Medicine in the Mushkegowuk: A Connection Between North and South

*the following guest blog was written by Brendan Cull, 2013 Curatorial Assistant at the Museum of Health Care. 

Residents of Kingston will be aware of the positive impact that the local hospitals have on our city’s overall health, but what many of us might not know is that they have a much wider reach than just Kingston and its neighbouring communities; in fact, Kingston General Hospital, Hotel Dieu and Providence Care have been intimately linked with a hospital in a remote area of northern Ontario for the past fifty years.

Early Health Care in Moose Factory

Moose Factory, Ontario is located 1500 kilometres north of Kingston on MooseFactoryIsland in the Moose River, which flows into James Bay. Traditionally, the Moose Cree First Nation has called the island home. In 1673, the Hudson’s Bay Company began to develop the island into the main trading post for the region with the goal of supplying furs to Europe.[1]

Aerial Image of Moose Factory Island c. 1870
The Hudson’s Bay Company began to set up permanent settlements on Moose Factory Island in the late seventeenth century. The community was originally known as Moose Fort and served as the capital of James Bay. Moose Factory, ON (c. 1870), Library and Archives Canada/C-001723

While the Hudson’s Bay Company brought a small number of doctors and surgeons to the area, there were no organized hospital services near Moose Factory until the turn of the twentieth century. At that time the Oblate Fathers and Grey Nuns (later known as the Catholic Hospitals of James Bay) opened AssumptionHospital in the nearby community of Moosonee, as well as St. Anne’s Hospital in FortAlbany and St. Mary’s Hospital in Attawapiskat up the coast of James Bay.[2] In the late 1940s, Moose Factory was selected as the setting for a tuberculosis sanatorium due to its isolated location.[3] This served as the regional tuberculosis treatment centre for Cree and Inuit patients for the next two decades. In the 1960s, a number of circumstances, including changes to government funding programs, a movement towards greater social equity and the loss of Moosonee’s hospital in a fire, contributed to the reorganization of the hospital in Moose Factory and resulted in the change from sanatorium to general hospital.[4]

The Moose Factory–Kingston Link

A partnership between north and south also began in the 1960s when the Federal Government formally recognized the need to improve health care services to First Nations people in Canada’s North.[5] As part of this effort, the Faculty of Medicine at Queen’s University was asked to serve as the main link with the Moose Factory Zone (within what is currently called the Mushkegowuk Territory).[6] In August 1965, the first paediatric clinic, organized and operated by the Department of Paediatrics at Queen’s University, was held in Moose Factory.[7] However, the paediatricians who participated in this work treated patients of all ages and needs.[8] Some of the patients they saw had to be referred for more specialized care in the south and as a result, they were sent to Kingston General Hospital.[9] It was clear that the medical needs of the area encompassed more than just paediatric care. In a year-end report they noted cases of glandular fever, measles, pneumonia, congenital heart disease, anaemia, cerebral palsy, epilepsy, gunshot wounds, burns and dental caries, to highlight a few of the conditions they identified over the two weeks they spent in the north.[10] The group recommended that comprehensive medical services, training and research were immediate needs related to health care reform in the area.[11]

The paediatricians’ findings sparked the creation of the Queen’s–Moose Factory Program[12] which was set up to provide the area with stable health care services, as well as establish a research and learning environment for students from the Faculty of Medicine at Queen’s University.[13] The Faculty of Nursing Science also began a similar program with the goal of training nurses who would be inclined to stay and provide service at the General Hospital in Moose Factory.[14] These programs are still active today, although on a smaller scale.

As the link between north and south began to develop further, a chartered seven-seat airplane began to take physicians north at regular intervals in the 1980s.[15] This three-hour flight took consultant physicians and other medical professionals to Moosonee every second Wednesday.[16] Increased access to Kingston’s specialists meant that more patients were being referred to Kingston hospitals. While these programs and services offered better treatment opportunities, there were problems associated with sending Cree patients south.[17] For those who could not speak English, or who had never travelled outside of their region, the trek was exhausting, frustrating and confusing.[18] Many patients arrived in Kingston with instructions written on a piece of paper that they would show a taxi driver.[19] They were often taken to the taxi driver’s preferred hospital, where hospital staff might not know anything about the referral.[20] To provide a better service to Cree patients, as well as to streamline the system, Kingston General Hospital and Hotel Dieu created a committee in 1983 to examine the issues and challenges associated with treating the Cree in Kingston.[21] They identified a number of issues related to cultural awareness and sensitivity, language use, privacy, consent, and liaison services.[22]

