses to give up a year and a half of their lives to train grads, but some may be willing to mentor for 12-week shifts. In the long run, it might mean filling the existing 16 vacant community health nurse positions with long-term, Northern-trained staff.
Marketing the communities for new nurses should be easy. There is no better environment for a fledgling nurse to develop a plethora of skills than in a nursing station, where duties will vary compared to specialized positions in Yellowknife.
MLAs often maintain two residences, one in their home community and one in Yellowknife, where they attend sessions of the legislative assembly.
Surely, none of the MLAs come home to mould in their walls, plumbing that doesn't always flow and heat that isn't always reliable.
Yet, that's the reality of some residents in NWT public housing.
Tu Nedhe MLA Tom Beaulieu said housing has been the number one issue in his home community of Fort Resolution since he was elected four years ago; it remains atop the list of problems today. He mentioned an elder who complained of a leaky roof in 2007 but it was only being fixed this year. Even worse, the delay caused mould to form and the house became uninhabitable.
That's unacceptable.
The GNWT is reducing its home repair budget to $5.6 million from $8.5 million in 2011-2012. How many more leaky roofs and mouldy homes will go neglected due to the fewer funds?
While some tenants in public housing are, unfortunately, guilty of damaging their homes and not paying rent, there are policy changes that can be made to address those issues. Leaving homes in an unsafe or unhealthy state is not right.
Beaulieu is a former president of the NWT Housing Corporation. He knows that of which he speaks. For the sake of his constituents in his riding and across the NWT, he must make the case for housing improvements with such conviction that his fellow MLAs cannot turn a deaf ear - and he could use the backing of people across the territory who are not going to stand for it any more.
The death of a family of four in what appears to have been a murder-suicide in Iqaluit has set off a chorus of calls for grief counselling, mental health services, and more support for child and family services.
Iqaluit city councillors have gone so far as to say Nunavut is in a mental health crisis.
According to the Nunavut Suicide Prevention Strategy released in 2010, RCMP responded to 983 incidents where people were reported to be threatening or attempting suicide in Nunavut in 2009. The suicide rate for Inuit is 11 times the Canadian average.
Meanwhile, in the recent session of the legislative assembly, Health Minister Tagak Curley stood up to dispute how he was quoted in the The Globe and Mail in April downplaying the severity of Nunavut's suicide rate, and came under fire for the lengthy delay in tabling an action plan to implement the Suicide Prevention Strategy released last October.
Iqaluit city council is not alone in wondering what could be done on their part to speed things along. As Coun. Joanasie Akumalik puts it, "When the government tries to do things, it's a bit slow."
These concerns are voiced in the Suicide Prevention Strategy document itself, which reports that during the community consultations, "informants spoke at length about the lack of implementation of government strategies, and were concerned that this one too would 'sit on a shelf and collect dust.'"
When released in October, the parties involved - the GN, Nunavut Tunngavik, the RCMP and the Embrace Life Council -- committed to drafting an implementation plan within 90 days.
Almost eight months and two sessions of the legislature have since passed without an action plan being tabled.
The basic tenets proposed in the strategy are to ensure mental health services and supports are in place, to introduce interventions that have been proven in other jurisdictions to reduce the number of suicides, and to foster community-development activities that promote mental wellness.
Suicide prevention is ineffective without mental health services, and mental health services include treatment for substance abuse.
In January, the Department of Health and Social Services put out a request for proposals for two residential treatment centres that would open this spring in pre-existing facilities already furnished and equipped. But then spring came and the department backpedalled, saying it would take years rather than months to do the planning and get the funding to get the treatment centres up and running.
These delays in getting badly needed mental health services to Nunavummiut are costing lives.
If the strategy is going to be put in place, the pressure has to come from people in every community telling every MLA that suicides have to be stopped and action has to be taken now.
Without that public pressure, the only thing the Suicide Prevention Strategy will do is what it has been doing for the past eight months -- collecting dust.
