A/HRC/41/34/Add.2 British Columbia and Alberta.30 Indigenous peoples are also overrepresented among those who have mental health conditions, die by suicide and are incarcerated. Furthermore, they continue to experience various types of discrimination throughout many aspects of their daily life. 75. These phenomena indicate the existence of cross-cutting risk factors that affect the health of indigenous peoples who live in remote communities but also in urban centres, where they continue to face discrimination, higher rates of homelessness, “problematic substance use” and poverty. There is a need to develop culturally appropriate measures; medicalized health and mental health services are insufficient, and broader policies that effectively address the determinants of health should be prioritized. Moreover, jurisdictional disputes between federal and provincial health-care providers pose severe barriers for indigenous peoples’ access to health care. 76. To address delays and denials of health-care services for First Nations children, the Federal Government supported a motion in the House of Commons on Jordan’s Principle in 2007. The Principle aims to avoid jurisdictional disputes in health care, social and education services for First Nations children and calls upon the government of first contact to ensure they can gain access to public services on an equal basis with other children. In May 2017, the Canadian Human Rights Tribunal found that Jordan’s Principle had not been applied properly and in its full meaning and scope, resulting in unnecessary gaps, delays and denials of essential public services to First Nations children and young people. The Tribunal established key principles, including its application to all First Nations children, on or off reserves, and not limited to First Nations children with disabilities. It also ordered that Canada review previous requests for funding that had been denied, to ensure compliance with the key principles. The Special Rapporteur hopes that current efforts by the Federal Government to support children who need help immediately and to make longterm changes for the future will ensure the effective implementation of Jordan’s Principle. Specific cases 77. The Special Rapporteur collected many testimonies about the situation in Red Sucker Lake, an indigenous First Nations community north-east of Winnipeg. The community is accessible only by air or winter road, and its nursing station provides only sporadic basic health services. To receive appropriate diagnosis and gain access to medical treatment for dialysis, chemotherapy, heart disease or other major primary health-care issues, community members often have to travel long distances. Sometimes, they have to relocate, either temporarily or permanently, to Winnipeg, notably in cases of dialysis. 78. This health care is exclusively based on a biomedical model that leaves aside aspects that affect community members’ well-being. On the one hand, the ancient and holistic indigenous approach to health and wellness, which includes the spiritual, mental, physical and emotional sphere, is disregarded; on the other hand, relocating indigenous peoples to alien urban centres breaks the connection to their land, family, community and culture, further creating additional needs in terms of the determinants of health. These include housing, healthy and nutritious foods, transportation, education, social care and services for children with disabilities, among others. Community members are not only isolated in the city but are also exposed to different levels of discrimination and jurisdictional barriers when gaining access to health care, including health determinants. 79. The right to health compels States to ensure equal access to all health determinants and to abstain from prohibiting or impeding traditional preventive care, healing practices and medicines. The federal authorities, in consultation with the community, should improve the medical services available locally, notably for dialysis treatment, and the federal, provincial and city of Winnipeg authorities should coordinate efforts to provide broader support when a Red Sucker Lake community member is relocated for medical reasons. Municipal authorities may consider income assistance, transportation, interpretation and social support, the establishment of community centres and cultural support, in consultation with the community. 30 Ibid. 15