One of my personal goals since coming to Saskatchewan has been to visit the northern part of the province. I have wanted to better understand what it is like to live in northern communities and the experience that people have when they need to access health services in our Region. Recently, I had the opportunity to spend three days visiting seven communities in the Keewatin Yatthe and Mamawetan-Churchill River Health Regions. I learned a lot and would like to share with you what I heard and saw.

Richard Petit and Kathy Chisholm, CEOs for the two Regions, were my gracious hosts. They and their colleagues did a wonderful job of making me feel welcome and able to see many aspects of their communities. I was struck by the incredible beauty of communities positioned on large lakes surrounded by vast forests. I was astonished to see the sandy beach at Buffalo Narrows, which made me feel quite at home.

I saw how connected people in these communities are to the land. Many residents, who are largely First Nations and Métis, have long histories and traditions of living off the land. Visiting the Trading Post in La Ronge and seeing piles of pelts for sale was amazing. I saw some wonderful examples of Aboriginal culture, including the Circle of Courage embraced by the community of Pinehouse Lake. This model encompasses four core values: belonging, mastery, independence and generosity. The community has defined expected behaviours based on these values. All community leaders and services are trained in and support the model, which has also served as a powerful platform for engaging the community in improving the health of the community. More information on this model is available at: http://www.reclaiming.com/content/about-circle-of-courage.

My visit was also a sometimes painful reminder of the impact of the determinants of health. Some of the communities I visited experience third-word levels of poverty and unemployment. Community resources are very limited, even access to a grocery store and recreation facilities, things most of us take for granted are limited or non-existent. I saw great examples of communities taking collective ownership of these enormous challenges. Some solutions are easier than others – controlling the wild dog population to reduce dog bites or holding community yard sales to enable families to access clean second hand clothes. In these communities, strong local leadership and collaboration among community leaders, the health and education systems, and other partners are making a difference, despite enormous challenges.

I learned a lot about providing primary care in remote, rural communities. Primary care teams were largely lead by nurse practitioners or advanced practice nurses working with family physicians who often visited the community a few days a week. I saw many examples of innovation and a “can do” attitude by dedicated staff committed to serving their community.

I asked many people about their experience accessing services in Saskatoon Health Region. Generally their comments were very favourable. They felt we were there for them when they needed us and praised the care they received from the Region. They also appreciated having some of our staff also work in their region, including some physicians who hold periodic clinics in the north, saving people from taking the long trek south to see a specialist. Appreciation was also expressed for the use of Telehealth.

The main concerns I heard related to when patients need to return to their community following care in Saskatoon. Often, we need the patient to vacate the hospital bed with short notice, leaving too little time to arrange transportation or follow up care. We sometimes assume that patients will be able to access prescriptions, special baby formula, or other services in their home community even though there are no physiotherapists and it may take several days for the local pharmacists to stock special prescriptions that would be more readily available elsewhere. I heard many times that people would greatly appreciate more use of Telehealth, which, in some cases, can provide quality care while avoiding the cost and inconvenience of people having to travel many hours far from home.

This was my first experience in northern Saskatchewan. I did not get to the far, far north and hope to return. I believe we have much to learn from the north, appreciating the challenges people have in staying healthy and accessing health services. As a provincial referral centre, we have a responsibility to help them when they need us, and to respond in ways that are culturally sensitive and represent exceptional service.

Maura Davies
President & CEO
Saskatoon Health Region