These include the homeless day shelter on 51 Street, Somba K'e Civic Plaza, and the redevelopment of a one block section of 50 Street on the west side of Franklin Avenue, completed in 2009.
"Streetscaping" of 50 Street was all the rage three years ago when the city's now defunct downtown enhancement committee held public meetings and bravely suggested the infamous "Range Street" be closed to traffic and spruced up with new paving, sidewalks, planters and decorative garbage bins.
It was even proposed the Gold Range Hotel be designated as a heritage site to lend a more trendy and tourism-friendly aura to the old rough and tumble saloon.
The original plan was to complete this portion in 2010 but it has since been bumped to 2012. In the meantime, the southern-based owners of the lower level of Centre Square Mall have barricaded its 50 Street entrance and the city's dream of bringing back the boutiques remains just that.
It's strange to think that just a few short years ago, this one block stretch was home to several successful stores: Langlois, Chic Chik, Wolverine Sports Store, For Men Only, not to mention the Bank of Montreal - despite the regular and common complaints about loitering, drunkenness and litter.
Not much was done to encourage new businesses to move in when these ones left and now more than ever this street is ground zero for all complaints businesses and residents have about downtown.
Part of council's solution, if we are to judge the amendments proposed to the city's zoning bylaw which passed first reading last week, seems to be more rules.
These rules would require larger, new developments to have pedestrian-friendly "amenity spaces" outside and other open or retails spaces on the ground floor for those on Franklin Avenue. It also calls on new buildings to have at least two complementary colours and no reflective windows.
Some of its contents seem reasonable enough, but considering the difficulties the city has faced selling land at Niven Lake and the Engle Business District in recent years, would not an encouraging carrot be more effective than a stick in attracting developers?
But more than that, the bylaw amendments are pointless if revitalizing downtown is what council is truly after.
The city points to the lost opportunity with the Gallery building replacement on Franklin Avenue, where some of its new schemes could have been applied had these amendments already been in place. But even if that opportunity has passed, the new building is better than the derelict structure that stood there before. Now that it's almost complete, we are not aware of a whole lot of new development plans in the downtown core to hyper-regulate.
The new Shopper's Drug Mart is done, and the federal government's building spree is over. It will likely be many years before any major building activity takes place downtown, which takes us back to streetscaping and the successes already evident.
People may say attempts to beautify Range Street will be thwarted by drunks and vandals but there is no hope to revitalize this street as it stands now. No business is going to build facades and patios unless there is the potential for pedestrian traffic.
More streetscaping will take place this summer on 52 Street adjacent to the new Gallery building and on Old Airport Road. We say the more the better, especially downtown.
It's a better remedy than focusing on bylaws for buildings that aren't being built.
For the past approximately five years some Fort Providence residents have been growing increasingly concerned about the amount of sports fishing taking place in the waterways around the community. The problem isn't local residents but rather tourists and visitors who either bring along their fishing poles for fun, or arrive with the express purpose of going fishing.
Local residents are worried about over-fishing and damage to spawning areas that could affect the catches some of them depend on as a seasonal food source. While the problem isn't great what's being done about it is.
Deh Gah Got'ie First Nation has listened to its members' concerns and has taken action. In partnership with the Fort Providence Resource Management Board, the band has hired six residents to act as monitors.
The monitors are creating a local presence on the waterways and using video cameras to record possible illegal fishing activity. The footage will be turned over to the Department of Environment and Natural Resources, or Fisheries and Oceans Canada for further investigation.
This is a clear example of self-determination. The First Nation has chosen a course that will allow it to have a measure of control over activities on its traditional lands.
The band could have chosen to ignore the issue or depended on the government to deal with the problem.
Instead local residents have been given the chance to participate in the reaction to an issue that directly affects them.
The First Nation's initiative is being noticed. Staff with Fisheries and Oceans Canada (DFO) will be holding a meeting in the community on Thursday, in part to listen to residents' concerns and possible solutions.
