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New dialysis training centre in Waskaganish brings hope to diabetes patients

BY Patrick Quinn Jun 2, 2023

The grand opening of the Home Dialysis Training Centre and Respiratory Clinic in Waskaganish was celebrated May 16 as a step toward bringing more Cree people with diabetes home to Eeyou Istchee. Ispeyimuunikaitmikw – the Hope Centre – will allow patients to conduct peritoneal dialysis and hemodialysis treatments from the comfort of their homes. 

“This is a building of hope, that families can reunite and be together,” said Deputy Chief Samson Wischee at the inauguration before holding a moment of silence for those previously unable to return home for treatments. “This is a testament that working together we can make things happen.”

With soaring rates of kidney disease in the territory, the initiative will alleviate some of the need for dialysis patients ahead of the expected opening of the new Community Miyupimaatisiiun Centre (CMC) in 2026, which will position Waskaganish as a third hub for regional health services, along with Chisasibi and Mistissini. 

Patients requiring treatment currently travel long distances, sometimes spending years away from their families in Montreal or Chibougamau. While home dialysis was first offered in Waswanipi in 2019 and later in Chisasibi, the Hope Centre is the first to be entirely operated by specialized nurses, eliminating the need for several weeks of training in Montreal.

“Whereas with hospital dialysis you do three times a week for four hours, with home dialysis you can work 9-to-5 and do your dialysis in evenings after you’re done with your little ones,” shared Harriet Shem from Chisasibi. “I can relax at home with them and still travel with my machine by vehicle short distances.”

In collaboration with nephrologists at the McGill University Health Centre (MUHC) in Montreal, Waskaganish expedited this project by offering the old police station as a facility. Cree Health Board executive director Daniel St-Amour said this gesture accelerated negotiations with the Quebec health ministry.

“We announced at the Waskaganish AGA in 2019 there was going to be a new CMC, but they wanted something sooner,” St-Amour told the Nation. “When we started talking about the training centre, it took a month before we got the ministry to approve it. I’ve never seen a project get approved that fast. The community is taking charge.”

MUHC nephrologists will determine whether patients qualify for home care. Some may not initially qualify due to overcrowded housing, physical disabilities or cognitive ailments that prevent working with the equipment, but families may help persuade the nephrologist by offering additional assistance to their loved ones.

Although the centre has three chairs available, St-Amour expects it can initially train one local patient per month and gradually offer service to those from other communities as more staff are trained. Personalized to the patient’s pace over four to six weeks, the training will show how to operate and maintain the machine until patients are completely autonomous.

Training nurses will accompany patients at home until they feel comfortable dialyzing on their own and will remain available to intervene afterwards in case of difficulties. Patients will continue to be welcomed at treatment units in Chisasibi and Mistissini.  

This facility also provides respiratory therapists a better working space until the new CMC arrives, with new equipment like a “body box” to help assess lung function. The CMC will likely have five chairs for home dialysis training along with a full clinic, radiology services and hemodialysis lab so people won’t have to be sent down south.  

“We’re going to need lab techs so it would be great if we have Cree interested in that trade to optimize the use of the hemodialysis chairs,” St-Amour explained. “There are a lot of interesting trades we have to fill. Nurses are very important, but they can’t do the work alone.”

While hemodialysis involves pumping blood to and from an artificial kidney machine, home care isn’t an option when conditions require proximity to hospital equipment. St-Amour admitted that while this initiative is a band-aid helping patients live longer and more comfortable lives, it doesn’t resolve the growing crisis of diabetes in Eeyou Istchee. 

“One-third of the population has diabetes, which is very high,” said St-Amour. “We have to work on those 100 clients on a pre-dialysis list to ensure they can stay off hemodialysis as long as possible. Doing prevention, instead of having hemodialysis within two years, you can go five or maybe 10 years.”

The prevalence of Type 2 diabetes in the region has steadily increased since the early 1980s, when it impacted 1.5% of the population. By 2016, the chronic disease affected 26.7% of Cree over age 20, a rate 3.6 times higher than the general population of Quebec. The health board emphasizes staying active, reducing stress and eating nutritious food to prevent or delay diabetes. 

“It’s great to have a home dialysis program happening now but bringing more machines is not what we want to make our primary focus,” said CHB chairperson Bertie Wapachee. “There are a number of potential patients at the doorstep of dialysis – if we don’t do anything we’ll just be repeating ourselves over and over again to get more machines.”

Wapachee foresees a coming diabetes campaign emphasizing taking responsibility for one’s own health. While diabetes is exacerbated by systemic issues like overcrowded housing and food security, it can be mitigated by exercise on the land and choosing vegetables over sugary snacks.

“We’ve been promoting shared responsibility to improve every individual’s mental and physical health,” Wapachee explained. “If we don’t look after our health, we expect more people to move down south for dialysis. We’re almost waiting to lose lives – we must change that. We’ll do everything we can so every one of them returns home.”

by Patrick Quinn, Local Journalism Initiative Reporter

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Patrick Quinn lives in Montreal with his wife and two small children. With a passion for words and social justice, he enjoys sharing Eeyou Istchee's stories and playing music.