Indigenous communities worldwide continue to disproportionately bear the burden during pandemics due to ongoing health inequities and systemic exclusion from pandemic decision-making processes. As the global community prepares for the next pandemic, it is critical to prioritise Indigenous leadership and governance within public health responses. This commentary highlights successful models of Indigenous-led pandemic responses during COVID-19 in Canada and Australia. It introduces the EPIC (Equity, Partnerships, Intelligences, and Change) framework, that emphasises equity, leadership and local and cultural intelligence as critical components to improve pandemic preparedness and response for Indigenous communities. This international collaboration calls on governments and health authorities to uphold Indigenous sovereignty, self-determination, and leadership in pandemic planning and response efforts.

The COVID-19 pandemic exacerbated food insecurity issues in geographically isolated communities, including Fort Albany First Nation (FAFN). This research examines FAFN’s adaptive strategies to improve food security, highlighting community resilience and leadership. Data were gathered through semi-structured interviews with 20 community members who were involved in the pandemic response, either as members of the pandemic committee or as managers of community programs. Thematic analysis revealed significant adaptation of existing programs and the establishment of new initiatives to address food security during the pandemic. Initiatives, such as the community garden and the Fort Albany Farmers Market were food security programs that existed prior to the pandemic, and despite labor shortages during the pandemic, logistical hurdles were addressed to maintain operations and enhance food distribution efficiency. New emergency food initiatives, backed by government support and community efforts, successfully delivered food to vulnerable households. Traditional subsistence activities, such as hunting and fishing, were essential for providing sustenance and strengthening community resilience. These adaptive strategies highlight the critical role of local leadership, community participation and ingenuity, and the utilization of Indigenous knowledge in overcoming food security challenges during crises. This paper underscores the need to support Indigenous food sovereignty and build resilient local food systems tailored to the unique needs of First Nations communities. The experiences of FAFN during the COVID-19 pandemic provide invaluable insights into the resilience and innovation required to improve food security in remote and vulnerable populations, emphasizing the need for sustained investment and policy support in these communities.

INTRODUCTION:Geese harvesting is a longstanding cultural tradition deeply ingrained among the Omushkego Cree in Fort Albany First Nation, embodying a holistic approach to health that integrates Indigenous knowledge, community wellbeing, and resilience. Despite historical disruptions stemming from colonization and assimilation policies, women have played a pivotal role in preserving and passing down traditional practices. The significance of goose harvesting extends beyond providing a nutrient-rich and cost-effective food source; it serves as a vehicle for cultural preservation and education, particularly fostering language acquisition among children. Nevertheless, concerns persist regarding the potential decline in the transmission of Indigenous knowledge. The interruption of intergenerational knowledge transfer not only poses implications for overall wellbeing but also worsens historical trauma within the community. In response to these challenges, the Niska (goose) harvesting program was developed with an aim to revitalize community harvesting practices, with a specific focus on incorporating the perspectives of women, especially in the preparatory and smoking phases of the geese. METHODS:Omushkego Cree women were approached to participate. The study was conducted during the spring of 2018, and employed photovoice and semi-structured interviews that explored the impact of geese preparatory activities on the health and wellbeing of Indigenous women. RESULTS:Major themes from the qualitative data included the importance of knowledge sharing, cultural continuity, healing, and the profound connection to the land. Women emphasized the value of sharing acquired knowledge, passing on traditions, and maintaining a connection to their cultural identity. Cultural continuity, depicted through intergenerational teachings and experiences, emerged as crucial for overall wellbeing. Participants spoke of the healing dynamics derived from engaging in traditional activities, highlighting the positive impact on physical, mental, emotional, and spiritual wellbeing. The land was identified as a central element in this healing process, representing more than just a physical space but an extension of home, contributing to a sense of peace and tranquility. The land became a medium for transmitting cultural teachings, shaping identity, and sustaining a subsistence lifestyle. CONCLUSION:The study emphasizes the importance of future research including more female youth participants to uncover specific challenges and strengths within this demographic. Overall, the Niska program demonstrates a comprehensive approach that intertwines cultural revitalization, community engagement, and holistic wellbeing, emphasizing the need for interventions that go beyond immediate challenges to create enduring positive impacts on Indigenous communities.

