Canada’s First Nations Communities Call for Clean Water

Dozens of First Nations communities across Canada live their day-to-day lives with concerns about the quality of their drinking water, never-ending boil water advisories, and water-related illnesses.

In northern Ontario, for instance, members of the Neskantaga First Nation have endured the longest boil water advisory in the country. It has lasted for nearly 30 years since it was issued in February 1995.

“All we want is clean drinking water — for the young, for the middle-aged, for the elders — the same rights to clean drinking water as any other Canadian,” Chief Chris Moonias told Medscape Medical News.

The Ojibwe, a group of indigenous peoples that includes the Neskantaga, have a community about 440 km northeast of Thunder Bay, Canada. It is reachable by air travel, winter road, or boat. It includes about 400 people, including 300 who live on the reserve along Attawapiskat Lake.

In recent years, the Neskantaga community has evacuated more than 200 vulnerable members several times because of unsafe water conditions, including a broken water pump in 2019 and an oily substance on the surface of the water reservoir in 2020.

The community previously hired an outside consultant to investigate the situation and joined a class action lawsuit with other First Nations communities. Although the lawsuit was settled in 2021, awarding $8 billion to more than 120 First Nations communities that experienced long-term water advisories between 1995 and 2021, many people are still awaiting payment.

The federal government has also allocated more than $16 million since 2017 to upgrade Neskantaga’s water treatment plant, but community members say that the money has gone to contractors or been dispensed without community input — and they still have a boil water advisory.

For Moonias, whose great-grandfather signed the Treaty 9 agreement in 1905 regarding land use in northern Ontario, more needs to be done.

“He would be very, very sad at the state that we’re living in now,” Moonias said. “He agreed to sharing the resources that our land has to offer so we can all prosper as Canadians and Ontarians, but that’s not happening.”

What’s Happening?

First Nations communities have long confronted unsafe water conditions. Decades of systemic issues were linked to a lack of infrastructure and funding originated in the 1876 Indian Act. In the 1990s and 2000s, for instance, more than 700 water advisories affected more than 250 First Nations communities.

In recent years, Prime Minister Justin Trudeau and Liberal politicians have vowed to end boil water advisories for Indigenous communities across the country. While campaigning in 2015, the party pledged to lift all the then-active 105 advisories by 2021. To date, it has invested nearly $6 billion to incite change.

Government data indicate that 145 long-term (of 1 year or longer) drinking water advisories have been lifted in more than 90 First Nations communities since November 2015. As of September 7, 32 long-term advisories were in effect in 30 communities.

In 2023, six were lifted and three were added, and so far in 2024, two have been lifted but five added.

The advisories occur for different reasons and often lead to different physical and mental health problems, including skin infections, higher-than-average cancer rates, and even suicide among young community members. Studies across numerous provinces have noted the dangerous contaminants and their effects.

“When it comes to infectious disease, water plays a huge role, whether you look at cholera in London in the 1850s or the prevalence of infectious diseases in different communities today,” said Ayush Kumar, a professor of microbiology at the University of Manitoba in Winnipeg, Manitoba, Canada.

Kumar and colleagues have studied the microbiological content of water among First Nations communities in Manitoba, particularly the bacterial diversity and resistome of drinking water stored in cisterns. They found that the cistern water had a high number of bacteria and diverse antimicrobial resistance genes, which can lead to major health risks and the spread of drug-resistant infections.

Notably, the bacterial diversity and antimicrobial resistance genes varied from those found in the untreated source water, which means that the contaminated water came from the treatment plant — or somewhere along the delivery route to the homes. That finding highlights the need for better maintenance of the water distribution system and water treatment facilities, the study authors said. Moreover, more than a dozen communities nationwide don’t even have the infrastructure capable of providing clean water.

“A lack of access to clean drinking water is always associated with poorer health outcomes,” said Kumar. “Many of us in Canada and the United States take water for granted, and it’s a huge privilege to be able to just trust the tap water when you’re thirsty. Most places in the world don’t have that privilege.”

What’s Next?

After the class action lawsuit was settled in 2021, the federal court ordered the 2013 Safe Drinking Water for First Nations Act to be repealed and replaced with new legislation that includes input from First Nations communities. The new legislation, called the First Nations Clean Water Act, is intended to implement minimum standards for water quality, provide sustainable funding, and shift control to communities for their water supply.

The legislation, Bill C-61, was first read in the House of Commons in December 2023 and sent to the Standing Committee on Indigenous and Northern Affairs in early June. The committee held meetings in June and September and will issue a report. Liberal officials hope to pass the legislation in 2025.

“As I’ve heard from Indigenous women and leaders in recent years, water is life,” said Hon. Patty Hajdu, Minister of Indigenous Services and Minister responsible for the Federal Economic Development Initiative for Northern Ontario.

“In their history and stories, Indigenous people will say that without water, there is not life,” she said. “It’s fundamental, and every time I hear that, I’m reminded about the profound importance of this work.”

In July, Star Blanket Cree Nation in Saskatchewan, Canada, held the grand opening of a new water treatment plant, which had received $10.5 million in funding. Some of the funds will provide training for the water treatment operator during the next 3 years. The community, home to 300 residents, previously had a 17-year boil water advisory.

At the grand opening, Chief Michael Starr “talked about the important role of the water operator because of the length of the boil water advisory,” said Hajdu. “He mentioned that it’s hard to trust the water coming out of the tap, yet he expressed confidence in testing within the community to take care of the water.”

Other First Nations communities have expressed concerns about trusting the new proposed legislation as well as new infrastructure, especially given the physical and mental health damage incurred in the past.

“A number of boil water advisories are still in place — some are newer and have come in the last month or so — and we’re working diligently with the communities, so they won’t be there for long,” said Hajdu. “The decision is ultimately up to the chief and council on behalf of the members to indicate that it’s time. It can be a delicate conversation in the community because of that trust issue.”

Kumar reported no relevant financial disclosures.

Carolyn Crist is a health and medical journalist who reports on the latest studies for Medscape Medical News, MDedge, and WebMD.