Access to safe drinking water in First Nations communities and beyond

As public health professionals at the First Nations Health Authority (FNHA), which serves First Nations communities in BC, we read with great interest Dr Charuka Maheswaran’s article, “Water, water everywhere but not a drop to drink!” in the May 2018 issue of the BCMJ.[1] We would like to thank Dr Maheswaran and the Environmental Health Committee of the Doctors of BC’s Council on Health Promotion for their interest in this very important topic. We agree that it should indeed be possible for all Canadians to have potable water in their homes, and are working on this in partnership with First Nations communities in BC and the Department of Indigenous Services Canada (ISC).

There are common issues across remote, rural, and very small systems in Canada, including lack of access to and ability to retain trained operators, issues of scale, and treatment acceptance (chlorination), among others. In general, however, and unlike in some areas of Canada, in First Nations communities in BC all homes that are occupied year round have access to piped water, and there is a low frequency of significant water quality issues such as E. coli and chemical exceedances in community and public water systems. Out of the 334 community and public water systems that the FNHA reports on, 4% of drinking water systems are currently under drinking water advisories (as of 31 October 2018).[2] The number of advisories can fluctuate mainly due to short-term advisories.

While the majority of First Nations community water systems meet Canadian guidelines for safe drinking water, additional progress can and must be made to improve support for systems under advisory and for smaller systems (those with fewer than five connections), which currently do not receive infrastructure funding through the federal government. The following key activities are supporting progress toward sustainable access to safe drinking water:

• First Nations communities work with the FNHA to assess if water meets or exceeds federal and provincial guidelines for drinking water quality, and support access to safe drinking water.
• The FNHA and First Nations communities work together to increase the capacity and ownership of water systems in communities. The FNHA trains and funds members of First Nations communities as community-based water monitors to sample and test drinking water using in-community and accredited labs, and fully supports and funds this testing.
• ISC provides funding for community water systems infrastructure and operation and has committed additional funding to support the resolution of drinking water advisories. The FNHA’s drinking water safety program manager and environmental health officers work with ISC to resolve drinking water issues and provide sustainable access to safe drinking water in First Nations communities.
• ISC provides training for First Nations water systems operators, and supports the Circuit Rider Program, which provides training and mentorship by highly experienced and certified operators and works with operators in First Nation communities to support operation of drinking water systems.
• First Nations leaders have expressed interest in determining and developing priorities and strategies for safe drinking water legislation and a framework that would effectively support safe and sustainable drinking water for communities.
• First Nations water operators in BC and Yukon have launched their own network (First Nations’ Operators Water Net) to support and advocate for their profession.

This great work needs to be sustained and expanded. Community or public water systems may not address all water needs in First Nations communities; the federal fiduciary responsibility to these communities needs to be extended to fund and support smaller systems, which also serve residents in First Nations communities. We also need to recognize that First Nations view water holistically, extending beyond what comes from the tap to source water and issues that arise in watersheds. Joint collaboration across First Nations communities, local governments, provincial ministries and regional health authorities, and land owners is needed to achieve effective source water protection.

While supporting the continued drive to improve services, we also need to highlight what is going well in First Nations communities. The development of highly skilled women and men as water treatment plant operators and caretakers of their water, installation of modern-day treatment facilities, and a supportive network of community, government, and FNHA staff have all contributed to a reduction in the number and duration of advisories. The excellent work carried out by First Nations water treatment plant operators, community-based drinking water monitors, community health staff, and many others in communities who support provision of safe drinking water is but one example of First Nations individuals and communities leading wellness.

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This article has been peer reviewed.

References

1.    Maheswaran C. Water, water everywhere but not a drop to drink! BCMJ 2018;60:195. www.bcmj.org/cohp/water-water-everywhere-not-drop-drink.

2.    First Nations Health Authority. Drinking water safety program. Accessed 31 January 2019. www.fnha.ca/what-we-do/environmental-health/drinking-water-safety-program.

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Dr Swinkels is the senior medical officer public health for the First Nations Health Authority. Dr Struck is the manager, drinking water safety program, for the First Nations Health Authority. Ms Pillsworth is the manager, environmental health services, for the First Nations Health Authority.