Background/purpose In response to the opioid use challenges exacerbated from the COVID-19 pandemic, Fort Albany First Nation (FAFN), a remote Cree First Nation community situated in subarctic Ontario, Canada, implemented a buprenorphine-naloxone program. The newly initiated program was collaboratively developed by First Nations' nurses and community leaders, driven by the community's strengths, resilience, and forward-thinking approach. Using the First Nations Information Governance Centre strengths-based model, this article examines discussions with four community leaders to identify key strengths and challenges that emerged during the implementation of this program. Methods this qualitative study amplify the positive aspects and community strengths through the power of oral narratives. We conducted 20 semi-structured face-to-face interviews with community members who helped lead FAFN's COVID-19 pandemic response. Utilizing the Medicine Wheel framework, this work introduces a holistic model for the buprenorphine-naloxone program that addresses the cognitive, physical, spiritual, and emotional dimensions of well-being. Results Recommendations to support this initiative included the need for culturally competent staff, customized education programs, and the expanding of the program. Additionally, there is a pressing need for increased funding to support these initiatives effectively and sustainably. The development of this program, despite challenges, underscores the vital role of community leadership and cultural sensitivity to address the opioid crisis in a positive and culturally safe manner. Conclusion The study highlights the successes of the buprenorphine-naloxone program, which was developed in response to the needs arising from the pandemic, specifically addressing community members suffering from opioid addiction. The timely funding for this program came as the urgent needs of community members became apparent due to pandemic lockdowns and isolation. Holistic care, including mental health services and fostering community relations, is important. By centering conversations on community strengths and advocating for culturally sensitive mental health strategies that nurture well-being, resilience, and empowerment, these findings can be adapted and expanded to support other Indigenous communities contending with opioid addiction.

The COVID-19 pandemic has disproportionately impacted Indigenous populations worldwide placing much importance on rapid and equitable vaccination. Nevertheless, many Indigenous communities have reported high vaccine hesitancy and low COVID-19 vaccine uptake. This may be attributed to various factors, including a lack of support for Indigenous leadership efforts to protect their communities and the pervasive infodemic targeting First Nations Peoples. In August 2022, we hosted an international symposium to bring together Indigenous and non-Indigenous community leaders, clinicians, and researchers to discuss pandemic experiences and lessons learnt. This commentary highlights examples of harnessing Indigenous leadership and self-governance to design and deliver tailored community-based and culturally appropriate COVID-19 vaccination programmes that improved vaccine uptake in Australia and Canada. These case studies demonstrate that Indigenous social-governance systems need to be valued, respected, and upheld if we are to make meaningful efforts to address health inequities among Indigenous communities during future pandemics.

Purpose. To plan community-driven health promotion strategies based on a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the healthy eating and physical activity patterns of First Nation (FN) youth. Design. Cross-sectional qualitative and quantitative data used to develop SWOT themes and strategies. Setting. Remote, subarctic FN community of Fort Albany, Ontario, Canada. Subjects. Adult (n = 25) and youth (n = 66, grades 6–11) community members. Measures. Qualitative data were collected using five focus groups with adults (two focus groups) and youth (three focus groups), seven individual interviews with adults, and an environmental scan of 13 direct observations of events/locations (e.g., the grocery store). Quantitative data on food/physical activity behaviors were collected using a validated Web-based survey with youth. Analysis. Themes were identified from qualitative and quantitative data and were analyzed and interpreted within a SWOT matrix. Results. Thirty-two SWOT themes were identified (e.g., accessibility of existing facilities, such as the gymnasium). The SWOT analysis showed how these themes could be combined and transformed into 12 strategies (e.g., expanding and enhancing the school snack/breakfast program) while integrating suggestions from the community. Conclusion. SWOT analysis was a beneficial tool that facilitated the combination of local data and community ideas in the development of targeted health promotion strategies for the FN community of Fort Albany.

The remote First Nation (FN) communities of the Mushkegowuk Territory on the west coast of James Bay, Ontario, Canada are currently facing increased development pressures and the imposition of a government land use planning process. The land use planning process is mandated in the Far North Act (received Royal Assent on September 23, 2010). There is a need for capacity enhancement for community-based natural resource planning and management in the Territory. A number of frameworks are emerging for addressing change brought on by resource development and building resilience to such change at the community level. Among these include the concept of adaptive capacity. In collaboration with FN community leaders, we explored the use of "collaborative geomatics" tools to foster adaptive capacity. Our action research suggests that collaborative geomatics technologies should enhance the Mushkegowuk First Nations' adaptive capacity to address environmental and policy change by allowing them to collect and manage data collaboratively (e.g., traditional environmental knowledge, western science) to create opportunities for innovative community development, including natural resource development and management. (C) 2011 Elsevier Ltd. All rights reserved.

