Maybe I should live near a reserve...

Today I drove with another doctor to a First Nations reserve and spent my day working there. It was an amazing, eye-openning experience, into the simplicity and complexity of life in an isolated world. Reserves are not just isolated geographically (45 minutes from the big town of Marathon) but they really are a world unto themselves. Not many job opportunities, not much to do, and nowhere to go. This reserve in particular houses a Band that used to be transient, migrating back and forth between the big lake in the summer and the hills for hunting in the winter, until the railway came through. Then they established a trading post (which used to have a hudson's bay company) and it's now home to about 425 on reserve, and another 300 or so registered Band members off reserve.

Our day started with a meeting of the local Drug Addictions Committee. This is a group of band members, as well as a doctor and a local police officer, who are seeking to address the absolute epidemic of drug addictions. They are currently making a survey to assess the level of addiction in the community so that they can apply for more support from the government, but suffice it to say that they wouldn't be surprised if almost everyone on the reserve is doing drugs. It is a sad state of affairs when you are writing a survey so that even a 7 year old can tell you about what drugs they have taken. The cool thing though was the way everyone was working together on this. People who had lived there their whole lives were giving insight into how best to reach people, and what they would be responsive to. And one of the elders started our meeting with a prayer (first in his language and then in english) asking the spirits to guide us, and saying how he had lit his pipe that morning to call for strength and guidance in the group. Something about prayer in different ways, and different languages...it's just magical to me :)

Then it was off to the clinic! There is something about an outpost clinic that really appeals to me. A portable, with nothing fancier than an opthalmoscope (thingy for looking in eyes for those of you who have complained about my overly medical posts!), a stack of charts, and a waiting room full of people who have dropped in because they know that this is the one day of the week when there will be a doctor. Simple. Elegant. Beautiful.

The one heart wrenching thing is the drugs. It is so sad how they can take over a life. I saw someone today who came in to ask to be placed in the hospital, weaned off drugs, and then sent for treatment. This is not uncommon - you have to be clean before you can go into a treatment centre and its tough to get to that point. But its wild to think of how they got here, and how to get them back. This person takes 4 to 5 - 80mg Oxycontin per day. I know this number means nothing to you...but you should be looking shocked and amazed right now. To put it in perspective:
Starting dose of Morphine - 10mg orally every 3-4 hours
Average dose after a while - 10 to 30mg, so let's say 20mg for arguments sake
So theoretical amount of morphine in a day - 120mg max

10mg of Oxycontin = 20mg of Morphine (ie. it is roughly twice as strong)
This person is taking 320 to 400mg of Oxycontin per day
Do the math...that's like 800mg of morphine
*insert shocked face here*

AND its expensive. According to my super secret sources (random patients who are willing to admit this stuff) an 80 of oxycontin is worth about $20 in the big city of Sault Ste. Marie, probably about $40 in Marathon and up to $80 or $100 EACH on the reserve!
*insert another shocked face here*

Needless to say...this addiction has taken over his life and his money. Thankfully he is asking for help. Sad truth- 50/50 chance the treatment will work.

That being said...today was one of the most fulfilling and encouraging days I have had so far. It was a wonderful atmosphere, and despite the addictions and the incredible amount of diabetes, these people are just wonderful. They have a spirit that you don't often see. And a sense of commitment to each other that is we should all learn.

A quote to sum up my thoughts on life today: "We make a living by what we get, but we make a life by what we give."

Lots of love
Pamela

p.s. I am participating in a cross country skiing distance challenge on saturday! I will happily take friendly bets as to how far I will make it - just post your guess as a comment and the person closest to how far I actually go will win some sort of prize...probably a care package of cookies :) To get you started - the most I have ever done in a day before is 7km, and the most I have heard from this distance challenge is 120km!!!