The Chief of the Atikamekw Council of Manawan Sipi Flamand recalls from the outset that this ambulance is expected
.
He talks about the major health problems of the members of his community, chronic diseases. It is important to consider this reality so that the department serves [la communauté avec] another ambulance. We do not know what can happen, but we must protect ourselves and have the necessary tools to respond to situations.
According to him, in 2018, former chief Jean-Roch Ottawa had already recommended having two ambulances in Manawan. Finally, at the end of 2018, after decades of waiting and negotiating, the community of 2,500 people got their ambulance service with just one ambulance.
If the arrival of this ambulance has really improved the situation, the need is such – and also growing – that regularly there are service failures
, says chef Sipi Flamand. Sometimes these service disruptions contribute to tragedies, as was the case in April 2022 for a baby.
After her inquest, the coroner concluded that emergency care had been received too late. According to coroner Géhane Kamel, the significant delays, in particular of ambulance transport, had an impact in the death of the child. It took more than 8:30 hours between the initial call and the arrival of the 7-month-old baby at the CHU Sainte-Justine.
In this context, and given the initial medical assessment, it seems to me very likely that delays of this magnitude had an impact on the child’s survival.
concluded coroner Géhane Kamel.
During the call for the little girl, the Manawan team was overwhelmed and could not take the call. We had to ask a team from Saint-Michel-des-Saints to come to Manawan.
More than one call per day
Since its deployment at the end of 2018, the Manawan ambulance has left with a patient in the direction of Saint-Michel-des-Saints or Joliette between 300 and 350 times each year, according to a document obtained by Indigenous Spaces under the Act respecting the access to documents held by public bodies and on the protection of personal information.
In 2022, the Saint-Michel-des-Saints ambulance was called by Manawan at least 72 times.
In 2021 and 2022, in 10% of cases, the response to an ambulance request in the community was made by a sector other than Manawan.
These numbers don’t throw down
the Deputy President and CEO of the Integrated Health and Social Services Center (CISSS) of Lanaudière, Philippe Éthier.
Considering the number of people [dans la communauté] and remoteness is a fairly constant volume of calls over the years and follows what we have in other regions in terms of proportionality
he explains.
« The big difference with Manawan is the travel time. »
According to the document obtained by Indigenous Spaces, the average time to respond to calls from Manawan from Saint-Michel-des-Saints (i.e. 86 kilometers) for the period from 1is August 2018 to December 7, 2022 is 1:21 a.m.
You then have to return to Saint-Michel-des-Saints, then go to Joliette hospital, nearly 100 kilometers away.
To500calls in Terrebonne, it’s not the same thing in terms of ambulance availability as in Manawan. Because in Manawan, you have to calculate that the ambulance will be gone for at least four hours. The absence of a vehicle is longer. The second vehicle will come and sort it out for the most part”,”text”:”400 to 500 calls in Terrebonne, it’s not the same thing in terms of ambulance availability as in Manawan. Because in Manawan, you have to calculate that the ambulance will be gone for at least four hours. The absence of a vehicle is longer. The second vehicle will come and fix this in large part””>400 to 500 calls in Terrebonne are not the same thing in terms of ambulance availability as in Manawan. Because in Manawan, you have to calculate that the ambulance will be gone for at least four hours. The absence of a vehicle is longer. The second vehicle will come and settle this in large part
continues Philippe Éthier.
To reduce transport time, the CISSS had already set up a transfer system at Saint-Michel to allow the Manawan ambulance to return to the community.
The Deputy President and CEO of the Integrated Health and Social Services Center (CISSS) of Lanaudière, Philippe Éthier.
Photo: Courtesy: CISSS de Lanaudière
The schedule for paramedics will change. Currently, they are on call waiting 24 hours a day. Starting in April, a hybrid formula, the core-flex, will be introduced. These schedules allow paramedics to have eight hours of guaranteed rest rather than remaining on call at all times, and therefore ambulance service is technically provided for 16 hours.
The model we deploy is to counteract the effects of the faction. For example, when we have an ambulance that had two to three calls on the line after a certain number of hours, we had to give the paramedics a rest period
says Philippe Éthier.
And there we were with a coverage challenge. Sometimes, we had to bring an ambulance from Saint-Michel or try to find a replacement team in Manawan for eight or ten hours. However, it is not easy, because we do not have a large bank of paramedics on call in Saint-Michel and Manawan is far away.
he explains.
« This second vehicle will make it possible to organize the hours so that, in the greatest call periods, we have more coverage. »
It will also limit the local domino game
in the region when an ambulance from Saint-Michel left for Manawan and was therefore no longer available to respond elsewhere, he continues.
Frontline services are provided by the Manawan Health Center. The Lanaudière Regional Hospital Center is located nearly 190 kilometers from the Atikamekw community.
Photo: Radio-Canada / Marie-Laure Josselin
Laurent Hamel, general manager of Paraxion, the ambulance company serving Manawan, also believes that with these two teams, That should settle the frequency of breaks a lot.
thanks to the presence of another ambulance available in the community, unless she left on another call of course
.
The paramedics will be temporarily housed at the Manawan Elders’ House, where four rooms will be rented.
The question of their accommodation remains complicated, since Manawan, like the vast majority of indigenous communities, faces a constant challenge of lack of housing for its members. Nearly 40% live in overcrowded housing and almost half of homes need major repairs, according to the 2016 Statistics Canada census.
A helicopter in case of extreme emergency
Laurent Hamel also reminds us that if Manawan is not so far from Montreal or from a city, it’s very isolated
. In emergency cases, even if the paramedic goes quickly, he is very far from the hospital in time
he said.
Transfer by helicopter is currently possible for cases of extreme urgency, indicates Chief Sipi Flamand. The aircraft then lands at the pow-wow site. A project to have a heliport in Manawan is being drafted. It was one of the recommendations of coroner Géhane Kamel following the infant’s death last April.
A helicopter is good for cases of extreme emergency, but you still have to consider the weather conditions, and the fact that it leaves Saint-Hubert to come here, it still takes time to be able to bring to a nearby hospital
nuance all the same Sipi Flamand.
He is therefore delighted with the arrival of a second ambulance. Everything is fine on that side, but the road is still problematic
he recalls.
« It is inhuman what the patients transported by ambulance must live on this road. We also put members of the community at risk! »
Because the 86 kilometer path is beautiful and paved for the first eight kilometers until the crossroads leading to the Lac Taureau inn. Then, gravel, a succession of bends and a path that is often in poor condition. For years, the Atikamekw of Manawan have been asking for a new, safer road.
Manawan is a special case, says Laurent Hamel of Paraxion,kilometers which is passable, but difficult, not very lit. Summer is a washboard. Winter is a little better, so transport is a little faster. Fall and spring are very difficult with snowmelt or rains”,”text”:”an isolated area at the end of an 85 kilometer forest road which is passable, but difficult, not very well lit. Summer is a washboard. Winter is a little better, so transport is a little faster. Autumn and spring, it is very difficult with snowmelt or rains”}}”>an isolated area at the end of an 85 kilometer logging road that is passable, but difficult, not very well lit. Summer is a washboard. Winter is a little better, so transport is a little faster. Autumn and spring, it is very difficult with snowmelt or rains.
A better road would solve a big problem in terms of vehicle maintenance and speed up the response time of paramedics
he assures.
Another report will deal with the state of the road between Manawan and Saint-Michel-des-Saints and the impact on health services.