Although lead isotope ratios have been used to identify lead ammunition (lead shotshell pellets and bullets) as a source of exposure for First Nations people of Canada, the actual source of lead exposure needs to be further clarified. Whole blood samples for First Nations people of Ontario, Canada, were collected from participants prior to the traditional spring harvest of water birds, as well as post-harvest. Blood-lead levels and stable lead isotope ratios prior to, and after the harvest were determined by ICP-MS. Data were analyzed by paired t-tests and Wilcoxon Signed-Ranks tests. All participants consumed water birds harvested with lead shotshell during the period of study. For the group excluding six males who were potentially exposed to other sources of lead (as revealed through a questionnaire), paired t-tests and Wilcoxon Signed-Ranks tests showed consistent results: significant (p<0.05) increases in blood-lead concentrations and blood levels of (206)Pb/(204)Pb and (206)Pb/(207)Pb towards the mean values we previously reported for lead shotshell pellets; and a significant decrease in (208)Pb/(206)Pb values towards the mean for lead shotshell pellets. However, when we categorized the group further into a group that did not use firearms and did not eat any other traditional foods harvested with lead ammunition other than waterfowl, our predictions for (206)Pb/(204)Pb, (206)Pb/(207)Pb and (208)Pb/(206)Pb hold true, but there was not a significant increase in blood-lead level after the hunt. It appears that the activity of hunting (i.e., use of a shotgun) was also an important route of lead exposure. The banning of lead shotshell for all game hunting would eliminate a source of environmental lead for all people who use firearms and/or eat wild game.

The use of lead shotshell to hunt water birds has been associated with lead-contamination in game meat. However, evidence illustrating that lead shotshell is a source of lead exposure in subsistence hunting groups cannot be deemed definitive. This study seeks to determine whether lead shotshell constitutes a source of lead exposure using lead isotope ratios. We examined stable lead isotope ratios for lichens, lead shotshell and bullets, and blood from residents of Fort Albany and Kashechewan First Nations, and the City of Hamilton, Ontario, Canada. Data were analyzed using ANOVA and regression analyses. ANOVA of isotope ratios for blood revealed significant differences with respect to location, but not sex. Hamilton differed from both Kashechewan and Fort Albany; however, the First Nations did not differ from each other. ANOVA of the isotope ratios for lead ammunition and lichens revealed no significant differences between lichen groups (north and south) and for the lead ammunition sources (pellets and bullets). A plot of 206Pb/204Pb and 206Pb/207Pb values illustrated that lichens and lead ammunition were distinct groupings and only the 95% confidence ellipse of the First Nations group overlapped that of lead ammunition. In addition, partial correlations between blood-lead levels (adjusted for age) and isotope ratios revealed significant (p<0.05) positive correlations for 206Pb/204Pb and 206Pb/207Pb, and a significant negative correlation for 208Pb/206Pb, as predicted if leaded ammunition were the source of lead exposure. In conclusion, lead ammunition was identified as a source of lead exposure for First Nations people; however, the isotope ratios for lead shotshell pellets and bullets were indistinguishable. Thus, lead-contaminated meat from game harvested with lead bullets may also be contributing to the lead body burden.

