First Nation mother of three dies after health agency fails to arrange four follow-up trips

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Miranda Mamakwa, a 31-year-old mother of three from Fort Severn First Nation on Hudson Bay, died on Sept. 8 after missing four follow-up appointments following open-heart surgery. Her mother, Eva Mamakwa, says Indigenous Services Canada's non-insured health benefits program never arranged the travel for any of them — and that her daughter would be alive if she had made it to even one. Mamakwa underwent valve-replacement surgery at the University of Ottawa Heart Institute in April and arrived home in Ontario's most northerly community on May 24. Her doctors wanted echocardiograms and a vascular surgeon in Thunder Bay, roughly 850 kilometres away. Her mother began the administrative process at the nursing station, where nurses faxed documentation to the NIHB program — faxes are the protocol. The family says the request never arrived, despite more than one tranche being sent. Eva Mamakwa reached the program's Sioux Lookout office by phone and was told travel would be sent. It never came, and the same failure repeated for appointments on May 28, June 11, July 2 and Aug. 6. As the summer wore on, Miranda grew tired, slept more and lost feeling in her fingers. On Aug. 19 she wrote on Facebook about the program and the missed appointments: "If I die, pls go after (them)." On Sept. 6 she fell ill and was airlifted by Ornge's Skycare to intensive care in Thunder Bay. She died two days later. Since her death, more than a dozen First Nations and tribal councils have filed a human rights complaint alleging widespread neglect of their communities' health needs, and chiefs have demanded reform of the federal agency that arranges medical travel for remote communities. The responsible minister has ordered a fact-finding mission into the circumstances. Indigenous Services Canada says it is working to improve delivery of the service. Fort Severn has no road out, no alternative carrier, and no other provider to switch to when the fax machine doesn't answer. The last mile of Canada's health guarantee is a government monopoly run on paper.