The options for more permanent solutions, however, make it evident that there is a need for more room for First Nation self-determination.
DFO has a number of ways it could restrict fishing in the areas the First Nation is concerned about if it becomes apparent there is a conservation issue. The problem is the restrictions would be applied equally to everyone.
The fish population would be secure from over-fishing by non-local anglers but local residents who were previously practicing sustainable harvesting would also have their catches limited. In helping to preserve fish, community members would be penalized.
A third way is needed to would allow Fort Providence residents to continue to fish in their traditional lands while the activities of non-residents would be curtailed.
After Deh Gah Got'ie Koe First Nation deals with the initial problem of over-fishing, this may be the challenge they have to tackle next.
However, in the rest of the communities there is only one permanent doctor and Inuvik is lucky enough to have her. There are 25.5 funded positions for the Beaufort Delta, Fort Smith, Hay River and Sahtu Health and Social Services Authority and only one is filled.
Yes, all these communities are served by locum doctors, doctors who stay for six weeks and then return to their southern homes.
None of them stay.
And why would they? Locum doctors get free flights to and from Inuvik and free accommodations during their stay. Permanent doctors receive a salary, health benefits, moving expenses, special allowances, but no extra perks.
How does this make sense? Why would the GNWT put its energy into providing perks for the temporary doctors and not the permanent doctors? Is it no wonder that locums, no matter how much they love the North, aren't willing to stay? The freedom and benefits they have now can't compare to a permanent position, which seems almost like a punishment in comparison.
The GNWT is relying on the love of the lifestyle and not acknowledging the competition of other jurisdictions doctors could work in. They are recognizing the challenge, but not acting on it.
The government should look at other Northern jurisdictions in the provinces and territories and see how they are recruiting doctors. What perks are they offering? Take the benefits they offer and one-up them. Offer more holidays, a number of free flights out per year, housing costs and even bonuses to keep doctors in the territory. It's basically what the government is offering locums, so why not offer it to the doctors who choose to stay in the territory?
Residents of the North need permanent doctors. With continuous care from one doctor, they will be healthier because the doctor knows their conditions, will have knowledge of their history and gain their trust through regular checkups, allowing the doctors to catch minor health problems before they become huge issues.
This will save the government money, too! –fewer medevacs from smaller communities, fewer specialists needed, reduced health care costs all around.
It's time for the GNWT to look outside of Yellowknife, notice the smaller communities and compare them to and compete with other jurisdictions. Bring doctors to the rest of the territory. We need them.
There will be less money available from Ottawa and we need to be very careful in the way we spend our funds.
There is $150 million in the federal budget for the Dempster Highway extension, from Inuvik to Tuktoyaktuk, an amount that must be matched by the GNWT. This project will undoubtedly bring benefits to that region, but it won't bring significant gains to the NWT as a whole.
The wheels may already be turning on that project, but the GNWT needs to think long and hard about the costs and benefits of its next infrastructure investments. A Mackenzie Valley Highway would be similar to the Dempster extension - it will really just benefit the residents of those communities which it would reach, and possibly bring a modest number of additional tourists, if they brave the atrocious Liard Highway or the awful stretch from Behchoko to Yellowknife on Highway 3.
On that note, upgrading and paving our southernmost roads, which connect to the provinces, would be a sound investment so the gateway to the North doesn't look like a step backwards in time.
Another option that deserves even greater priority is a road north to the Snap Lake and the Lac de Gras area to service and refuel the territories' three diamond mines, with the possibility of branching towards Kennady Lake, just southeast of Snap Lake, for the proposed Gahcho Kue diamond mine. This road to resources may even attract investment from the mining companies.
