(Flu) shots all round!: Liveblogging the H1N1 hearing

You know the drill, everybody: Check back at 1pm for full coverage of today’s action-packed, supersized emergency health committee meeting on Canada’s readiness for an H1N1 epidemic, including an hour and a half with Health Minister Leona Aglukkuq, and many, many more hours with various and sundry First Nations health officials.

Plus, David Butler Jones!
1:02:29 PM
Well, this is fun: After a spate of scrums — some flu-related, some all about the far more politically juicy story of the day — we’re inside, and it’s standing room only. Not only have we been relegated to West Block, but the sheer number of witnesses — three panels’ worth — coupled with a surprisingly good turnout by the press has made it a distinctly tight squeeze here in the audience. They’ve also removed one of the two media tables, which is leaving ITQ feeling oddly exposed in her front row seat, where she is right behind the minister — who just turned up — and the perennially cool (and today, leather-jacket-clad) David Butler Jones.

As is ITQ’s new protocol, she’s not going to liveblog every word of the minister’s opening statement — or anyone else’s opening statement, for that matter — but only the bits that don’t simply reiterate what we’ve heard before.

1:13:50 PM
Well, so far, this sounds a lot like what we heard from Agglukaq during her last appearance — which was most noteworthy for its brevity, at least as far as the subsequent grumbling from the opposition

Okay, here we go — she’s going to focus on First Nations preparation, since health delivery in those communities is, of course, a shared responsibility. She discusses the increased vulnerability of some segments of the population — pregnant women, people with diabetes — and then moves swiftly to the need for cooperation before reminding us that she’ll be meeting with her provincial counterparts next month.

1:18:41 PM
Okay, I’d just like to note that it is absolutely *ridiculous* that this meeting has been shoehorned into this particular committee room. There aren’t even close to enough seats for the witnesses, let alone staff and media. Did the gift shop launch a dawn assault on the disputed territory across the Hall of Honour or something?

1:21:28 PM
Okay, they’re now starting to stack research staff — Library, that is, not caucus — in the middle aisle. Good thing the Hill is exempt from municipal fire code regulations. Well, also, that there’s not much chance we’ll go up in flames, of course.

1:23:09 PM
That’s it for the minister, which means that the chair has to thank her for “being so available”, and oh, please let that be the last time she does so this afternoon.

Over to Carolyn Bennett, who gets off to a shockingly direct — for her, at least — start, inquiring whether the H1N1 preparation plan is available in Inuktuk, which the minister suggests it is, although Bennett points out that someone from the Inuit Tapiirisat said just yesterday that it was *not*. Bennett then snaps to her next line of questioning — has the minister visited any of the affected First Nations? She has, as it happens — but not specifically to discuss H1N1.

Bennett expresses concern over the fact that much of the prepwork is being done by conference call, and wonders how the government is measuring and testing capacity to revise “the plan” — wait, so we do officially have one now, yes? Is it publicly available? Anyway, Shelagh Jane Woods — who some of you may remember from the last meeting, and who is in charge of First Nations and aboriginal health — assures Bennett that pandemic coordinators have been to ‘virtually all the communities’ by this point, and can confirm that over 90% have plans — most of which have been “tabletop tested”. No, I don’t have the slightest idea what that means, but it sounds suspiciously like something that would involve multisided dice.

1:32:23 PM
After a few more pointed questions from Bennett — who didn’t wander off into a rambling monologue even *once*, and see how much more she was able to get out of the witnesses in her seven minutes of allotted time? — it’s over to the Bloc Quebecois, and Luc Malo, who wants to know why native communities — especially those in Manitoba — seem to be hit so hard by the virus. Woods and Butler Jones attempt to answer the question, but Malo looks sceptical; he notes that, in her opening statement, the minister seemed to be suggesting that there was a larger percentage of people in the previously noted vulnerable groups — chronic illness, pregnancy — in these communities. Is that the only reason, he wonders — or are there other risk factors?

Agglukaq jumps in to answer the question, and tells Malo that Butler Jones will be meeting with *his* counterparts next week to discuss that and other issues.

For his part, Butler Jones points out that there are “many challenges” for native communities; of the thirty people who died in intensive care, 60% had “preconditions” that could explain why they were harder hit.

1:40:31 PM
That’s it for Malo, as far as this round goes; the floor now goes to Judy Wasylycia-Leis, who suggests — politely — that the government is putting a “rosy face” on its readiness, but some of the witnesses here today representing native communities tell a different story.

With that out of the way, she moves to specifics: What about the fact that some Manitoba communities are being forced to hold fundraising drives for flu kits?

