I’ve been tracking the Neskantaga crisis since my first visit three years ago. What struck me then remains painfully evident today: how quickly essential services we take for granted in urban Canada can collapse in remote communities.
The closure of Neskantaga First Nation’s only health centre last week marks another devastating blow to a community already enduring Canada’s longest-standing boil water advisory – now stretching beyond 28 years.
“We’re facing a public health emergency on top of our ongoing water crisis,” Chief Wayne Moonias told me during our phone conversation yesterday. “Our people have nowhere to go for basic medical care except to fly out to Thunder Bay.”
The nursing station, operated by Indigenous Services Canada, shut down after significant structural damage was discovered during a routine maintenance inspection. According to federal officials, the building’s foundation has deteriorated to “unsafe levels,” with preliminary assessments indicating extensive repairs needed before healthcare workers can safely return.
For the 300-plus residents of this fly-in Oji-Cree community located about 450 kilometres north of Thunder Bay, this closure eliminates their only point of contact for everything from prenatal care to chronic disease management to mental health services.
The health centre typically houses two nurses who handle approximately 30 patient visits daily. Community members requiring specialized care already faced challenging medical evacuations, but now even basic health services require expensive air travel to Thunder Bay.
“Every earache, every fever, every prenatal checkup – our people now face a choice between expensive flights or going without care,” Moonias explained. His voice carried the weight of a leader watching his community absorb yet another infrastructure failure.
Statistics from the Sioux Lookout First Nations Health Authority paint a troubling picture of health outcomes in remote northern communities. Life expectancy in these areas falls 8-10 years below the provincial average, while chronic conditions like diabetes affect over 20% of adults – nearly double the rate in southern Ontario.
The timing couldn’t be worse. Winter’s approach means increasingly unpredictable flying conditions, potentially leaving community members stranded without medical attention during emergencies. Last winter, three medical evacuations were delayed by more than seven hours due to weather conditions.
Community health worker Loretta Moonias (no relation to the chief) has been coordinating care since the closure. “We’re using the band office for basic first aid, but we have no secure place for medications, no examination rooms, and our elders struggle to even reach this temporary location,” she said.
Indigenous Services Canada has promised temporary solutions, including rotating visiting healthcare providers and expanding telehealth services. However, the community’s internet infrastructure remains unreliable, with regular outages lasting days – another infrastructure challenge that compounds the healthcare crisis.
The health centre closure exists in a broader context of infrastructure deficiency. Beyond the internationally recognized water crisis, Neskantaga faces chronic housing shortages, with approximately 40% of homes requiring major repairs according to the most recent housing assessment.
NDP MP Charlie Angus, whose riding includes several remote First Nations communities, called the situation “completely unacceptable” in Parliament last week. “How many more emergencies does Neskantaga have to endure before this government delivers the basic infrastructure that every Canadian deserves?”
Federal Indigenous Services Minister Patty Hajdu acknowledged the urgency, promising “immediate steps” to restore services. Her office confirmed yesterday that engineering assessments are underway, with plans to deliver a portable healthcare facility within two weeks.
I spoke with Dr. Michael Kirlew, a physician who has worked extensively in northern First Nations communities, who contextualized this closure within systemic healthcare inequities. “What we’re seeing in Neskantaga reflects the broader two-tier healthcare system that exists in Canada. The standards of care and infrastructure that would never be acceptable in urban centers are somehow tolerated in remote Indigenous communities.”
Neskantaga’s water crisis offers a troubling parallel. Despite repeated federal promises and investments, community members still cannot drink from their taps after nearly three decades of boil water advisories. The health centre closure follows a similar pattern – infrastructure neglected until catastrophic failure forces emergency response rather than sustainable solutions.
Chief Moonias remains skeptical of temporary fixes. “We’ve heard promises before. My community needs permanent solutions – a new health facility that meets modern standards and the trained staff to run it.”
The lack of healthcare access amplifies other community challenges. School principal Frank Dixon reports increasing student absences as families leave the community to seek medical care in Thunder Bay. “We lose educational continuity when families must choose between staying healthy and staying in school,” Dixon explained.
Elder Mary Sakanee, 78, exemplifies the human cost. She manages diabetes and heart conditions requiring regular monitoring. “I can’t afford flights to Thunder Bay every month for checkups,” she told me. “So I just pray nothing goes wrong until they fix our nursing station.”
The crisis highlights broader questions about Canada’s commitment to reconciliation and infrastructure equity. While urban Canadians expect immediate solutions to service disruptions, Neskantaga’s experience suggests a different standard applies to remote Indigenous communities.
As federal officials prepare their response, Chief Moonias emphasizes that piecemeal solutions won’t address the fundamental issues. “We need the same infrastructure commitment that any Canadian community would receive – nothing more, nothing less.”
For now, community members wait for help, managing as best they can with limited resources and uncertain timelines. Their resilience remains remarkable, but as Chief Moonias reminded me: “Resilience shouldn’t be required to access basic healthcare. That’s something every Canadian deserves by right.”
