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Urgent resources for COVID-19 in Indigenous Communities

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Dear Prime Minister Justin Trudeau, Deputy Prime Minister Chrystia Freeland, Minister of Health Patty Hajdu, Minister of Indigenous Services Marc Miller, Defence Minister Harjit Sajjan, Northern Affairs Minister Dan Vandal, Dr. Tom Wong, CMOH Indigenous Services Canada (ISC), Dr. Evan Adams, Deputy CMOH ISC, Auditor General Karen Hogan:  
First Nations, Inuit and Métis, are among the most vulnerable Canadians and the least equipped to deal with the COVID-19 pandemic. During the H1N1 crisis, Indigenous people were 6.5 times more likely to be admitted to the ICU. Many Indigenous communities experience poverty, overcrowding, food and water insecurity, and lack adequate access to healthcare and there is a higher rate of chronic disease. All of this increases risk of severe COVID-19. 
There are many Indigenous leaders who have the knowledge of the resources and deficits in the communities. While we recognize that one approach will not meet the needs of all communities, we believe urgent intervention will be needed NOW to avert catastrophic consequences to many communities.  
The federal government’s initial pledge of $315 million in pandemic assistance for all Indigenous Canadians is less than one-per cent of the $82 billion in funding assistance for mainstream Canadians. This is simply unacceptable. While there have been additional investments made for Indigenous communities many Indigenous leaders and health organizations are calling for more assistance and supplies.     
Through this petition, with over 50,000 signatures, we want the Federal Government to urgently implement suggestions from our community leaders. We are asking that the Federal Government’s pandemic plan for outbreaks of COVID-19 in Indigenous communities be transparent and open, and easily searchable. This plan should be prepared in advance and implemented on request by any Indigenous community to prepare and avert an outbreak, and rapidly respond should an outbreak occur.  We ask: “What would you expect for yourself, children, elders, and constituents if there was an outbreak?”, and challenge you to reflect on differential treatment as being inequitable.  
Covid-19 has highlighted the inequities in Canadian society, disproportionately attacking vulnerable populations. While many Indigenous communities have managed to prevent catastrophic outbreaks through restricting access to the communities, this is a temporary solution. The situation of COVID-19 among the Navajo reminds us of the vulnerabilities of Indigenous peoples in North America. We must work toward improving the determinants of health such as food, water, housing security as human rights issues. While communities may be developing their individual plans, there must be adequate resources, funding, equipment and personal to support the communities in case of outbreak.  
Our current suggestions include: 
1. Recognizing UNDRIP 
We recognize UNDRIP and the rights of Indigenous peoples to protect themselves from COVID-19 in the most effective way possible. This includes the restrictions of travel into regions populated by self-governed Indigenous communities. Any eventual lifting of such restrictions would require the free, prior and informed consent of the Indigenous communities involved. 
2.     Urgently enhance healthcare capacity in the communities.  
Most Indigenous communities have been chronically under-sourced for health care. There must be surge capacity to help communities under the direction of community Indigenous leaders.  The government’s current plan for surge capacity needs to be clearly documented and transparent on the COVID-19 Indigenous pandemic plan. The surge capacity may consist of increased healthcare staff at Indigenous Services Canada, physicians, nurses, and nurse practitioners.  
The Federal Government should create a roster of other individuals outside of Indigenous Services Canada to help with surge capacity, including:  
Canadian physicians 
nurses, nurse practitioners 
respiratory therapists  
public health specialists  
Other organizations for consideration include:  
the Canadian Red Cross 
Doctors without Borders 
health care providers in the Canadian Armed Forces, under the direction of the community leadership.  
Consideration should be given to Cuban doctors who have won numerous awards for responding to COVID-19 outbreaks around the world   
3.     Enhanced Testing and outbreak control   
a.     Rapid COVID-19 test kits need to be prioritized for Indigenous communities, especially for communities who are fly-in or do not have rapid access to a critical care hospital.  
b.     For all Indigenous communities to have access to hand sanitizer, medications, and PPE for all health care providers and essential workers.   
c.      Cloth masks should be distributed now to all communities in need.  
d.  Ventilators should be sent to communities who are experiencing outbreaks with properly trained personnel (physicians, respiratory therapists or EMS).   
e. Plans must be in place for separation: temporary housing is needed to separate potentially infected individuals from overcrowded homes prevalent in far too many communities.   
e.     Should there be an outbreak of COVID-19, there needs to be a plan to rapidly isolate community members who would be at high risk for severe illness, including the elderly or those with chronic health issues. Hotels or temporary shelters or other facilities should be considered.   
f.      We must also ensure that during this outbreak there are enough critical resources, such as food and clean water and cleaning supplies to manage the outbreak.   
4. Travel Restrictions  
We support UNDRIP 4.2 of the United Nations Declaration on the Rights of Indigenous Peoples, which states: “Indigenous individuals have an equal right to the enjoyment of the highest attainable standard of physical and mental health. States shall take the necessary steps with a view to achieving progressively the full realization of this right." 
In the time of COVID-19 we affirm that the protection of the health Indigenous communities is of the highest priority, and must be assured before recreational and non-essential economic activities are expanded in territories which put Indigenous peoples at risk for COVID-19. 
This includes the restrictions of travel into regions populated by self-governed Indigenous communities. Any eventual lifting of such restrictions would require the free, prior and informed consent of the Indigenous communities involved. 
All of this must be resourced and funded in an equitable way to all Indigenous communities at risk as soon as possible and done in consultation with the Indigenous community experts and leaders.  
Isadore Day, CEO Bimaadzwin,  
Grand Chief Wilton Littlechild, Commissioner Truth and Reconciliation  
Michele Audette, Commissioner MMIWG  
Tony Belcourt, Founding President of the Métis Nation of Ontario 
Grand Chief Alvin Fiddler, Nishnawbe Aski Nation, Ontario  
Dr. David Suzuki, Science broadcaster and environmental activist  
Jesse Wente, Broadcaster, ED Indigenous Screen Office Grand Chief Southern Chiefs Organization, Manitoba  
Dr. Anna Banerji, Co-chair Indigenous Health Conference (IHC)  
Michele-Elise Burnett President Kakekalanicks LTD, Co-chair IHC 
Allison Deer, Bimaadzwin, Senior Projects Advisor 
Bryan Hendry, Bimaadzwin, Director of Marketing and Communications 
Mae Katt, Primary Health Care Nurse Practitioner 
Angela DeMontigny, Cree/Metis designer  
Kevin Sandy, President Iroquois Lacrosse Program  
Rodney Haring, Director Centre for Indigenous Cancer Research 

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