Inside Sandy Lake’s fight with diabetes
March 31, 2010
Elvira Cordileone
STAFF REPORTER
SANDY LAKE — Stop any of the people wandering the aisles of the only general store in Sandy Lake, a remote aboriginal community in Northern Ontario, and chances are one in four you’ll hit on someone who has diabetes.
• Photo Gallery: Sandy Lake
Whether the person has the disease or not, he or she will likely share a tale of woe — about a father who lost a foot to the complications of diabetes, or of an entire family forced to leave the community because of the dialysis a member needed to deal with the kidney disease it caused. Or maybe the story will be about the untimely deaths of aunts, uncles, brothers or sisters caused by diabetes-related heart problems.
“My father is diabetic. My grandmother died of complications. Every year we lose people,” says band chief of council, Adam Fiddler, 36.
Sandy Lake has a population of 2,700, and new cases of Type 2 diabetes show up routinely.
High rates of diabetes among Canada’s aboriginal people are common; the rate is three to five times higher than it is for the general population, according to Health Canada.
Sandy Lake, situated 1,000 kilometres northwest of Thunder Bay, is unique, because almost two decades ago, worried community leaders took up arms against the voracious disease.
In 1993, they joined hands with then-regional medical director, Dr. Stewart Harris, and Dr. Bernard Zinman, a clinician-scientist at Toronto’s Mount Sinai and a recognized leader in the field of diabetes.
Two things resulted from the collaboration: academic research, including a comprehensive baseline survey of the residents, and prevention activities run by local people.
Sandy Lake leaders use education to fight the elusive enemy.
Their message has two prongs: Eat properly and be active.
The “stay-active” message is an easier sell.
Rod Fiddler has managed the reserve’s diabetes prevention program since 1998. Among others things, he runs weight-loss programs and fitness classes for adults, and offers incentives for success.
His assistant, Gary Manoakeesic, works with the elementary and high school students to coordinate hockey and baseball teams. He takes them out net fishing. Every day in August he runs a day camp in the bush.
“We used to hike, hunt and fish,” says Manoakeesic. “In the ’80s and ’90s, everything changed fast. Everybody got lazy, and we started eating foods brought in.”
After years of preaching the nutritional dos and don’ts of diabetes prevention, including adding diabetes education to the Grades 3 and 4 school curriculum, most people got the message about how to stay healthy.
“We know,” says Jenny Meekis, 44, “But we can’t afford the things we’re supposed to be taking daily.”
A walk through the northern general store is sobering: Apples cost $7.45 a kilogram, bananas go for $2.29 a kilogram and cabbage is $7.99 a kilogram. A 1.25-kilogram outside round roast has a $17.74 price tag.
Supplies must be flown in, except for two or three months of the year when the frozen river is used as a road. This contributes to high prices. The soil is too poor for summer gardens.
“We eat mostly ground beef and boil it to get the fat out,” says Meekis. “We only buy apples or bananas every two weeks.”
Like most Sandy Lake residents, Meekis and her husband Jimmy Meekis, 48, who also has diabetes, survive on welfare, except for the seasonal work he does as a carpenter.
Their youngest son, Kendra, 18, was diagnosed with Type 2 diabetes when he was 7.
“We used to have a great big family,” Jenny Meekis says. “Almost all are dead, most by heart attacks.”
Neither Mount Sinai’s Zinman, nor University of Toronto epidemiologist Anthony Hanley, can say definitively that the rates of diabetes have dropped in Sandy Lake thanks to the prevention work.
Hanley, who lived in Sandy Lake for more than two years when the partnership started, says that would require repeating the oral-glucose test used in the original survey, and the research team has no money to do that.
But he insists they’ve made headway on a number of fronts.
“We have in place now community-wide programs that are addressing the root causes,” Hanley says. “People want to see diabetes cured, but we’re not able to do that anywhere in the world.”