1:44:11 PM
Aglukkaq — backed up by Butler Jones — points out that her officials are still trying to determine what is actually *in* those flu kits — is it basic necessities that all households should have, like Tylenol, soap and water? Wasylycia-Leis, however, wants to know more about what steps are actually being taken to help these communities *right now*, either by providing additional resources or filling flu kits.

Aglukkaq reminds WL that she knows very well what the challenges are for these communities — some of which don’t have hospitals. “I was born and raised in that environment,” she notes – and she still lives in an aboriginal community. That’s why they’re focusing on prevention — and the vaccine rollout. But is the purchase of handsoap a federal responsibility? I’m not sure if that was actually a rhetorical question, nor –it seems — is WL, but she’s out of time, which mean we may never know.

1:47:55 PM
Over to the government side of the table, and Colin Carrie — Dr. Colin Carrie, that is — who wants to know what *parents* need to know before the school year begins. Butler Jones lists the usual suggestions — don’t send a sick kid to school, wash your hands — and gives credit to the media — yes, us! — for spreading awareness.

Carrie muses that, when SARS broke out, he “was actually quarantined”, and wonders what advice the government has for frontline workers. Wait, isn’t Carrie a chiropractor? Are they considered “frontline workers”? Was that why he was quarantined?

Anyway, Butler Jones reminds us that the guidelines are available, but you can’t necessarily apply the same protocol to rural Saskatchewan as you would in downtown Toronto.

1:56:32 PM
Everyone, it turns out, is delighted by the return of Dr. Paul Gully, who was a surprise addition to the witness list, and is now back at Health Canada after his recent secondment to the World Health Organization. He hasn’t really gotten to say all that much yet, but he’s new (or a newly returned), so maybe that’s for the best.

1:58:28 PM
Okay, time for round two, and Kristy Duncan, who doesn’t seem to have gotten the memo about short, sweet preambles; she wastes most of her five minutes — yes, we’re down to five minute rounds now — before imploring the minister — or anyone really — to tell her more about the plan — or The Plan, as I guess we should call it for convenience.

2:01:57 PM
Hey, Marcel Proulx just brought up the tinyness of the room, and points out that the media people — “that’s us” — are working under ridiculous conditions. Chairwoman Smith assures him that she asked for the biggest room she could get, and then forces the clerk to explain that there was “work” going on in the big committee room — which I’ve actually been told by email is not the case, but I can’t confirm that since I’m here, and not there.

2:04:05 PM
Okay, where were we? Oh, at one point, I think Butler Jones surprised both the opposition and the minister’s office by inviting her to next week’s meetings — although he follows up with an offer of “regular briefings” – not just for critics, but the entire committee.

2:08:18 PM
According to Woods, it is the provinces that provide the information used by medical staff — hands on, I guess — but notes that the department did a mailout to communities earlier this year, and works closely with the Public Health Agency of Canada.

2:09:41 PM
Over to the BQ’s Nicolas Dufour, who wants to go back to the question of why these communities seem to be harder hit, and notes that in his region, there are First Nations families without access clean drinking water — a *basic necessity*. What, he wonders, is the government prepared to do to address *that*? Aglukkaq points out that water isn’t actually within her departmental jurisdiction, although both she and Woods note that they work “closely” with Indian Affairs, and Woods goes on to remind Dufour that boiled water can be used instead. Butler Jones, meanwhile calls it a “long term challenge”, which it is.

Finally, Dufour wants to know if there will be enough nurses during a pandemic, and Woods assures him that that’s the goal.

2:15:19 PM
Hey, did you know we were “really lucky to have SARS”? Because we were, according to the Conservative MP up now, whose nameplate, alas, I can’t read at this precise moment — it allowed us to prepare for *this*. Why, going on that logic, aren’t we lucky to be facing a possible H1N1 outbreak, since you never know when the bubonic plague might make a return appearance?

2:18:49 PM
According to Woods, the government is actively looking for ways to expand the number of health care professionals who are authorized to provide the vaccine, and Butler Jones pops up to note that he’s even been contacted by the Canadian Veterinary Association – who are, as he reminds us, accustomed to delivering shots, albeit into other species.

2:22:04 PM
There’s a bit of back and forth between Proulx and the minister — well, the witnesses — over exactly what material is available online, which eventually ends up with a request that the minister table the information in question. Ooh, is it The Plan?

He also wants to know whether general practitioners are involved in developing the guidelines — which, according to the minister, they are — and information sharing in general.

Oh, and he also wants to know about possible compensation, and claims that it’s the Prime Minister’s Office that is refusing to release the action plan.


