Tara Dawn, VFMP 2014
For the month of July, I was privileged to complete my rural rotation in Vanderhoof. Having never travelled north of my native Okanagan valley, I enjoyed exploring the neighboring towns and scenery in the Nechako Valley. Yet, my interest peaked when conversation turned to the First Nation communities in the surrounding areas. As a member of UBC’s Aboriginal Health Initiative group for the past two years, a chance to serve and learn about this population was a priority throughout my time up North. So when an opportunity arose to travel to four of these neighboring First Nations communities over the course of the week, I was quick to volunteer.
I joined a team led by family physician, Dr. John Pawlovich. Monday took us to Yekooche, a community north of Vanderhoof on the end of Stuart Lake, via a 5 hour drive by 4×4. This community of 220 members is in the early days of receiving any medical care on Reserve. The next day, and a 6 hour drive through the mountains later, we were stationed at Takla Landing. Three days later we concluded the week by helicoptering over the mountains westward to work for a day at a clinic in Fort Babine and then Tachet, both north of Burns Lake. At each of these communities, a team of Community Health Reps and the Nurse Practitioners (which work either continually at the community or weekly), would have prepared the community members for our visit. Thus, our days were physically full and emotionally satisfying. The poverty and remoteness of the communities was striking. I found it hard to believe that in British Columbia, individuals live in such isolation and travel such long distances to obtain their basic necessities.
Dr. Pawlovich was a phenomenal mentor and teacher, who knew when to prioritize either the physical medical concern or the urgent social issue as the key lesson. We were working in remote areas, yet, I remained very encouraged to see the relationships that Dr. Pawlovich has built with the members of the various communities. Although he has visited these communities only a handful of times in the past, he has maintained the relationships as he has introduced Telemedicine into his practice. I saw first-hand how this technology is being used to strengthen the doctor-patient relationship, and at the same time provide primary care.
Clinically, my eyes were opened daily to the challenges of the individuals on these reserves. In one community, we were met with a woman in her 30th week of pregnancy who had not yet received any prenatal care. Although we attempted to connect her up with the local NP and provide her with appropriate swabs, screens and exams, it was humbling to think about how her physical remoteness had translated into her hesitation to seek care. In another community, two elders struggling with constant dyspnea, due to long term COPD, desperately required at-home oxygen yet without a voice to advocate for them, their breathlessness remained. Additionally, the evidence of substance dependence and the wake of colonization touched nearly everyone we saw.
I can say without hesitation, that this week-long trip not only enriched my experience in Vanderhoof, but it has broadened my perspective and understanding of Family Medicine and Rural Practice. I would fully recommend that any future students or residents who express an interest in First Nations health be allowed to seek out an experience like this one. I am grateful for the UBC Faculty of Medicine and the Department of Family Medicine for allowing me to do so.
Tara Dawn is a third year VFMP Student. Born and Raised in the Okanagan Valley, Tara graduated with her BSc. in Biology from Trinity Western University before moving to Vancouver with her husband Andrew. At UBC, Tara is a member of the Aboriginal Health Initiative and UBC’s Chapter of the Christian Medical and Dental Society.
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