The Religious Hospitallers of St. Josephs at Hotel Dieu were the first to provide Cree patients with their own accommodations, separate from the hospital.[23] They designated the house at 176 Johnson Street as a hostel for patients and their families who came south for paediatric care at Hotel Dieu.[24] Since then, this address has been known as Geaganano Residence (meaning Our Home) and accommodates patients of varying needs who stay in Kingston for short periods of time.[25] Previously, all Cree patients were admitted to hospital regardless of their condition; however, with this new facility, most patients coming to Kingston are now treated as outpatients. This allowed them and their families more freedom and time away from the hospital.[26]

Geaganano Residence provides a comfortable environment for Cree patients to relax while in Kingston. It is located across the street from Weeneebayko Patient Services on the Johnson Street side of Hotel Dieu. Image courtesy of Weeneebayko Patient Services, Hotel Dieu.
Geaganano Residence provides a comfortable environment for Cree patients to relax while in Kingston. It is located across the street from Weeneebayko Patient Services on the Johnson Street side of Hotel Dieu. Image courtesy of Weeneebayko Patient Services, Hotel Dieu.

In 1985, a Native Patient Services program was piloted at Hotel Dieu.[27] Its main focus was on patient services and cultural sensitivity. Translators from the Mushkegowuk Territory were hired to provide confidential translation and cultural interpretation for health care teams in Kingston.[28] That same year, the Mushkegowuk Tribal Council declared that they would not allow their people to be sent to a place where no one spoke Cree.[29] In response, Kingston health care providers advocated for a permanent program to address the concerns of the people of the Mushkegowuk area.[30] Since the 1980s, Weeneebayko Patient Services (Weeneebayko means Two Bays – a reference to James and Hudson Bays) has continued to provide translation services, book medical appointments, help patients find accommodation in Kingston, support families, and coordinate travel bookings.[31]

Current Health Care in the Mushkegowuk Territory

Today, the hospital in Moose Factory, renamed Weeneebayko GeneralHospital, works in partnership with Kingston hospitals to deliver specialized care within the MushkegowukTerritory along the west coasts of James Bay and Hudson Bay.[32] As part of the Weeneebayko Area Health Authority (WAHA), the General Hospital still serves as the main health care centre for the region, providing medical services to a population of about 11,000 people[33] living in the communities of Moose Factory, Moosonee, Fort Albany, Kashechewan, Attawapiskat and Peawanuck.[34]

Weeneebayko General Hospital, Moose Factory, Ontario. Image Courtesy of Weeneebayko General Hospital.
Weeneebayko General Hospital, Moose Factory, Ontario. Image Courtesy of Weeneebayko General Hospital.

While it offers medical, surgical, obstetrical and emergency care as well as outpatient clinics and traditional healing (to name a but few services),[35] the hospital reaches out to other health care centres, such as Kingston, Timmins, Toronto, and Sudbury, for additional resources. Patients with more complex conditions (such as high-risk births) or who require specialist treatment (for example, haemodialysis or cancer treatments) are often transported via chartered airplane to Kingston.

From mental health programs at Providence Care, to cardiology services at Hotel Dieu, to dialysis at Kingston GeneralHospital, Kingston area hospitals currently offer a number of essential services to patients from the MushkegowukTerritory. One recent example of the close collaboration between the two communities is the haemodialysis unit of Weeneebayko GeneralHospital which was opened in 2005.

Weeneebayko General Hospital’s dialysis unit was created in partnership with Kingston General Hospital to support treatment in the North. Image Courtesy of Weeneebayko General Hospital.
Weeneebayko General Hospital’s dialysis unit was created in partnership with Kingston General Hospital to support treatment in the North. Image Courtesy of Weeneebayko General Hospital.

Dialysis patients are first referred to Kingston GeneralHospital for assessment and treatment of their condition. Once their health is deemed stable enough to be served in Moose Factory, they are cleared to return to the north. These patients are required to live in either Moose Factory or nearby Moosonee so that they can access one of the six dialysis machines at Weeneebayko GeneralHospital. With the help of specialized nurses, trained at Kingston General Hospital, these patients receive their treatments and through an online connection, a nephrologist (kidney specialist) in Kingston can monitor a patient in Moose Factory during his/her treatment and, in real time, provide live feedback and adjustments when needed.[36]

The dialysis unit at Weeneebayko General Hospital. Image Courtesy of Weeneebayko General Hospital.
The dialysis unit at Weeneebayko General Hospital. Image Courtesy of Weeneebayko General Hospital.

