Road to recovery: Cancer in the COVID-19 era

In the Rural Municipality of St. Laurent, Manitoba, a historical Métis community of approximately 1,400 people, Community Connector Marlene Combot is making sure residents have the support they need throughout their cancer journeys from prevention to treatment, survivorship or end-of-life care.

At the onset of the pandemic, Marlene helped effect a swift transition from in-person to online engagement, ensuring that community members continued to be connected and had opportunities to share stories and ask questions about their cancer care.

People in this community can face many obstacles once they receive a cancer diagnosis. The burden of travelling to a treatment centre and the cost of cancer care are two main barriers to accessing care. When a patient was unable to arrange timely transportation into Winnipeg for radiation therapy, Marlene connected them to supports to help provide an affordable stay at a hotel attached to the hospital.

Marlene has also helped patients navigate the administrative burden of treatment. The need for this kind of support has become even more important during the pandemic as people who would typically rely on family or friends have become isolated due to public health measures meant to prevent the spread of COVID-19. Having a Community Connector has helped close the gaps standing in the way of equitable care for residents in the Rural Municipality of St. Laurent.

Feelings of vulnerability or reluctance to seek health care are not uncommon for some of our Indigenous, Métis and underserved residents due to negative experiences from accessing care in the past. Asking for help is difficult and many prefer to avoid it because of that lack of trust in our health-care system. This is especially true for those living in small communities and having someone in the community that they trust, who is Métis, is definitely making a difference.”

Marlene Combot
Community Connector

Accessing medical care is challenging for many Métis in Saskatchewan. Unlike First Nations and Inuit, Métis do not have access to federal health services and non-insured health benefits. As well, some medical services are available only in Saskatoon, Regina and Prince Albert, requiring significant travel and costs for Métis citizens across the province.

One thing that I really really appreciate is what MN–S has done for me. My gratitude is just overwhelming. The mileage, room and stuff they pay, that takes half the burden away. All I had to worry about was my cancer. I hope people don’t abuse this and it can continue forever.

Métis cancer patient

To ensure Métis citizens receive the care they need, and in recognition of the economic challenges brought by the pandemic, the Métis Nation–Saskatchewan (MN–S) improved access to transportation services and supports that helped lessen the stress of travel when dealing with medical concerns, including cancer.

Given the success of the initiative, MN–S was able to establish the Medical and Cancer Travel Assistance Pilot Program, which provides reimbursement of fuel costs, accommodation support and a healthy food allowance to registered Métis citizens and immediate family members who require medical, cancer or dialysis appointments outside their home communities. The program will improve outcomes by addressing travel-related barriers that contribute to health inequities for Métis people in Saskatchewan.

The MN–S Medical and Cancer Travel Assistance Programs have been successful since their launch in July 2020 as they have reduced the financial burdens for citizens travelling to their medical and cancer appointments outside their home community. Many of our citizens have been able to attend their appointments with peace of mind as they have a place to stay with both fuel and parking being covered by Partnership funds, and food and accommodations covered by MN–S. Service providers across the province have also expressed how the programs are helpful in providing the services Métis citizens need to guarantee they attend their treatments without disruption. Reducing these barriers means one less thing to worry about for both Métis patients and service providers in Saskatchewan, as they focus on well-being and keeping safe during the pandemic.

MN–S Programs and Service Manager

In the Northwest Territories, half of people with colorectal cancer are diagnosed at later stages when the chances of cure and survival are lower. To catch cancers at earlier stages, in 2020, the first-ever organized colorectal cancer screening program was implemented in the Beaufort Delta region, an area that historically has had the lowest colorectal cancer screening rates in the Northwest Territories.

The Beaufort Delta is the northernmost region of the territory and is home primarily to the Inuvialuit and Gwich’in First Nations in eight communities. Traditionally, the most effective method of engaging with these communities has been in person but, due to the pandemic, there was a need to shift to virtual community engagement.

Through close collaboration with Indigenous governments, local health-care providers and community health representatives (individuals who have well-established, trusted relationships with members of the community), a virtual engagement approach and community awareness campaign was developed to ensure a culturally appropriate, respectful and community-centred approach to cancer screening. The screening program also included the distribution of fecal immunochemical screening test kits by mail.

Despite the pandemic, the screening program helped increase regional colorectal cancer screening participation rates from 6.7% to 16.5%. Some communities across the region tripled or even quadrupled their screening rates, with one seeing participation climb from 7% to 43.5%.

The success of the program provides lessons on the importance of engaging and collaborating with local stakeholders to successfully engage communities, which can be applied to the implementation of a territory-wide screening program to ensure all residents can benefit from the early detection and treatment of colorectal cancer.

During the pandemic, the close partnership between health-care providers at Qikiqtani General Hospital in Nunavut and The Ottawa Hospital led to the creation of a new and innovative way to provide cancer care for Inuit living in Nunavut.¹ To eliminate the burden of travel and isolation restrictions in place during the pandemic, which would have made it impossible for Nunavummiut to travel home between treatments, the teams at both hospitals worked together to ensure training, policies and cancer drugs were in place and available in Nunavut so that patients could receive their cancer treatment closer to home at Qikiqtani General Hospital.