Outside of transfer payments from Ottawa, the NWT's future revenue will largely come from both taxes and resource royalties from the mines, as devolution becomes a reality. Snap Lake and Gahcho Kue each have close to a decade of expected mine life while BHP is forecasting that cost-cutting measures could extend diamond extraction at Ekati until as long as 2040. There are numerous other prospects for metal and mineral finds in the area as well.
A road to resources would be an investment in our economy - the type of project we need to invest in as the country and the NWT fight their way out of debt.
Incumbent Ed Sangris is back as Dettah's chief for another four years after election results rolled in Monday. The majority of voters are obviously pleased with his leadership.
Sangris, a longtime band councillor with four years of chiefdom under his belt, has a strong foundation in the community and has represented the people well. The Chief Drygeese Government Building was developed as a new meeting place in the community during his tenure. He has also fought beyond the boundaries of Dettah, working last summer to help reach an agreement for the Yellowknives Dene to split the cost of paving Ndilo's roads with the City of Yellowknife.
Sangris has been strong in his stances on many issues, voicing his concerns over the NWT's devolution agreement-in-principle and how that will affect the Akaitcho territory if federal authority is transferred to the territorial government.
He has also raised questions about why the city is proposing to relocate its water source to Yellowknife Bay from Yellowknife River and has openly criticized last fall's decision that Diavik Diamond Mines Inc. would reinstate Edmonton as a pick-up point for southern workers, possibly reducing job opportunities for members of his band.
His platform continues to be structured around issues of housing, promoting the traditional language and protecting the land. Sangris' determination to create change for his community is hopefully just getting started.
The Government of Nunavut's (GN) seemingly determined method of conducting its affairs in a clandestine and heavy-handed manner is a dangerous game, slowly opening a number of rifts which could prove most difficult to heal if they continue to grow.
While conducting business devoid of transparency and accountability is, in itself, cause for utmost concern (please Google auditor general's report on the matter of $50 million in G8 Legacy Infrastructure Fund spending for a prime example), even more disconcerting is the effect the GN's way of doing business is having on regular folks.
Leading the way in creating ill will between Inuit and non-Inuit residents in a number of communities, from businesses all the way down to students, is Nunavummi Nangminiqaqtunik Ikajuuti, known to most Nunavummiut as simply the NNI policy.
The GN is fighting a behind-the-scenes battle with the NWT and Nunavut Construction Association which, if an agreement can't be reached and the association's members stay united, could see Nunavut contractors stop bidding on GN contracts.
A number of contractors feel the GN has ramped up its clandestine efforts against them by quietly spreading rumours of missing materials and other issues in an attempt to point the finger of blame at them for the Nunavut Housing Corp.'s well-publicized $110-million-plus shortfall.
They also feel the NNI policy is not being interpreted properly and the GN's implementation practices are going to increasingly alienate true Nunavut contractors and open the door for southern firms and fly-by-night operators.
Concern is also rising over a growing number of student summer positions being offered to only one segment of our communities under the guise of the NNI policy.
Most people with any sense would not doubt the validity of priority being given to Nunavut beneficiaries for most positions, skill sets not withstanding.
But to discriminate against non-Inuit Nunavummiut, especially students, and not allow them to apply for summer positions in their own community -- jobs administered by a hamlet office which is supposed to represent the entire populace -- is close enough to racism to make most people feel more than a little uncomfortable.
What better way to alienate youth who have lived the majority of their lives in Nunavut and encourage them to move south permanently upon completing their education than this approach?
Or is that the intent?
The GN and Nunavut Tunngavik Inc. should be challenged to explain how such an approach benefits the growth of this territory.
Bright young adults who have spent the majority (if not all) of their lives here, understand the way of life, are comfortable and productive in a multi-cultural environment, and view the community as their home are denied the same opportunities as others based on the colour of their skin?
This sound familiar?
It is nothing short of despicable, in this day and age, for something such as the NNI policy to be twisted enough in its application to deny equal opportunity to those so young, and with so much to offer our territory in the future.
It is a policy going horribly awry!
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