2:26:55 PM
Over to Judy Wasylycia-Leis, who is *apalled* at the minister’s suggestion that it should be left up to native communities to hold a bake sale to pay for basic supplies. She just can’t believe it. Also, she points out that some nursing stations aren’t even authorized to hand out Tylenol, and then repeats her entire diatribe in French.

Her question, then: Are they going to stop “putting the lens of a middle class family on this”, and address the challenges facing First Nations communities, and “when this hits”, who will these people call?

2:30:33 PM
Aglukkaq is doing her best to explain what she meant with her handsoap comment, although she keeps getting thrown off by the heckles — or spontaneous, interactive commentary — coming from the opposition side of the table. Lots of headshaking over there.

And — oh, apparently, that’s it, although before I forget, I should note that according to a CPAC-glued ITQ correspondent, the MP who sees the bright side of SARS is Cathy MacLeod, who hails from British Columbia.

2:36:40 PM
After a far too brief break to allow the next panel of witnesses to settle in at the table, the chair welcomes all and sundry in her signature saccharine manner, and then hands the floor over to Ron Evans — sorry, I didn’t catch which First Nation it is of which he is the Grand Chief; in my defence, it’s total chaos in here. I’m not sure if you can tell from the CPAC feed, but there are witnesses wandering around trying to figure out which panel they’re on, and general confusion all around.

Anyway, Evans, it seems, is very, very, very, very, very underwhelmed by the response from the government. The word “tightfisted” comes up, as does the comparison to the willingness of the same government to prop up the hog industry, but not, apparently, spend money on these communities. Although they’re eagerly awaiting a vaccine, they’re not sure when it will be available, which is why they’ve put together the much-discussed flu kit.

2:45:16 PM
Has the chair even seen the witness list before right this second? She seems surprised by every new arrival, and feels the need to point out how grateful and honoured she is every single time. Which is either very sweet, if unnecessary, or a passive aggressive minifilibuster tactic.

Meanwhile, newly elected Assembly of First Nations grand chief Shawn Atleo is up now, and *his* principle message, it seems, is the importance of *joint* policy development, joint communication — really, joint consideration of all the issues, and *full* collaboration and transparency. There are ‘disparities’ in information, and in what is happening on the ground, and that causes tension.

While this is a crisis, he says, it can be turned into an opportunity to talk about what’s *not* working — everything from water to education to high early pregnancy rates.

2:54:43 PM
That’s it for Atleo — at least for the moment, and honestly, if they’re going to give five minute opening statements to every witness on this panel, they’re probably not going to have more than a few minutes for questions. Next up is Don Deranger, from the Prince Albert Grand Council, who has a similar message to Evans: the lack of financial resources is crucial, and puts these communities at a disadvantage from the start, as does their difficulties in retaining nurses

As such, he tells the committee, preparing for — and potentially dealing with the effects of — H1N1 could push the already strained system to the breaking point.

3:00:47 PM
The chair then hands the floor over to Sydney Garrioch, chief of the Manitoba Keewatinowi Okimakanak — with the now familiarly simpery commentary: “Did I pronounce that correctly?”. Garrioch, who – I am reminded by the CPAC-glued correspondent – is, as it happens, the Liberal candidate in Churchill. So he’ll be running against Niki Ashton, then? Ooh. She’s small but wiry!

Anyway, he tells much the same story as the preceding witnesses, and worries that First Nations communities are being “left out” of the process by PHAC and Health Canada. The resources available are “wholly inadequate” relative to demand.

3:06:36 PM
There are no First Nations community epidemic plans that have been *tested*, according to Garrioch. I should note that David Butler Jones and Shelagh Jane Woods are actually slated to return to the witness docket at 5pm for a final half hour session, so we can probably expect that sort of apparent contradiction in testimony to come up then.

3:10:58 PM
Next up: Gail Turner, chair of the National Inuit Committee on Health for the Inuit Tapiriit Kanatami, who points out that, like many First Nations communities, there is significant overrepresention amongst vulnerable groups, particularly youth and pregnant women; add to that the logistical difficulties involved in travelling just before giving birth, and other unique qualities, she wants a pan-Inuit pandemic strategy.

According to Turner, Butler Jones has seemed amenable to her suggestion, and the chair interrupts to suggest that she should maybe wrap it up, since they’re running out of time, which doesn’t go over well at all with Turner, as it turns out. She continues with her statement, which – to be honest – isn’t terribly specific to the issue at hand, but more of a general condemnation of past and present aboriginal policy.

3:18:51 PM
Finally, it’s time for Joel Kettner — Manitoba’s chief public health officer — who promises to provide insight from what his province learned during the first wave of the outbreak, including the severity with which First Nations communities were hit. He’s the first to come right out and say that, even aside from the known risk factors — age, preconditions — H1N1 just seems to hit aboriginal people harder than others.