During the 1990s, my family called Moose Factory home. While there, we got to experience all of the weird and wonderful facets of medical care in the North, both as health care providers (in my mother’s case) and patients. When a member of my family required specialized care to treat cancer, fortunately we had access to the incredible facilities at Kingston GeneralHospital. The strong relationship that has evolved between Kingston and the communities along the coasts of James and Hudson Bays acts as a lifeline to connect the medical expertise of the south to the people of the north.

A special thank you to Midge Rouse, Director of Weeneebayko Patient Services at Hotel Dieu, and Rachel Cull, Vice President of Patient Services and Chief Nursing Officer at Weeneebayko Area Health Authority, for sharing their stories of the Kingston-Moose Factory connection and to Robert Gagnon, Quality Coordinator for the Weeneebayko Area Health Authority for kindly providing many of the photos in this blog post.

*We acknowledge the financial support of the Government of Canada (Youth Employment Strategy) through the Department of Canadian Heritage for the Young Canada Works Program 

Sources:

Cull, Brendan. Interview with Midge Rouse. Personal interview. Kingston, Ontario, August 12, 2013.

Cull, Brendan. Interview with Rachel Cull. Personal interview Timmins, Ontario, August 16, 2013.

Cull, Rachel. Email correspondence. Moose Factory, Ontario, August 8, 2013.

HotelDieuHospital. Weeneebayko Patient Services. Hotel Dieu Online. http://www.hoteldieu.com/wpsmain.html.

Hudson’s Bay Company. “Places: Forts & Posts: The Staff House at Moose Factory.” Our History. Hudson’s Bay Company Online. http://www.hbcheritage.ca/hbcheritage/history/places/forts/the-staff-house-at-moose-factory.

Kolewaski, Carrie D., Margo L. Paterson, Karen E. Yeates, Cheryl E. King-Van Vlack. “Relocating From the MushkegowukTerritory for Hemodialisis: The Cree Illness Experience and Perceived Quality of Life.” Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 8, no. 3 (2010): 103-149.

Rouse, Midge. “Weeneebayko and Kingston: 46 Years of Service.” Unpublished, Weeneebayko Patient Services, HotelDieuHospital, 2011.

Weeneebayko Area Health Authority. WAHA Dialysis Program. Weeneebayko Area Health Authority Online. http://www.weeneebaykohealth.ca/siteengine/activepage.asp?PageID=57

Weeneebayko Area Health Authority. WAHA Programs and Services. Weeneebayko Area Health Authority Online. http://www.weeneebaykohealth.ca/siteengine/activepage.asp?PageID=4

[1]Hudson’s Bay Company, “Our History: Places: Forts & Posts: The Staff House at Moose Factory,” Hudson’s Bay Company Online, http://www.hbcheritage.ca/hbcheritage/history/places/forts/the-staff-house-at-moose-factory.

[2] Midge Rouse, “Weeneebayko and Kingston: 46 Years of Service” (Unpublished, Weeneebayko Patient Services, HotelDieuHospital, 2011), 1.

[3] Ibid, 2.

[4] Ibid, 1-2.

[5] Ibid, 2.

[6] Ibid.

[7] Ibid.

[8] Ibid.

[9] Ibid, 3.

[10] Ibid, 2-3.

[11] Ibid, 3.

[12] Interview with Rachel Cull, August 16, 2013.

[13] Rouse, 3.

[14] Ibid.

[15] Ibid.

[16] Ibid.

[17] Ibid, 3-4.

[18] Interview with Midge Rouse, August 12, 2013.

[19] Ibid.

[20] Ibid.

[21] Rouse, 3.

[22] Ibid, 4.

[23] Ibid.

[24] Ibid.

[25] Ibid.

[26] Interview with Midge Rouse, August 12, 2013.

[27] Rouse, 4.

[28] Ibid.

[29] Ibid.

[30] Ibid.

[31] Interview with Midge Rouse, August 12, 2013.

[32] Carrie D. Kolewaski, Margo L. Paterson, Karen E. Yeates, Cheryl E. King-Van Vlack, “Relocating From the Mushkegowuk Territory for Hemodialisis: The Cree Illness Experience and Perceived Quality of Life,” Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health 8, no. 3 (2010): 129.

[33] Rachel Cull, email message to author, August 8, 2013.

[34] Hotel Dieu Hospital, Weeneebayko Patient Services, Hotel Dieu Online, http://www.hoteldieu.com/wpsmain.html.

[35] Weeneebayko Area Health Authority, WAHA Programs and Services, Weeneebayko Area Health Authority Online, http://www.weeneebaykohealth.ca/siteengine/activepage.asp?PageID=4

[36] Weeneebayko Area Health Authority, WAHA Dialysis Program, Weeneebayko Area Health Authority Online, http://www.weeneebaykohealth.ca/siteengine/activepage.asp?PageID=57


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