...continued from PART 1

The IIJ contacted 13 different health agencies and ministries at the provincial level. They said they did not track water-related illnesses or deaths on First Nations, though seven said they did track this information for the off-reserve population. Most said this was the jurisdiction of the federal government; others referred the IIJ to individual First Nations or simply said they did not have the information.

B.C.’s First Nations Health Authority, the first province-wide health authority to serve First Nations in Canada, reported that it wasn’t tracking water-related illnesses or deaths in First Nations.

“Our only involvement with FN water systems is from an environmental health standpoint. I would refer you to Indigenous Services Canada which is responsible for on-reserve water systems,” said communications officer John Moody.

Uncounted deaths

Coroner offices in Alberta, Quebec and the Yukon reported no deaths related to drinking water since the year 2000, nor did the Saskatchewan Coroners Service since the beginning of their electronic records in 2015.

“I think there’s a major data gap here,” said Jeff Reading, a health sciences professor at Simon Fraser University who said the government has a responsibility to know the health impact of years of living with deficient water systems.

In 2018, reporting by the Auditor General found policy-makers needed more data about indicators such as education, income and health to close socio-economic gaps between First Nations people living on reserves and other Canadians.

The report revealed Indigenous Services Canada has collected and has access to a significant amount of data that could “help effect real change and improve lives,” but that it failed to use this data to assess if well-being was improving in First Nations communities. That failure could lead to a misallocation of funding and areas requiring attention could be missed, the auditors said.

By not measuring the progress of its programs, the government is leaving policy-makers and First Nations in the dark about what’s effective. “First Nation leadership, they are very interested in knowing how these programs are working or not working to help them better gauge success,” said Joe Martire, one of the principal auditors on the file.

Water-related deaths, of children and infants, have been suspected in places like Lytton First Nation and Gull Bay.

In 1999, Darlene King lost her baby son Owen John in Gull Bay First Nation. He died of bacterial meningitis when he was seven months old. “I was just so filled with grief, my whole world had come crashing down,” said King.

Over 20 years later, she still doesn’t know if the water in the community played a role, “I’ve been wondering all these years,” said King. At the time of her son’s death, dangerous levels of E. coli were reported in the community’s water.

“Back then, you just drank whatever water was available,” said King.

She said more should be done to get to the bottom of how living with bad water is affecting the health of people living in Gull Bay and First Nations across the country. “A lot of people die without even finding out the causes. Like people back home will have cancer for years, or people complaining about something wrong with them. Like knowing that something’s wrong with them already, and saying it’s probably, you know, could be the water.”

In Canada, deaths are classified by the World Health Organization system, which selects for a single immediate cause of death. Health professionals can list an underlying cause, although it is not required. Experts say this system makes it hard for researchers or the government to understand what role water may have played in a death.

“Most of these deaths would be deemed natural — people may not link the origin of the infection to the drinking water source — and thus, we would be unaware of the scope of this issue,” said Stephanie Rea of the Ontario Office of the Chief Coroner, in an email. If the death were assumed to be natural, the coroner’s office wouldn’t be called to investigate, she wrote.

In 2019, researchers from the Manitoba Centre for Health Policy Leona Star and Alan Katz reviewed data on First Nations deaths and concluded that the international coding system for deaths does not “adequately describe First Nations experiences.” They found deaths are often grouped as from ‘external causes,’ which can include injuries, poisonings and also potentially water-related issues.

“We were stuck with large categories that we just couldn’t make sense of, in terms of the real reason that people had died,” said Katz. He said the categorization of deaths doesn’t take into account the issues around racism and colonization at the root of many deaths.

In part, he said this is because of the lack of data. “To describe racism, you need to actually have some data to support that. And we have traditionally not collected that within the health-care system,” said Katz.

He said that as a result, solutions are stunted. “Unless you actually have some statistics to point out why it’s an issue, it’s very often difficult to get people to respond to a problem,” said Katz.

Data obtained by the IIJ from Statistics Canada shows the infant mortality rate on-reserve is near to double the off-reserve rate. In the developing world, poor sanitation due to a lack of safe water is the cause for one in five infant deaths according to WaterAid, an international charity that works around water and sanitation issues. In Canada, less is known about how water impacts the infant mortality rate, though some suspect a connection.

“Water is so essential to life, right? And our ability to nourish our bodies and create strong, healthy children,” said Amber Skye, a researcher at McMaster University and a resident of Six Nations of the Grand River in Ontario. “We see higher rates of pretty much everything in First Nations women’s health in terms of diabetes, gestational diabetes and preterm births, overweight births.”

Water is not only crucial to the physical well-being of mothers and children, said Skye, but also for mental and spiritual health. “Birth is a ceremony for our people, and that connection with our birth and the water is very strong.”

Skye’s mother Dawn Martin-Hill, an associate professor of Indigenous studies and anthropology at McMaster University, is leading a large-scale study looking at issues with water on Six Nations. She said she was shocked to find that even the community’s birth centre struggles with water. “They were in crisis several times because they had multiple births happening and they ran out of water,” said Martin-Hill.

Midwives from the community estimate near to half of mothers returning home with new babies don’t have access to clean water. The midwives are currently doing research to find exact numbers.

Bad water’s ripple effect

Sol Mamakwa is an NDP MPP in the riding of Kiiwetinoong, Ontario. He lived without running water in Kingfisher Lake First Nation until he was 23. “It was hard. But it was just the way things were,” said Mamakwa.

He now represents 31 First Nations, including Neskantaga First Nation, which has faced the longest-running boil water advisory in Canadian history. He said water issues weigh on residents of First Nations.

...continued in Part 3