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Several First Nations in Ontario's Far North are in a "very dire situation" as they deal with a surge in COVID-19 amid an ongoing shortage of health-care workers, a doctor with a health organization in the region said as he called on governments to address the issue.

Dr. Lloyd Douglas, a public health physician with the Sioux Lookout First Nations Health Authority, said the recent rise in COVID-19 cases in certain First Nation communities have put an "additional burden" on health-care services that were already strained before the pandemic. 

"Our communities and our community members face a very dire situation," said Douglas, whose health unit provides a variety of essential health services to 33 northern and remote First Nations communities.

"The long history of limited access to health care and health-care services, the inequities in terms of the system, this is now compounded by critical staff shortages, increases in COVID-19 cases, the direct and indirect impacts of COVID over the past two-plus years. So we have a very challenging time."

Douglas said he'd like to see all levels of government work to maintain the resources necessary to provide adequate and equitable health care to First Nation communities.

"We really need to implement policies that will ensure that the workforce for this region in terms of health care is adequate and appropriate, and this can be sustained and maintained for many, many years to come," he said. 

In Sandy Lake First Nation, more than one-seventh of the population – or 613 out of roughly 3,500 people – had COVID-19 as of Monday, statistics from the Sioux Lookout First Nations Health Authority show.

Monias Fiddler, the executive director of the First Nation, said there were six nurses working in the community on Tuesday, including two who were sent in that day to specifically deal with the local COVID-19 outbreak.

Sandy Lake First Nation Chief Delores Kakegamic said the number of nurses is supposed to be closer to 12, and as a result of the shortage, nurses were recently being limited to responding to health emergencies. 

While the situation is manageable for now, it's "really nice" when more health-care workers are sent up north, she said.  

"The current nurses that are here, they get overwhelmed too, so it's nice to see us getting extra hands, especially in our nursing department," Kakegamic said.

To the east, the Webequie First Nation recently had as many as 64 active COVID-19 cases in a population of roughly 850 people, said Chief Cornelius Wabasse. That number stood at 11 on Monday. 

Wabasse said there are currently two nurses in his community and a doctor typically comes in on a monthly basis, but there's supposed to be three or four nurses at a given time. Due to the shortage, he said the nurses have to occasionally be called in during their time off. 

Having limited access to health care means many residents of Webequie First Nation who are experiencing mental health issues cannot get the help they need and community members need to be flown out if they have more complex health issues, Wabasse said. 

Part of the reason the Webequie First Nation has struggled to attract more health-care workers is due to the lack of accommodations available in the community. 

"For us to have more nurses in our community, we will need to have accommodations, but we have limited accommodations," Wabasse said. 

To further complicate matters, the lack of housing and overcrowding in First Nation communities in Ontario, including Sandy Lake and Webequie, causes COVID-19 to spread like wildfire, the chiefs of those communities said. 

"Sometimes there are, I'd say, 10 people per house, and of course, you know the houses are not so big, so yeah, overcrowding is definitely one of the reasons why all families are getting positive," Kakegamic said of the situation in Sandy Lake. 

"They're passing it around their houses, because there's nowhere else to go to isolate." 

Wabasse said that's even more of a concern when the weather gets colder and people spend more time indoors. 

"We keep trying to work with our governments so that we can address some of the housing issues to alleviate some of the problems we have," he said. "If there's going to be an outbreak in the fall, we're gonna have an issue." 

A spokeswoman for the Ontario Ministry of Health said the province continues to work with the federal government and First Nation partners "to support, co-ordinate and align processes in health care and public health services."

Anna Miller wrote in a statement that the ministry and Ontario Health also launched the COVID-19 Temporary Summer Locum Program Expansion, which provides additional support to eligible hospitals in rural and northern Ontario to maintain 24-7 emergency department services between June 1 through to Sept. 5.

She added that the government is adding 160 undergraduate seats and 295 postgraduate positions, including 30 undergraduate seats and 41 postgraduate positions at the Northern Ontario School of Medicine, over the next five years to increase access to health-care professionals "in every corner of the province." 

The federal government did not immediately respond to requests for comment.

This report by The Canadian Press was first published July 13, 2022.

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This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship.

Noushin Ziafati, The Canadian Press