The potential exists for human exposure to polychlorinated biphenyls (PCBs) and other contaminants originating from abandoned Mid-Canada Radar Line (MCRL) sites in sub-arctic Canada. We examined patterns of differences with respect to body burden of organochlorines (lipid-adjusted) between residents of the Ontario First Nations of Fort Albany (the site of MCRL Site 050) and Kashechewan (no radar base) and Hamilton (an industrial, southern Ontario community) to assess whether the presence of Site 050 influenced organochlorine body burden with respect to the people of Fort Albany. PCBs (Aroclor 1260 and Sigma 14 PCBs congeners [CBs]) and DDE in the plasma of Fort Albany and Kashechewan subjects were elevated relative to Hamilton participants. PCB and DDE-plasma levels in First Nation women were of comparable magnitude to those reported for Inuit women living in the west/central Northwest Territories. Significantly lower DDE/DDT ratios observed for Fort Albany indicates exposure to higher levels of DDT compared to Kashechewan. The probable source of DDT exposure for Fort Albany people is the DDT-contaminated soil surrounding buildings of Site 050.The results of the correspondence analysis (CA) indicated that people from Hamilton had relatively higher pesticides and lower CB body burdens, while people from Fort Albany and Kashechewan exhibited relatively higher CBs and lower pesticide levels (CA-1). The separation of Fort Albany and Kashechewan from Hamilton was also clear using questionnaire data (i.e., plotting dietary principal component [PC]-1 scores against PC-2); PC-1 was correlated with the consumption of a traditional diet. Separation of Kashechewan and Albany residents occurred because the people of Kashechewan ate more traditional meats and consumed shorebirds. Only one significant relationship was found between PC analysis and contaminant loadings; PC-1 versus CA-3 for Kashechewan.The presence of Site 050 on Anderson Island appears to have influenced organochlorine body burden of the people of Fort Albany. ANCOVA results revealed that it was not activity on Anderson Island that was important, but activity on Site 050 was the influential variable. When these results are considered with the DDE/DDT ratio data and the CB 187 results (Fort Albany and Kashechewan residents differed significantly), the findings are suggestive that Site 050 did influence organochlorine body burden of people from Fort Albany. (c) 2006 Elsevier B.V. All rights reserved.

Abandoned radar line stations in the North American arctic and sub-arctic regions are point sources of contamination, especially for PCBs. Few data exist with respect to human body burden of organochlorines (OCs) in residents of communities located in close proximity to these radar line sites. We compared plasma OC concentration (unadjusted for total lipids) frequency distribution data using log-linear contingency modelling for Fort Albany First Nation, the site of an abandoned Mid-Canada Radar Line station, and two comparison populations (the neighbouring community of Kashechewan First Nation without such a radar installation, and Hamilton, a city in southern Ontario, Canada). This type of analysis is important as it allows for an initial investigation of contaminant data without imputing any values. The two-state log-linear model (employing both non-detectable and detectable concentration frequencies and applicable to PCB congeners 28 and 105 and cis-nonachlor) and the four-state log-linear model (using quartile concentration frequencies for Aroclor 1260, PCB congeners [99,118,138,153,156,170,180,183,187], beta-HCH, p,p'-DDT +p,p'-DDE, HCB, mirex, oxychlordane, and trans-nonachlor) revealed that the effects of subject gender were inconsequential. Significant differences (p < 0.05) between the groups examined were attributable to the effect of location on the frequency of detection of OCs or on their differential distribution among the concentration quartiles. In general, people from Hamilton had higher frequencies of non-detections and of concentrations in the first quartile (p < 0.05) for most OCs compared to people from Fort Albany and Kashechewan (who consume a traditional diet of wild meats that does not include marine mammals). An unexpected finding was that, for Kashechewan males, the frequency of many OCs was significantly higher (p < 0.05) in the 4th concentration quartile than that predicted by the four-state log-linear model, but significantly lower than expected in the 1st quartile for beta-HCH. The levels of PCBs found for women in Fort Albany and Kashechewan were greater than those reported for Dene (First Nation people) and Métis (mixed heritage) of the western Northwest Territories (NWT) who did not consume marine mammals, and for Inuit living in the central NWT (occasional consumers of marine mammals). Moreover, the levels of total p,p'-DDT were greater for Fort Albany and Kashechewan women compared to these same aboriginal groups.

Recently, First Nation (FN) organizations have entered into agreements with federal and provincial government representatives to remediate radar-line sites in Ontario. These agreements stipulated that FN people would take part in the site delineation and remediation process to gain job experience and economic benefits. One important aspect of the process was protecting FN personnel from contaminant exposure and thus, from potential negative health outcomes associated with the cleanup work itself. In this paper, we describe the safety precautions used by FN workers preparing Mid-Canada Radar Line (MCRL) Site 050 for Phase 2 of the delineation process and the health monitoring protocol that was tested. We measured concentrations of total polychlorinated biphenyls (PCBs as Aroclor 1260),14 individual PCB congeners, p,p'-DDT, p,p'-DDE, nine other organochlorine pesticides, and lead in the blood of Fort Albany FN workers before they started work at Site 050 and approximately a week before they completed their three-month work period in the contaminated zone. No significant differences were found in the paired samples. These results indicate that the safety precautions taken were adequate for the work and the site in question. The monitoring protocol discussed here may be used as a template and modified to meet the specific needs of other projects. The results of this study are important because other Aboriginal groups have entered or will be entering into agreements with government organizations for the remediation of other MCRL sites in Ontario and across Canada.