“Is there anything good about a water advisory?”: an exploration of the consequences of drinking water advisories in an indigenous community

Abstract

Background In Ontario, Canada, Indigenous communities experience some of the province’s worst drinking water, with issues ranging from deteriorating water quality to regulatory problems and lack of support. When water is known, or suspected, to be unsafe for human consumption, communities are placed under a Drinking Water Advisory. Between 2004 and 2013, approximately 70% of all on-reserve communities in Ontario were under at least one Drinking Water Advisory. Despite the widespread impact of Drinking Water Advisories on health and wellbeing, little is known about First Nation individuals’ perceptions and experiences living with a Drinking Water Advisory. This study presents information shared by members of a community who have lived with Boil Water Advisories on and off for many years, and a long-term Boil Water Advisory since 2017. The goal of this paper is to unpack and explore the Boil Water Advisories from the perspective of community members and provide considerations for current and future Boil Water Advisory management. Methods Methodological choices were driven by the principles of community-based participatory research. Two data collection methodologies were employed: hard copy surveys and interviews. Results Forty-four individuals (19.5%) completed a survey. Eight Elders and 16 key informants participated in 20 interviews. Respondents expressed varying degrees of uncertainty regarding protective actions to take while under a Boil Water Advisory. Further, 79% of men but only 46% of women indicated they always adhere to the Boil Water Advisory. Knowledge gaps that could lead to risky behaviours were also identified. Finally, Boil Water Advisories were demonstrated to have physical, financial, and time impacts on the majority of respondents. Conclusions A direct outcome was the identification of a critical need to reinforce best practices for health protection through community education and outreach. More broadly, Chief and Council were able to use the findings to successfully advocate for improved drinking water for the community. Additionally, benefits of participatory research and community ownership include enhanced local research capacity, and increased awareness of, and desire for, research to inform decisions.

Drinking water perception and consumption in Canadian subarctic Indigenous communities and the importance for public health

“…While it is unknown whether the number of advisories describes the prevalence of waterborne disease in communities, drinking water advisories have adverse consequences. This includes limiting access to drinking water (Lucier et al 2020), potentially resulting in an increased consumption of other beverages, such as sugar-sweetened beverages. This may have health consequences as sugar-sweetened beverages are associated with obesity and type 2 diabetes (Hu and Malik 2010).…”

Indigenous Peoples understand human health relies on healthy waters

“…Water is life-sustaining-water is life and has spirit as a living entity providing life to all peoples and beings. [4][5][6]22,23 Indigenous health is linked to water due to the spiritual understanding that water is the first medicine 16 and water is alive with spirit. The Sylilx Nation Siwɬkʷ Declaration informs that water is the lifeblood connecting us to all life and is needed for the health of people.…”

“…Health disparities in Indigenous communities are largely the result of historical and contemporary colonialism of global extractive industry, neoliberal economic reforms, global capitalism, and government legislation. 15,16 Colonization has attempted to eradicate Indigenous Peoples, their laws, knowledge, and governance systems. Colonization is rooted in capitalism, individualism, ownership, and possession and position Indigenous Peoples and the environment as less than and disposable.…”

“…Indigenous framing of human health and wellness differs from the Western biomedical model, which sees health as the absence of disease. 16 Therefore, several Indigenous organizations have created models or frameworks for Indigenous holistic health, wellness, and well-being. 19 There are variances in the models, but all demonstrate the interconnectedness of the lands, waters, and the four pillars of health.…”

Le racisme comme déterminant de la santé et des soins de santé

“…Au Canada, cela se produit particulièrement dans le racisme spécifique envers les Autochtones, comme l'illustrent les constatations d'un rapport sur le racisme et la discrimination dans les soins de santé en Colombie-Britannique, produit pour le compte de la province, et les réformes requises pour répondre aux 94 appels à l'action dans le rapport final de la Commission de vérité et réconciliation 43,48 . Les niveaux méso et macro du racisme sont particulièrement cruels et vont aussi loin que le refus de répondre à des droits fondamentaux de la personne, comme une eau potable et des installations sanitaires sécuritaires 49,50 .…”