A month after Kitchenuhmaykoosib Inninuwug First Nation declared a state of emergency over a lack health services, its leaders say Ontario’s failure to respond has left them no choice but to take legal action.

Chief and council for the fly-in First Nation of 1,500 people declared a state of emergency on July 31, demanding equitable paramedicine resources and Emergency Medical Services, following the poisoning deaths of two local 14-year-olds. The girls were admitted to the nursing station in the morning but medivac wasn’t able to fly them the 600 kilometres south to Thunder Bay until that evening. Their families said doctors told them the deaths could have been prevented with timely care.

Jacob Ostaman, KI’s director of lands and resources, says Ontario has since taken no action, whatsoever. Over that time, eight more young people survived being airlifted out of the community for poisoning, three of which have occurred in the past week. 

“I haven’t heard of any government official responding to that state of emergency. What else can we do? We can just do a legal action, I guess.”

The Independent First Nations Alliance, a group of five First Nations in which KI is a member, has filed a human rights complaint against Ontario over emergency medical services, claiming the Ministry of Health, “has persistently failed to provide adequate funding and resources, forcing these communities to have inadequate – or completely absent – EMS.”

The five IFNA First Nations in northwestern Ontario – Kitchenuhmaykoosib Inninuwug, Lac Seul, Muskrat Dam, Pikangikum, and Whitesand – filed complaints on Friday that contend Ontario is discriminating against the 6,000 total people living in those communities.

Ostaman says Ki is “completely empty, compared to emergency services in Ontario. Just look at all the reserves up north, there is nothing whatsoever. We should have that infrastructure: a building, even an air base for ambulance. Those things need to be looked at.”

The complaint filed with the Human Rights Tribunal of Ontario compares the poor on-reserve paramedicine services with those in Ignace, a municipality of 1,200 people on the Trans-Canada Highway halfway between Thunder Bay and Winnipeg. Ignace has two ambulances, heated infrastructure to store them, and eight staff, three of which are full-time paramedics. Pickle Lake, a municipality of only 400 people located 300 kilometres north of Ignace, has the same physical resources and five staff, three of whom are paramedics.

By contrast, IFNA contends that First Nations in Ontario are the only communities in Canada that are expected to use volunteers as emergency responders.

Whitesand and Lac Seul rely on services funded in the neighbouring municipalities of Armstrong and Sioux Lookout, respectively. In Lac Seul’s case, paramedics take between 25 and 45 minutes to arrive.

The fly-in communities of KI and Muskrat Dam’s only have medivac services through Ornge, stationed in Thunder Bay or Sault Ste. Marie. The system in the remote Pikangikum First Nation relies on volunteer emergency responders to supplement paramedics.

IFNA’s complaint accuses Ontario’s “discriminatory refusal to provide equitable funding” as being “akin to telling the Applicants that they are being treated as ‘less than’ due to their First Nations identity.”

It cites unique and “disproportionate suicide rates; traumatic incidents from accidents, drownings, and house fires; birth complications; and injuries from exposure to the elements,” that Ontario is not addressing with equitable services under the Ambulance Act.

The complainants are seeking $10,000 in damages for every person living in IFNA communities who have endured the physical and metal impacts of inequitable funding.

“There’s nothing in the provisions of the Act that indicates the exclusion for a person or group of people from the provision of these paramedic services,” the complaint reads. “Ambulance services ‘are comprehensively regulated by [Ontario],’ and as such, the funding for [the] same can be sought from Ontario, regardless of whether the services are provided to First Nations. As such Ontario is required to provide the communities with EMS equitable to those received by residents of similarly situated, non-First Nation communities and municipalities. There is no reason for Ontario to not provide funding for EMS to the applicants.”

IFNA says it has “repeatedly” requested funding to close those gaps, but that the “one-time” funding the province has issued in response fails to meet the IFNA’s needs, constituting a failure for the minister.

“It is, in my opinion, inhumane to expect someone to volunteer to go into the most traumatic incidents you can imagine when it’s their cousin, their uncle, their dad, their kookum or their grandchild,” says Nicholas Rhone, IFNA’s emergency services director. 

“There is no other emergency service that I’m aware of where that’s a standard expectation that you’re going to volunteer to go into the worst incidents possible.”

Rhone says the one-time funding arrangements prohibit communities from designing sustainable solutions and force efforts into emergent efforts. He claims to have participated in a call on which federal government officials initially refused to provide transportation for two donated, used ambulances to Pikangikum First Nation that were waiting 100 kilometres away in Red Lake. He says they instead asked him why he couldn’t just fix the broken-down pickup truck that had been serving the community of over 3,000 people.

In February 2023, IFNA submitted a $4.2-million proposal that would establish paramedicine and 911 dispatch in Pikangikum. Operating costs would have amounted to $3.3 million annually. The Minister of Health didn’t respond until late January 2025, with a retroactive one-year funding commitment.

Undeterred, IFNA designed a community paramedicine program and in September 2023, submitted a proposal that would have cost $13 million to establish and could operate at $6 million per year. The ministry rejected it.

What little funding IFNA emergency services has, Rhone’s team contends they were able to procure from the ministry’s envelopes designed to support vulnerable seniors and those awaiting long-term care.

Rhone says the chiefs have reached the point where they’re no longer willing to accept a system without equity or rationale.

“In every other domain in the north, whether it be police officers, nurses, physicians, teachers, no one’s volunteering. So when did it ever become acceptable as a model that we should have volunteer emergency first responders or paramedics or police or firefighters? And I’m not aware of any document that explains how that decision was made.”

Ontario Minister of Health and Long-Term Care Sylvia Jones’s office did not respond to requests for comment. 

IFNA communities have filed a separate, parallel action against Canada over “grossly inadequate” and inequitable fire services. The complaint filed at the Canadian Human Rights Commission, cites a 2016 fire in Pikangikum in which nine members of the same family perished, as well as a KI fire in 2019, which killed a mother and her four children.

Jon Thompson is a Local Journalism Initiative Reporter based in Thunder Bay. Contact him with tips and story ideas at Jon@ricochet.media.

Correction: An earlier version of this story stated that IFNA-member communities rely entirely on volunteers for emergency medical services. In fact, Pikangikum First Nation maintains a roster of trained paramedics who are employed in the community.