First Nations are exerting more control over their borders. Health care could be next

On the onlyroad connectingPimicikamakCree Nation to the rest of Manitoba, there's a checkpoint designed to staunch the spread of COVID-19.

Anyone driving in and out ofwhat's also known as Cross Lake must stop at the row of pylons and disclose contact-tracing information, including their name, phone number, point of origin and intended destination.

They're given temperature checks, asked if they've been tested for COVID-19 and if they have any symptoms. If they intend to stay in the community and interact with anyone, they may be required to spend days inside a school converted into a makeshift isolation centre.

For all intents and purposes, Pimicikamakhas exerted control ofits borders in a manner befitting a sovereign nation.

All it took was a global pandemic and the mortal threat it poses to isolated, remotecommunities with substandard health care and overcrowded housing.

"We had to be ready for the virus," saidDonnieMcKay, the Pimicikamakcouncillor responsible for health care, who helped oversee the creation of the checkpoint during the early months of the pandemic. "They said it would never get here. Bullshit."

Officially,Pimicikamak has 89 active COVID-19 cases, though that number is presumed to be smaller due to the lag time in designating patients as recovered. McKay said he believes the checkpoint has helped prevent more illness and he's not alone.

"If it wasn't for those checkstops, our communities would be in even more dire situations," said Grand Chief Garrison Settee of Manitoba Keewatinowi Okimakanak, an organization representing26 northern Manitoba FirstNations.

Indigenouscommunities bearing brunt of pandemic

In recent weeks, remote Indigenous communities have borne the brunt of the pandemic in Manitoba.

As daily case counts and infection rates started to subside in the southern half of the province, home to all butabout 100,000 of Manitoba's 1,379,000 people, remote First Nations across the north as well as on the isolated east side of Lake Winnipeg became the new front in the pandemic fight.

Some, like Shamattawa, are recovering from outbreak. Others, like the fourIsland Lakecommunities, are trying to contain active infections.

There are also new crises underway, most recently in Pauingassi, where theentire Family Lake community was placed under code-red restrictions on Tuesday.

What is now a largely Indigenous and remote pandemic in this province is once again exposing the dangerous state of health care and housing on remote and isolated First Nations.

"It seems like we don't have alistening ear out there unless there is a real crisis and everyone's up on their hind legs," said McKay.

'It's frustrating'

His community, situated three hours south of Thompson by road, claims a population of7,200 people.

Pimicikamakconverted a school to an isolation centre because it has few empty structures of any sort. And while a hospital is under construction, the community's health-care needs are met for now by a nursing station that resembles a provincial park campground office.

Ground has broken fora hospital that will replace the nursing station, but McKay saidthe band continually has to press Indigenous Services Canada for additional resources such as isolation accommodations or rapid COVID-testing equipment.

"It's frustrating. It's silly sometimes, the responses we get regarding things that we ask for," he said.

Like all First Nations, Pimicikamakmust deal with multiple levels of government to fulfil its health-care needs. Ottawa has a treaty obligation to provide health care on reserve. Manitoba's Northern health region provides care for members living elsewhere in the north.

The Winnipeg Regional Health Authority, meanwhile, cares for members who must travel south for serious ailments, including serious cases of COVID-19.

Settee said bureaucracy could be reduced if First Nations like Pimicikamakdelivered their own health care.

"This is not new. We've been talking about it for decades," he said.

Helga Bryant, the CEO of Northern Health, suggested she supports a future where Indigenoushealth care is led by Indigenous people.

"They are sovereign nations. They have a right to govern themselves," Bryant said in Thompson."They know those needs in their communities and I fully support efforts that they can make and hopefully will continue to make in the future."

Back at Pimicikamak, McKay speaks of the need to "repatriate" health care from Ottawa.

"It's very, very different than what people have in the south," he said. "They have facilities there we don't have."