3:23:39 PM
Once Kettner is finished, the chair proposes — reasonably, in ITQ’s view — to move straight to five minute rounds, which everyone seems to support, although Bennett complains that they could have had *much* more time had the meeting started earlier in the day — which is true — and also has to confess to getting confused about what Turner was looking for from the minister, which isn’t for the plan to be translated into Inukshuk, but for an Inuit-specific plan to be developed in cooperation with Inuit communities themselves.

Oh, and according to Garrioch, only two norther communities currently have a plan, and none have been tested, and Evans goes into a mini-tirade about the minister’s comments on the flu kit, and that bar of soap. That is *not* what First Nations communities are looking for, he fumes — they don’t just want soap. They want a plan, and more than that, they want to be consulted on that plan.

3:30:39 PM
Luc Malo then takes three minutes to set up the only question he’s likely going to have the chance to ask: “Do the witnesses agree that the vaccine has to be available, and delivery-ready, as soon as possible?” Not surprisingly, the answer is left, but Atleo once again veers back towards what he sees as the real issue here, which is First Nations health care and living conditions.

3:32:47 PM
Over to Judy Wasylycia-Leis, who wonders what the witnesses would like to see the committee *do* to mitigate the risk of an H1N1 outbreak, and Kettner runs down the usual list — prevention, via handwashing etc — and dealing with the likelihood that most will be exposed to the disease.

3:36:03 PM
Gail Turner notes that, in her region — northern Newfoundland and Labrador — on a “good day” — one with no H1N1 outbreak — they have “no capacity”, add to that the variables of weather and geography, and she has no idea how they’re going to immunize her community.

3:39:22 PM
Back to Colin Carrie to close us out, and he tees up Kettner for an answer that he hopes will undo some of the damage done by today’s testimony: Would he – Kettner – not agree that Manitoba and Ottawa have worked closely during the first wave, but Kettner, somewhat endearingly, will only say that it is “better” — better than what, we’re not sure. There’s still a long way to go, however.

3:44:36 PM
That’s it for the second panel — two more to go, although ITQ may miss the first few opening statements of that one, as she’s going to check out the scrums outside. Honestly, I suspect the testimony is going to be very similar to what we’ve just heard, so there probably won’t be much in the way of new information.

3:54:15 PM
Okay, new rule — not a permanent one, but for this meeting — assume, for the purposes of saving my thumbs a little extra work, that the witnesses are going to say pretty much the same thing as the last ones.

3:57:23 PM
Well, great, apparently I missed the best opening statement of the day, as far as community preparedness goes: the witness in question being Pamela Nolan, director of health and social services for Garden River First Nations, whose Wellness Centre has put together one heck of a plan. She got a round of applause for her presentation, even — and the chair described herself as “blown away”. They even have a poster — featuring a local elder — that her assistant held up for the cameras, which – alas – means it was facing the other direction, which means that ITQ didn’t get to see it.

3:59:36 PM
On to Jerry Knott, chief of the Wasagamack First Nation, who doesn’t have nearly so upbeat a message for the committee: there is a housing crisis in his community, people living in closed quarters, many of whom rely on outhouses. These, he stresses, are the conditions they live in — and this is the environment in which they are expected to prepare for an epidemic. He reminds us of the constitutional right to health care, and notes that, in his community, they simply don’t have the doctors, the nurses and the access to medical treatment required.

4:03:32 PM
It be wrong, Knott says starkly, to say that his community is ready for a pandemic. They’re just not there, and they need both a short- and long-term response to the challenges facing his people.

4:06:20 PM
Thanks to Judy Wasylycia-Leis, ITQ has gotten a peek at the Garden River Wellness Centre Emergency Preparedness Guide, which really is incredibly thorough and user-friendly, and includes a section on preparing for, and enduring a flu pandemic.

4:12:00 PM
We’re now on to Albert Mercredi, chief of Fond de Lac First Nation, who notes that “significant progress has been made” as far as planning — but their ability to implement that plan is greatly constrained by lack of resources.

The chair hurries him along — I really can’t imagine what these witnesses must think, being hustled through their presentations, but there’s no other way to deal with the limited time.

4:14:20 PM
And – questions; five minute rounds again, of course. Kristy Duncan wants to know which officials approached her group to develop a plan, and Nolan explains that actually, they weren’t contacted by anyone. They knew there was a template available through Health Canada, and they figured that they should get ready, so — they just did, with no assistance or direction from the government. “We were lucky you visited our community,” she tells Duncan and the other opposition members. “Now everyone knows what we’ve done.”

