Embracing Change in Onion Lake Cree Nation

Pharmacist Justin Aggarwal operates the sole pharmacy at Onion Lake Cree Nation, which straddles both the Saskatchewan-Alberta border—Canada’s only border Cree Nation. Onion Lake Pharmacy is less than 300 square feet, but it’s all the space Aggarwal needs to help the more than 7,000 members of the community.

The pharmacy is jointly owned by Aggarwal and the Onion Lake Cree Nation Band and it is this unique partnership that contributes to the pharmacy’s success, says Aggarwal. “To have a pharmacy on the reserve and be owned by the Band is beneficial for the population and something Onion Lake takes pride in,” he says.

Fulfilling healthcare needs in Onion Lake is certainly a team effort, says Aggarwal whose pharmacy is located inside the area’s community health centre. Here patients can see physicians five days a week. There is also a certified diabetes educator, nurse practitioner, and dietician, with a lab and X-ray services available.

“I literally only have to walk down the hallway to speak with the health team. They are open to suggestions,” says Aggarwal. “Anybody followed by the health clinic is closely followed by everyone.”

Aggarwal, who is not First Nations, has owned and operated the Onion Lake Pharmacy since 2010 when the lease on the existing pharmacy became available. Prior to that, the University of Saskatchewan graduate owned a pharmacy in Lloydminster about 50 kilometres away. “I saw a lot of patients from Onion Lake who had come into the city.” That connection helped spark Aggarwal’s interest in the First Nation’s community and made him a familiar face to many.

The pharmacy is primarily a dispensary with a few over-the-counter medicines, and most of the work Aggarwal does in the pharmacy is diabetes-related. Indigenous Services Canada reports that First Nations on reserve have a rate of diabetes three to five times higher than that of other Canadians.

Adherence to medication, as elsewhere, is an issue. “I try to find a balance between emphasizing the need for compliance and telling the patient what to do. I am mindful of the community,” Aggarwal says.

The pharmacy also prescribes for minor ailments and over-the-counter medication, such as Tylenol and Pedialyte, which are covered by the federal government.

Aggarwal says working in Onion Lake is a “dream job.” There are no insurance forms to complete as everyone is covered through an agreement with Indigenous and Northern Affairs Canada. There is also an extensive formulary. “You don’t have to jump through hoops to get [drug] coverage.”

The Cree Nation pharmacy has one full-time technician who is from Onion Lake and has worked with Aggarwal for nearly 20 years. There is also a part-time pharmacist.  Much of their day mirrors that of others across the country (although there are few questions about over-the-counter medicines since there is a very limited front store). Aggarwal, however, is very aware that he is not First Nations and needs to earn the respect of his patients. “Continuity is important [as] that builds trust,” he says. “I know my patients and they know me.”