Health-care workers in Nunavut say changes to a federal funding program for Inuit children are forcing some pregnant to make a tough choice: have a safe birth or ensure the kids they already have are properly cared for.
The Inuit Child First Initiative (ICFI) was launched in 2019 to ensure Inuit kids have access to health and social services without having to leave their communities.
Funding for the program, which has mirrored JordanSA国际影视传媒檚 principle and helps backstop a wide range of programs and services, is set to sunset on March 31 unless Ottawa can get approvals through Parliament to extend it by a year SA国际影视传媒� or come up with a longer-term solution.
Under JordanSA国际影视传媒檚 Principle, First Nations families are to apply for and receive funding as its needed, with the provinces and federal government later sorting out jurisdictional battles over which is responsible for the bill.
Community health centres in Nunavut lack proper birthing services, so pregnant women there typically fly to hospitals in Iqaluit, Winnipeg or Yellowknife to deliver. The territorial government covers the cost of flying an expectant mother and one escort SA国际影视传媒� typically a partner SA国际影视传媒� to an outside hospital to give birth.
The federal ICFI, meanwhile, has paid for children to travel with their parents in cases where theySA国际影视传媒檝e had to leave their communities for medical treatment SA国际影视传媒� including childbirth services SA国际影视传媒� where adequate child care at home isnSA国际影视传媒檛 possible.
One organization helping Inuit women file ICFI applications says since the beginning of November it has seen a drop in the number of applications being approved and an increase in the number of applications being referred for national review.
SA国际影视传媒淧reviously, when we were getting denials or escalations, we would get a rationale attached from (Indigenous Services Canada) of what the reasoning was. Recently, we are not seeing that,SA国际影视传媒� said Erica Loiselle, a senior service coordinator with the Arctic Children and Youth Foundation.
The organization said from July to October, it helped process 46 ICFI applications in the Qikiqtaaluk from patients SA国际影视传媒� including pregnant women SA国际影视传媒� who wanted their kids to fly out with them. Only two were escalated to national review, two were denied and 21 were approved.
But in November and December, only four of the 27 applications it helped process were approved, while 10 were sent for national review and two were denied.
Following inquiries from The Canadian Press, Indigenous Services Canada sent a bulletin to ICFI service providers on Feb. 10, confirming it has changed the way itSA国际影视传媒檚 processing applications.
The wide-ranging bulletin said non-medical supports like travel costs, non-medical respite care and child care, would no longer be covered unless accompanied by a letter of support from a medical professional.
SA国际影视传媒淭he professional must be able to provide a child-specific recommendation based on their professional designation and their knowledge of the Inuk childSA国际影视传媒檚 specific needs,SA国际影视传媒� the bulletin reads.
It also said the department is SA国际影视传媒渆xtending decision making powers to regional staff to speed up the processing of requests,SA国际影视传媒� shifting away from what LoiselleSA国际影视传媒檚 group has experienced over the last few months.
And while Loiselle said ISC has already been SA国际影视传媒渃racking downSA国际影视传媒� on the support letters, she said it isnSA国际影视传媒檛 always possible to get one from someone in health care. In past, social workers would sometimes vouch for the lack of adequate care in the community.
SA国际影视传媒楻eally scary precedentSA国际影视传媒�
The Canadian Press spoke with three health-care workers in Nunavut about the impact the change in procedure has had on their patients. They asked to not be named because they are government employees and not authorized to speak publicly about patientsSA国际影视传媒� cases.
They all said theySA国际影视传媒檙e worried about women flying out to give birth without having adequate arrangements to look after their kids back home SA国际影视传媒� or women opting to stay put, putting their pregnancies at risk.
SA国际影视传媒淲e canSA国际影视传媒檛 definitively ever tell a mom that they wonSA国际影视传媒檛 be approved, but we know reading between the lines, based on the trends that weSA国际影视传媒檙e seeing, that they wonSA国际影视传媒檛,SA国际影视传媒� one health-care worker said.