They did eventually get supplies for the emergency preparedness kit — a box of various supplies, with nothing but a packing slip as far as instructions.

Okay, so the theme here is Garden River First Nation: Triumphing Despite No Help At All From Ottawa. “We were fortunate,” Nolan says, “We went for it.” Other communities, she adds, did not — and aren’t ready.

4:19:51 PM
Malo wants to go back to “structural problems” within these communities — water, housing — which aggravate the situation. Are those conditions known by Health Canada? What about DIAND?

In response, Knott notes that he — and his community — have made numerous pleas to the government, but still, the problems persist, with money flowing to non-native communities, and overseas, while his people lack the basic necessities.

Malo wonders whether Health Canada has ever made overtures to the Garden Hill Wellness Centre as far as taking their program across the country, and Nolan tells her that they did manage to get an official to look at their magnet a few years back, and she was “so excited” that she asked if Health Canada could duplicate it, and send it across the country. Other than that, though — no.

4:29:22 PM
In response to a question from Judy Wasylycia-Leis on how the rest of the country can learn from, and perhaps even imitate the Garden River success story, Nolan – who is ridiculously well-prepared, yet very natural, and will likely end up a star candidate for some political party or other within the next few years if she has any hankering in that direction – once again expresses her surprise that *every* community isn’t as aware, and prepared, as hers. When Bennett and Duncan visited the Wellness Centre, she says, she couldn’t understand why they were so impressed by what had been done — and now she realizes why.

4:35:18 PM
Rob Clarke quizzes Vince Robillard – I believe he’s with Mercredi, but I’m not positive – on the geography of northern Saskatchewan — as far as logistics, that is — but runs out of time.

Time for the final panel of the day, which could end up being the most contentious: the return of David Butler Jones and Shelagh Ann Woods.

4:37:17 PM
Oh, thank goodness — no presentations, right to questions, although as Bennett points out, the idea was to have these officials respond to what they’d heard from the witnesses, so why not open it up to them?

“I’m not sure where to start,” Butler Jones confesses — there was just so much that came up, as far as the challenges facing these communities. He notes that, during his days as a public health officer in Algoma, Garden Hill was under his jurisdiction, so it was nice to see the “payoff”, so to speak.

As for the advice, they’ve been consulting with aboriginal groups on the most effective way to bring them into the development process; when it comes to applying it, like all emergency preparedness plans, communities are at “varying” levels of readiness.

4:41:23 PM
Bennett asks Shelagh Ann Woods what she thinks of Garrioch’s comments on the preparedness in *his* region, and she doesn’t have much to say, what with the fact that this appears to be the first time she’s heard that those hundreds of communities are short of plans and resources. She’ll talk to the chief, and the officials involved, and see what needs to be done.

Duncan, rather gently, points out that it seems that it might be a good idea to actually *look at the plans* that these communities are reporting that they have, and Gully speaks up to note that there clearly is a difference, in terms of perception, if not information, on the level of preparedness.

4:44:39 PM
Judy Wasylyia-Leis gets to go ahead of Malo, since she has a plane to catch, and wants to know where the witnesses stand as far as making First Nations communities a priority. “Oh, and flu kits,” she adds. Will the government pay for flu kits? Butler Jones reminds her that he doesn’t get to decide how to spend the money, but assures her that, when it comes to vaccine delivery, they will be at the top of the list.

4:49:46 PM
Malo wonders why the Garden River plan has been virtually forgotten by Health Canada, and Woods — who seems frazzled — takes issue with the suggestion that the department should turn into the plan police: If a community tells them that they’ve got a plan, she notes, she doesn’t demand to see it; she assumes they do.

4:52:40 PM
Back to the government side of the room, and Mike Wallace, who wants to know more about what we heard from the ITK, and Hunter’s claim that Butler Jones had agreed to develop an Inuit-specific plan. Butler Jones tries to downplay the idea that this would require an entirely new strategy, but acknowledges that the reality demands that unique challenges like climate, transportation issues and that sort of thing be taken into account.

Oh, and according to Woods, we *are* better off than we were when SARS hit.

5:00:47 PM
And – hey, that’s it, as it turns out. Wow, the last hour or so just flew by, didn’t it? Anyway, the committee is now discussing whether to hold hearings into the isotope crisis the first Wednesday after the House gets back — it sounds like they’re going to hand that issue over to the steering committee — with the promise of more meetings on H1N1 too.

Alright, ITQ is going to sign off — for the day, which has been surprisingly newsalicious, all things considered. Have a great weekend, everyone!

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