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Indigenous people had some of the highest rates of ER visits during 2014 Yellowknife wildfires: study

Researchers suggest lack of access to care, inadequate housing and systemic racism may have played a role in health outcomes in Inuit and Dene communities during record-breaking wildfire season

Melaine Simba will never forget the months she spent inside her home on Ka’a’gee Tu First Nation, south of Yellowknife, with her windows tightly shut to prevent wildfire smoke from seeping in. It was the summer of 2014 and she was following public health orders to stay inside during the Northwest Territories’ worst wildfire season on record.

“There were fires all around us,” Simba told The Narwhal. “I couldn’t go outside, and I couldn’t take my son outside.”

“It was just so hard to breathe in that smoke with all the falling ash.”

According to a new study published in the journal BMJ Open, the wildfires caused extremely poor air quality during the more than two months of unrelenting smoke exposure. This led to a sharp increase in respiratory illnesses, with vulnerable populations, such as children and Indigenous people, disproportionately affected. 

The study also found that public health advisories asking people to stay inside during the wildfires were “inadequately protective,” possibly because people grew tired of the long period of isolation. With climate change contributing to longer and more intense wildfire seasons, the study authors say there’s an urgent need to be far more prepared in the future.

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“A really big take home of this study is that climate change is bad, and it is going to get worse,” Courtney Howard, the lead author of the study and an emergency physician in Yellowknife, told The Narwhal, adding that smoke exposure levels during the wildfires were believed to be some of the worst ever studied globally.

“We are going to need new, proactive approaches as we go into a warmer, smokier state on this planet.”

Warmer temperatures caused by climate change can spur drier conditions, increasing the risk of wildfires. In 2014, moderate to severe drought conditions and lightning strikes were the catalyst for 385 fires that impacted 3.4 million hectares of forest in the Northwest Territories.

According to the federal government, temperatures across the North are warming more than twice as fast as the global rate. In Yellowknife, between 1943 and 2011, the annual average temperature in the city increased by 2.5 C

Particulate matter increased fivefold during the wildfires

The average level of particulate matter (PM 2.5) in the air was five times higher than normal during the 2014 wildfires, compared with the two previous years and 2015. PM 2.5 — inhalable particles less than 2.5 microns in diameter — is associated with a range of respiratory conditions.

The study found this increase in particulate matter was associated with an increase in visits to the hospital for asthma, pneumonia and chronic obstructive pulmonary disease. Asthma-related emergency room visits doubled, with the highest rates found in women, people older than 40 and Dene. Visits for pneumonia increased by 57 per cent, with men, children and Inuit particularly affected. And visits for chronic obstructive pulmonary disease increased by 11 per cent, with men, the Inuit and Dene populations and people over 60 showing the greatest risk. 

While the results suggest that Indigenous people were more affected, Howard said it’s difficult to say for sure because they may have been more likely to go to the ER due to lack of access to medical clinics. 

The demand for medicine that helps alleviate the symptoms of asthma surged, too. The dispensation of salbutamol, the agent found in puffers, increased by 48 per cent.

courtney howard standing in a snowy field

Yellowknife emergency physician Courtney Howard was lead author on a study on the health effects of the 2014 Yellowknife wildfires, published in the journal BMJ Open in February 2021. Photo: Pat Kane / The Narwhal

“In fact, one of the pharmacies ran out over the course of the summer,” Howard said. 

Supply chain problems “demonstrated a lack of resilience,” she added.

The study also sheds light on systemic issues that contribute to worse health outcomes in vulnerable populations, including Indigenous people.

“Climate-related health effects impact all populations but are likely to disproportionately affect communities living at the frontlines of rapid climate change, as well as those experiencing systemic racism, socioeconomic and health disparities, and/or the enduring effects of colonization,” the study states.

‘Some people were visibly traumatized by this event’

Protracted periods of isolation, a lack of exercise, fear and stress during the wildfires also had negative impacts on people’s mental health and way of life, according to a 2018 report that Howard was also involved with. 