SA国际影视传媒淎nd so it has led to situations where mothers have almost delivered in community. And thatSA国际影视传媒檚 a really scary precedent because the health centres are not equipped for safe birth.SA国际影视传媒�
While no births have yet happened in communities because of ICFI funding not coming through, health-care workers say itSA国际影视传媒檚 only a matter of time.
SA国际影视传媒淚tSA国际影视传媒檚 gotten close to happening. Because when weSA国际影视传媒檙e in a situation where weSA国际影视传媒檙e trying to get an approval and weSA国际影视传媒檙e negotiating with the mom, we sometimes are able to really push in an exceptional circumstance,SA国际影视传媒� the first worker said.
SA国际影视传媒淏ut that exceptional advocacy is not a policy that will prevent births in a community. It will happen.SA国际影视传媒�
The health-care workers also said they also worry about women who decide to travel, even though they havenSA国际影视传媒檛 been able to make proper child care arrangements.
One staffer said patients may worry about SA国际影视传媒渨hether there is someone that they trust to care for their children, or SA国际影视传媒� about putting their children in a different household where itSA国际影视传媒檚 already overcrowded, (or) thereSA国际影视传媒檚 already food insecurity and thereSA国际影视传媒檚 possibly already violence occurring in that house.SA国际影视传媒�
One health staffer said one pregnant mother couldnSA国际影视传媒檛 find anyone else to watch her children other than her partner, who was facing domestic abuse charges.
SA国际影视传媒淗er current plan is to drop charges against her partner so that he wonSA国际影视传媒檛 be in jail and heSA国际影视传媒檒l be able to watch her children when she travels,SA国际影视传媒� said the staffer.
In another case, which wasnSA国际影视传媒檛 pregnancy-related but required a mother to leave their community for medical reasons, a child was left in the care of another family member.
SA国际影视传媒淭he kid was actually kind of being passed around between a bunch of family members, who sadly didnSA国际影视传媒檛 identify early enough that the child had a severe respiratory infection,SA国际影视传媒� the second worker described.
The child, they said, ended up admitted to the pediatric intensive care unit at the ChildrenSA国际影视传媒檚 Hospital of Eastern Ontario in Ottawa.
SA国际影视传媒淚tSA国际影视传媒檚 not (pregnancy-related) directly, but itSA国际影视传媒檚 itSA国际影视传媒檚 an example of when you leave children unattended,SA国际影视传媒� the staffer said.
ItSA国际影视传媒檚 also putting the womenSA国际影视传媒檚 pregnancies at risk, the health-care workers say.
SA国际影视传媒淲eSA国际影视传媒檝e seen a lot of challenges with people wanting to go home early. For example, requesting what we call like elective inductions of labour because they donSA国际影视传媒檛 want to be separated from their children anymore,SA国际影视传媒� said a third health-care worker.
SA国际影视传媒淲e do sometimes see family services involvement that probably would not otherwise happen. People complain that whoever is caring for their kids are not feeding them properly, and then family services has to go in and provide food, that type of thing.SA国际影视传媒�
SA国际影视传媒淭he government of Nunavut is responsible for providing health-care services to all Nunavummiut, including out of territory care,SA国际影视传媒� Indigenous Services Minister Patty Hajdu said in an interview with The Canadian Press.
SA国际影视传媒淛ordanSA国际影视传媒檚 principle was never meant to replace the responsibility of provinces and territories in their own specific jurisdiction.SA国际影视传媒�
While the territorial government covers the cost of pregnant women and their escorts to travel to give birth, there are no programs set up for covering the cost of additional children to travel in cases where there is inadequate child care.
SA国际影视传媒淚 would just say that, essentially mothers should continue to apply, that obviously weSA国际影视传媒檙e going to be looking at each case, individually. Nobody wants a family to struggle because of the, hopefully, joyful occurrence of giving birth,SA国际影视传媒� Hajdu said, adding the government is working with Inuit partners for a long-term plan for ICFI.
SA国际影视传媒淏ut we also want to make sure that provinces and territories are continuing to provide their government-funded supports for Inuit children within their territory.
SA国际影视传媒擝y Nick Murray, The Canadian Press
