They weren't quite familiar with how the virus spread and what people could do to protect themselves. We answered a lot of questions, as many as we asked of participants, and we also went back to the community to share things through school presentations, as well as a call-in TV station that they had locally within the community.
With that example, the reason I use it is to highlight the important lesson not only of engaging with communities through partnership, but also of making use of existing communication infrastructure in areas where cellphone and Internet coverage may be poor.
When I started on the work with the Manitoba Metis Federation, I was asked to also conduct an evaluation of an intervention that had been developed specifically between the Metis Federation and the Manitoba health government. One of the things to understand during pandemic H1N1 was that part of the response tables involved not just the standard public health and surveillance tables. There was also a social justice and equity table, as well as specific engagement with indigenous peoples—specifically, the Assembly of Manitoba Chiefs, INAC, Health Canada and the Province of Manitoba— but there was no seat at the table for the Metis Federation, despite their representation of 40% of Manitoba's indigenous population.
The Metis Federation had to advocate hard to be included in these indigenous response tables. Part of their success is owed to the strong research capacity they had in partnership with the university to create what was at that time the very first Métis atlas in Manitoba, which documented Métis health status alongside that of other Manitobans. It was one of the first times that the Metis Federation could provide some evidence and could document experiences and outcomes similar to those of first nation citizens.
What is important to understand is that the Métis live diffusely in the province, with approximately half of our citizens living in Winnipeg and the rest living in the broader Red River Settlement areas along the lake systems, where Métis depend on access to the land for survival. If you were to look at a distribution map of first nations reserves alongside a map of Métis communities, you would see that they are quite close in proximity, particularly in the northern parts of the province.
While on a first nations reserve you might have access to a health centre, Métis citizens often have to access health services much like other Manitobans do: through provincial health offices that might be available in larger centres. This means that Métis in smaller communities and more isolated communities have to travel considerable distances to access primary care, as well as to seek more specialized care, and this travel has to be covered out of pocket. Métis do not receive benefits from first nations and Inuit health grants, such as access to medical van transportation, as an example, and this was something that was frequently raised in focus groups that I was conducting in different Métis communities about why they would—