Livelihood and land-based activities were disrupted for some interviewees, which had negative consequences for mental, emotional and physical well-being,” the report states.

During the summer, Indigenous people across the territory fish, hunt and visit old villages and the gravesites of relatives, Jason Snaggs, the chief executive officer of Yellowknives Dene First Nation, told The Narwhal. The wildfires prevented people from taking part in these cultural activities, he added. 

“This leads to depression, and you have sort of a compounding effect, in terms of colonialism, the effects of residential schools, intergenerational trauma,” Snaggs said.

“Some people were visibly traumatized by this event.”

Sheltering in place can lead to increased rates of family violence, including violence against Indigenous women, Snaggs added.

huge smoke cloud. photo taken from a road next to a field

The 2016 Fort McMurray wildfires might have caused similar increases of family violence, as is evidenced by the 300 per cent increase of calls to a local family crisis centre. Photo: Jason Woodhead / Flickr

During the 2016 wildfires that tore through Fort McMurray, Alta., calls to a local family crisis centre increased by upward of 300 per cent, according to Michele Taylor, executive director of Waypoints, an emergency shelter for women and children. 

Howard said the 2014 wildfires were a seminal event in people’s understanding of climate change in the region.

“At the time, ecological grief and eco-anxiety hadn’t really shown up in the evidence base,” she said. “Looking back at our analysis, I think we can easily apply those terms to what we found and say it was a trigger for ecological grief and anxiety for a lot of people.”

Communities need to prepare long before wildfire season 

Howard said communities — particularly Indigenous communities — need to be better equipped to withstand wildfires.

Some homes in Indigenous communities are overcrowded and aren’t built to the same standards as those elsewhere in the territory. Howard emphasized the need to address this problem first and foremost.

The BMJ study recommends governments install ventilation systems in old and new homes ahead of wildfire season. Doing so would ensure residents have access to clean air without having to leave the house. 

“Our infrastructure decisions need to be based on the temperature and precipitation patterns that we’re anticipating for the coming century as opposed to the ones we had in the last one,” Howard said.

Satellite image of the smoke from the Northwest Territories wildfire near Great Slave Lake.

Satellite imagery near Great Slave Lake shows the spread of wildfire smoke in the Northwest Territories during the 2014 wildfires. The centre of the photo shows a pyrocumulonimbus cloud, sometimes called fire clouds, which are an atmospheric phenomenon generated by extreme heat and rising smoke, usually from wildfire or volcano eruptions. Courtney Howard, lead author of a new study on the 2014 wildfires, says smoke exposure levels during that period were some of the worst ever studied. Photo: NASA Earth Observatory

The study also recommends primary health-care practitioners identify people who may grapple with respiratory illnesses and ensure that air filters and puffers are readily available prior to wildfire season.

“That will allow people to manage their symptoms at home and never get to the point where they’re stuck in the emergency department,” Howard said. “The sooner particularly vulnerable people have access [to air filters and puffers], the better.”

In 2014, the City of Yellowknife waived user fees for a multi-purpose recreation facility so residents could go there to breathe clean, filtered air and exercise, Howard said. But not everyone in Yellowknife is afforded the same level of access. N’Dilo, which is part of Yellowknives Dene First Nation and is located in Yellowknife proper, only has one space people can gather in during a wildfire — a 45-year-old gym that isn’t equipped with a filtration system to keep air clean.

The study suggests that public health practitioners use satellite-based smoke forecasting to determine whether clean air shelters are needed in advance of wildfire season and, if necessary, make more available. 

The 2018 report — which documented the experiences of 30 community members from Yellowknife, Dettah, N’Dilo and Kakisa who lived through the wildfires — found there was a consensus among participants about the need for improved communication and coordination at the community and territorial levels as wildfires intensify.

Howard said residents and health-care providers need to proactively prepare for wildfire season every year.

 “We need to be viewing wildfire season the same way we view cold and flu season.”

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