Sachigo Lake Wilderness Emergency Response Education Initiative

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Mervin Farmer
5 years ago
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1 OTC and EXTRA Alumni Event October 21, 2010 Sachigo Lake Wilderness Emergency Response Education Initiative Aaron Orkin, MSc, MD; David VanderBurgh, MD; Karen Born, MSc, PhD(c) 1

3 Presentation Outline Motivation Project Overview Guiding Principles Context 3 Phased Approach Learnings from site visit Anticipated Results Challenges 3

4 Motivation First Nation Canadians are 4 times more likely to suffer trauma than non-first Nations 5x motor vehicle accident injury 10x of injury secondary to assault (Karmali et al. CMAJ 2006) Inclement weather, harsh natural conditions can impede rescue and transportation Vast distances to access trauma care in Ontario (Gomez et al. Trauma 2010) Direct transport to trauma center from scene is 62 minutes Average time for transfer to trauma center if first transported to non-trauma center is 6 hours 4

5 Project Overview Aim: Increase Capacity, Build through Collaboration Conventional first aid courses do not address needs of remote communities Collaborative approach with community will develop course focused on skills specific to isolated, lowresource, remote settings 3 phased project design is an innovative model of inter cultural and inter professional consultation between health care practitioners, educators, researchers, community leaders and community members 5

6 Guiding Principles Employing culturally appropriate, local, and collaborative solutions to address, research issues in First Nation communities Principles: 1.Build Community Capacity 2.Partnership & Collaboration 3.Excellence in first response and wilderness medicine 4.Participant Experience 6

7 SACHIGO LAKE SIOUX LOOKOUT THUNDER BAY TORONTO 7

Sachigo Lake First Nation Total Population 450 425 km north of Sioux Lookout Ice road access for transport during winter months, fly-in community during non winter months health care is year-round

8 Sachigo Lake First Nation Total Population km north of Sioux Lookout Ice road access for transport during winter months, fly-in community during non winter months health care is year-round air transport Oji-Cree language is spoken Approximately 50% of diet comes from hunting, fishing Dry community no alcohol Community resources include nursing station, library, community center, elementary school, airport (Source: Statistics Canada, 2006) 8

9 Phase 1: Site Visit & Curriculum Development (May 2010) Focused on meeting community members, learning about the community, developing partnerships and strengthening relationships. Needs assessment review existing emergency management systems and training understand sentinel events Meetings with community members develop course objectives and content develop Research Agreement Identify research partners 9

10 Phase 1: Process Informal, open-ended conversational meetings, with notes taken, recording was not welcome by community Meetings took place with 25 community members including : Band Chief and two Council members Director of the Health Center Health Center staff, including two medical drivers, one mental health worker, two clerks, two Community Health Resource-persons, one caretaker and one Registered Health Canada Nurse (from outside community) Six members of the community Canadian Rangers Team Four members of the community First Response Team Two community Home Health Worker 10

11 Phase 1: Learnings 1. Community members have a complex relationship with the land 2. There are processes in place when people goes out on the land 3. Life in Sachigo Lake is a balance of traditional ways with modern approaches 4. Many community groups for first response with overlapping mandates, unclear roles 5. History of irrelevant, unsustainable first aid courses in the community 11

12 Phase 2 : Course & Capacity Building (November 1-5, 2010) participants, 5 day course duration Course participants will be Rangers, First Response Team, Crisis Team and Nursing Station staff. Participants will develop: Patient assessment and treatment competencies specific to remote, lowresource situations Develop critical thinking and communication strategies Approaches to multiple casualty incidents 12

13 Phase 3: Evaluation & Dissemination Participatory research is the overarching approach, following on methodology employed by other Canadian health services researchers working with Aboriginal communities (MacAuley et al. 1998; Meadows et al. 2003) Methods validated by community: participant observation, focus groups (sharing circles) Research aims are to evaluate aspects of the course delivery, applicability, relevance and reception from community KT & E plan and dissemination will be determined by research partners, community input 13

14 Challenges Scheduling - 2 site visits (November 2009, March 2010) cancelled due to extenuating circumstances Ensuring participation of relevant community members Cultural, social differences adult education, curriculum development/design Aboriginal worldview, divergent meanings of wilderness, medicine Legacy of colonial relationships has implications for ability to trust, collaborate with research team 14

15 Anticipated Results New, collaborative approach to health education with First Nations Capacity building and health promotion program, delivered entirely within the community, aims to increase local capacity in the management of emergencies Strong community partnerships, and project evaluation using collaborative and participatory methodologies will assist with KT & E and dissemination for other remote, First Nation communities 15

16 Let me share a story Sachigo Lake Wilderness Medicine Program becomes Sachigo Lake Wilderness Emergency Response Education Initiative Different meanings of wilderness medicine revealed during meeting with Chief and Band Council Council member I don t know much about the project beyond the program name. I don t know if you re looking at working with elders who know about different things, used in the past for medicinal purposes, or else if you re putting out what you guys know about stuff Research partner developed current name, with input from research team 16

17 Thank you!

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