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Experiencing Rural Medicine in First Nations Communities in Northern Canada

Tara Dawn measures the blood pressure of a patient in a First Nations community in northern British Columbia.

Since that fateful day when I read the words ‘Congratulations, you have been accepted…’, I consider my medical education to be my ticket into the world of international development. With the tools I obtain through my medical degree, I dream of setting up medical clinics in remote jungles and responding to need following natural disasters.

Prior to medical school, I served at a rural Salvation Army medical clinic in Ghana, where I was the lone obruni, or white person, in a four-hour radius. During an outreach trip after my first year of medical school, I traveled to the Thailand-Cambodia border to set up primary care clinics for displaced people. Although I thoroughly enjoyed traveling across the globe, as it was deeply satisfying and life-giving, a recent experience showed me the great need for health care development close to home, in my own province of British Columbia.

This summer, after finishing my pre-clerkship years in Vancouver at the southern end of the province, I traveled north to complete my rural rotation in northern British Columbia. Throughout my rotation, it became increasingly evident that the aboriginal First Nations communities in northern Canada face a unique set of struggles. As a member of the University of British Columbia’s Aboriginal Health Initiative group, I made it a personal priority to serve and learn about these populations during my time in the north. When an opportunity arose to travel to four of the First Nations communities over the course of a week, I was quick to volunteer.

Monday took us to a small First Nations reserve of 220 people, established for hundreds of years, that still lacks basic access to medical care.  After a six-hour drive through the mountains on a dusty logging road, we arrived at the edge of Takla Lake at a reserve of 250 residents, an astounding 320 kilometers from the closest medical center. Every day, my eyes were opened to the enormous challenges of the aboriginal residents of these reserves. The inability to overcome language, financial and education barriers has resulted in a complete lack of medical care for these communities. Children presented for check-ups with lice crawling down from their hairline. Bugs were fished from ear canals. Countless referrals were made to larger medical centers for incontinence, visual impairment and dental maladies.

We concluded the week by helicoptering two hours westward to work for a day at two other small communities on Lake Babine.  Our days were physically taxing and emotionally satisfying.  As we traveled through the lush green mountains of Northern BC, the poverty and remoteness of the communities was striking. I found it hard to believe that in my native BC, individuals live in such isolation and travel such long distances to obtain basic medical care.

In one community, we met a woman in her 30th week of pregnancy who had not yet received any prenatal care. Although we attempted to connect her with the local nurse practitioner and provide her with the appropriate swabs, screens and exams, it was humbling to think about how her physical remoteness had translated into her hesitation to seek care. In another community, we met two elders who struggled with constant dyspnea due to long term COPD. Although they desperately needed at-home oxygen, they had no voice to advocate for them, and their breathlessness remained. The evidence of substance dependence and the wake of colonization touched nearly everyone we saw.

This week-long trip has not only enriched my experience during my rural rotation, but it also has broadened my perspective and understanding of family medicine and rural medical practice. I am thankful for the Takla Lake, Tl’azt’en and Lake Babine Nations for welcoming us and teaching our team so much. I recommend any students or residents who express an interest in First Nations health or international development to seek an experience like this one.

It is now fully evident to me that my medical skills can, indeed, one day be put to use in the realm of international development. However, I may not have to travel as far as I once believed.

Tara Dawn Tara Dawn (1 Posts)

Contributing Writer Emeritus

University of British Columbia Vancouver Fraser Medical Program

Tara Dawn is a Class of 2014 medical student at UBC in Vancouver. Originally from the interior of BC, she ventured to the big city on a journey to obtain her medical degree. Along the way she got her BSc. at Trinity Western University, traveled to West Africa, fell in love and married her best friend, and discovered her love of the First Nations communities in BC.