The Cree Health Board and the Canadian Red Cross held a milestone winter exercise in Chisasibi February 18 to demonstrate how the Nâtimâchâukimikw Mobile Health Unit (MHU) can improve medical response in northern communities.
The exercise included the Canadian Rangers, Waswanipi’s public safety team and first responders from Chisasibi, where the initiative first originated in 2018. Chief Daisy House emphasized that working together helps ensure that Cree cultural perspectives are integrated into regional healthcare solutions.
The MHU builds competency in winterized infrastructure, equipment and clinical setups that can respond to medical emergencies in extreme subarctic conditions. A newly acquired tent can withstand temperatures below -60°C and winds up to 120 mph.
“We were testing all that equipment while also providing training for the local capacity of human resources,” said Jason Coonishish, the CHB Director of Emergency Measures and Disaster Planning.
The simulation combined two healthcare scenarios commonly encountered in the North. First was treatment for smoke inhalation resulting from a housefires, which are five times more common in Indigenous communities. The team then received snowmobile accident victims transported from 10 km away by the Canadian Rangers.
“One patient came from the ambulance service here and another from a bush call that the Canadian Rangers responded to,” explained Dr. Kavi Singh-Gosal, who manages clinical operations for MHU deployments. “The Rangers had packaged the patient in the field, then we initiated therapy and made plans to transfer the patient.”
As climate change and geopolitical instability heightens the North’s strategic importance, the Red Cross wants to improve healthcare access and capacity for disaster preparedness. Knowledge has flowed both ways between organizations like the Rangers, a Canadian Army Reserve unit known as the “eyes and ears” of the North, and the CHB.
“We have supported the development of a MHU that is locally guided, culturally grounded and designed to meet the realities of northern and remote communities, especially in times of crisis,” stated Canadian Red Cross CEO Conrad Sauvé.
For the CHB, the MHU is a complementary layer of emergency response that provides valuable flexibility during emergencies. The concept already proved beneficial in 2021 when three tents were used to house Chisasibi Elders for eight months after a fire destroyed their housing.
During the pandemic, tents outside the regional hospital supported triage, with rapid tests deployed in a waiting room, preventing Covid-positive patients from entering the main building. With the nearly 50-year-old building needing frequent renovations, the MHU can provide missing services until Chisasibi’s new hospital opens.
“Covid showed us that when things go off the rails you can’t count on help coming fast,” said Singh-Gosal. “We may require help from outside, but we need to respond to our own emergencies. The partnership is for the Cree Nation to build self-sufficiency and resilience.”
As a modular unit, the team can mobilize supplies and staff as required. When the Waswanipi health clinic was flooded a few years ago, they used a temporary building and only needed the MHU to house supplies. In the event of wildfire smoke, tents could use HEPA filters and fans to create a clean air shelter.
“When Wemindji evacuated about 200 people to Chisasibi [in 2023], that was phase one,” said Coonishish. “If we had moved to the other two phases, I’m sure the staff of their clinic would have served the Wemindji people at the mobile hospital, so they do not disturb the local clinic or hospital.”
At the first full-scale deployment during the 2024 Eeyou Istchee Summer Games in Mistissini, the MHU provided on-site care for 129 patients, ensuring the local clinic wasn’t overwhelmed. Just as fans successfully kept the tent comfortable on hot days, the new winterized tent was tested for air circulation to allow for improvements.
“Our vision has remained, where access to care is never out of reach, even across a territory as wide and weather as unpredictable as ours,” said Coonishish. “When we deploy the MHU, we always include a teepee with a team that takes care of the cultural and psychosocial components.”
The MHU can be up and running 48 hours from getting a call. Kepa Transport currently responsible for moving it from Chisasibi on 18-wheeler trucks. Coonishish said the company is familiar with the territory, and even predicted the precise arrival time at the isolated Mirage camp this fall for land-based training workshops.
Participants learned operating procedures and how to overcome challenges of the northern climate and limited resources. A key part is planning selection and layout of equipment that’s sufficiently rugged yet lightweight, easy to transport, stock and store.
“It’s kind of like when you fly in a helicopter,” observed Singh-Gosal. “We choose our equipment very carefully because there’s a weight and space limitation. Everything you carry has to be analyzed for how big it is, can we use it if it’s dark. That kind of mindset developed in the North helps the Red Cross be more efficient.”
Singh-Gosal said basic emergency response isn’t that different in Eeyou Istchee from what it would be at the North Pole or the moon. An exercise with the Canadian Space Agency next month will explore healthcare similarities between a hunter in the bush and an astronaut in space.
As the Red Cross heads to Nunavik after reaching a deal to help fight tuberculosis, Coonishish believes the MHU could be deployed to assist with mass testing and containment. With its newly expanded four-season adaptability, the organization is building the autonomy to deploy whenever and wherever needed.
“It has been amazing working with the Canadian Red Cross,” said Coonishish. “My regional department, Pimuhteheu, means ‘we walk together.’ And throughout this project, that is what we have done. It meant a great deal to see how genuinely they listened and learned from the Cree way of doing things.”