Diabetes Health Centre welcomed by the Carrier Nation

Dec 8, 2016 | News

In the fall of last year, the Diabetes Health Centre was approached by the First Nations Health Authority through Margot Wilson, director of Chronic Disease Management Strategy here at St. Paul's Hospital, to partner and provide diabetes education and treatment to clients in remote communities using Telehealth. We met with Dr. Marie Pierre Dallaire one of the physicians who provides outreach medicine who then introduced us to Dr. John Pawlovich.

This exciting initiative was spearheaded by Dr. John Pawlovich.  “Dr. John”, as he is known to his clients, is the medical director for the Carrier Sekani Family Services also known as CSFS.  Dr. John visits the Carrier Nation communities of Fort Babine, Tachet, Stellaquo, Yekooche and Takla on a monthly basis. In between these visits, he connects with his clients using Telehealth conferencing. 

To prepare for Telehealth Conferencing, staff at the Diabetes Health Centre were briefed on the initiative via meetings, emails and teleconferencing. Then, to better understand the communities and challenges faced by many remote Indigenous communities, all staff took the Indigenous Cultural  Competency training provided by Providence Health online. Ongoing throughout this time IT met and set-up the Teleheath system and a ‘how to ’ session was presented to staff. To ready the room designated for Telehealth, a fresh coat of paint was applied and noise - absorbing panels were installed. 

During preparations Anita Skihar, patient care manager for Ambulatory Care Medicine clinics of which Diabetes is one, suggested that a representative dietitian and nurse travel with Dr. Pawlovich to meet the Carrier Nation communities involved with this initial Telehealth initiative. A proposal for funding to the St. Paul’s Foundation patient enhancement fund was generously accepted. So, early on Sunday November 13, Stephanie Chung, RD, and Daphne Wright, RN, along with Dr. John and his two residents Dr. Mark and Dr. Gabe, crossed the tarmac at YVR to take a Dash 8 to Smithers.  Along the way, Dr. Stephen Vallyntyne, a Physiatrist working for Northern Health and often travelling with Dr. John, met up with the team.

Over the next six days the group visited the Carrier Nation communities of Fort Babine, Tachet, Stellaquo, Yekooche and two days in Takla. At each community the entire team was met with hospitality and generosity. Meals were shared between staff and clients creating a gathering point at which to learn about and from each other. At Fort Babine the Diabetes Team was given some bear grease to take home, (good for hair and skin and cooking too) this precious cargo each day travelled on ice until it got to Vancouver. Invited into an addictions meeting at Stellaquo, the Diabetes team was given the honour of being allowed to Smudge with the group and to sit in on the meeting. At a potlatch in Takla, food - including delicacies such as white fish caught that very morning from Lake Takla, moose meat recently hunted and the best bannock - was shared with the team as were many laughs and more than a few great stories. On a walk in Takla the two members of the Diabetes Health Care Team were invited into an elder’s home and where shown how moose hide is dried.  

Visiting each community and learning about their way of life and the challenges they face will only help us to better understand where our Telehealth clients are coming from. The travel between each community was long, often bumpy and, at times, dangerous. We are now better able to understand the challenges faced by these communities as they make their way into town for staples. Food costs when people do get to the grocery store are high and choice is limited. The distances between each community and the nearest town can be long. For example, in Takla access to services can mean a three and a half-hour trip down an isolated, icy, bumpy, unpaved logging road and then a two hour trip on paved highway before making it to Prince George.  It's understandable why people are not able to attend appointments or get blood work completed. Anyone of us would find these challenges daunting. And so, on return, the Diabetes Health Centre Team is keen to start using Telehealth with these communities as a starting point. The first Telehealth client for the team is scheduled for early December.   

A very special thanks is needed for those who have helped to make this visit to the Carrier Nation possible. Thank you to Dr. John Pawlovich for organizing the trip and allowing us to join him.  Thank you to  Anita Skihar patient care manager, Ambulatory Care Medicine clinics, and to the St Paul’s Foundation for making the trip possible. Thank you to the rest of the Diabetes Health Centre team for holding down the fort while two staff members were away. An especially big thanks to the people’s of the Carrier Nation for allowing us the opportunity to visit their communities and being so very welcoming to us. A big thank you to the Carrier Sekani Family Services (CSFS).

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